Pengaruh Sistem Pengingat Melalui Pengiriman Pesan Singkat (Text-Messaging Reminder System) untuk Meningkatkan Kepatuhan Pasien dalam Pengobatan Tuberkulosis: Tinjauan Kasus Berbasis Bukti
Abstract
Abstrak
Indonesia merupakan negara kedua di dunia dengan insidensi Tuberkulosis (TB) terbanyak setelah India, sehingga Indonesia termasuk high-burden country dalam penyakit TB. Angka keberhasilan pengobatan TB di Indonesia baru mencapai 84% pada tahun 2016 sehingga perlu ditingkatkan. Inovasi yang banyak dikembangkan untuk meningkatkan kepatuhan pasien dalam pengobatan TB adalah metode pengingat dengan menggunakan media elektronik, salah satunya melalui SMS mengingat pengguna aktif telepon genggam di Indonesia cukup banyak, yaitu mencapai 70,2 juta untuk smartphone pada tahun 2017 dan terus meningkat. Tujuannya untuk mengetahui pengaruh sistem pengingat melalui pesan singkat (text-messaging reminder system) dalam kepatuhan pasien terhadap pengobatan TB. Pencarian literatur dilakukan pada beberapa pangkalan data jurnal ilmiah kedokteran besar seperti Pubmed, Cochrane, EBSCOhost, dan Science Direct. Artikel disaring sesuai desain yang dibutuhkan untuk tinjauan intervensi, kriteria inklusi, dan kriteria eksklusi. Telaah kritis menggunakan metode intervensi sesuai Oxford Center for Evidence Based Medicine 2011. Telaah kritis dilakukan pada dua artikel terpilih dengan metode RCT dan telaah sistematis. Pada studi RCT terhadap 2207 pasien di Pakistan, diperoleh penggunaan sistem pengingat SMS tidak berpengaruh terhadap kepatuhan pengobatan TB. Pada telaah sistematis yang meninjau empat artikel, diperoleh kesimpulan bahwa sistem SMS mampu meningkatkan kepatuhan pengobatan TB. Namun, signifikansinya masih diragukan karena studi yang diinklusi merupakan studi dengan tingkatan bukti rendah berdasarkan kategori GRADE. Pengaruh metode pengingat berupa SMS terhadap kepatuhan pengobatan TB masih inkonklusif. Diperlukan penelitian lebih lanjut dengan populasi besar serta desain penelitian yang sesuai (RCT).
Kata kunci: Tuberkulosis, SMS, Sistem Pengingat, Kepatuhan, Pengobatan
Abstract
Indonesia ranked second in the world for its Tuberculosis (TB) incidence. Therefore, Indonesia is included in the list of high burden countries for TB. TB treatment success rate in Indonesia for 2016 is 84%, but this number still needs to be increased. Many innovations using electronic devices such as handphones are developed to increase patient’s adherence to TB treatment. One of the easiest applicable methods is through SMS. Indonesia is also a developing country with developing technology usage, with 70.2 million active smartphone users in 2017. To determine whether a text messaging reminder system can increase adherence in patients with Tuberculosis treatment. Literature searching was conducted in large medical journal databases such as Pubmed, Cochrane, EBSCOhost, and Science Direct. The articles are selected by considering the study designs that correlate with the intervention appraisal method, inclusions, and exclusions criteria. Intervention type appraisal was conducted using the guideline of the Oxford Center for Evidence-Based Medicine 2011. Appraisals were made for two chosen articles: one with the RCT method, and the other with a systematic review method. RCT study conducted in Pakistan showed that text messaging reminder system does not affect adherence in patients with TB treatment. The other study that reviews four articles concludes that a text messaging reminder system may increase adherence in TB patients undergoing treatment. But, the significance is still doubted as the studies included in this review are of low evidence level based on the GRADE category. The impact of the text messaging reminder system in increasing treatment adherence of TB patients is still inconclusive. Further research with a large population, better design and methodology are still needed.
