<![CDATA[Diabetes melitus (DM) dengan hipertensi merupakan penyakit komplikasi sindrom metabolik dengan terapi lebih dari satu obat. Selain faktor pengetahuan, faktor perilaku dan motivasi dari luar dapat menjadi salah satu faktor kebosanan pasien dalam menjalani terapi jangka panjang. Dibutuhkan edukasi dan motivasi untuk kepatuhan perilaku berobat dalam mencapai target terapi pasien DM-hipertensi. Penelitian ini bertujuan untuk mengetahui pengaruh brief-counseling 5A modifikasi oleh apoteker dan dukungan motivasi pesan singkat dalam meningkatkan perilaku dan outcome klinis pasien DM-hipertensi rawat jalan di RSUD Panembahan Senopati, Bantul, Yogyakarta. Penelitian ini menggunakan metode kuasi-eksperimental dengan desain pre-post. Pengambilan data dilakukan secara prospektif selama periode Maret–Mei 2017. Sebanyak 99 orang yang memenuhi kriteria inklusi dibagi menjadi 3 kelompok yang terdiri dari 33 pasien. Tingkat perilaku pasien diukur melalui wawancara menggunakan kuesioner perilaku pasien DM-hipertensi, sedangkan data outcome klinis pasien diambil dari data rekam medis. Hasil penelitian ini menunjukkan bahwa proporsi tingkat perilaku pada tahap aksi kelompok perlakuan 1 (brief counseling 5A modifikasi) dan 2 (brief counseling 5A modifikasi + SMS motivasi) lebih besar (masing-masing sebesar 21,2%) dibandingkan kelompok kontrol (12,1%). Pemberian brief counseling 5A modifikasi dapat menurunkan tekanan darah sistolik sebesar 8,36±12,21 mmHg (p=0,000), diastolik 2,42±10,69 mmHg (p=0,202) dan gula darah sewaktu (GDS) 24,66 mg/dL (p=0,017). Pemberian brief counseling 5A modifikasi + SMS motivasi dapat menurunkan tekanan darah sistolik sebesar 8,79±17,32 mmHg (p=0,012), diastolik 5,0±9,92 mmHg (p=0,007), dan GDS 24,91 mg/dL (p=0,079). Kelompok brief counseling 5A modifikasi disertai pesan (SMS) motivasi lebih efektif dalam meningkatkan perilaku pasien dan pengontrolan outcome klinik dibandingkan kelompok kontrol maupun brief counseling 5A modifikasi.Kata kunci: Brief counseling 5A modifikasi, diabetes melitus, hipertensi, pesan motivatif (SMS motivasi) Effect of Brief Counseling 5A Modification and Pharmacist Motivation Message in Improving Behavior and Clinical Outcome of Diabetes Mellitus-Hypertensive Outpatients in Panembahan Senopati Hospital, BantulAbstractDiabetes mellitus (DM) with hypertension is a complicating disease of metabolic syndrome with more than one drug therapy. Aside from knowledge, behavior and motivation also can be factors that trigger patient’s boredom in undergoing long-term therapy. Education and motivation are needed for adherence to treatment in order to achieve therapeutic target of DM-hypertensive patients. This study aimed to determine the effect of brief counseling 5A modification by pharmacists and short message (SMS) motivation to improve behavior and clinical outcomes of DM-hypertensive outpatients at Panembahan Senopati Hospital, Bantul, Yogyakarta. This study used a quasi-experimental method with pre-post design, and data collection was conducted prospectively during the period of March–May 2017. A total of 99 patients who were eligible for inclusion criteria were divided into 3 groups consisting of 33 patients. Level of patient’s behavior was measured through interviews using behavioral questionnaire of DM-hypertensive patients, while the patient’s clinical outcome was taken from medical record. The results of this study indicate that the proportion of behavioral levels in action stage of group 1 (brief counseling 5A modification) and group 2 (brief counseling 5A modification + SMS motivation) were greater (21.2% each) than control group (12.1%). Brief counseling 5A modification could reduce systolic blood pressure by 8.36±12.21 mmHg (p=0.000), diastolic 2.42±10.69 mmHg (p=0.202) and blood glucose level 24.66 mg/dL (p=0.017). Brief counseling 5A modification with SMS motivation could reduce systolic blood pressure by 8.79±17.32 mmHg (p=0.012), diastolic 5.0±9.92 mmHg (p=0.007), and blood glucose level 24.91 mg/dL (p=0.079). The brief counseling 5A modification group with SMS motivation was more effective in improving patient behavior and controlling clinical outcomes compared to the control group and brief counseling 5A modification group.Keywords: Brief counseling 5A modification, diabetes mellitus, hypertension, motivational message (SMS)]]>
