Perbandingan Kualitas Pelayanan Puskesmas Kecamatan Koja dan Tarumajaya terhadap Kepatuhan Minum Obat Pasien Tuberkulosis

Addien Hakim Candra, Retnosari Andrajati, Sudibyo Supardi

Abstract


Abstract
WHO global data indicated that Indonesia is in the second rank of a country with largest prevalance of pulmonary tuberculosis after India. The main cause of healing failure in health centers is patients’ compliance in taking medication. The purpose of this study is to analyze the influence of health services to medication adherence among pulmonary TB patients in health centers. The study design was crosssectional comparative study using data from questionnaires and medical status records. The population
was all pulmonary TB patients aged 15 years and above and being a category one in the Koja and Tarumajaya health centers from January until May 2016. Data analysis was a chi square test and multiple logistic regression method. The result showed that service quality provided for the TB patients between the two health centers were the service including accessible location, incomplete indoor facilities and active caregivers. There is a significant relationship between adequacy of seating facilities (p-value 0.038) and accessible location (p-value 0.038) in both health centers on the level of medication compliance. Medication service quality (p-value 0.042; OR 1.66) active caregivers (p-value 0.000; OR 2.4) and other
additional medication (p-value 0.01; OR 0.5) are the determinants of TB patients’ medication compliance.

Keywords: Service quality, adherence, pulmonary tuberculosis, health center

Abstrak
WHO menyatakan bahwa Indonesia menempati peringkat kedua sebagai negara yang mempunyai prevalensi TB paru terbesar setelah India. Penyebab gagalnya penyembuhan pasien TB paru di Puskesmas
salah satunya adalah kepatuhan pasien dalam minum obat tuberkulosis. Tujuan penelitian ini menganalisis hubungan pelayanan terhadap kepatuhan minum obat pasien TB paru di Puskesmas. Desain penelitian
yang digunakan adalah studi komparatif dengan desain potong lintang menggunakan data kuesioner dan kartu status pengobatan TB paru. Populasi pada penelitian ini adalah seluruh pasien TB paru berumur 15
tahun ke atas kategori satu di Puskesmas Koja dan Tarumajaya pada bulan Januari sampai dengan Mei 2016. Analisis data menggunakan uji chi square dan regresi logistik ganda. Hasil penelitian menunjukkan
bahwa penilaian pelayanan di Koja lebih baik daripada di Tarumajaya dalam hal akses, ketersediaan tempat duduk yang mencukupi dan adanya pengawas minum obat (PMO). Terdapat hubungan yang signifikan antara pelayanan fasilitas tempat duduk yang mencukupi (p-value 0,038) dan lokasi mudah terjangkau (p-value 0,038) di kedua puskesmas terhadap tingkat kepatuhan minum obat. Pelayanan obat yang baik (p-value 0,042; OR 1,66) dan PMO yang aktif (p-value 0,000; OR 2,4) merupakan determinan dalam meningkatkan kepatuhan minum obat pada pasien TB.

Kata kunci : Kualitas Pelayanan, Kepatuhan, Tuberkulosis, Puskesmas


Keywords


Kata kunci : Kualitas Pelayanan, Kepatuhan, Tuberkulosis, Puskesmas

References


WHO. The Global Plan to Stop TB PARU 2011-2015. Geneva: World Health Organization; 2010.

WHO. The Global Report TB PARU 2014. Geneva: World Health Organization; 2015.

Kemenkes. Riset Kesehatan Dasar (RISKESDAS). Jakarta : Kementerian Kesehatan RI; 2013.

Depkes. Pharmaceutical Care untuk Penyakit Tuberkulosis. Jakarta : Departemen Kesehatan R.I; 2005.

Kemenkes. Pedoman Nasional Pelayanan Kedokteran : Tata laksana Tuberkulosis. Jakarta: Kementerian Kesehatan RI.;2013.

Kemenkes. Stop TB PARU Strategi Nasional. Jakarta : Kementerian Kesehatan R.I; 2011.

Surya A, Bassari C, Kamso S. Pedoman Nasional Pengendalian Tuberkulosis. 2nd. Jakarta: Kemenkes RI; 2011.

Schoenthale.A., William F Chaplin., John P.A., Senaida Fernandez., Marleny Diaz- Gloster., et al. Provider communication effect medication adherence Africans Americans. New York: J.PEC; 2009.

Dahlan Sopiyudin, Analisis Multivariat Regresi Logistik, Jakarta: Salemba Medika;2012.

Lwanga SK., Lameshow., Sampel Size Determination in health studies : a poractical manual. Geneva: WHO;1991.

Williams G.,Allarcon E.,Jittimanee S.,Walusumbi M.,Sebek M.,Berga E.,et al. Care During the Intensive Phase : Promotion of adherence. International Journal of Tuberc and Lung Disease. 2008. 12(6):601-5.

