Post on 02-Apr-2019
Kepada Yth,
Peserta Poster
Bersama ini kami informasikan bahwa poster dengan judul “Evaluation Of Pulmonary
Tuberculosis Outpatient’s Knowledge, Adherence, And Therapeutic Outcomes At Rspad Gatot
Soebroto Hospital” telah dipamerkan pada Sesi Poster yang diselenggarakan pada 1st ISPOR
Indonesia Conference 2014, 24-27 Mei 2014 di Sanur Paradise Plaza Convention Center-Bali.
Denpasar, 27 Mei 2014
Ahmad Fuad Afdhal Ph.D
(President ISPOR Indonesia Chapter)
Dengan hormat,
Bersama ini kami menginformasikan bahwa abstrak dengan judul “Evaluation Of Pulmonary
Tuberculosis Outpatient’s Knowledge, Adherence, And Therapeutic Outcomes At Rspad Gatot Soebroto
Hospital”, berdasarkan penilaian Tim Evaluasi Abstrak, maka abstrak saudara dinyatakan
diterima dan memenuhi syarat.
Untuk itu harap mencetak abstraknya dalam bahasa Inggris dengan ukuran kertas A2 dan dibawa
sendiri dan diserahkan ke panitia pada hari Jum’at 23 Mei 2014 di sekretariat panitia, Sanur Paradise
Plaza & Convention Center.
Atas perhatian dan kerjasamanya kami sampaikan terima kasih.
Jakarta, 8 Mei 2014
Tim Evaluasi Abstrak ISPOR Indonesia Conference 2014
dr. Deliana Permatasari
Evaluation of Pulmonary Tuberculosis Outpatient’s Knowledge,
Adherence, and Therapeutic Outcomes
at
RSPAD Gatot Soebroto Hospital
Dian Ratih Laksmitawati*), Sesilia Andriani K, Gladys
Faculty of Pharmacy, Pancasila University
Jalan Srengseng Sawah, Jagakarsa, South Jakarta 12640 *)corresponding author : dianratih.ffup@gmail.com
BACKGROUND The prevalence of tuberculosis (TB) in Indonesia is still high. This proved that the therapeutic outcome of TB treatment is still low. Therapeutic outcome can be improved by increasing the adherence that is supported by the increase of the patient’s knowledge.
OBJECTIVES To evaluate the knowledge, adherence, and therapeutic outcome in patients with pulmonary tuberculosis at RSPAD Gatot Soebroto Hospital.
METHODS This is an observational analytic study with cross sectional design, conducted on 30 patients using total sampling technique. Data were taken prospectively towards newly diagnosed pulmonary tuberculosis patients and followed for 2 months. The tools used in this research is Modified Morisky Scale questionnaire to access
adherence and knowledge about diseases and drugs questionnaire. The therapeutic outcome were measured by counting the percentage of patients that entered the
extension phase after completing the intensive phase therapy.
Number of Patients Answered Correct from the Disease Knowledge Questionnaire
Number Of Patients Answered Correct From The TB Drug Knowledge
Questionnaire
Paired t test was performed to determine whether there is a mean difference between the knowledge of patients before and after starting treatment; and Wilcoxon test
was conducted to determine mean difference between the patient’s adherence at the beginning and end of the intensive phase of therapy. The results showed that 90% of
patients achieve improvement in the therapeutic outcome. In addition there is a significant increase in patient’s knowledge about the disease (14.41%) and drug (2.39%). As for adherence, there is a significant decrease as much as 9.44%.
CONCLUSION During 2 months of intensive phase TB therapy, the patients experienced an increase in their knowledge of TB disease and drugs compared to before therapy. Using Morisky Scale to measure adherence, there has been a decrease in the motivation through the observation of the significant reduction in the patient’s adherence in
drug consumption.
Ten percent of patients are categorized as experiencing therapy failure during intensive phase, therefore patients were given drug inserts for 1 month.
Research Scheme
newly diagnosed TB patients After 2 month intensive phase
excluded
Descriptive analysis T-paired and Pearson analysis
Pre-post datas
Therapy outcome
Questionnaires of :
Disease knowledge Drug knowledge Adherence
Meet the inclusion criterias Did not meet the in-clusion criterias
Pulmonary Tuberculosis Outpatient at RSPAD
Gatot Soebroto Hospital
ACKNOWLEDGEMENT Appreciation are given to RSPAD Gatot Soebroto Hospital for the cooperation during this research
DISCUSSION
In the first 2 weeks of the intensive phase, are patients most likely to experience full motivation to recover. The first target desired by patients are negative sputum smear examination. But over the past 2-4 weeks there will be a possibility when the patients become bored and forget to take their TB drugs along with the improvement of the
patient’s condition. This has led to a decrease in patient’s adherence, which is detected by the shift in the Morisky Scale quadrant. Ten percent of patients in this study
were categorized as experiencing therapy failure and therefore they must receive drugs inserts for 1 month.
Correlation test were conducted between knowledge of TB disease, TB drugs, and patient’s adherence. The test showed that only knowledge of TB disease hase a
significant correlation with patient’s acherence (p value 0.002).
23.33
83.33
20
76.67
56.67
93.33
66.67
33.33
96.67
26.67
76.67
70
100
80
0
20
40
60
80
100
120
The cause of TB
Part of the body infected
The spread of disease
How person are exposed
to TB
TB symptoms Can TB be cured/not
Duration of treatment
Num
ber o
f pat
ient
s an
swer
ed c
orre
ctly
(%)
TB Disease Knowledge
Before therapy After intensive phase therapy
Demography Data
Types of TB Medicines (A) and Insurance (B)
Notes : A.Non-Fixed Dose Combination
(Non-FDC) = R/H/Z/E drugs given single, therefore patients receive single dose of 4 different tablets; Fixed Dose
Combination (FDC) = R/H/Z/E drugs are combined together, therefore patients
only received 1 tablet;
B.Privilege = health insurance
for army patients or their family; Health insurance (ASKES) = insurance given to
civil servants; Jakarta Health Card (KJS) = insurance given
Therapeutic Outcome in
Percentage
Sliding of Patient’s Adherence (Morisky Scale Adherence)
No. Quadrant Percentage of
Patients Before Oral Anti-tuberculosis
Therapy
(%)
Percentage of
Patients After Oral Anti-tuberculosis
Therapy
(%)
1. I - -
2. II - 3.33
3. III - 10
4. IV 100 86,67
Notes : A = age (yr),; B = gender, C = education, D = married status, E= job
LITERATURE
1. Case Management Society of America. Case Management Adherence Guidelines (CMAG). Edisi II. Amerika: Case Management Society of America; 2006.p. 39-41, 28-30. 2. Departemen Kesehatan Republik Indonesia. Pedoman Penanggulangan Tuberkulosis (TB). Edisi ke-2. Jakarta : Depkes RI; 2006
3. WHO. Promoting adherence to treatment for tuberculosis: the importance of direct observation. Bulletin of WHO May 2007; p 325-420
Information :
I = low knowledge, low motivation; II = low knowledge, high motivation; III = high
knowledge, low motivation; IV = high knowledge, high motivation
30
100 100
5046.66
100 100 100
30
100 100
5056.66
100 100 100
0
20
40
60
80
100
120
Drug name How the drugs are
used
Number of drugs taken
When draugs are taken
positive effect of drug
negative effect of drug
How to store drugs
When to refill drugs
Num
ber o
f pat
ient
s ans
wer
ed c
orre
ctly
(%)
TB Drug Knowledge
Before therapy
After intensive therapy