Analisis Outcome Klinis Berdasarkan Kualitas Hidup dan Biaya Medik Langsung Pasien Diabetes Melitus Tipe 2

Pande Made Desy Ratnasari, Tri Murti Andayani, Dwi Endarti

Abstrak


Diabetes Melitus (DM) tipe 2 merupakan penyakit kronis yang membutuhkan terapi untuk mengontrol glukosa darah. Pengontrolan glukosa darah yang buruk berdampak pada penurunan kualitas hidup dan peningkatan biaya. Tujuan penelitian adalah menganalisis perbedaan outcome klinis yaitu kadar Glukosa Darah Sewaktu (GDS) selama 3 bulan berdasarkan kualitas hidup dan biaya medis langsung. Outcome klinis dikatakan terkontrol apabila GDS <200 mg/dL dan tidak terkontrol apabila GDS ≥200 mg/dL. Rancangan penelitian ini adalah cross sectional dengan jenis observasional. Kriteria inklusi mencakup pasien DM tipe 2 yang memperoleh antidiabetik yang sama minimal 3 bulan di Instalasi Rawat Jalan RSUD Panembahan Senopati Bantul pada September 2017. Kriteria eksklusi meliputi kondisi hamil atau menyusui. Pengambilan data dilakukan melalui pengisian kuesioner, rekam medis dan bagian keuangan. Data demografi dianalisis secara deskriptif sedangkan outcome klinis diolah menggunakan uji Kruskal Wallis. Hasil penelitian menunjukkan sebanyak 129 dari 200 pasien menunjukkan outcome klinis tidak terkontrol (64,5%) dengan rata-rata nilai kualitas hidup yang baik (65,7±7,7) serta mengeluarkan biaya medis langsung sebesar Rp 489.005. Terdapat perbedaan outcome klinis berdasarkan kualitas hidup (p=0,000) pada domain fungsi fisik (p=0,034), kepuasan pribadi (p=0,000), kepuasan pengobatan (p=0,000) dan frekuensi gejala penyakit (p=0,012) serta berdasarkan biaya medis langsung (p=0,012). Pasien dengan outcome klinis terkontrol menunjukkan kualitas hidup yang lebih tinggi dan mengeluarkan biaya lebih rendah.

Kata Kunci


diabetes melitus; DM tipe 2; outcome klinis; kualitas hidup; biaya medis langsung,

Teks Lengkap:

PDF

Referensi


Rwegerera GM, Moshomo T, Gaenamong M, Aderonke T, Gollakota S, Piña Y, et al. Health-related quality of life and associated factors among patients with diabetes mellitus in Botswana. Alexandria J Med. 2017;54(2):111–8. https://doi.org/10.1016/j.ajme.2017.05.010

Kaiser A, Zhang N, Pluijm W. Global Prevalence of Type 2 Diabetes over the Next Ten Years (2018-2028). Diabetes. 2018;67(1):202. https://doi.org/10.2337/db18-202-LB

Amelia R, Lelo A, Lindarto D, Mutiara E. Quality of life and glycemic profile of type 2 diabetes mellitus patients of Indonesian : a descriptive study. IOP Conf Ser Earth Environ Sci 125. 2018;125:1–5. https://doi.org/10.1088/1755-1315/125/1/012171/

Gebremedhin T, Workicho A, Angaw DA. Health-related quality of life and its associated factors among adult patients with type II diabetes attending Mizan Tepi University Teaching Hospital , Southwest Ethiopia. BMJ Open Diab Res Care. 2019;7: e000577. https://dx.doi. org/10.1136/bmjdrc-2018-000577

Soelistijo S, Novida H, Rudijanto A, Soewondo P, Suastika K, Manaf A. Konsensus Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Di Indonesia 2015. Pengurus Besar Perkumpulan Endokrinologi Indonesia (PB PERKENI); 2015.

Bakris G, Blonde L, Boulton A, de Groot M, Greene E, Henry R, et al. Standards of Medical Care In Diabetes 2017. J Clin Apllied Res Educ. 2017;41(1):1–150.

