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

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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