Path Analysis on the Determinants of Adherence to Anti Tuberculosis Drug Treatment in Kaur District, Bengkulu, Indonesia

Surahman Hamidi, Setyo Sri Raharjo, Mahendra Wijaya

Abstract

Background: Drug treatment compliance was the behavior of patients to take medication and undergo treatment according to the rules determined by professional health personnels. Many factors influenced the compliance with treatment for tuberculosis patients. This study aimed to examine determinants of drug treatment compliance among tuberculosis patients.

Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted at 16 community health centers in Kaur Regency, Bengkulu, Indonesia, from January to February 2019. A sample of 206 study subjects was selected by purposive sampling. The dependent variable was drug treatment adherence. The indepen­dent variables were age, gender, education, income, knowledge, role of drug taking supervisor, side effect of drug treatment, distance to health service, drug availability, family support, and tenure. The data were collected by questionnaire and analyzed by path analysis.

Results: Adherence to anti tuberculosis treatment was directly and positively affected by age (b= 2.96; CI 95%= 1.12 to 4.79; p= 0.002), gender (b= 1.48; CI 95%= 0.02 to 2.95; p= 0.047), education (b= 2.18; CI 95%= 0.24 to 4.11; p= 0.027), income (b= 0.85; CI 95%= 0.76 to 2.45; p= 0.031), knowledge (b= 2.27; CI 95%= 0.32 to 4.22; p= 0.023), the role of drug taking supervisor (b= 3.46; CI 95%= 1.57 to 5.36; p<0.001), drug availability (b= 0.04; CI 95%= -6.07 to 6.16; p= 0.989), and family support (b= 2.97; CI 95%= 1.30 to 4.64; p<0.001). It was negatively affected by the side effects of the drug (b= -3.07; CI 95%= -4.90 to -1.24; p= 0.001), distance to health service (b= -1.86; CI 95%= -3.61 to -0.11; p= 0.037), and tenure (b= -2.16; CI 95%= -3.95 to -0.38; p= 0.017). Adherence to anti tuberculosis treatment was indirectly affected by income, knowledge, and role of drug treatment supervisor.

Conclusion: Adherence to anti tuberculosis treatment is directly and positively affected by age, gender, education, income, knowledge, the role of drug taking supervisor, drug availability, and family support. It is negatively affected by the side effects of the drug, distance to health service, and tenure.

Keywords : treatment adherence, tuberculosis, determinants, path analysis

Correspondence: Surahman Hamidi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: surahmanhamidi@student.uns.ac.id. Mobile: 085267­456713.

Journal of Epidemiology and Public Health (2019), 4(3): 205-214
https://doi.org/10.26911/jepublichealth.2019.04.03.08

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References

Adane K, Spight M, Johanna L, Noortje D, Abera FA, Dinant GJ (2017). Tuberkulosis knowledge, attitudes, and practise among Northren Prisoners: Implication For TB Control Efforts. Plos One. 12(3): e0174692. http://doi.org/10.1371/journal

Ariani NW, Rattu AJM, Ratag B (2015). Faktor-faktor yang berhubungan dengan keteraturan minum obat penderita tuberkulosis paru di wilayah kerja Puskesmas Madayang, Kabupaten Dolaang Mangandow Timur. JIKMU. 5(1). www.ejournal.unsrat.ac.id.

Ariyani H (2016). Hubungan tingkat pengetahuan dengan kepatuhan pada pengobatan penderita tuberkulosis paru di puskesmas Pekauman Kota Banjarmasin. Jurnal Pharma Science, 03(02).

Boru CG, Shimels T, Bilal AI (2017). Factor contributing to non adherence with treatment among tb patients in Sodo Woreda, Soutern Ethiophia: A Qualitative Study. Journal Of Infection and Public Health: 10: 527 533. http://elsevier.com/docate.ijrph.

Dinkes Kabupaten Kaur (2018). Profil kesehatan kabupaten Kaur Tahun 2017. Bintuhan: Dinas Kesehatan Kabupaten Kaur.

