* Corresponding Author
KEPATUHAN PENGGUNAAN ANTIHIPERTENSI SEBAGAI PREDIKTOR LAJU KEJADIAN DAN BIAYA RAWAT INAP
https://doi.org/10.22146/jmpf.288 Nurmainah Nurmainah(1*), Achmad Fudholi(2), Iwan Dwiprahasto(3)
(1)
(2)
(3)
(*) Corresponding Author
Abstract
Persistensi penggunaan antihipertensi pada pasien hipertensi sangat diperlukan. Mengingat luaran utama dari terapi hipertensi adalah menurunkan atau mencegah terjadinya kejadian penyakit kardiovaskular seperti infark miokard, stroke yang berujung pada risiko kematian. Penelitian ini bertujuan untuk mengevaluasi dampak klinis berupa laju kejadian dan biaya rawat inap pada kelompok pasien hipertensi yang persisten dan tidak persisten menggunakan obat antihipertensi berdasarkan klaim resep pengobatan PT Askes (Persero). Rancangan penelitian yang digunakan adalah studi kohort retrospektif dengan menggunakan basis data pasien hipertensi rawat jalan peserta asuransi kesehatan PT Askes (Persero) di RSUD Panembahan Senopati Bantul. Jumlah subjek yang ikut dalam penelitian ini sebanyak 304 pasien hipertensi yang menggunakan obat antihipertensi pertama kali (tanggal indeks pengobatan 1 Juli 2007 – 31 Desember 2008). Analisis data yang digunakan pada penelitian ini, antara lain uji khi kuadrat, analisis kesintasan Kaplan-Meier, dan cox proportion hazard test. Setelah dilakukan pengamatan berkisar 3 sampai 4,5 tahun bahwa laju kejadian rawat inap pada pasien yang persisten menggunakan antihipertensi lebih lambat dan bermakna secara statistik daripada pasien hipertensi yang tidak persisten menggunakan antihipertensi (HR= 0,12; IK 95%= 0,006-0,23). Rata-rata biaya untuk mengatasi luaran klinis berupa rawat inap pada kelompok pasien yang persisten menggunakan antihipertensi (Rp. 2.758.109,28) lebih rendah daripada kelompok pasien hipertensi yang tidak persisten menggunakan antihipertensi dan dirawat inap (Rp. 4.125.412,00). Kesimpulan dari penelitian ini adalah peningkatan persistensi penggunaan antihipertensi pada pasien hipertensi dapat menekan laju kejadian dan biaya rawat inap.
Kata kunci: persistensi, hipertensi, kejadian rawat inap, biaya
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AHA, 2013, Statistical Fact Sheet 2013 Update, High Blood Pressure, http:// www.heart.org.idc/ groups/ heartpublic/ @wcm/ @sop/ document/ downloadable/ ucm_319587, diakses 26 Desember 2013.
Blouin, J., Dragomir, A., Fredette, M., Ste-Marie, L.G., Fernandes, J.C., Perreault, S., 2009, Comparison of Direct Health Care Costs Related to The Pharmacological Treatment of Osteoporosis and to The Management of Osteoporotic Fractures among Compliant and Noncompliant Users of Alendronate and Risedronate: A Population-Based Study, Osteoporosis International, 20: 1571-1581.
Bohm, M., Schumacher, H., Laufs, U., Sleight, P., Schmieder, R., Unger, T., et al., 2013, Effect of Nonpersisten with Medication on Outcomes in High-Risk Patient with Cardiovascular Disease, American Heart Journal, 166(2): 306-314.
Borghi, C., Veronesi, M., Dormi, A., Prandin, M.G., Cosentino, E., Strocchi, E., 2007, Persistence of Treatment and Blood Pressure Control in Elderly Hypertensive Patients Treated with Different Classes of Antihypertensive Drugs, The American Journal of Geriatric Cardiology, 16(5): 280286.
Chobanian, A.V., Bakris, G.L., Black, H.R., Cushman, W.C., Green, L.A., Izzo, J.L., et al., 2003, Sevent Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, Hypertension, 42: 1206-1252.
Conen, D., Ridker, P.M., Mora, S., Buring, J.E., Glynn, R.J., 2007, Blood Pressure and Risk Developing Type 2 Diabetes Mellitus: The Women’s Health Study, European Heart Journal, 28(23): 2937-2943.
