KEPATUHAN BEROBAT PENDERITA HIPERTENSI DI WILAYAH KERJA PUSKESMAS PAYANGAN KABUPATEN GIANYAR

Abstract

ABSTRAK
Kepatuhan terhadap pengobatan merupakan salah satu faktor yang menentukan keberhasilan terapi penderita hipertensi. Penelitian ini bertujuan untuk mengidentifikasi tingkat kepatuhan dan menganalisis faktor yang berhubungan. Penelitian ini merupakan penelitian kuantitatif dengan rancangan cross-sectional yang dilaksanakan di wilayah kerja Puskesmas Payangan, Gianyar-Bali pada bulan Mei-Juni 2015. Populasi adalah seluruh penderita hipertensi yang tercatat dalam data rekam medis di Puskesmas Payangan. Prosedur pemilihan sampel menggunakan teknik simple random sampling. Data dikumpulkan dengan melakukan wawancara menggunakan kuesioner di rumah penderita hipertensi. Pengukuran kepatuhan dilakukan dengan menggunakan kuesioner MMAS-8 (Morisky Medication Adherence Scale-8). Faktor predisposisi,faktor pemungkin dan faktor penguat dianalisis sebagai faktor yang berhubungan dengan kepatuhan menggunakan uji Chi-square dan regresi logistik. Hasil penelitian menunjukkan dari total 242 responden yang dilibatkan dalam penelitian diketahui bahwa 41,32% patuh dan 58,68% tidak patuh melakukan pengobatan. Terdapat hubungan bermakna antara komorbiditas (p=0,007) dan ketersediaan obat (p=0,045) dengan kepatuhan berobat. Berdasarkan analisis regresi logistik diketahui bahwa komorbiditas merupakan variabel yang paling dominan berhubungan dengan kepatuhan berobat (p=0,006, OR=3,943, CI 95%=1,470-10,575). Kesimpulan dari penelitian ini adalah kepatuhan berobat pasien hipertensi masih rendah. Untuk memaksimalkan kepatuhan, perlu meningkatkan interaksi profesional kesehatan diantara pasien tanpa komorbiditas.
Kata Kunci: kepatuhan berobat, hipertensi, MMAS-8, Puskesmas, Payangan, Bali
ABSTRACT
For patients with hypertension, adherence to treatment is one of the factors that determines the success of therapy. A survey was conducted to identify adherence patterns and explore predisposing, enabling and amplifying factors that associated with adherence to treatment among hypertensive patients. A cross-sectional study was conducted among hypertensive patients registered in Payangan village health center medical records. Respondents were selected using simple random sampling from the register. Data were collected in May-June 2015 through interviews at patient homes. Adherence to treatment was measured using MMAS-8 (Morisky Medication Adherence Scale) containing 8 questions. Sociodemographic factors, knowledge, comorbidities, family history of hypertension and attitude to treatment were predisposing factors explored. Availability of drugs, accessibility of drug, perception of distance, availability of transportation, ease of drug consumption were enabling factors explored. Family support, health worker support, health insurance, exposure to health information were reinforcing factors explored. We constructed a Chi-square test and logistic regression model to explore as factors associated with adherence. Results of 242 respondents, 41.32% were adherent and 58.68% were non-adherent to treatment. Factors included having comorbidities (p value=0.007) and availability of drugs (p value=0.045) have a associate with adherence. Using a logistic regression model, comorbidities have most dominant to associated with adherence to treatment (p value=0.006, OR=3.943, CI 95%=1.470-10.575). Adherence to treatment is low among hypertensive patients. The existence of comorbidities associated with adherence to treatment. To maximize likelihood of adherence, need to improve the health professional interaction among non-comorbidities patients.
Keywords: adherence to treatment, hypertension, MMAS-8, healthcare center, Payangan, Bali