A Digital Therapeutic Communication Model to Improve Treatment Compliance of Hypertension Patients at Ubud Health Center 1 Gianyar District, Bali Province

I Nyoman Purnawan; Nyoman Suarjana; Ni Made Kurniati

Authors

I Nyoman Purnawan Dhyana Pura University
Nyoman Suarjana Dhyana Pura University
Ni Made Kurniati Dhyana Pura University

Keywords:

Medication adherence, hypertensive patients, digital therapeutic communication models, Ubud Health Center 1, Bali

Abstract

The main problem in controlling hypertension in Indonesia is low adherence to treatment hypertension patient. An important effort that is currently being done is to change patient behavior to be more compliant with treatment. Factors that influence medication adherence. It is important that it is studied in full, compiled on a strong theoretical basis and proven scientifically empirical. One of the factors that play an important role in increasing success. Treatment is therapeutic communication between health workers and patients. However, during the syndemy (synergy and pandemic) period of covid-19 with restrictions on interaction hinder the process of therapeutic communication so that there is a need for digital transformation. For Therefore, this study aims to assess the factors of medication adherence, compile and prove digital therapeutic communication models can improve adherence to treatment of hypertensive patients at Ubud Health Center 1, Gianyar Regency, Bali Province. Research implementation consists of 3 stages, namely: 1) Research cross-sectional study with a sample size of 390 hypertensive patients selected by simple random sampling. Data collected by interview

using structured questionnaires in selected patient homes; 2) Modeling digital therapeutic communication and 3) Proof of models with quasi-experimental designs using a cluster randomized controlled trial design. Structural equation modelling (SEM) was used for factor analysis of medication adherence and the Poisson regression test was used to test and assess the capabilities of digital therapeutic communication models for improve adherence to treatment of hypertensive patients. Factors that are proven to improve adherence to treatment is a type of communicator (β=0.297), content of the message conveyed (β=0.237) and the type of digital media (whatsapp) used (β=0.443). Therapeutic communication model. Digital is proven to increase medication adherence by 4.1 times (95% CI: 0.845-11.557). It can be concluded that therapeutic communication with WhatsApp media is very effective carried out supported by the ability of the communicator and the content of the message conveyed.

References

Asnawi, B. (2011) Faktor-faktor yang Berhubungan dengan Kepatuhan Berobat Penderita Diabetes Mellitus di Kota Jambi Tahun 2010. Tesis. Universitas Indonesia.

Anjaswarni, Tri. (2016). Komunikasi dalam Keperawatan. Jakarta: Pusat Pendidikan Sumber Daya Manusia Kesehatan Badan Pengembangan dan Pemberberdayaan SDM Kesehatan

World Health Organization. (2013) A Global Brief on Hypertension, Available at: [Accessed: 2021, December 9].

Badan Pusat Statistik. (2020), Bali Dalam Angka 2019, Denpasar: Badan Pusat Statistik Provinsi Bali.

Dinas Kesehatan Provinsi Bali. (2020), Laporan Tahunan Penyakit Tidak Menular Provinsi Bali Tahun 2020.Denpasar: Dinas Kesehatan Provinsi Bali.

Dinas Kesehatan Kabupaten Gianyar. (2020), Laporan Tahunan Kesehatan Kabupaten Gianyar Tahun 2020. Gianyar: Dinas Kesehatan Kabupaten Gianyar.

Hidayat, A., Aziz, A., Mahmud, B. (2017) Metode Penelitian Keperawatan dan Teknik Analisis Data. Jakarta: Salemba Medika.

Jiang, B., Liu, H., Ru, X., Zhang, H., Wu, S., Wang, W. (2014) Hypertension Detection, Management, Control and Associated Factors Among Residents Accessing Community Health Services in Beijing, Sci. Rep., 4845(4): 127-134.

Kementrian Kesehatan Republik Indonesia. (2020), Profil Kesehatan Indonesia 2020. Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan.

Kementrian Kesehatan Republik Indonesia. (2018), Profil Kesehatan Indonesia 20018 Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan.

Kementrian Kesehatan Republik Indonesia. (2019), Profil Kesehatan Indonesia 2019. Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan.

Morisky, D.E., Green, L.W., Levine, D.M. (1986) Concurrent and Predictive Validity of a Self–Reported Measure of Medication Adherence, Med. care, 24(5): 67-74.

Morisky, D.E., Ang, A., Krousel-Wood, M., Ward, HJ. (2008) Predictive Validity of a Medication Adherence Measure in an Outpatient Setting, The Journal of Clinical Hypertension, 10(5): 348-354.

Rao, C.R., Kamath, V.G., Shetty, A., Kamath, A. (2014) Treatment Compliance among Patients with Hypertension and Type 2 Diabetes Mellitus in a Coastal Population of Southern India, Int. J. Prev. Med., 5(8): 992-998.

Riyanto, A. (2018) Pengolahan dan Analisis Data Kesehatan. Yogyakarta: Mulia Medika.

Saeed, K.M., Rasooly, M.H., Brown, N.J. (2012) Prevalence and Predictors of Adult Hypertension in Kabul Afghanistan, BMC Public Health, 10(14): 1471-1479.

Saepudin, Padmasari, S., Hidayanti, P., Endang, S., Ningsih. (2013) Kepatuhan Penggunaan Obat Pada Pasien Hipertensi di Puskesmas. Jurnal Farmasi Indonesia, 6(4): 246-253.

Yashar, M., Saadat, H., Babak, N.S., Rai, A., Saadat, Z., Aerab-Sheibani, H., Naghizadeh, M.M., Morisky, D.E. (2014) Validation of the Persian Version of the 8-item Morisky Medication Adherence Scale (MMAS-8) in Iranian Hypertensive Patients, Global Journal of Health Science, 7(4): 173-183.