diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13068diaendo-13068Research ArticleОригинальные исследованияOriginal StudiesПриверженность к медикаментозной терапии у пациентов с сахарным диабетом в Индонезии и факторы, влияющие на нееMedication Adherence in Patients with Diabetes Mellitus and Influencing Factors in Indonesiahttps://orcid.org/0000-0001-6506-5436LestariPujiLestariPuji

Кафедра сестринского дела, Факультет здравоохранения

Семаранг

Puji Lestari, BScN, RN, MNSc (Epid)

Department of Nursing, Faculty of Health

186 Diponegoro Street, 50512 Gedanganak, East Ungaran, Semarang, Central Java

pujilestari@unw.ac.idhttps://orcid.org/0000-0003-3531-7043Liyanovitasari.Liyanovitasari.

Кафедра сестринского дела, Факультет здравоохранения

Семаранг

Liyanovitasari, BScN, RN, MNSc

Department of Nursing, Faculty of Health

186 Diponegoro Street, 50512 Gedanganak, East Ungaran, Semarang, Central Java

liyanovie05@gmail.comhttps://orcid.org/0000-0002-8063-4788PrabowoHeriPrabowoHeri

Кафедра менеджмента, факультет бизнеса и экономики

Семаранг

Heri Prabowo, PhD, BSc (Economics), MSc (Management)

Department of Management, Faculty of Business and Economics

Semarang

heriprabowo@upgris.ac.idУниверситет Нгуди ВалуйоИндонезияUniversitas Ngudi WaluyoIndonesiaУниверситет ПГРИ СемарангИндонезияUniversitas PGRI SemarangIndonesia202523052025282237242Copyright © Lestari P., Liyanovitasari .., Prabowo H., 20252025Lestari P., Liyanovitasari .., Prabowo H.Lestari P., Liyanovitasari .., Prabowo H.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13068ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Сахарный диабет существенно влияет на качество человеческих ресурсов и значительно увеличивает расходы на здравоохранение. Хорошая приверженность лечению помогает контролировать уровень сахара в крови и снижает риск госпитализаций.

ЦЕЛЬ

ЦЕЛЬ. Определить профиль приверженности к медикаментозной терапии у пациентов с сахарным диабетом и выявить влияющие на неё факторы.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. Была проведена поперечная (cross-sectional) выборка в амбулаторном центре Калиньяматан, Центральная Ява, Индонезия, с участием 90 пациентов с сахарным диабетом 2 типа. Первичные данные собирались с помощью предварительно протестированных анкет. Для набора участников использовалась стратегия сплошной выборки. Для определения факторов, влияющих на приверженность к лечению, был проведен логистический регрессионный анализ.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. Приверженность к лечению была низкой у 22 человек (24,4%) и высокой у 68 человек (75,6%). На приверженность достоверно влияли следующие четыре фактора: возраст (p=0,007), уровень образования (p=0,048), род занятий (p=0,012) и семейная поддержка (p=0,002). Пол (p=0,259) и длительность заболевания (p=0,547) не показали значимого влияния.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Медицинские работники должны мотивировать пациентов с сахарным диабетом соблюдать назначенное лечение.

BACKGROUND

BACKGROUND: Diabetes Mellitus significantly impacts the quality of human resources and substantially increases healthcare costs. Good adherence to diabetes treatment can control blood sugar levels and minimize hospitalization.

AIM

AIM: To determine the medication adherence profile in patients with diabetes mellitus and the influencing factors.

MATERIALS AND METHODS

MATERIALS AND METHODS: A cross-sectional study was used in Kalinyamatan Primary Health Center, Central Java, Indonesia, involving 90 patients with type 2 diabetes mellitus. Primary data was collected using pretested questionnaires. This research used a total sampling technique to recruit participants. To determine the factors influencing medication adherence in patients with diabetes mellitus, we conducted a logistics regression analysis.

RESULTS

RESULTS: The study showed that medication adherence indicated low in 22 individuals (24.4%) and high in 68 individuals (75.6%). Four factors were significantly influencing medication adherence in patients with diabetes mellitus: age (p-value 0.007), education (p-value 0.048), occupation (p-value 0.012), and family support (p-value 0.002). However, two factors, namely gender (p-value 0.259) and duration of illness (p-value 0.547), were found to have no significant impact on medication adherence.

CONCLUSION

CONCLUSION: Healthcare professionals should have to motivate patients with Diabetes Mellitus to ensure adherence to their prescribed treatment regimen.

