Keyword:hypertension motivational counseling SMS behavior compliance blood pressure DOI : 10.20885/JKKI.Vol7. Iss3.art3 Background: Patients with hypertension often fail to achieve treatment goals of controlling their blood pressure, hence they fall onto the condition of uncontrolled hypertension. In addition to counseling and patient-education programme, an enhanced methods of intervention is needed by pharmacist to increase patient adherence and commitment in taking antihypertension medicine. Motivational intervention has not been widely used by pharmacist in conducting pharmaceutical care to patients. Objective: This research is aimed to understand the effect of motivational counseling and short text messages (SMS) with adherence and behavioral changes in outpatient with hypertension at PKU Muhammadiyah Hospital Bantul, Yogyakarta. Methods: Sixty patients who meet the inclusion criteria was divided into two groups, which were experimental group (n=30) who received motivational counseling and SMS, and control group (n=30) who received usual care. Data was collected by interviews, behavioral questionaire, adherence questionaire using Morisky Medication Adherence Scale (MMAS), and blood pressure measurement according to the medical record. Results: Trans theoretical model (TTM) was used in this research. Stages of behavioral changes were divided into pre-contemplation, contemplation, preparation, and action. Result showed that pharmacist intervention, using motivational counseling and SMS as reminder, contribute to an increase of patient adherence and action stage of behavioral changes in the experimental group by 50% compared to 20% in the control group (p=0,035). Increase of adherence as much as 83,33% was seen in experimental group (p=0,000). A bigger decrease of systolic and diastolic blood pressure (SBP/DBP) was also seen in the experimental group compared to control group (SBP=15,37 vs 1,27mmHg), (DBP=6,73 vs 0,43 mmHg) on their second visits. Conclusion: Based on these results, it can be concluded that motivational counseling with SMS as a reminder and motivation by pharmacists in hypertensive patients give a positive influence on behavioral changes that improve adherence, and increase of systolic and diastolic blood pressure control.

AbstrakDiabetes melitus (DM) dengan hipertensi merupakan penyakit komplikasi sindrom metabolik dengan terapi lebih dari satu obat. Selain faktor pengetahuan, faktor perilaku dan motivasi dari luar dapat menjadi salah satu faktor kebosanan pasien dalam menjalani terapi jangka panjang. Dibutuhkan edukasi dan motivasi untuk kepatuhan perilaku berobat dalam mencapai target terapi pasien DM-hipertensi. Penelitian ini bertujuan untuk mengetahui pengaruh brief-counseling 5A modifikasi oleh apoteker dan dukungan motivasi pesan singkat dalam meningkatkan perilaku dan outcome klinis pasien DM-hipertensi rawat jalan di RSUD Panembahan Senopati Bantul, Yogyakarta. Penelitian ini menggunakan metode kuasi-eksperimental dengan desain prepost. Pengambilan data dilakukan secara prospektif selama periode Maret-Mei 2017. Sebanyak 99 orang yang memenuhi kriteria inklusi dibagi menjadi 3 kelompok yang terdiri dari 33 pasien. Tingkat perilaku pasien diukur melalui wawancara menggunakan kuesioner perilaku pasien DM-hipertensi, sedangkan data outcome klinis pasien diambil dari data rekam medis. Hasil penelitian ini menunjukkan bahwa proporsi tingkat perilaku pada tahap aksi kelompok perlakuan 1 (brief counseling 5A modifikasi) dan 2 (brief counseling 5A modifikasi + SMS motivasi) lebih besar (masing-masing sebesar 21,2%) dibandingkan kelompok kontrol (12,1%). Pemberian brief counseling 5A modifikasi dapat menurunkan tekanan darah sistolik sebesar 8,36±12,21 mmHg (p=0,000), diastolik 2,42±10,69 mmHg (p=0,202) dan gula darah sewaktu (GDS) 24,66 mg/dL (p=0,017). Pemberian brief counseling 5A modifikasi + SMS motivasi dapat menurunkan tekanan darah sistolik sebesar 8,79±17,32 mmHg (p=0,012), diastolik 5,0±9,92 mmHg (p=0,007), dan GDS 24,91 mg/dL (p=0,079). Kelompok brief counseling 5A modifikasi disertai pesan (SMS) motivasi lebih efektif dalam meningkatkan perilaku pasien dan pengontrolan outcome klinik dibandingkan kelompok kontrol maupun brief counseling 5A modifikasi.Kata kunci: Brief counseling 5A modifikasi, diabetes melitus, hipertensi, pesan motivatif (SMS motivasi) AbstractDiabetes mellitus (DM) with hypertension is a complicating disease of metabolic syndrome with more than one drug therapy. Aside from knowledge, behavior and motivation also can be factors that trigger patient's boredom in undergoing long-term therapy. Education and motivation are needed for adherence to treatment in order to achieve therapeutic target of DM-hypertensive patients. This study aimed to determine the effect of brief counseling 5A modification by pharmacists and short message (SMS) motivation to improve behavior and clinical outcomes of DM-hypertensive outpatients at Panembahan Senopati Hospital, Bantul, Yogyakarta. This study used a quasi-experimental method with pre-post design, and data collection was conducted prospectively during the period of March-May 2017. A total of 99 patients who were eligible for inclusion criteria were divided into 3 groups consisting of 33 patients. Level of patient's behavior was measured through interviews using behavi...