Umpierrez E. Glycemic Variability: How to Measure and Its Clinical Implication for Type 2 Diabetes. Am J Med Sci. 2018;356(6): 518–27. https://doi.org/10.1016/j.amjms.2018.09.010

Adriaanse MC, Drewes HW, Heide I Van Der. The impact of comorbid chronic conditions on quality of life in type 2 diabetes patients. Qual Life Res. 2016;25(1):175–82. https://doi.org/10.1007/s11136- 015-1061-0

Mehta R, Subedi S, Bohora S. Health Related Quality of Life of Diabetic Patients Visited In Koshi Zonal Hospital, Biratnagar. J Chitwan Med Coll. 2014;4(9):13–6. https://doi.org/10.3126/jcmc.v4i3.11933

Mishra SR, Sharma A, Bhandari PM, Bhochhibhoya S. Depression and Health-Related Quality of Life among Patients with Type 2 Diabetes Mellitus : A Cross-Sectional Study in Nepal. PLoS One. 2015;74:1–13. https://10.1371/journal.pone.0141385

Perwitasari DA, Adikusuma W, Rikifani S, Supadmi W. Quality of Life and Adherence of Diabetic Patients in Different Treatment Regimens Kualitas Hidup dan Kepatuhan Pasien Diabetes Melitus dengan Pengobatan yang Berbeda. Indones J Clin Pharm. 2014;3(4):107–13. https://doi.org/10.15416/ijcp.2014.3.4.107

Adikusuma W, Perwitasari D, Supadmi W. Pengukuran Kualitas Hidup Pasien Diabetes Melitus Tipe 2 yang Mendapat Antidiabetik Oral Di Rumah Sakit PKU Muhammadiyah Bantul Yogyakarta. J Ilm Ibnu Sina. 2016;1(1):1–8. https://doi.org/10.36387/jiis.v1i1.23

Rokhmah FD, Handayani D, Al-rasyid H. Korelasi lingkar pinggang dan rasio lingkar pinggang-panggul terhadap kadar glukosa plasma menggunakan tes toleransi glukosa oral. J Gizi Klin Indones. 2015;12(1):28–35. https://doi.org/10.22146/ijcn.22425

Banerji MA, Dunn JD. Impact of Glycemic Control on Healthcare Resource Utilization and Costs of Type 2 Diabetes : Current and Future Pharmacologic Approaches to Improving Outcomes. Am Heal Drug Benefits l. 2013;6(7):382–92.

American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033–46. https://doi. org/10.2337/dc12-2625

Lum ZK, Tsou KYK, Lee JY. Research : Care Delivery Mediators of medication adherence and glycaemic control and their implications for direct outpatient medical costs : a cross-sectional study. Diabet Med. 2018;807–15. https://doi.org/10.1111/dme.13619

Almutairi N, Alkharfy KM. Direct Medical Cost and Glycemic Control in Type 2 Diabetic Saudi Patients. Appl Heal Econ Heal Policy. 2013;11:671–5. https://doi.org/10.1007/s40258-013 0065-6

Shen W, Kotsanos JG, Huster WJ, Mathias SD, Andrejasich CM, Patrick DL. Development and validation of the diabetes quality of life clinical trial questionnaire. Med Care. 1999;37(4):AS45–66.

. Hartati T. Kualitas Hidup Penderita DM Tipe 2: Perbandingan Antara Penderita Kadar Gula Darah Terkendali dan Tidak Terkendali [tesis]. Program Pascasarjana, Universitas Gadjah Mada, Yogyakarta; 2003.

. Kamuhabwa A, Charles E. Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam. Drug Healthc Patient Saf. 2014;6:155–65. https://doi.org/10.2147/ DHPS.S68786

Manicardi V, Rossi MC, Romeo EL, Giandalia A, Calabrese M, Cimino E, et al. Gender differences in type 2 diabetes (Italy). Ital J Gender-Specifi C Med. 2016;2(2):60–8. https://doi.org/10.1723/2446.25646

Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev. 2016;37(3):278–316. https://doi.org/10.1210/ er.2015-1137

Bhalerao S, Somannavar M, Vernekar S, Rajashree R, Goudar S. Risk factors for type 2 diabetes mellitus in rural population of North Karnataka: A community-based cross-sectional study. Int J Pharm Med Bio Sc 2014. 2014;3(1):1–17.