Julaiha,S. Pengaruh Reaksi Obat Yang Tidak Dikehendaki Terhadap Kepatuhan Berobat Pasien Tuberkulosis Paru Dewasa Kategori I di RS Sumoharjo Lampung.[ Tesis ] Depok: Universitas Indonesia; 2015.

Petri, William A. Kemoterapi Tuberkulosis, dalam Goodman & Gilman: DasarFarmakologi Terap, alih bahasa, Elin Yulinah Sukandar, Jakarta : Penerbit EGC; 2012.

Dipiro,JT. Pharmacoterapy Hand book approach 8th edition, NewYork :Mc Graw Hill; 2011.

Chen,Songhua.,Huai,Pengcheng.,Wang,Xi aomeng., Zhong, Jieming., Wang Xinting., Wang,Kai.,et al. Risk Factors for Multidrug Resistant among Previously Treated Patients with Tuberculosis in eastern China: a case control study, International Journal of Infectionus Disease. 2013. 17,1116-e1120.

Xiaozhen Tang, Shaowen., Xia,Yinyin., Wang, Xiaomeng., Yuans,Yanli., Hu, Daiyu., Lius,Feiying., et al. Adverse Reaction due to directly observed Treatment Strategy Therapy in Chinese Tuberculosis Patients : a prospective Study. PLOS ONE. 2013. 8 (6):1-8.

Green, L.W dan Kreuter, M.W. Health Program Planning : An Educational and Ecological Approach. Fourth Edition. New York : McGraw-Hill; 2005.

Pohan, Imbolo. Jaminan Mutu Layanan Kesehatan. Jakarta : EGC; 2007.

Srinivasan R, Ramya G.Adverse drug Reaction-Causality Assesment review article. International Journal of Research In Pharmacy. 2011. 1(3);606-612.

Ibrahim, L. M., Hadejia, I. S., Nguku, P., Dankoli, R., Waziri, N. E., Akhimien. Factors associated with interruption of treatment among Pulmonary Tuberculosis patients in Plateau State, Nigeria. The Pan African Medical Journal. 2014.

Samsurian. Pengaruh efek samping obat anti tuberkulosis terhadap default di RS Islam Pondok Kopi Jakarta Timur periode Januari 2008 - Mei 2010. [Tesis]. Depok : Fakultas Kesehatan Masyarakat Universitas Indonesia ; 2010.

Rusen ID, Aid-Khalid N, Alarcon E Cochrane systematic review of directly observed therapy for treating tuberculosis- good analysis of the wrong outcome. Int J Tuberc Lung Dis. 2007. p. 11, 120-121.

Aslan Mohamed, Chick Kaw. Clinical Pharmacy. Jakarta : Elex Media Kompotindo; 2003.

Boogaar Jossy V, Kibiki Gibson S, Kisanga Elton R. , Boeree Martin J, Aarnoutse Rob E. New Drugs against Tuberculosis: Problems, Progress, and Evaluation of Agents in Clinical Development. American Society for Microbiology. Agents Chemother. 2009. 48: 340–343.

Edwards, Ralph & Aronson, Jefrey K. Adverse drug reaction : definition, diagnosis, and management. Lancet. (2000). p.356, 1255-59.

Belilovsky, E. M., Borisov, S. E., Cook, E. F., Shaykevich, S., Jakubowiak, W. M., & Kourbatova, E. V. Treatment interruptions among patients with tuberculosis in Russian TB hospitals. International Journal of Infectious Diseases, 2010. 14(8), e698–703.

Afrizal, B. Analisa Tingkat Kepatuhan Pasien Rawat Jalan Program Asuransi Kesehatan Masyarakat Miskin (Askeskin) Terhadap Mutu Pelayanan Kesehatan Puskesmas di Kabupaten Serang Tahun 2007[Tesis], Depok: Fakultas Kesehatan Masyarakat, Universitas Indonesia; 2007.

Sardar P, Jha A, Roy D, Roy S, Guha P, et al. Intensive phase noncompliance to anti tubercular treatment in patients with HIV-TB coinfection: a hospital-based cross-sectional study. J Community Health. 2010. 35: 471– 478.

Notoatmodjo,S. Pendidikan dan Perilaku Kesehatan, Buku Ilmu Kesehatan Masyarakat,Jakarta: Rhineka Cipta; 2003.

Yuli, Nazila Sidy. Analisa pengaruh Pengawas Menelan Obat dari anggota keluarga terhadap kepatuhan pengobatan penderita Tuberkulosis di Kota Pariaman tahun 2010-2011.[Tesis]. Depok :Fakultas Kesehatan Masyarakat, Universitas Indonesia; 2012.


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