сахарный диабетфакторы влиянияприверженность к медикаментозному лечениюdiabetes mellitusinfluencing factorsmedication adherenceReferencesWorld Health Organization. [Internet]. Noncommunicable diseases in emergencies. World Health Organization; 2016 [cited 2024 Sep 10]. Available from: https://iris.who.int/handle/10665/204627World Health Organization. [Internet]. Noncommunicable diseases in emergencies. World Health Organization; 2016 [cited 2024 Sep 10]. Available from: https://iris.who.int/handle/10665/204627Animaw W, Seyoum Y. Increasing prevalence of diabetes mellitus in a developing country and its related factors. PLoS One. 2017;12(11):e0187670. Published 2017 Nov 7. doi: https://doi.org/10.1371/journal.pone.0187670Animaw W, Seyoum Y. Increasing prevalence of diabetes mellitus in a developing country and its related factors. PLoS One. 2017;12(11):e0187670. Published 2017 Nov 7. doi: https://doi.org/10.1371/journal.pone.0187670International Diabetes Federation [Internet]. IDF Diabetes Atlas, 19th Edition; 2019 [cited 2024 Sep 10]. Available from: https://diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdfInternational Diabetes Federation [Internet]. IDF Diabetes Atlas, 19th Edition; 2019 [cited 2024 Sep 10]. Available from: https://diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdfBadan Penelitian dan Pengembangan Kesehatan [National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia] [Internet]. Laporan Nasional Riskesdas 2018 [Basic Health Research Report 2018]. Kementerian Kesehatan Republik Indonesia; 2019 [cited 2020 Nov 14]. Available from: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdfBadan Penelitian dan Pengembangan Kesehatan [National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia] [Internet]. Laporan Nasional Riskesdas 2018 [Basic Health Research Report 2018]. Kementerian Kesehatan Republik Indonesia; 2019 [cited 2020 Nov 14]. Available from: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdfDinkes Jateng D. Profil Kesehatan Provinsi Jawa Tengah Tahun 2020. Dinkes Jateng; 2020.Dinkes Jateng D. Profil Kesehatan Provinsi Jawa Tengah Tahun 2020. Dinkes Jateng; 2020.American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S14-S31. doi: https://doi.org/10.2337/dc20-S002American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S14-S31. doi: https://doi.org/10.2337/dc20-S002Ligita T, Wicking K, Francis K, Harvey N, Nurjannah I. How people living with diabetes in Indonesia learn about their disease: A grounded theory study. PLoS One. 2019;14(2):e0212019. doi: https://doi.org/10.1371/journal.pone.0212019Ligita T, Wicking K, Francis K, Harvey N, Nurjannah I. How people living with diabetes in Indonesia learn about their disease: A grounded theory study. PLoS One. 2019;14(2):e0212019. doi: https://doi.org/10.1371/journal.pone.0212019Perkeni. Konsesus Pengolahan Dan Pencegahan Diabetes Melitus Tipe 2 Di Indonesia. Perkeni 2011. 2011;1(69):5-24.Perkeni. Konsesus Pengolahan Dan Pencegahan Diabetes Melitus Tipe 2 Di Indonesia. Perkeni 2011. 2011;1(69):5-24.Lin LK, Sun Y, Heng BH, Chew DEK, Chong PN. Medication adherence and glycemic control among newly diagnosed diabetes patients. BMJ Open Diabetes Res Care. 2017;5(1):e000429. doi: https://doi.org/10.1136/bmjdrc-2017-000429Lin LK, Sun Y, Heng BH, Chew DEK, Chong PN. Medication adherence and glycemic control among newly diagnosed diabetes patients. BMJ Open Diabetes Res Care. 2017;5(1):e000429. doi: https://doi.org/10.1136/bmjdrc-2017-000429Basu S, Garg S, Sharma N, Singh MM, Garg S. Adherence to selfcare practices, glycemic status and influencing factors in diabetes patients in a tertiary care hospital in Delhi. World J Diabetes. 2018;9(5):72-79. doi: https://doi.org/10.4239/wjd.v9.i5.72Basu S, Garg S, Sharma N, Singh MM, Garg S. Adherence to selfcare practices, glycemic status and influencing factors in diabetes patients in a tertiary care hospital in Delhi. World J Diabetes. 