Lopez JMS, Bailey RA, Rupnow MFT, Annunziata K. Characterization of Type 2 Diabetes Mellitus Burden by Age and Ethnic Groups Based on a Nationwide Survey. Clin Ther. 2014;36(4):494–506. https://doi. org/10.1016/j.clinthera.2013.12.016

Zoungas S, Woodward M, Li Q, Cooper ME, Hamet P, Harrap S, et al. Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes. Diabetologia. 2014;57:2465–74. https://doi. org/10.1007/s00125-014-3369-7

Zibaeenezhad MJ, Aghasadeghi K, Bagheri FZ, Khalesi E. The Effect of Educational Interventions on Glycemic Control in Patients with Type 2 Diabetes Mellitus. Int Cardiovasc Res J. 2015;9(5):17–21. https:// doi.org/10.18203/2394-6040.ijcmph20150487

Persaud H, Williams S. Occupational Stress and Increased Risk for Type 2-Diabetes : A Narrative Review. J Complement Med Altern Healthc. 2017;2(5): 555599. https://doi.org/10.19080/JCMAH.2017.02.555599

Natasya A, Andrajati R, Sauriasari R. Cross-Sectional Study of Association Between Glycemic Control and Quality of Life Among Diabetic Patients. Int J App Pharm. 2018;10(1):92–6. https://doi.org/10.22159/ijap.2018.v10s1.19

Harahap A, Nasution M. Comparison quality of life patients treated with insulin and oral hypoglycemic drugs Comparison quality of life patients treated with insulin and oral hypoglycemic drugs. IOP Conf Ser Earth Environ Sci. 2018;125:012166. https://doi.org/10.1088/1755-1315/125/1/012166

Prajapati VB, Blake R, Acharya LD, Seshadri S. Assessment of quality of life in type II diabetic patients using the modified diabetes quality of life (MDQoL)-17 questionnaire. Brazilian J Pharm Sci. 2015;53(4):1–9. https://doi.org/10.1590/s2175-97902017000417144

Saleh N, Alwahedi Z, Taher M, Mostafa A, Hashim M, Almahdi H. Primary Health Care: Open Access Quality of Life Predictors and Glycemic Control among Type 2 Diabetic Patients Attending Primary Health Care Centers in Qatar. Prim Heal Care. 2016;6(2):1000222. https://doi.org/ 10.4172/2167-1079.1000222

Maniarasu K, Muthunarayanan L. Prevalence of Certain Chronic Complications of Diabetes among Type 2 Diabetic Patients in Rural Population of Kancheepuram District, Tamil Nadu-A Cross Sectional Study. Int J Med Public Heal. 2017;7(1):41–6. https://doi.org/10.5530/ijmedph.2017.1.7

Sepulveda E, Poínhos R, Pais-ribeiro J, Freitas P, Carvalho D. Health-related quality of life in type 1 and type 2 diabetic patients in a Portuguese central public hospital. Diabetes Metab Syndr Obes. 2015;8:219–26. https://doi.org/10.2147/DMSO.S80472

Bene BA, Connor SO, Mastellos N, Majeed A, Fadahunsi KP, Donoghue JO. Impact of mobile health applications on self-management in patients with type 2 diabetes mellitus : protocol of a systematic review. BMJ Open. 2019;9: e025714. https://doi.org/10.1136/bmjopen-2018-025714

Briganti C, Silva M, de Almeida J, de Cássia C. Association between diabetes mellitus and depressive symptoms in the Brazilian population. Rev Saude Publica. 2019;53:5. https://doi.org/10.11606/S1518-8787.2019053000608

Feng X, Astell-burt T. Impact of a type 2 diabetes diagnosis on mental health, quality of life, and social contacts : a longitudinal study. BMJ Open Diabetes Res Care. 2017;5: e000198. https://doi.org/10.1136/bmjdrc-2016-000198

