Overview of Medication Compliance in MDR-TB Patients in Jambi
Province
Puteri Paramita Ningrum, Melly Miranda, Wini Bertha and Endang Trianingsih
Faculty of Pharmacy, University of 17 August 1945, Jakarta 14350, Indonesia
Keywords: Compliance, MDR TB Drugs, MDR TB Disease.
Abstract: MDR-TB has become an obstacle to effective TB control; multidrug resistance (MDR-TB) is the biggest
problem in global TB prevention and elimination. Indonesia ranks 8th out of 27 countries with the most MDR-
TB in the world. MDR-TB is disease caused by _ Mycobacterium tuberculosis is minimally resistant to
rifampicin and isoniazid. because _ That in this research researchers try to see a picture of medication
adherence patient with MDR-TB in the province of Jambi and for know the influencing factors obedience
patient in consume medicine. Population and sample in this research is all over Multi Drug Resistance (MDR)
Tuberculosis patients in the MDR TB Polyclinic at Raden Mattaher Hospital, Jambi. The type of research
used is descriptive with a cross-sectional approach. A total of 19 patients interviewed using Mmas-8
questionnaire, obtained results as many as 26% of patients were treated return after failing in treatment, and
31.5% of patients treated because relapsed after finishing treatment, and 10% of patients not enough obedient
drink medicine. For health officer expected can give advice on tuberculosis about definition, symptoms,
methods of prevention, method of transmission and treatment, for patient patient diligent treatment in a way
regular and follow recommended instructions health officer.
1 INTRODUCTION
TB is an infectious disease caused by the bacterium
Mycobacterium tuberculosis. There are a number of
Mycobacterium species, including: M. tuberculosis,
M. africanum, M. bovis, M. leprae and so on. Mostly
these bacteria infect the lungs but can also affect other
organs of the body. Pulmonary TB is disease most
influential contagion as reason morbidity and
mortality, incl number incident in Indonesia.
Indonesia is one of the countries that it has the
greatest burden of TB among 5 countries, namely
India, Indonesia, China, Philippines and Pakistan
(Global Tuberculosis Report, 2017). Apart from that,
there is necessary challenge to get attention that is
increasing case of tuberculosis HIV, tuberculosis with
DM, tuberculosis in children and society susceptible
to others. This matter spur national TB control
continue to do
intensification, acceleration, extensification and
programme innovation. Indonesia has taken many
steps to control this disease, which causes disability
and death. One of these is directly observed
treatment, short-course (DOTS), developed by WHO
and IUALTD in the 1990s. DOTS is carried out
routinely and without interruption. When TB
treatment efforts are interrupted and do not meet
DOTS standards, cases of multiple resistance to anti-
TB drugs (OAT), namely rifampicin and isoniazid,
emerge. This has led to the emergence of new TB-
related problems, namely the double immunity of TB
bacteria to anti-TB drugs, or what is known as
multidrug-resistant tuberculosis (MDR TB).
The number of MDR-TB cases reported
worldwide in 2015 was 480,000 new cases, with an
estimated 250,000 deaths. In 2016, the number of
diagnosed MDR TB cases increased to 490,000 new
cases. It is estimated that 350,000 (330,000-370,000)
cases of MDR TB are TB patients. The highest
incidence of MDR-TB in 2016 was in South-East
Asia (45%) and the African region (25%).
This infectious disease can still be cured if the
patient receives regular treatment. Medication needs
to be taken under the supervision and with the support
of family members. If the treatment is not carried out
well, there is a possibility of relapse one day and the
tuberculosis bacteria will become resistant to the
drug. The duration of treatment, compliance and
regularity of treatment, motivation of the patient, lack
Ningrum, P., Miranda, M., Bertha, W. and Trianingsih, E.
Overview of Medication Compliance in MDR-TB Patients in Jambi Province.
DOI: 10.5220/0012641800003821
Paper published under CC license (CC BY-NC-ND 4.0)
In Proceedings of the 4th International Seminar and Call for Paper (ISCP UTA ’45 JAKARTA 2023), pages 191-193
ISBN: 978-989-758-691-0; ISSN: 2828-853X
Proceedings Copyright © 2024 by SCITEPRESS Science and Technology Publications, Lda.
191
of patient attitude towards treatment are several
factors that greatly influence the success of treatment.