Dinkes Provinsi Bengkulu (2018). Profil kesehatan provinsi Bengkulu Kaur Tahun 2017. Bengkulu: Dinas Kesehatan Provinsi Bengkulu.

Friedmen (1998). Keperawatan Keluarga. Jakrta: EGC

Green LW, Kreuter MW (2000). Health promotion planning; An educational and enviromental approach, second edition. London: Mayfield Publishing Company.

Gunawan AR, Simbolon RL, Fauzia D (2017). Faktor-faktor yang mempengaruhi tingkat kepatuhan pasien terhadap pengobatan tuberkulosis Paru di Lima Puskesmas Se-Kota Pekanbaru. JOM FK: 4 (2).

Kemenkes RI (2014). Pedoman Nasional Pengendalian Tuberkulosis. Jakarta: Kementerian Kesehatan RI.

_____ (2018). Profil Kesehatan Indonesia 2017. Jakarta: Kementerian Kesehatan RI.

Kisambu J, Nuwaha F, Sekandi JN (2014). Adherence to treatment and supervision for tuberkulosis in a DOTS programme among postoralists in Uganda. International Journal Tuberkulosis Disease 18(7): 799-853 http://dx.doi.org/10.538/ijtld.13.0753

Alfiyani L, Demartoto A, Murti B (2017). Biopsychosocial determinants of multi drug resistant tuberculosis in Surakarta, 2(3): 255-266. http://doi.org/10.26911/jepublichealth.2017.02.03.07

Kondoy, Priska PH (2014). Faktor-faktor yang berhubungan dengan kepatuhan berobat pasien tuberkulosis paru di Lima Puskesmas di Kota Manado. Jurnal Kedokteran Komunitas dan Topika: 15 (1)

Mokennen HS, Azagew AW (2018). Non-adherence to anti-tuberkulosis treatment, reason and associated factors among TB patients attending at Gondar Town Health Centers, North-west Ethiopia. BMC Research Notes 11: 691. https://doi.org/10.1186/s13-1040183789-4

Murti B (2018). Prinsip dan Metode Riset Epidemiologi Edisi ke Empat. Surakarta: Program Pasca Sarjana, Universitas Sebelas Maret.

Notoatmodjo S (2003). Pendidikan dan perilaku kesehatan. Rineka Cipta. Jakarta.

Nursalam (2008). Konsep dan penerapan metodologi penelitian keperawatan. Jakarta: Info medika

Osterberg L, Blaschke T (2005). Adherence to Medication. N. Engl. J. Med, 353, 487-497.

Puspitasari L, Murti B, Demartoto, A (2016). Social support on the adherence to treatment of tuberculosis in Cilacap, Indonesia. Journal of Epidemiology and Public Health, 1(1): 58-65. http://doi.org/jepublichealth.2016.01.01.07

Vera, Rahardjo SS, Murti B (2017). Health belief model and PRECEDE PROCEED on the risk factors of multidrug resistant tuberculosis in Surakarta, Central Java, 2(3): 241-254. http://doi.org/10.26911/jepublichealth.2017.02.03.06

WHO (2013). Adherence To Long - Term Therapies: Evidence For Action. Geneva.

_____ (2017). Global Tuberkulosis Report 2016. Geneva.

_____ (2018). Global Tuberkulosis Report 2017. Geneva: World Health Organization

Wulandari DH (2015). Analisis faktor-faktor yang berhubungan dengan kepatuhan pasien tuberkulosis dari tahap untuk minum obat di RS Rumah Sehat Terpadu Tahun 2015. Jurnal Administrasi Rumah Sakit. 2(1): 17-28

Xu L, Gai R, Wang X, Liu Z, Cheng J, Zhou C, Liu J, Zhang H, Li H, Tang W (2010). Socioeconomic factors affecting the success of tuberkulosis treatment in six countries of Shandong Province, China. International Journal Tuberkulosis Lung Diseases 2010 (14): 440-446.

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