Pengukuran Kualitas Hidup Pasien Program Pengelolaan Penyakit Kronis (Prolanis) di Puskesmas Menggunakan Instrumen EQ-5D-5L

Abstract

ABSTRAKPrevalensi penyakit diabetes melitus (DM) dan hipertensi di Indonesia semakin tahun semakin meningkat. Pemerintah melalui Badan Penyelenggara Jaminan Sosial (BPJS) mencanangkan Program Pengelolaan Penyakit Kronis (Prolanis) untuk mencapai kesehatan yang optimal dan kualitas hidup yang baik pada penyakit DM dan hipertensi. Studi ini bertujuan untuk mengukur kualitas hidup pasien prolanis di puskesmas menggunakan instrumen EQ-5D-5L. Studi dilakukan pada 200 pasien prolanis yang terdiri dari 100 pasien diabetes melitus dan 100 pasien hipertensi. Lokasi pengambilan sampel berada di puskesmas Kota Palu Provinsi Sulawesi Tengah untuk pasien DM dan Kabupaten Aceh Barat Provinsi Nangroe Aceh Darussalam untuk pasien hipertensi yang dilakukan dalam kurun waktu 3 bulan (September-November 2018). Penelitian menggunakan rancangan cross-sectional study dengan metode convenience/accidental sampling. Kualitas hidup diukur menggunakan instrumen European Quality of Life-5 Dimension-5 Level (EQ-5D-5L) dan konversi health utility (utility) dengan value set Indonesia. Analisis data menggunakan uji independent t-test untuk melihat perbedaan kualitas hidup pada tiap kelompok karakteristik pasien DM dan hipertensi. Hasil penelitian menunjukkan domain rasa sakit/tidak nyaman merupakan domain yang paling banyak dilaporkan terjadi masalah pada pasien DM maupun Hipertensi. Nilai utility pasien DM sebesar 0,843±0,081, sedangkan hipertensi sebesar 0,767±0,154. Terdapat perbedaan signifikan nilai utility berdasarkan karakteristik umur (p=0,001), riwayat penyakit keluarga (p=0,006), lama menderita penyakit (p=0,000) dan frekuensi kontrol (p=0,000) pada pasien hipertensi, sedangkan pada pasien DM hanya pada karakteristik memiliki penyakit lain (p=0,026). ABSTRACTThe prevalence of diabetes mellitus (DM) and hypertension in Indonesia is increasing every year. The government through the BPJS has launched a prolanis program to achieve optimal health and good quality of life in DM and hypertension patients. This study aimed to measure the quality of life of prolanis patients in primary healthcare centers using the EQ-5D-5L instrument. The study was conducted on 200 prolanis patients consisting of 100 diabetes mellitus patients and 100 hypertensive patients. Data were collected from patients in the primary healthcare centers of Palu Municipality Central Sulawesi Province for DM and from patients in the primary healthcare centers West Aceh District Nangroe Aceh Darussalam Province which were carried out within 3 months (September-November 2018). The study was a cross-sectional study design using convenience/accidental sampling method. Health related quality of life was measured using the European Quality of Life-5 Dimension-5 Level (EQ-5D-5L) and conversion to health utility (utility) used the Indonesian value set. Data analysis used the independent t-test to show the difference in quality live in each group of patients characteristics. The results showed that pain/discomfort was the domain most reported to have problems in DM and hypertension p...

Hubungan Pengetahuan Dengan Kualitas Hidup Pasien Diabetes Melitus Tipe 2 Dan Faktor Yang Mempengaruhinya

“…Then, most of the respondents were not disturbed by their activities because these patients had a controlled lifestyle and sugar levels. A research Hamida et al (2019) is in line with this study for as many as 98% of DM patients at Palu City Health Center did not find it difficult to carry out self-care. However, generally, the average type 2 DM patients had poor quality in the dimension of mobility, namely the patient's ability to walk or move, as well as experiencing anxiety/depression 25 .…”

“…A research Hamida et al (2019) is in line with this study for as many as 98% of DM patients at Palu City Health Center did not find it difficult to carry out self-care. However, generally, the average type 2 DM patients had poor quality in the dimension of mobility, namely the patient's ability to walk or move, as well as experiencing anxiety/depression 25 . In addition, studies in other countries in patients with type 2 DM, such as in Bangladesh and India also showed the same constraints 44,37 .…”

“…The characteristics of the respondents in this study were mostly aged 60 years (53.3%), female (50.7%), first education level (SD-SMP) (64%). A research by Hamida et al (2019) which measured the quality of life of DM and hypertension patients, the majority of DM sufferers are women 25 . Patients with type 2 diabetes also have different age levels, patients >45-year-old have the potential to develop type 2 DM and most of them are found to have macro vascular complications that can develop progressively 26 .…”

“…(2019) which showed that type 2 DM patients reported having a mean utility value of > 0.800 with a minimum number of respondents at the level 5 25 . The difference in utility values in type 2 DM patients does not occur in only in the regions of Indonesia, but is also shown in several other Asian countries such as Thailand, China, Hong Kong, India, Bangladesh, Iran, respectively 0.801 34 ; 0.939 35 ; 0.840 36 ; 0.803 37 ; 0.620 38 ; 0.770 and 0.720 39 .…”

“…However, there were still type II DM patients in this study who were in the severe category (levels 4 and/or 5) in each dimension (<2%). Such respondents were generally respondents who had a long-term history of DM and experienced quite severe complications and had an uncontrolled lifestyle which ultimately affected the patient's quality of life 25,43 . Then, most of the respondents were not disturbed by their activities because these patients had a controlled lifestyle and sugar levels.…”