Hubungan Kepatuhan Penggunaan Obat Anti Epilepsi terhadap Kejadian Kejang Pasien Epilepsi menggunakan kuesioner ARMS (Adherence Refill Medication Scale)
DOI:
https://doi.org/10.53342/pharmasci.v4i1.128Abstract
ABSTRAK
Epilepsi termasuk penyakit kronis otak yang dikarakterisasi dengan kejang berulang (2 kali atau lebih), dimana terjadi gerakan involunter yang melibatkan sebagian tubuh (partial) atau seluruh tubuh (generale), dan seringkali disertai dengan hilangnya kesadaran dan kontrol fungsi saluran cerna atau saluran kemih. Pengobatan epeilepsi sering menggunakan OAE (Obat AntiEpilpsi). Diketahui 70% anak-anak dan dewasa dengan epilepsi berhasil diterapi dengan obat antiepilepsi. Salah satu ukuran manajemen terapi obat pada penyakit epilepsi adalah menurun atau hilangnya kejang, sehingga adanya kejadian kejang menjadi salah satu ukuran pencapaian end outcome. Kejadian kejang dipengaruhi oleh beberapa faktor diantaranya ada tidaknya faktor pemicu kejang dan kepatuhan konsumsi obat antiepilepsi. Penelitian ini merupakan penelitian observasional cross sectional yang dilakukan di poli neurologi Instalasi Rawat Jalan RSUD dr. Soetomo dan Instalasi rawat Jalan RS Universitas Airlangga. Selama penelitian diperoleh 52 pasien epilepsi yang menggunakan obat antiepilepsi. Pada
penelitian ini diamati hubungan kepatuhan terhadap adanya kejang pasien epilepsi dalam penggunaan obat anti epilepsi. Pada penelitian ini diketahui nilai koefisien korelasi/ nilai rho (r) sebesar -0,348 dengan nilai p= 0,011 (p<0,05) atau signifikan secara statistik. Hasil tersebut menunjukkan adanya hubungan antara kategori kepatuhan (menggunakan kuesioner ARMS) dengan kejadian kejang, dimana semakin tinggi skor ARMS (dianggap semakin tidak patuh) berbanding lurus dengan peningkatan kejang.
Kata kunci: Epilepsi, Kepatuhan, OAE, Kejang, ARMS
Epilepsy is a chronic brain disease characterized by recurrent seizures (2 times or more), in which involuntary movements involve part of the body (partial) or whole body (general). Treatment of epilepsy uses antiepileptic drugs. It is known that 70% of children and adults with epilepsy are successfully treated with antiepileptic drugs. One of measurements of drug therapy management in epilepsy is decreasing or losing seizures, so that the event of seizures is one measure of end outcomes. Seizure events are influenced by several
factors including the presence or absence of seizure trigger factors and adherence with the consumption of antiepileptic drugs. This study was an observational cross sectional study conducted at the neurology department dr. Soetomo and Airlangga University hospital. This study aims to observe the relationship of adherence of antiepileptic drug consumption with seizures of epilepsy patients. This study observed 52
outpatients with epilepsy taking antiepileptic drugs. This study showed that the correlation coefficient / rho value (r) is -0,348 with a value of p = 0.011 (p <0.05). These results indicate that an association between adherence categories (using the arms questionnaire) with the events of seizures, whereas the higher of the arms score (considered to be increasingly disobedient) is directly proportional to the increase in seizures.
Keywords: Epilepsy, Adherence, AED, Seizure, ARMS
References
Leach JP, Davenport RJ. Neurological Disease. Dalam : Walker BR, Colledge NR, Ralston SH, Penman ID, (Ed.), Davidson’s Principles & Practice of Medicine Edisi ke-2. London : Churchill Livingstone Elsevier; 2014.
Aminoff M Douglas V. Nervous System Disorders. Dalam: Papadakis MA, McPhee SJ, Rabow MW, (Ed.), Current
Medical Diagnosis & Treatment Edisi ke-56. New York : McGraw Hill
Education; 2017
World Health Organization. Epilepsy [diunduh tanggal 4 April 2018]. Tersedia dari:www.who.int/mediacentre/factsheets/ fs999/en. 4
Lowenstein DH. Seizures and Epilepsi. Dalam: Hauser SL. Harrison’s Neurology in Clinical Medicine Edisi ke-4. New York: McGraw-Hill Education; 2017.
Widyati, Soediatmoko, Ikawati Z, Hakim L. Dampak Positif Pelayanan Farmasi Klinik Pada Pasien Epilepsi. Jurnal Manajemen dan Pelayanan Farmasi, 2013: 3(3): 217-222.
Hovinga CA, Asato MR, Manjunath R, Wheles JW, Phelps SJ, Sheth RD. Association of non-adherence to antiepileptic drugs and seizures, quality of life, and productivity: survey of patients with epilepsy and physicians. Epilepsy Behav.2008: 13(2):316–22.
Paschal AM, Hawley SR, Romain TS, Ablah E. Measures of adherence to epilepsy treatment: Review of present practices
and recommendations for future directions. Epilepsia. 2008: 49(7):1115–22.
Kripalani SJ, Gatti ME, Jacobson TA. Development and Evaluation of the Adherence to Refill and Medication Scale (ARMS) among Low –Literacy Patients with Cronich Disease. Value
Disease. 2009: 12 (1): 118-123.
Culig, Leppee M. From Morisky to HillBone, self-report scale for measuring adherence to medication. Collegium Antropologicum. 2004: 38 (1): 55-62.
Pratiwi PI. Kepatuhan Penggunaan Obat Pada Pasien Lansia dengan Penyakit Kronis (skripsi). Surabaya: FakultasFarmasi Universitas Airlangga; 2016.
Al Al-aqeel S, Al-sabhan J. Hiligsmann M. Strategies for improving adherence to antiepileptic drug treatmentin people
withepilepsy. Cochrane Database of Systematic Review. 2017: 2:CD008312.
Rasheva M, Staikov I, Svinarov D, Mihnev N, Neykov N, Staneva M. Low Serum Levels of Antiepileptic Drugs in Patients with Epilepsy-Bad Compliance or Something Else?. Austin J Clin Neurol. 2015: 2(10): 1083;
Rogers SJ, Cavazos JE. Epilepsy. Dalam: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. (Ed.). Pharmacotherapy A Pathophysiologic Approach Edisi ke-8. New York : the McGraw-Hill Companies, Inc; 2011.
Manjunath R, Davis KL, Candrilli SD, Ettinger AB. Association of antiepileptic drug nonadherence with risk of seizure in adults with epilepsy. Epilepsy Behaviour. 2009 :14(2): 372-8.
Ferrari CM, De Sousa RM, Castro LH. Factors associated with treatment nonadherence in patients with epilepsy in Brazil. Seizure.2003: 22(5): 384–89.