2018;9(5):72-79. doi: https://doi.org/10.4239/wjd.v9.i5.72Adikusuma W, Qiyaam N. Adherence level and blood sugar control of type 2 diabetes mellitus patients who gets counseling and short messages service as reminder and motivation. Asian J Pharm Clin Res. 2018;11(2):219. doi: https://doi.org/10.22159/ajpcr.2018.v11i2.22988Adikusuma W, Qiyaam N. Adherence level and blood sugar control of type 2 diabetes mellitus patients who gets counseling and short messages service as reminder and motivation. Asian J Pharm Clin Res. 2018;11(2):219. doi: https://doi.org/10.22159/ajpcr.2018.v11i2.22988Aminde LN, Tindong M, Ngwasiri CA, et al. Adherence to antidiabetic medication and factors associated with nonadherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocr Disord. 2019;19(1):35. doi: https://doi.org/10.1186/s12902-019-0360-9Aminde LN, Tindong M, Ngwasiri CA, et al. Adherence to antidiabetic medication and factors associated with nonadherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocr Disord. 2019;19(1):35. doi: https://doi.org/10.1186/s12902-019-0360-9Bagonza J, Rutebemberwa E, Bazeyo W. Adherence to anti diabetic medication among patients with diabetes in eastern Uganda; a cross sectional study. BMC Health Serv Res. 2015;15:168. doi: https://doi.org/10.1186/s12913-015-0820-5Bagonza J, Rutebemberwa E, Bazeyo W. Adherence to anti diabetic medication among patients with diabetes in eastern Uganda; a cross sectional study. BMC Health Serv Res. 2015;15:168. doi: https://doi.org/10.1186/s12913-015-0820-5Kemenkes RI. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. Perkeni; 2015.Kemenkes RI. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. Perkeni; 2015.Mubarak WI. Ilmu Keperawatan Komunitas 2: Teori dan Aplikasi dalam Praktik dengan Pendekatan Asuhan Keperawatan Komunitas, Gerontik dan Keluarga. 2nd ed. Sagung Seta; 2017.Mubarak WI. Ilmu Keperawatan Komunitas 2: Teori dan Aplikasi dalam Praktik dengan Pendekatan Asuhan Keperawatan Komunitas, Gerontik dan Keluarga. 2nd ed. Sagung Seta; 2017.Budiman D, Herlina N. Hubungan status demografi dengan kepuasan masyarakat tentang pelayanan Jamkesmas di wilayah Puskesmas Tanjungsari Kabupaten Bogor. Jurnal Kesehatan Kartika. 2010;2(7):1-13.Budiman D, Herlina N. Hubungan status demografi dengan kepuasan masyarakat tentang pelayanan Jamkesmas di wilayah Puskesmas Tanjungsari Kabupaten Bogor. Jurnal Kesehatan Kartika. 2010;2(7):1-13.Notoatmodjo S. Promosi Kesehatan Dan Perilaku Kesehatan. Rineka cipta; 2018.Notoatmodjo S. Promosi Kesehatan Dan Perilaku Kesehatan. Rineka cipta; 2018.Suprianto, Purnawan, Arna, Kuspiantiningsih K. Dukungan Sosial Keluarga dengan Kepatuhan Menjalankan Program Pengobatan Pasien Hipertensi di URJ Jantung RSU Dr. Soetomo Surabaya. Jurnal Keperawatan. 2019;2(2).Suprianto, Purnawan, Arna, Kuspiantiningsih K. Dukungan Sosial Keluarga dengan Kepatuhan Menjalankan Program Pengobatan Pasien Hipertensi di URJ Jantung RSU Dr. Soetomo Surabaya. Jurnal Keperawatan. 2019;2(2).Ihwatun S, Ginandjar P, Saraswati LD, Udiyono A. Faktor-Faktor Yang Berhubungan Dengan Kepatuhan Pengobatan Pada Penderita Hipertensi Di Wilayah Kerja Puskesmas Pudakpayung Kota Semarang Tahun 2019. Jurnal Kesehatan Masyarakat. 2020;8(3):352-359. doi: https://doi.org/10.14710/jkm.v8i3.26396Ihwatun S, Ginandjar P, Saraswati LD, Udiyono A. Faktor-Faktor Yang Berhubungan Dengan Kepatuhan Pengobatan Pada Penderita Hipertensi Di Wilayah Kerja Puskesmas Pudakpayung Kota Semarang Tahun 2019. Jurnal Kesehatan Masyarakat. 2020;8(3):352-359. doi: https://doi.org/10.14710/jkm.v8i3.26396Kalogianni A. Factors affect in patient adherence to medication regimen. Health Science Journal. 2011;5:157-158.Kalogianni A. Factors affect in patient adherence to medication regimen. Health Science Journal. 