Pengobatan Pasien Gangguan Jiwa yang Dipasung Oleh Keluarga: Studi Kasus di Kabupaten Trenggalek

  • Sulisetiorini Program Studi Magister Farmasi, Universitas Surabaya, Surabaya-Indonesia
  • Adji Prayitno Fakultas Farmasi, Universitas Surabaya, Surabaya-Indonesia
  • Yosi Irawati Wibowo Fakultas Farmasi, Universitas Surabaya, Surabaya-Indonesia
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Keywords: apoteker, kepatuhan, pasung, psikotik

Abstract

AbstractIn Trenggalek Regency, East Java Province, psychotic patients are still found on pasung by their families even though the Free Pasung Program has been intensively carried out since 2015 by The Indonesian Government. This research aims to identifying the characteristics and status of pasung, medication history, and patient’s adherence to medication. The data collection was carried out through interviews with family members of patients with pasung and observation of medical records. A total of 14 psychotic patients were included in this study. Patients were in the productive age of 30-60 years (100%), not working (92.86%), the ratio of patients on pasung and with history of pasung was 1:1, the highest educational level was elementary school (71.43%), and family history (14.29%). Out of 14 patients, 3 patients received no medications, 4 patients received both oral and injectable medications, and 7 patients received oral medications; the majority of patients were given complementary medications (64.29%). The most common injections given were haloperidol decanoate and long-acting flufenazine decanoate; while oral medications frequently given were risperidone, chlorpromazine, trihexiphenidyl, haloperidol and trifluoperazine. Patients’ medication adherence rate was 63,64%. This finding indicated the importance of pharmacists’ role in providing drug information and counseling services to improve medication adherence of patients with psychotics.

Keywords: adherence, pasung, pharmacist, psychotic 

 

Abstrak—Di Kabupaten Trenggalek Provinsi Jawa Timur masih ditemukan pasien gangguan jiwa psikotik yang dipasung oleh keluarga meskipun Program Bebas Pasung sudah gencar dilakukan sejak tahun 2015 oleh pemerintah Indonesia. Penelitian ini bertujuan untuk mengidentifikasi karakteristik dan status pasung, riwayat pengobatan, serta kepatuhan pasien terhadap pengobatan. Metode pengumpulan data melalui wawancara anggota keluarga pasien dengan pasung dan pengamatan rekam medis. Empat belas pasien gangguan jiwa psikotik terlibat dalam penelitian ini. Pasien berusia produktif 30-60 tahun (100%), tidak bekerja (92,86%), rasio status pasien dalam pasung dan riwayat pasung adalah 1:1, riwayat pendidikan terbanyak adalah sekolah dasar (71,43%), dan riwayat keluarga (14,29%). Dari 14 pasien, 3 pasien tidak menerima pengobatan, 4 pasien menerima pengobatan oral dan suntikan, dan 7 pasien menerima pengobatan oral; mayoritas pasien menerima pengobatan komplementer (64,29%). Obat suntikan yang paling umum diberikan adalah haloperidol dekanoat dan flufenazine dekanoat kerja panjang; sedangkan obat oral yang sering diberikan adalah risperidon, klorpromazin, triheksifenidil, haloperidol dan trifluoperazin. Tingkat kepatuhan pengobatan pasien adalah 63,64%. Temuan ini menunjukkan pentingnya peran apoteker dalam memberikan informasi obat dan layanan konseling untuk meningkatkan kepatuhan pengobatan pasien gangguan jiwa psikotik.

Kata kunci: apoteker, kepatuhan, pasung, psikotik

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References

Psychol Med. 2014;36:119–24. https://pubmed.ncbi.nlm.nih.gov/24860209/. doi: 10.4103/0253-7176.130962.

Fallot RD. Spirituality and religion in recovery: some current issues. Psychiatr Rehabil J. 2007;30:261-270. https://pubmed.ncbi.nlm.nih.gov/17458450. doi: 10.2975/30.4.2007.261.270.

Borras L, Mohr S, Brandt PY, Gilliéron C, Eytan A, Huguelet P. Religious beliefs in schizophrenia: Their relevance for adherence to treatment. Schizophr Bull. 2007 Sep;33:1238-1246. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632364/. doi: 10.1093/schbul/sbl070.

Sariah AE, Outwater AH, Malima KIY. Risk and protective factors for relapse among individuals with schizophrenia: A qualitative study in Dar es Salaam, Tanzania. BMC Psychiatry. 2014;14:240-252. https://pubmed.ncbi.nlm.nih.gov/25168715. doi: 10.1186/s12888-014-0240-9.

Tham XC, Xie H, Chng CML, Seah XY, Lopez V, Klainin-Yobas P. Exploring predictors of medication adherence among inpatients with schizophrenia in Singapore's mental health settings: A non-experimental study. Arch Psychiatr Nurs. 2018;32:536-548. https://pubmed.ncbi.nlm.nih.gov/30029745. doi: 10.1016/j.apnu.2018.02.004.

Mohr S, Brandt PY, Borras L, Gilliéron C, Huguelet P. Toward an integration of spirituality and religiousness into the psychosocial dimension of schizophrenia. Am J Psychiatry. 2006;163:1952-1959. https://pubmed.ncbi.nlm.nih.gov/17074947. doi: 10.1176/ajp.2006.163.11.1952.

Peraturan Menteri Kesehatan Republik Indonesia Nomor 54 Tahun 2017 Tentang Penanggulangan Pemasungan Pada Orang Dengan Gangguan Jiwa.

