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All Journal Jurnal Impresi Indonesia International Journal of Health and Pharmaceutical (IJHP)
Dalimunthe, Almira
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Religion Economics, Econometrics & Finance Education Law, Crime, Criminology & Criminal Justice Nursing Public Health Social Sciences

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Social Support and Healthcare Service Quality as Determinants of Treatment Interruption Among Drug-Resistant Tuberculosis Patients in Medan, Indonesia Dalimunthe, Almira; Magdalena Sinaga, Bintang Yinke; Siagian, Parluhutan; Amelia, Rina
Jurnal Impresi Indonesia Vol. 4 No. 11 (2025): Indonesian Impression Journal (JII)
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i11.7122

Abstract

Indonesia ranks second globally in pulmonary TB cases after India, and drug-resistant TB remains a major cause of mortality in the country. Treatment adherence is influenced by multiple interacting factors, making dropout decisions a dynamic process. Early, targeted efforts to boost patient adherence and minimize loss-to-follow up are essential to prevent progression to more severe disease or death. This study aims to evaluate factors that lead to loss-to-follow up among drug-resistant tuberculosis patients in Medan, Indonesia. This research is a descriptive analytical study using a cross sectional approach. It was carried out at Adam Malik Hospital Medan on DR-TB patients who had been diagnosed bacteriologically. The data used were 104 patient subjects who met the inclusion and exclusion criteria. divided into groups who was loss in follow up and groups who completed treatment. The independent variables consist of social support and health care services. From the 104 research samples, 34 of them were DR pulmonary TB patients who was loss in follow up and 70 DR pulmonary TB patients who completed treatment. Bivariate analysis showed significant associations between loss-to-follow up and social support (p < 0.001; OR = 14.50), and healthcare service quality (p < 0.001; OR = 5.72). No significant association was found for age, sex, occupation, marital status, or family history of TB. In conclusion, social support and healthcare service quality play critical roles in determining adherence among DR-TB patients. Strengthening patient support networks and improving patient-centered healthcare delivery may help reduce treatment default rates.
Factors Influencing The Incidence of Loss To Follow-Up Treatment In Drug-Resistant Tuberculosis Patients Dalimunthe, Almira; Yinke Magdalena Sinaga, Bintang; Siagian, Parluhutan; Amelia, Rina
International Journal of Health and Pharmaceutical (IJHP) Vol. 5 No. 4 (2025): November 2025
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v5i4.475

Abstract

Drug-resistant tuberculosis (DR-TB) represents a significant global health challenge with Indonesia ranking second highest for pulmonary TB cases. Treatment adherence in DR-TB patients is influenced by multiple interacting factors requiring systematic investigation to identify independent risk determinants. This descriptive analytical cross-sectional study assessed associations between independent variables and loss to follow-up treatment outcomes in DR-TB patients at Adam Malik Hospital, Medan, from May to November 2024. A purposive sampling strategy enrolled 104 bacteriologically confirmed DR-TB patients comprising 34 loss to follow-up cases and 70 treatment completers. Data collection utilized validated questionnaires assessing attitudes toward treatment, perceived social support, and healthcare service quality. Statistical analysis employed chi-squared testing for bivariate associations and multiple logistic regression for multivariate analysis with significance level p<0.05. Results demonstrated that 85.3% of loss to follow-up patients experienced low to moderate social support, 67.6% held poor treatment attitudes, and 64.7% perceived insufficient healthcare services. Bivariate analysis revealed significant associations between education (PR=4.13; p=0.023), attitudes (PR=6.04; p<0.001), social support (PR=14.50; p<0.001), and healthcare services (PR=5.72; p<0.001) with treatment discontinuation. Multivariate analysis identified three independent risk factors: low to moderate social support emerging as the predominant determinant (PR=14.01; 95% CI=4.26–46.02; p<0.001), followed by inadequate healthcare services (PR=3.33; 95% CI=1.18–9.43; p=0.023), while unemployment showed protective effect (PR=0.315; p=0.045). This investigation concludes that social support constitutes the principal modifiable risk factor for loss to follow-up treatment in DR-TB patients, necessitating implementation of family-based psychosocial interventions and quality healthcare service improvements to sustain treatment adherence during the challenging 20-month therapeutic regimen.
Co-Authors Magdalena Sinaga, Bintang Yinke Parluhutan Siagian Rina Amelia Yinke Magdalena Sinaga, Bintang