Keywords: Tuberculosis, SMS, Text Messaging, Reminder System, Adherence, Treatment
References
K Dheda, Barry CE, Maartens G. Tuberculosis [Summary]. Lancet [Internet]. 2015 [diakses pada 24 Februari 2018]; vol 387: 1211-26. Tersedia pada: DOI:https://doi.org/10.1016/S0140-6736(15)00151-8
World Health Organization. Global tuberculosis report 2016. Geneva:WHO Library Cataloguing- in-Publication Data [Internet]. 2016 [diakses pada 24 Februari 2018]. Tersedia pada: https://apps.who.int/medicinedocs/documents/s23098en/s23098en.pdf
Kementerian Kesehatan RI. Strategi Nasional pengendalian TB di Indonesia 2010-2014. Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan [Internet]; 2011 [diakses pada 24 Februari 2018]. Tersedia pada:https://www.who.int/docs/default-source/searo/indonesia/stranas-tb-2010-2014.pdf?sfvrsn=aa7e44a9_2
Kementerian Kesehatan. Tuberkulosis temukan obati sampai sembuh. Jakarta: Pusat Data dan Informasi Kementrian Kesehatan RI.; 2016 [diakses pada 24 Februari 2018]. 2016. Tersedia pada: https://pusdatin.kemkes.go.id/resources/download/pusdatin/infodatin/Infodatin-TB-2016.pdf
Statista. Number of smartphone users in Indonesia from 2011 to 2022 (in millions) [web page on the internet]. 2017 [diakses pada 24 Feb 2018]. Tersedia pada: https://www.statista.com/statistics/266729/smartphone-users-in-indonesia/
Mohammed S, Glennerster R, Khan AJ. Impact of a daily SMS medication reminder system on tuberculosis treatment outcomes: A randomized controlled trial. PLoS One [Internet]. 1 Nov 2016 [diakses pada 24 Februari 2018];11(11). Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5089745/pdf/pone.0162944.pdf. DOI:10.1371/journal.pone.0162944
Nglazi MD, Bekker LG, Wood R, Hussey GD, Wiysonge CS. Mobile phone text messaging for promoting adherence to anti-tuberculosis treatment: a systematic review. BMC Infect Dis [Internet]. 2013 [diakses pada 24 Februari 2018];13(566). 1-16. Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219402/pdf/1471-2334-13-566.pdf
Finitsis DJ, Pellowski JA, Johnson BT. Text message intervention designs to promote adherence to antiretroviral therapy (ART): A meta-analysis of randomized controlled trials. PLoS One [Internet]. 2014 [diakses pada 24 Februari 2018]; 9(2). Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3914915/pdf/pone.0088166.pdf
World Health Organization. Pakistan tuberculosis [web page on the internet]. 2018 [diakses pada 24 Feb 2018]. Tersedia pada: http://www.emro.who.int/pak/programmes/stop-tuberculosis.html
de Jongh T, Gurol-Urganci I, Vodopivec-Jamsek V, Car J, Atun R. Mobile phone messaging for facilitating self-management of long-term illnesses (Review). Cochrane Database Syst Rev [Internet]. 2012 [diakses pada 24 Februari 2018]; issue 12. Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6486189/pdf/CD007459.pdf
Zhao YY, Dang FP, Zhai TT, Li HJ, Wang RJ, Ren JJ. The effect of text message reminders on medication adherence among patients with coronary heart disease: A systematic review and meta-analysis. Medicine. 2019 [diakses pada 24 Februari 2018];98(52). Pp. 1-7. Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946488/pdf/medi-98-e18353.pdf. DOI: http://dx.doi.org/10.1097/MD.0000000000018353
Whittaker R, McRobbie H, Bullen C, Rodgers A, Gu Y. Mobile phone-based interventions for smoking cessation (Review). Cochrane Database Syst Rev [Internet]. 2016 [diakses pada 24 Februari 2018] ; issue 4. Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485940/pdf/CD006611.pdf. DOI: DOI: 10.1002/14651858.CD006611.pub4.
Group Health Research Institute. Improving chronic illness care [web page on the Internet]. 2016 [diakses pada 24 Feb 2018]. Tersedia pada: http://www.improvingchroniccare.org/index.php?p=1:_Models&s=363
Lorig KR, Sobel DS, Stewart AL, Brown BW Jr, Bandura A, Ritter P, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization and costs: A randomized trial [Abstrak]. Med Care [Internet]. 1999 [diakses pada 24 Februari 2018]; 37(1):5- 14. Tersedia pada: https://journals.lww.com/lww-medicalcare/Abstract/1999/01000/Evidence_Suggesting_That_a_Chronic_Disease.3.aspx.
Stellefson M, Dipnarine K, Stopka C. The chronic care model and diabetes management in US primary care settings: A systematic review. Prev Chronic Dis [Internet]. 2013 [diakses pada 24 Februari 2018];10:E26. Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604796/pdf/PCD-10-E26.pdf.DOI: http://dx.doi.org/10.5888/pcd10.120180.
Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the chronic care model in the new millenium. Health Aff (Millwood) [Internet]. 2 Nov 2016 [diakses pada 24 Februari 2018];28(1).Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091929/pdf/nihms825200.pdf. DOI: 10.1377/hlthaff.28.1.75.
da Silva DM, de Farias HBG, Villa TCS, de Sá LD, Brunello MEF, Nogueira JA. Care production for tuberculosis cases: analysis according to the elements of the Chronic Care Model. Rev Esc Enferm USP [Internet]. 2016 [diakses pada 24 Februari 2018];50(2):237-44. Tersedia pada: http://www.scielo.br/pdf/reeusp/v50n2/0080-6234-reeusp-50-02-0239.pdf. DOI: http://dx.doi.org/10.1590/S0080-623420160000200009