Risna, Mudatsir, Kamil H, Jannah SR, Tahlil T. Stigma Keluarga terhadap Penderita Skizofrenia Ditinjau dari Aspek Sosial Budaya dengan Pendekatan Sunrise Model. Prosiding Seminar Nasional Pascasarjana (SNP); 12 April 2017; Unsyiah. Banda Aceh, Indonesia; B121-128. https;//adoc.pub/queue/stigma-masyarakay-terhadap- penderita- skizofrenia.html.

Yang LH, Anglin DM, Wonpat-Borja AJ, Opler MG, Greenspoon M, Corcoran CM. Public stigma associated with psychosis risk syndrome in a college population: implications for peer intervention. Psychiatr Serv. 2013;64(3):284–288. doi: 10.1176/appi.ps.003782011.

Fond G, Vidal M, Joseph M, Etchecopar-Etchart D, Solmi M, Yon DK, et al. Self-stigma in schizophrenia: a systematic review and meta-analysis of 37 studies from 25 high- and low-to-middle income countries. Mol Psychiatry. 2023 Mar 8. doi: 10.1038/s41380-023-02003-4.

Dubreucq J, Plasse J, Franck N. Self-stigma in Serious Mental Illness: A Systematic Review of Frequency, Correlates, and Consequences. Schizophr Bull. 2021 Aug 21;47(5):1261-1287. doi: 10.1093/schbul/sbaa181.

Stuart GW. Prinsip dan Praktik Keperawatan Kesehatan Jiwa Stuart. Edisi Indonesia pertama. Budi Anna Keliat dan jesika Pasaribu. Singapore: Elsevier;2009.

Jayanti DMAD, Dharmawan PH. Family Stigma Correlation with Shackling in Schizophrenia Patients in Psychiatric Hospital of Bali Province. JNKI. 2018;6(2);97-104. http://ejournal.almaata.ac.id/index.php/JNKI.

Corrigan PW, Larson JE. Stigma. In: Mueser KT, Jeste DV, Editors. Clinical Handbook of Schizophrenia. New York: The Guilford Press; 2008. p. 533-540.

Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.02.02/MENKES/73/2015 Tentang Pedoman Nasional Pelayanan Kedokteran Jiwa.

Pengurus Pusat Perhimpunan Dokter Spesialis Kedokteran Jiwa. 2012. Pedoman Nasional Pelayanan Kedokteran Jiwa/Psikiatri (PNPK Jiwa/Psikiatri).

Direktorat Pelayanan Kefarmasian. 2021. Pedoman Pelayanan Kefarmasian pada Pasien Gangguan Jiwa. Jakarta: Kementerian Kesehatan RI.

Ng R, El-Den S, Stewart V, Collins JC, Roennfeldt H, McMillan SS, et al. Pharmacist-led interventions for people living with severe and persistent mental illness: A systematic review. Aust N Z J Psychiatry. 2022 Sep;56(9):1080-1103. doi: 10.1177/00048674211048410.

Sud D, Laughton E, McAskill R, Bradley E, Maidment I. The role of pharmacy in the management of cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness: a mixed-methods systematic literature review. Syst Rev. 2021 Mar 31;10(1):92. doi: 10.1186/s13643-021-01586-9.

Yalcin N, Ak S, Gurel SC, Celiker A. Compliance in schizophrenia spectrum disorders: The role of clinical pharmacist. International Clinical Psychopharmacology. 2019 Nov;34(6):298-304. doi: 10.1097/YIC.0000000000000280.

Simon E, Edwards AM, Sajatovic M, Jain N, Montoya JL, Levin JB. Systematic Literature Review of Text Messaging Interventions to Promote Medication Adherence Among People With Serious Mental Illness. Psychiatr Serv. 2022 Oct 1;73(10):1153-1164. doi: 10.1176/appi.ps.202100634.

Cooper SJ, Reynolds GP, Barnes TRE, England E, Haddad PM, Heald A, et al. BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. J Psychopharmacol. 2016 Aug;30(8):717-748. doi: 10.1177/0269881116645254.

Correll CU, Detraux J, De Lepeleire J, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry. 2015; 14(2):119–36. doi: 10.1002/wps.20204.

Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry. 2014;13(2):153–60. doi: 10.1002/wps.20128.

Cuijpers P, Vogelzangs N, Twisk J, Kleiboer A, Li J, Penninx BW. Comprehensive meta-analysis of excess mortality in depression in the general community versus patients with specific illnesses. Am J Psychiatry. 2014 Apr;171(4):453-462. doi: 10.1176/appi.ajp.2013.13030325.

Liu NH, Daumit GL, Dua T, Aquila R, Charlson F, Cuijpers P, et al. Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry. 2017;16(1):30–40. doi: 10.1002/wps.20384.

Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications a systematic review and meta-analysis. JAMA Psychiatry. 2015 Apr;72(4):334-341. doi: 10.1001/jamapsychiatry.2014.2502.

Published
2024-03-13
How to Cite
Sulisetiorini, Adji Prayitno, & Yosi Irawati Wibowo. (2024). Pengobatan Pasien Gangguan Jiwa yang Dipasung Oleh Keluarga: Studi Kasus di Kabupaten Trenggalek. Keluwih: Jurnal Kesehatan Dan Kedokteran, 5(2), 54-68. https://doi.org/10.24123/kesdok.V5i2.6050