Imran S, Agarwal G, Harpreet S, Ross S. Targets for Glycemic Control: Diabetes Canada Clinical Practice Guidelines Expert Committee. Can J Diabetes. 2018;42(Suppl 1):S42–6. https://doi.org/10.1016/j.jcjd.2017.10.030

Wu Y, Ding Y, Tanaka Y, Zhang W. Risk Factors Contributing to Type 2 Diabetes and Recent Advances in the Treatment and Prevention. Int J Med. 2014;11(11):1185–200. https://doi.org/ 10.7150/ijms.10001

Doneva M, Valov V, Borisova A, Tankova T, Savova A, Manova M, et al. Comparative Analysis of the Cost of Insulin Treated Patients in Bulgaria. Biotechnol Biotechnol Equip. 2014;27(2):3748–52. https://doi.org/10.5504/BBEQ.2013.0001

Henriques RS. Direct Costs of Type 2 Diabetes : A Brazilian Cost of Illness Study. Int J Technol Assess Health Care. 2018;34(2):180–8. https://doi.org/10.1017/S026646231800017X

Ulrich S, Holle R, Wacker M, Stark R, Icks A, Thorand B, et al. Cost burden of type 2 diabetes in Germany: results from the population-based KORA studies. BMJ Open. 2016;6(11):e012527. https://doi.org/10.1136/bmjopen-2016-012527

Cases M, Sanchez B, Mauricio D, Real J, Vlacho B, Nadal J, et al. The Association Between Poor Glycemic Control and Health Care Costs in People With Diabetes : A Population-Based Study. Diabetes Care. 2020;43(4):751–8. https://doi.org/10.2337/dc19-0573

Mosleh R, Aziz N, Ali S, Manan M, Zyoud S. Drug utilization pattern and predictors of costs among patients with type II diabetes in Palestine. Palest Med Pharm J. 2017;2(2):93–112.

Malhan S, Öksüz E, Babineaux SM, Ertekin A, Palmer JP. Assessment of the Direct Medical Costs of Type 2 Diabetes Mellitus and its Complications in Turkey Türkiye ’ de Tip 2 Diabetes Mellitus ve Komplikasyonlarının Doğrudan Tıbbi Maliyetine İlişkin Değerlendirme. 2014;18(2):39–43.

Javanbakht M, Baradaran HR, Mashayekhi A, Haghdoost AA, Khamseh ME, Kharazmi E, et al. Cost of Illness Analysis of Type 2 Diabetes Mellitus in Iran. Song Y, editor. PLoS One. 2011;6(10): e26864. https://doi.org/10.1371/journal.pone.0026864

Amissah I, Dunyah JD. The Direct Costs of type 2 Diabetes Mellitus Outpatient care in the Ghanaian Public Health System : A Case of the Cape Coast Teaching Hospital. Int J Sci Res. 2016;5(6):1089–93. https://doi.org/10.21275/v5i6.NOV164322

Meyers JL, Parasuraman S, Bell KF, Graham JP, Candrilli SD. The highcost, type 2 diabetes mellitus patient : an analysis of managed care administrative data. Arch Public Heal. 2014;72(1):6. https://doi.org/10.1186/2049-3258-72-6

Amalia, Andayani T, Yuniarti E. Hubungan Komplikasi Diabetes Melitus Terhadap Biaya. J Manaj dan Pelayanan Farm. 2015;5(3):159–70. https://doi.org/10.22146/jmpf.227




DOI: https://doi.org/10.25077/jsfk.7.1.15-22.2020

Article Metrics

Abstract view : 38 times
PDF view/download : 30 times



Jurnal Sains Farmasi & Klinis (J Sains Farm Klin) | p-ISSN: 2407-7062 | e-ISSN: 2442-5435

Diterbitkan oleh Fakultas Farmasi Universitas Andalas bekerjasama dengan Ikatan Apoteker Indonesia - Daerah Sumatera Barat 

       

 JSFK is licensed under Creative Commons Attribution-ShareAlike 4.0 International License.