Abstract. Non-adherence to the treatment of chronic diseases such as hypertension and Diabetes Mellitus (DM) is a major obstacle in achieving patient therapy targets and quality of life of patients. A comprehensive approach involving pharmacists counselling has shown influences on changes in health behaviour and patient compliance. Behaviour changes in patients are one of the parameters to assess the effectiveness of counselling and education by pharmacists. Therefore, it is necessary to develop questionnaires of behaviour change measurement in DM-hypertension patients. This study aims to develop a measurement instrument in the form of questionnaires in assessing the behaviour change of DMhypertension patients. Preparation of question items from the questionnaire research instrument refers to some guidelines and previous research references. Test of questionnaire instrument valid was done with expert validation, followed by pilot testing on 10 healthy respondents, and 10 DM-hypertension patients included in the inclusion criteria. Furthermore, field validation test was conducted on 37 patients who had undergone outpatient care at the PKU Muhammadiyah Yogyakarta City Hospital and The Gading Clinic in Yogyakarta. The inclusion criteria were male and female patients, aged 18-65, diagnosed with type 2 diabetes with hypertension who received oral antidiabetic drugs and antihypertensives, and who were not illiterate and co-operative. The data were collected by questionnaire interviews by a standardized pharmacist. The result of validation test using Person correlation shows the value of 0.33. The results of the questionnaire validation test on 37 patients showed 5 items of invalid questions with the value of r <0.33, e: questions 2, 3, 6, 10 and 11, while the other 10 questions show the value of Pearson correlation > 0.33. The reliability value is shown from the Cronbach's alpha value of 0.722 (> 0.6), implying that the questionnaire is reliable for DMhypertension patients. This Behavioural change questionnaire can be used on DM-hypertension patients, and an FGD approach is required for the development of factors affecting this questionnaire.

ABSTRAK Anemia pada kehamilan merupakan salah satu masalah dalam kehamilan. Data WHO pada tahun 2001 menunjukkan bahwa lebih dari 50 % wanita hamil mengalami anemia. Anemia pada kehamilan merupakan suatu kondisi dimana kadar hemoglobin kurang dari 11 mg/dL. Prevalensi anemia di Indoensia cukup tinggi yaitu sebesar 50-63%, sedangkan prevalensi di DI Yogyakarta adalah 14,32%.  Penelitian mengenai pengetahuan ibu hamil terkait kondisi kehamilannya di Selangor  diperoleh bahwa pengetahuan ibu hamil pada kategori baik, namun sebagian besar dari subyek memiliki penegtahuan yang rendah terkait suplemen zat besi. Instrumen penelitian mengenai pengetahuan dan suplemen zat besi yang tervalidasi di Indonesia masih belum ada, sehingga data pengetahuan ibu hamil mengenai kehamilan dan suplemen zat besi masih sangat kurang. Metode dalam penelitian ini adalah dengan melakukan pengembangan instrumen penelitian (kuesioner) yang dilakukan validasi oleh tiga orang ahli di bidangnya masing-masing (validasi konten). Langkah selanjutnya adalah dengan melakukan pilot test untuk mengetahui masukan maupun umpan balik dari subyek terkait kesalahan dan item pertanyaan yang membingungkan. Pilot test juga digunakan untuk mengukur waktu pengisian kuesioner. Langkah terakhir adalah melakukan validasi construct yang dilakukan pada 49 subyek penelitian. Analisis statistik menggunakan pearson correlation  dan cronbach alpha digunakan untuk mengukur validitas dan reliabilitas kuesioner. Subyek penelitian dalam validasi ini adalah sebanyak 49 pasien hamil yang mendapatkan suplemen zat besi dan atau asam folat di RS PKU Muhammadiyah Gamping pada periode Agustus sampai dengan September 2019. Berdasarkan hasil Uji validitas terhadap 15 item pertanyaan diperoleh 2 item pertanyaan yang tidak valid, selanjutnya item pertanyaan dihapus dan dilakukan validasi ulang dan diperoleh hasil valid dengan nilai koefisien pearson correlation ditasa nilai r tabel. Hasil uji reliabilitas menggunakan cronbach alpa diperoleh semua item pertanyaan memiliki nilai cronbach alpa diatas 0,6 sehingga dinyatakan reliabel. Kata Kunci: Validasi, pengetahuan, ibu hamil, suplemen zat besi     ABSTRACT Anemia in pregnancy is one of the problems in pregnancy. WHO data in 2001 showed that more than 50% of pregnant women had anemia. Anemia in pregnancy is a condition where the hemoglobin level is less than 11 mg / dL. The prevalence of anemia in Indonesia is quite high at 50-63%, while the prevalence in DI Yogyakarta is 14.32%. Research on the knowledge of