Cooper-DeHoff, R.M., Gong, Y., Handberg, E.M., Bavry, A.A., Denardo, S.J., Bakris, J.L., et al., 2010, Tigh Blood Pressure Control and Cardiovascular Outcomes among Hypertensive Patients with Diabetes and Coronary Artery Disease, JAMA, 304(1): 61-68.
Cramer, J.A., Roy, A., Burrell, A., Fairchild, C.J., Fuldeore, M.J., Ollendorf, D.A., et al., 2008, Medication Compliance and Persistence: Terminology and Definitions, Value in Health, 11(1): 44-47.
Depkes RI, 2008, Laporan Hasil Riset Kesehatan Dasar (Riskesdas) Nasional 2007, Badan Penelitian dan Pengembangan Kesehatan, Departemen Kesehatan Republik Indonesia, Jakarta.
Duh, M.S., Fulcher, N.M., White, L.A., Jayawant, S.S., Ramamurthy, P., Moyneur, E., et al., 2009, Costs Associated with Cardiovascular Events in Patients with Hypertension in US Managaed Care Settings, Journal of the American Society of Hypertension, 3(6): 403-415.
Grassi, G., Seravalle, G., dan Mancia, G., 2011, Cardiovascular Consequences of Poor Compliance to Antihypertensive Therapy, Blood Press, 20(4): 196-203.
Halpern, M.T., Khan, Z. M., Schmier, J. K., Burnier, M., Caro, J.J., Cramer, J., et al., 2006, Recommendations for Evaluating Compliance and Persistence with
Hypertension Therapy Using Retrospective Data, Hypertension, 47: 10391048.
Higashi, Y., Kihara, Y., dan Noma, K. 2012, Endothelial Disfunction and Hypertension in Aging, Hypertension Research, 35: 10391047.
Kemenkes RI, 2013, Penyajian Pokok-Pokok Hasil Riset Kesehatan Dasar 2013, Badan penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia, www. litbang. depkes.go.id/penerbitan/index.php/blp/cat alog/book/48, diakses 23 Desember 2013.
Leenen, F.H, 2004, ALLHAT: What has It Taught Us So Far, CMAJ, 171(7): 719-720.
Prandin, M.G., Cicero, A.F.G., Veronesi, M., Cosentino, E., Dormi, A., Strocchi, E., Borghi, C., 2007, Persistence on Treatment and Blood Pressure Control with Different First-Line Antihypertensive Treatments: A Prospective Evaluation, Clinical and Experimental Hypertension, 29: 553-562.
Sikka, R, Xia F, Aubert, R.E, 2005, Estimating Medication Persistency Using Administrative Claims Data, The American Journal of Managed Care, 11(7): 449-457.
Sunyecz, J.A., Mucha, L., Baser, O., Barr, C.E., Amonkar, M.M., 2008, Impact of Compliance and Persistence with Bisphosphonate Therapy on Health Care Cost and Utilization, Osteoporos International, 19: 1421-1429.
Veronesi, M., Cicero, A.F.G., Prandin, M.G., Dormi, A., Cosentino, E., Strocchi, E., et al., 2007, A Prospective Evaluation of Persistence on Antihypertensive Treatment with Different Antihypertensive Drugs in Clinical Practice, Journal of Vascular Health and Risk Management, 3(6): 999-1005.
Virdis, A., Ghiadoni, L., Giannarelli, C., Taddei, 2010, Endothelial Disfunction dan Vascular Disease in Later Life, Maturitas, 67(1): 20-24.
Wagner, A.K., Valera, M., Graves, A.J., Lavina, S., Ross-Degman, D., 2008, Cost of Hospital Care for Hypertension in an Insured Population without an Outpatient Medicines Benefit: an Obervational Study in The Philippines, BMC Health Services Research, 8: 161-168.
WHO, 2003b, Adherence to Long-term Therapies: Evidence for Action, http://www.who.int/chp/en/, diakses 2 Juni 2010.
WHO, 2003, World Health Organization (WHO)/ Internasional Society of Hypertension (ISH) Statement on Management of Hypertension, Journal of Hypertension, 21: 1983-1992.
DOI: https://doi.org/10.22146/jmpf.288
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