Properti Psikometri Kuesioner EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) dalam Mengukur Utilitas Pasien Penyakit Ginjal Kronis yang Menjalani Hemodialisis

YOFANI AULIA ROSADA, Prof. Dr. apt. Tri Murti Andayani, Sp.FRS.

2022 | Skripsi | S1 FARMASI

Penyakit ginjal kronis memiliki prevalensi yang tinggi. Untuk melihat efisiensi biaya, diperlukan studi farmakoekonomi Cost Utility Analysis (CUA). CUA mampu menggabungkan waktu kelangsungan hidup dan utilitas pasien menjadi satu ukuran (QALY). Instrumen EQ-5D-5L merupakan salah satu instrumen pengukur utilitas yang sensitif untuk menilai pasien dengan kondisi penyakit yang parah. Penelitian ini bertujuan untuk mengetahui properti psikometri kuesioner EQ-5D-5L dalam mengukur utilitas pasien penyakit ginjal kronis yang menjalani hemodialisis. Penelitian dilakukan dengan metode analisis data sekunder menggunakan data penelitian Andayani dkk. (2019) di Rumah Sakit Akademik UGM dan Rumah Sakit Umum Pusat Dr. Sardjito. Nilai utilitas dihitung menggunakan kuesioner EQ-5D-5L dengan value set untuk populasi Indonesia. Properti psikometri kuesioner EQ-5D-5L yang dinilai antara lain known-group validity dengan Uji Mann Whitney dan Kruskal Wallis, convergent validity dan internal-construct validity dengan Uji Korelasi Spearman, internal consistency reliability dengan nilai Cronbach alpha, dan ceiling effect dengan menghitung persentase pasien dengan status kesehatan sempurna. Analisis terhadap 108 data pasien menunjukkan rata-rata utilitas pasien penyakit ginjal kronis yang menjalani hemodialisis adalah 0,664 +/- 0,385. Known-group validity instrumen EQ-5D-5L baik karena dapat membedakan rata-rata utilitas pasien berdasarkan status pekerjaan, tingkat penghasilan, dan komorbid diabetes melitus (P < 0,05). Convergent validity instrumen EQ-5D-5L terhadap instrumen KDQOL SF-36 baik (r > 0,500). Internal-construct validity instrumen EQ-5D-5L baik karena dapat menilai fungsi fisik dan mental secara independen. Internal consistency reliability instrumen EQ-5D-5L baik dengan nilai Cronbach alpha 0,759. Ceiling effect instrumen EQ-5D-5L juga baik (13,90%). Kuesioner EQ-5D-5L valid dan reliabel dalam mengukur utilitas pasien penyakit ginjal kronis yang menjalani hemodialisis.

Chronic kidney disease has a high prevalence. To see cost efficiency, a Cost Utility Analysis (CUA) of pharmacoeconomic study is needed to be carried out. CUA is able to combine length of life and patient utility into one measurement (QALY). The EQ-5D-5L is one of the utility instrument measurements which sensitive to assessing patients with severe disease conditions. This study aims to determine the psychometric properties of the EQ-5D-5L questionnaire in measuring the utility of chronic kidney disease patients who were undergoing hemodialysis. The research was conducted using secondary data analysis method by utilizing research data from Andayani et al. (2019) at the UGM Academic Hospital and the Dr. Sardjito Hospital. The utility value was calculated by the EQ-5D-5L questionnaire with a value set for the Indonesian population. Psychometric properties of the EQ-5D-5L questionnaire were assessed include known-group validity with the Mann Whitney and Kruskal Wallis Tests, convergent validity and internal-construct validity with the Spearman Correlation Test, internal consistency reliability with Cronbach alpha values, and ceiling effect by calculating the percentage of patients with perfect health status. Analysis of 108 patient data show that the average utility of chronic kidney disease patients who were undergoing hemodialysis was 0.664 +/- 0.385. Known-group validity of the EQ-5D-5L instrument was good because it can distinguish the average utility of patients based on employment status, income level, and comorbid diabetes mellitus (P < 0.05). Convergent validity of the EQ-5D-5L instrument against the KDQOL SF-36 instrument was good (r > 0.500). The internal-construct validity of the EQ-5D-5L instrument was good because it can assess physical and mental functions independently. Internal consistency reliability of the EQ-5D-5L instrument was good with a Cronbach alpha value of 0.759. The ceiling effect of the EQ-5D-5L instrument was also good (13.90%). The EQ-5D-5L questionnaire was valid and reliable in measuring the utility of chronic kidney disease patients who were undergoing hemodialysis.

Kata Kunci : EQ-5D-5L, KDQOL SF-36, properti psikometri, penyakit ginjal kronis, hemodialisis