Kepatuhan Minum Obat Pada Pasien Lupus Eritematosus Sistemik di RSUP Dr. Hasan Sadikin Bandung

Shiane Hanako Sheba, Henni Djuhaeni, Budi Setiabudiawan, Deni K. Sunjaya, Kuswandewi Mutyara, Fedri Ruluwedrata Rinawan

Abstract


Lupus eritematosus sistemik (LES) merupakan penyakit autoimun kronik yang mengharuskan penyandangnya minum obat dalam waktu lama bahkan seumur hidupnya. Keadaan ini selain menimbulkan dampak fisik, psikis maupun sosial juga menyebabkab biaya tinggi sehingga LES digolongkan sebagai penyakit catastrophic. Ketidakpatuhan minum obat penyandang LES akan berpengaruh langsung terhadap memburuknya outcome penyakit lupus. Penelitian bertujuan mengeksplorasi pelaksanaan dan kepatuhan minum obat pada pasien LES dengan harapan terjadinya perbaikan penatalaksanaan LES yang berdampak pada peningkatan kualitas hidup serta penurunan angka kematian karena LES. Telah dilakukan penelitian kualitatif terhadap 6 informan pasien LES suku Sunda di klinik reumatologi RSUP Dr. Hasan Sadikin Bandung pada bulan Juli sampai September 2016 dengan menggunakan pedoman wawancara mendalam open question yang dikembangkan sesuai dengan jawaban informan. Paradigma penelitan adalah constructivism dengan triangulasi terhadap 2 orang keluarga pasien dan 3 dokter konsultan klinik reumatologi RSUP Dr. Hasan Sadikin Bandung. Data yang diperoleh dianalisis secara bertahap melalui proses transkripsi, reduksi, koding, kategorisasi, penyusunan tema, interprestasi data serta pembangunan konsep. Hasil penelitian menunjukkan ada 57 koding, 14 kategori, dan 3 tema yang mengarah kepada kepatuhan minum obat pasien LES. Ke-14 kategori kepatuhan tersebut terdiri dari: karakteristik individu, daya ingat, pengetahuan, eksperimen, dan manajemen konsumsi (faktor predisposing); karakteristik penyakit, karakteristik obat, biaya, kebijakan rumah sakit, akses ke rumah sakit, terapi alternatif dan enabler agent (faktor enabling); karakteristik tenaga kesehatan dan dukungan eksternal dari berbagai pihak (faktor reinforcing). Konsep dan konstruk yang ditemukan membangun konstruk lokal Jawa Barat berlatar belakang karakteristik masyarakat Sunda dan bersifat kontekstual terhadap penyakit lupus.

Kata kunci: Kepatuhan minum obat, lupus eritematosus sistemik, odapus


Drug Adherence Drug in Systemic Lupus Erythematosus Patients in Dr. Hasan Sadikin General Hospital Bandung

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that requires prolonged treatment. SLE creates physical, psychological, social, and economic burden for the patients; therefore, it is categorized as a catastrophic illness. Non-adherence to medication in SLE patient isan important factor that directly leads to poor outcome. The aim of this study was to explore the management and adherence of patients with SLE to improve the quality of life and to reduce the mortality rate. A qualitative study was undertaken to 6 sundanese SLE patients at the Rheumatology clinic in Dr. Hasan Sadikin General Hospital Bandung in July-September 2016 by using open-ended questions in in-depth interviews with probing based on informant answers. The paradigm used was constructivism with triangulation to family members of 2 patients and 3 rheumatologist consultants in Dr. Hasan Sadikin General Hospital Bandung. Data collected were analyzed gradually through transcription, reduction, coding, categorizing, theme analysis, data interpretation, and theorizing. The results showed 57 codes, 14 categories, 3 themes that focused on the medication adherence of Lupus patients.The themes were categorized as predisposing (individual characteristics, memory, knowledge, experimentation, and consumption management), enabling (drug characteristic, cost, hospital policies, access to hospital, alternative therapy, and enabler agent), and reinforcing (characteristics of health care professionals and social support) according to the predetermined theory. This study has also identified the local concepts and constructs Sundanese people in West Java, which is contextual to the lupus disease.

Key words: Adherence, systemic lupus erythematosus, odapus


Keywords


Kepatuhan minum obat; lupus eritematosus sistemik; odapus

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DOI: http://dx.doi.org/10.15395/mkb.v50n1.1229

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