Authors: Ernita Trivana1, Ady Soesetijo2, Dewi Rokhmah2
1 Student in the Faculty of Public Health, Graduate University of
2 Lecture in the Faculty of Public Health, University of Jember
Abstract
Diabetes Mellitus (DM) is a chronic disease whose prevalence increases. If the DM is not addressed properly will appear a variety of complications that affect the quality of life of patients. The presence of hypertension in DM disease increases the risk of heart disease, stroke, increases peripheral vascular resistance, albuminuria and renal injury. Non-compliance is one of the key factors that impede blood pressure control and blood sugar levels, requiring counseling interventions that are expected to change behavior, improve adherence to medication so that it can achieve blood pressure and blood sugar levels as well as improve the quality of life of patients. The purpose of this study was to determine the effect of brief counseling on the behavior, adherence of medication adherence, treatment outcomes, and quality of life of DM patients with outpatient hypertension at Jember Clinic Plantation Hospital. This research was conducted with experimental quasi design with prospective data taking outpatient during March-April 2018 period. Subjects who fulfilled inclusion criteria of 69 DM patients with hypertension were divided into two groups: 35 patients (50.72%) who received counseling as treatment group and 34 patients (49.28%) who did not receive counseling as a control group. Exclusion criteria are patients with conditions of pregnancy and deafness. The data were collected by conducting interviews based on the brief counseling procedure and completing the behavioral questionnaire, adherence compliance using the Morisky Modification Adherence Scale (MMAS) questionnaire and quality of life using the SF-36 questionnaire. Blood pressure data and blood sugar levels were taken from medical record records. This type of research is analytic with Quasi experimental research design. Results of the study using wilcoxon test to analyze differences in behavioral level, adherence adherence taking medication, blood pressure, Blood Sugar Occasionally (BSO) and patient life quality showed briefing counseling by counselor can change counselee behavior in treatment group (38.00%). Drug adherence adherence was increased in the treatment group (62%), the blood pressure in the treatment group did not decrease significantly (p> 0.05) in both systolic and diastolic blood pressure and at a decrease in blood glucose (BSO) there is a significant difference that is marked with a value of p <0.05, while the results of quality of life study also experienced a significant change marked with the value of p <0.05 that is in the general health domain (p = 0.090), physical role (p = 0.05), the role of emotion (p = 0.039) and vitality ( p = 0.022), whereas in the domain of social function, mental health, physical function and pain did not change significantly. Based on the results of this study it can be concluded that the brief counseling therapy can be in DM patients with hypertension can change behavior, improve adherence compliance of patients to take medicine, decrease blood glucose (BSO) and improve quality of life in general health domain, the role of emotion and vitality in DM patients with hypertension.
Keywords: Diabetes Mellitus, hypertension, oral pharmacist counseling, adherence behavior level, adherence, therapy result, quality of life