pregnant women regarding their pregnancy conditions in Selangor shows that the knowledge of pregnant women is in the good category, but most of the subjects have low knowledge regarding iron supplementation. Research instruments on validated knowledge and supplementation of iron in Indonesia still do not exist, so data on knowledge of pregnant women regarding pregnancy and iron supplements is still lacking. The method in this study was to develop a research instrument (questionnaire) which was validated by three experts in their respective fields (content validation). The next step is to conduct a pilot test to find out input and feedback from subjects related to errors and confusing question items. Pilot tests are also used to measure the time to fill out the questionnaire. The final step is to construct validation conducted on 49 research subjects. Statistical analysis using Pearson correlation and Cronbach alpha was used to measure the validity and reliability of the questionnaire. Research subjects in this validation were 49 pregnant patients who received iron supplements and / or folic acid at PKU Muhammadiyah Gamping Hospital in the period of August to September 2019. Based on the results of the validity test of 15 question items, there were 2 items that were invalid, further items questions were deleted and re-validated and valid results obtained with the Pearson correlation coefficient ditasa r table values. The reliability test results using Cronbach Alpha are obtained all questions items have a Cronbach Alpha value above 0.6 so that it is declared reliable. Keywords:validation, knowledge, pregnant women, iron suplements

The Health-Related Quality of Life (HRQoL) is one of the important psycho-social characteristics that can affect patient's ability to manage therapy. Poor of knowledge of hypertension and the changing lifestyle can affect the quality of life of patients. One of the pharmacist's interventions in hypertension management is to conduct counseling. Motivational counseling helps health service to assess patient's understanding and patient's readiness to change patient's behavior. Some motivational counseling methods still need to be developed. Therefore, this study aims to find the influence of the "brief counseling-5A" and "motivational SMS" by a pharmacist on the quality of life and blood pressure control in hypertension patients in the internal disease polyclinic, PKU Muhammadiyah Bantul Hospital, Yogyakarta. The study has been done by using the quasi-experimental method with prospective data collection during the period of January until April 2013. Sixty patients have met inclusion criteria and were divided into two groups. Thirty patients (50%) received "brief counseling-5A" and "motivational SMS" as intervention group and the other thirty patients (50%) received usual care as a control group. The data collection was done by interviewing patients. Medication adherence and QoL were assessed by using Morisky Medication Adherence Scale (MMAS) and SF-36. The values of blood pressure are taken from patient's medical records. Patient's quality of life showed a good improvement during post study. It is shown in 8 different domains including pain, fatigue, physical function, emotional function, social function, role physical, mental health, and general health. In intervention group, physical function, emotional function, and pain showed highly significant improvement (p<0.05). Systolic and diastolic blood pressure in the intervention group decreased significantly (p<0.05) (systolic p=0.001 and diastolic p=0.018) in the post study. From this study, it is concluded that the "brief counseling-5A by pharmacist" and "motivational SMS" had a positive impact on patient's QoL and patient's blood pressure, hence, the therapy outcome has been achieved. Hubungan kesehatan dan kualitas hidup (Health Related Quality of Life) merupakan salah satu karakter psiko-sosial penting yang dapat memengaruhi kemampuan pasien dalam penatalaksanaan terapi. Kurangnya pengetahuan mengenai hipertensi dan perubahan gaya hidup dapat memengaruhi kualitas hidup pasien. Salah satu intervensi farmasis dalam penatalaksanaan hipertensi adalah konseling. Konseling motivasional membantu pelayanan kesehatan untuk menggali pemahaman pasien serta kesiapan pasien untuk berubah. Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberian brief counseling-5A disertai SMS motivasi oleh farmasis terhadap kualitas hidup dan pengontrolan tekanan darah pasien hipertensi di poliklinik penyakit dalam RS PKU Muhammadiyah Bantul, Yogyakarta. Penelitian dilakukan secara quasi-eksperimental dengan pengambilan data secara prospektif selama periode Januari hingga A...