2011;5:157-158.Aloudah NM, Scott NW, Aljadhey HS, Araujo-Soares V, Alrubeaan KA, Watson MC. Medication adherence among patients with Type 2 diabetes: A mixed methods study. PLoS One. 2018;13(12):e0207583. doi: https://doi.org/10.1371/journal.pone.0207583Aloudah NM, Scott NW, Aljadhey HS, Araujo-Soares V, Alrubeaan KA, Watson MC. Medication adherence among patients with Type 2 diabetes: A mixed methods study. PLoS One. 2018;13(12):e0207583. doi: https://doi.org/10.1371/journal.pone.0207583Yazew KG, Walle TA, Azagew AW. Prevalence of antidiabetic medication adherence and determinant factors in Ethiopia: A systemic review and meta-analysis, 2019. International Journal of Africa Nursing Sciences. 2019;11:100167. doi: https://doi.org/10.1016/j.ijans.2019.100167Yazew KG, Walle TA, Azagew AW. Prevalence of antidiabetic medication adherence and determinant factors in Ethiopia: A systemic review and meta-analysis, 2019. International Journal of Africa Nursing Sciences. 2019;11:100167. doi: https://doi.org/10.1016/j.ijans.2019.100167Almeida C, Rocha C, Cruz R. Impact of adverse effects to oral antidiabetics on adherence and quality of life in patients with type 2 diabetes. European Journal of Public Health. 2020;30(Supplement_2):ckaa040.020. doi: https://doi.org/10.1093/eurpub/ckaa040.020Almeida C, Rocha C, Cruz R. Impact of adverse effects to oral antidiabetics on adherence and quality of life in patients with type 2 diabetes. European Journal of Public Health. 2020;30(Supplement_2):ckaa040.020. doi: https://doi.org/10.1093/eurpub/ckaa040.020Mohamed MR, Ramsdale E, Loh KP, et al. Associations of Polypharmacy and Inappropriate Medications with Adverse Outcomes in Older Adults with Cancer: A Systematic Review and Meta-Analysis. Oncologist. 2020;25(1):e94-e108. doi: https://doi.org/10.1634/theoncologist.2019-0406Mohamed MR, Ramsdale E, Loh KP, et al. Associations of Polypharmacy and Inappropriate Medications with Adverse Outcomes in Older Adults with Cancer: A Systematic Review and Meta-Analysis. Oncologist. 2020;25(1):e94-e108. doi: https://doi.org/10.1634/theoncologist.2019-0406Procidano ME, Heller K. Measures of perceived social support from friends and from family: three validation studies. Am J Community Psychol. 1983;11(1):1-24. doi: https://doi.org/10.1007/BF00898416Procidano ME, Heller K. Measures of perceived social support from friends and from family: three validation studies. Am J Community Psychol. 1983;11(1):1-24. doi: https://doi.org/10.1007/BF00898416Al-Qazaz HKh, Hassali MA, Shafie AA, Sulaiman SA, Sundram S, Morisky DE. The eight-item Morisky Medication Adherence Scale MMAS: translation and validation of the Malaysian version. Diabetes Res Clin Pract. 2010;90(2):216-221. doi: https://doi.org/10.1016/j.diabres.2010.08.012Al-Qazaz HKh, Hassali MA, Shafie AA, Sulaiman SA, Sundram S, Morisky DE. The eight-item Morisky Medication Adherence Scale MMAS: translation and validation of the Malaysian version. Diabetes Res Clin Pract. 2010;90(2):216-221. doi: https://doi.org/10.1016/j.diabres.2010.08.012Bekalu AF, Yenit MK, Tekile MT, Birarra MK. Medication-related burden and associated factors among diabetes mellitus patients at Felege Hiwot Comprehensive Specialized Hospital in northwest Ethiopia. Front Clin Diabetes Healthc. 2022;3:977216. doi: https://doi.org/10.3389/fcdhc.2022.977216Bekalu AF, Yenit MK, Tekile MT, Birarra MK. Medication-related burden and associated factors among diabetes mellitus patients at Felege Hiwot Comprehensive Specialized Hospital in northwest Ethiopia. Front Clin Diabetes Healthc. 2022;3:977216. doi: https://doi.org/10.3389/fcdhc.2022.977216Abhilash, Dsouza DJ, S S, et al. Factors influencing adherence towards oral hypoglycaemic agents- A cross-sectional study among patients with Type II Diabetes Mellitus. Diabetes Epidemiology and Management. 