EVALUASI PENGARUH KONSELING FARMASIS TERHADAP HASIL TERAPI PASIEN HIPERTENSI USIA LANJUT DI POLIKLINIK JANTUNG RSUD UNDATA PALU PERIODE NOVEMBER-DESEMBER 2011

ingrid faustine, Dra. Ika Puspita Sari, M.Si, Apt.

2012 | Tesis | S2 Mag.Farmasi Klinik

Seiring meningkatnya harapan hidup maka prevalensi usia lanjut terserang hipertensi semakin tinggi dan diperlukan penanganan yang intensif untuk mengontrol tekanan darahnya. Pemberian konseling yang tepat dan bermanfaat diharapkan dapat meningkatkan kepatuhan terhadap terapi obat demi mencapai tekanan darah yang diinginkan. Penelitian ini dilakukan untuk mengetahui pengaruh konseling Apoteker terhadap kepatuhan dan untuk mengetahui hubungan antara kepatuhan dan hasil terapi pasien hipertensi usia lanjut di poliklinik jantung RSUD Undata Palu. Penelitian dilakukan dengan rancangan quasi eksperimental. Pengambilan data pasien usia lanjut secara prospektif dilakukan selama periode November- Desember 2011. Subyek yang memenuhi kriteria inklusi yaitu pasien usia lanjut ≥ 60 tahun yang mendapat terapi antihipertensi dibagi menjadi 2 kelompok yaitu pasien yang mendapat konseling dari peneliti (kelompok intervensi) dan pasien tanpa mendapat konseling (kelompok kontrol). Pengumpulan data dilakukan dengan melakukan wawancara dan pengisian kuesioner kepatuhan MMAS sedangkan nilai tekanan darah diambil dari catatan medis. Pemantauan dilakukan selama 1 bulan. Diperoleh 71 subyek penelitian terdiri dari 37 (52,11%) kelompok intervensi dan 34 (47,89%) kelompok kontrol. Terdapat perbedaan bermakna pada kategori MMAS antara kelompok kontrol (kepatuhan tinggi = 1 pasien) dan intervensi (kepatuhan tinggi = 14 pasien) (p=0,000). Terjadi penurunan rerata tekanan darah bermakna pada kelompok intervensi 12,7 poin (p=0,000) pada tekanan darah sistolik dan 9,46 poin (p=0,000) pada tekanan darah diastolik, sedangkan pada kelompok kontrol tidak terdapat perubahan rerata yang bermakna. Hasil uji korelasi kepatuhan dan hasil terapi menunjukkan hubungan yang positif dan bermakna antara kategori MMAS dengan tekanan darah sistolik (p=0,000; r=0,618) dan diastolik (p=0,027; r=0,262). Penelitian ini menyimpulkan bahwa konseling dapat berpengaruh terhadap kepatuhan pasien sehingga dapat menurunkan tekanan darah sistolik dan atau diastolik pada kelompok intervensi dibandingkan kelompok kontrol.

In line with the increase of life expenctancy, the prevalence of the elderly suffering from hypertension get higher and it need intensive treatment to control their blood pressure. It is expected that appropriate and useful counselling to be able to increase the adherence on the medical therapy in order to achieve the desired blood pressure. This research was conducted to identify the influence of pharmacist’s counseling on the adherence and to identify the relation between the adherence and the therapy result of the elderly hypertension patients at Cardiac Polyclinic of Undata Palu Hospital The research was conducted using quasi-experimental design. Data collection of the elderly patients was conducted prospectively during the period of November until December 2011. Subjects who met the inclusion criteria were elderly patients aged ≥ 60 years old, receiving antihypertension therapy. They were divided into 2 groups, consisting of intervention group (receiving counseling from the researcher) and control group (not receiving counseling the researcher). Data collection was conducted by doing interview and completion of MMAS adherence questionnaire. Patients were selected randomly and group into, while values of blood pressure were taken from medical record. They were observed for 1 month. There were 71 research subjects consisting of 37 patients of the intervention group (52.11%) and 34 patients (47.89%) of the control group. There was significant difference in the MMAS category between the control group (high adherence = 1 patient) and the intervention group (high adherence = 14 patients) (p=0.000). The significant decrease of the average of blood tension occurred in the intervention group of 12.7 point (p=0.000) of systolic blood pressure and 9.46 point (p=0.000) of diastolic blood pressure, while there was no significant means of change in the control group. The result of correlation test between the adherence and the therapy result indicated a positive and significant correlation between the category of MMAS and systolic blood pressure (p=0.000; r=0.618) and diastolic blood pressure (p=0.000) ; r=0.262This research concludes that counseling can influence the patient’s adherence so that it can decrease the systolic and or diastolic blood pressure in the intervention group compared to that of control group.

Kata Kunci : Hipertensi, konseling, usia lanjut, kepatuhan