Efektivitas Intervensi Edukasi dan Program Reminder Berbasis Teori Perubahan Perilaku dalam Meningkatkan Pengetahuan dan Kepatuhan Minum Obat pada Pasien Diabetes Melitus di Wilayah Kerja Klinik Medika Utama Manggar, Balikpapan Timur
Keywords:
Diabetes Melitus, kepatuhan minum obat, Health Belief Model, COM-B, Chronic Care ModelAbstract
Pendahuluan: Diabetes Melitus (DM) merupakan penyakit kronis yang memerlukan kepatuhan terapi seumur hidup. Rendahnya kepatuhan minum obat masih menjadi masalah signifikan di Klinik Medika Utama Manggar, Balikpapan Timur. Penelitian ini bertujuan menganalisis efektivitas intervensi edukasi dan program reminder yang dirancang berdasarkan teori perubahan perilaku (Health Belief Model/COM-B/PPSA/Chronic Care Model) dalam meningkatkan pengetahuan dan kepatuhan pasien DM.
Metode: Penelitian menggunakan pendekatan diagnosis komunitas dengan desain pre-test dan post-test pada 30 pasien DM tipe 2 yang terdaftar dalam Program Rujuk Balik (PRB). Intervensi meliputi penyuluhan kesehatan terstruktur (media PowerPoint, leaflet) dan program reminder (kartu pengingat, pesan WhatsApp). Evaluasi menggunakan kuesioner KAP (Knowledge-Attitude-Practice) serta pemetaan determinan perilaku berdasarkan HBM, COM-B, PPSA, dan CCM.
Hasil: Terjadi peningkatan rata-rata skor pengetahuan dari 76,53±11,42 menjadi 88,97±7,36 (peningkatan 12,44 poin; 96,7% peserta mengalami peningkatan). Pada aspek kepatuhan, terjadi peningkatan pengambilan obat PRB dan pemeriksaan HbA1c. Analisis HBM menunjukkan persepsi hambatan (lupa 33,3%, jarak 25%) sebagai determinan utama. Analisis COM-B mengidentifikasi kesenjangan pada opportunity (akses, reminder) dan motivasi otomatis (kebosanan, persepsi sehat). Analisis PPSA menunjukkan faktor pemungkin (enabling) sebagai prioritas intervensi. Evaluasi CCM mengkonfirmasi perlunya transformasi sistem layanan proaktif.
Diskusi: Peningkatan pengetahuan signifikan mendukung HBM bahwa isyarat bertindak (cue to action) memperkuat persepsi manfaat. Program reminder mengatasi hambatan lupa dalam kerangka COM-B. Kesenjangan knowledge-practice (80% vs 67,8%) dijelaskan oleh PPSA bahwa faktor pemungkin tidak kalah penting dari faktor predisposisi. Chronic Care Model memberikan kerangka sistemik untuk keberlanjutan.
Kesimpulan: Intervensi edukasi dan program reminder berbasis teori perubahan perilaku efektif meningkatkan pengetahuan dan kepatuhan minum obat pasien DM. Pendekatan multi-teori direkomendasikan untuk pengelolaan penyakit kronis di pelayanan primer.
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