2023;12:100163. doi: https://doi.org/10.1016/j.deman.2023.100163Abhilash, Dsouza DJ, S S, et al. Factors influencing adherence towards oral hypoglycaemic agents- A cross-sectional study among patients with Type II Diabetes Mellitus. Diabetes Epidemiology and Management. 2023;12:100163. doi: https://doi.org/10.1016/j.deman.2023.100163Huber CA, Reich O. Medication adherence in patients with diabetes mellitus: does physician drug dispensing enhance quality of care? Evidence from a large health claims database in Switzerland. Patient Prefer Adherence. 2016;10:1803-1809. doi: https://doi.org/10.2147/PPA.S115425Huber CA, Reich O. Medication adherence in patients with diabetes mellitus: does physician drug dispensing enhance quality of care? Evidence from a large health claims database in Switzerland. Patient Prefer Adherence. 2016;10:1803-1809. doi: https://doi.org/10.2147/PPA.S115425Cho SJ, Kim J. Factors associated with nonadherence to antihypertensive medication. Nurs Health Sci. 2014;16(4):461-467. doi: https://doi.org/10.1111/nhs.12145Cho SJ, Kim J. Factors associated with nonadherence to antihypertensive medication. Nurs Health Sci. 2014;16(4):461-467. doi: https://doi.org/10.1111/nhs.12145Aravindakshan R, Abraham SB, Aiyappan R. Medication Adherence to Oral Hypoglycemic Drugs among Individuals with Type 2 Diabetes Mellitus - A Community Study. Indian J Community Med. 2021;46(3):503-507. doi: https://doi.org/10.4103/ijcm.IJCM_985_20Aravindakshan R, Abraham SB, Aiyappan R. Medication Adherence to Oral Hypoglycemic Drugs among Individuals with Type 2 Diabetes Mellitus - A Community Study. Indian J Community Med. 2021;46(3):503-507. doi: https://doi.org/10.4103/ijcm.IJCM_985_20Alqarni AM, Alrahbeni T, Qarni AA, Qarni HMA. Adherence to diabetes medication among diabetic patients in the Bisha governorate of Saudi Arabia - a cross-sectional survey [published correction appears in Patient Prefer Adherence. 2019 Feb 08;13:249. doi: https://doi.org/10.2147/PPA.S201661.]. Patient Prefer Adherence. 2018;13:63-71. doi: https://doi.org/10.2147/PPA.S176355Alqarni AM, Alrahbeni T, Qarni AA, Qarni HMA. Adherence to diabetes medication among diabetic patients in the Bisha governorate of Saudi Arabia - a cross-sectional survey [published correction appears in Patient Prefer Adherence. 2019 Feb 08;13:249. doi: https://doi.org/10.2147/PPA.S201661.]. Patient Prefer Adherence. 2018;13:63-71. doi: https://doi.org/10.2147/PPA.S176355Setiadi. Konsep & Proses Keperawatan Keluarga. Graha Ilmu; 2008.Setiadi. Konsep & Proses Keperawatan Keluarga. Graha Ilmu; 2008.Arifin, SD. Hubungan Dukungan Keluarga dengan Kepatuhan Diet Diabetes Melitus Tipe 2 di Poli Penyakit Dalam RSUP Dr. Soeradji Tirtonegoro Klaten. Jurnal Keperawatan Respati Yogyakarta. 2015;2(2):1–18.Arifin, SD. Hubungan Dukungan Keluarga dengan Kepatuhan Diet Diabetes Melitus Tipe 2 di Poli Penyakit Dalam RSUP Dr. Soeradji Tirtonegoro Klaten. Jurnal Keperawatan Respati Yogyakarta. 2015;2(2):1–18.Friedman MM, Bowden VR, Jones EG. Buku Ajar Keperawatan Keluarga: Riset, Teori & Praktik. 5th ed. EGC; 2014.Friedman MM, Bowden VR, Jones EG. Buku Ajar Keperawatan Keluarga: Riset, Teori & Praktik. 5th ed. EGC; 2014.Sarafino EP. Edward. Health Psychology Biopsychology Interaction. Third Edition. John Willey and Sans; 2014.Sarafino EP. Edward. Health Psychology Biopsychology Interaction. Third Edition. John Willey and Sans; 2014.Anggraeni R. Hubungan Dukungan Keluarga dengan Kepatuhan Minum Obat Pasien DM di Poli Penyakit Dalam RSUD. R. Syamsudin, S.H. Kota Sukabumi. Journal Health Society. 2021;11(1):133-138. doi: https://doi.org/10.62094/jhs.v11i1.43Anggraeni R. Hubungan Dukungan Keluarga dengan Kepatuhan Minum Obat Pasien DM di Poli Penyakit Dalam RSUD. R. Syamsudin, S.H. Kota Sukabumi. Journal Health Society. 2021;11(1):133-138. doi: https://doi.org/10.62094/jhs.v11i1.43

The authors declare that there are no conflicts of interest present.