Influence obedience to tuberculosis treatment can
be categorised as internal and external factors.
Internal factors are characteristics and perceptions
sufferer during undergo treatment. If desire for cured
reduce so perception about treatment tuberculosis
will react negatively so that obedience patient
tuberculosis experience irregularity schedule.
External factors is support as well as information
from health officer. Officer good health _ always
motivate patient For finish treatment in a way regular,
temporary lack of support family will cause regimen
wrong treatment can change compliance. Patient then
choose to stop drinking drug or drop out (drop out
medicine) no cured even resistant to treatment.
Patient separated drug can be dealt with with increase
invention case healing supported by all _ sector
development networking work to implement the
tuberculosis programme with good. The purpose of
study this introduction is For To identify influencing
factors_level obedience patient to treatment
tuberculosis.
2 RESEARCH METHODS
The type of research used is descriptive with a cross-
sectional approach. The population in this study were
all multi drug resistance (MDR) tuberculosis patients
in the MDR TB Polyclinic at Raden Mattaher
Hospital, Jambi. The samples in this study were all
Multi Drug Resistance (MDR) patients. Retrieval
technique sample used_ in this research is non-
probability sampling with purposive sampling,
samples used that is as much 19 people.
3 RESULTS AND DISCUSSION
According to the World Health Organization (WHO,
2011), there are about 500,000 cases of TB resistant
to isoniazid and rifampicin each year, with a death
rate of about 150,000, and about 10% of cases are
newly detected and treated. The Global Plan to Stop
Tuberculosis aims to treat approximately 1.6 million
MDR-TB patients worldwide between 2006 and
2015, with 60% of these patients in high-burden
countries, where the global prevalence of MDR-TB is
estimated to be 2-3 times higher than existing cases.
The number of MDR-TB patients receiving
treatment in Jambi province has continued to increase
since 2020. A total of 136 MDR-TB patients were
treated since 2020, of whom 16 died. In this study, a
total of 19 respondents were included in the inclusion
criteria, namely patients undergoing treatment at the
MDR-TB Polyclinic at Raden Mattaher Hospital
Jambi in the month of February to June in 2023, in
this study, where 12 respondents were included in the
adherent category and 7 respondents were non-
adherent, a total of 19 patients interviewed with
Mmas-8 questionnaire, obtained results as many as
26% of patients treated return after failing in
treatment, and 31. 5% of patients treated relapsed
after completing treatment, 90% of patients were
adherent and 10% of patients were not adherent.
The data shows that part of the large respondents
own level of obedience is high. Compliance level of
one of them is high can be influenced by existence
motivation. Motivation to increase awareness and
desire treatment sufferers are very influential to
success of TB treatment. Sometimes although
symptom disease start burdensome, however if the
sufferer no feel so sick, sufferer tend for no look for
treatment.
Results of the above research in line with the
results of research conducted by Reza Dhiyantari, et
al (2015), based on the answer respondents who have
researched received level obedience drink high drug
that is amounting to 86.67%. His height level
obedience treatment of respondents can be caused by
several factor supporters, such as medicines and
services given for free, central service easy health
accessible to the public as well as exists desire from
in self for recovery.
The above findings are also supported by the
findings of Sari, Yuniar, & Syaripuddin (2014), who
stated that the 92 patients who were respondents in
the study were still compliant in taking anti-
tuberculosis therapy, as evidenced by the fact that
they continued to take anti-tuberculosis therapy until
completion (for 6 months) and there was no leftover
medication every month. This is due to factors that do
not require external stimulation, which come from
within in the form of motivation, beliefs, attitudes and
personality of each respondent. Meanwhile, factors
that require external stimulation are social support in
the form of emotional support from other family
members or friends. Adherence to TB treatment is a
complex, dynamic phenomenon in which various
factors interact and influence behavioral choices. It is
therefore hoped that this study will provide
information that will help to reduce the level of non-
adherence to treatment among MDR-TB respondents.
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4 CONCLUSION
The results of this study showed that the incidence of
MDR-TB at Raden Mattaher Hospital Jambi was 19
respondents, of which 26% of patients were re-treated
after treatment failure and 31.5% of patients were
treated because of relapse after completion of
treatment. The compliance of MDR-TB respondents
is quite high with a result of 90%.
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