Evaluasi Kualitas Hidup Pasien Parkinson Berdasarkan Terapi Berbasis Levodopa
Abstract
Levodopa telah menjadi pilihan utama dalam pengobatan penyakit Parkinson selama lebih dari 40 tahun. Pemberian levodopa sering dikombinasi dengan obat lain untuk meningkatkan bioavailabilitas maupun efektivitasnya. Namun, di sisi lain, penggunaan levodopa dalam jangka panjang dapat menyebabkan efek samping berupa komplikasi motorik yang dapat menurunkan kualitas hidup pasien. Tujuan penelitian ini adalah untuk mengetahui hubungan penggunaan terapi levodopa dan kombinasi terhadap kualitas hidup serta mengidentifikasi faktor-faktor yang berhubungan dengan kualitas hidup. Penelitian ini menggunakan rancangan potong lintang. Subjek penelitian adalah pasien Parkinson rawat jalan di Poliklinik Saraf RSUD Arifin Achmad Pekanbaru, RSUP Dr. Hasan Sadikin Bandung, RSUD Cibabat Cimahi, dan RSAU Dr. Salamun Bandung pada periode Juli–Desember 2018. Pengukuran kualitas hidup dilakukan terhadap 33 subjek penelitian yang menerima terapi kombinasi dengan levodopa menggunakan kuesioner The 39-item Parkinson’s Disease Questionnaire (PDQ-39) versi bahasa Indonesia. Analisis dilakukan dengan membandingkan rata-rata skor total PDQ-39 antarkelompok pada masing-masing variabel. Perbandingan nilai skor total PDQ-39 dianalisis dengan uji T tidak berpasangan dan uji one way ANOVA untuk melihat adanya perbedaan skor PDQ-39 antarkelompok variabel. Hasil analisis bivariat menunjukkan tidak terdapat perbedaan rata-rata skor total PDQ-39 antarkelompok terapi kombinasi dengan levodopa (p=0,262). Hasil analisis multivariat menunjukkan variabel yang secara independen berkorelasi dengan kualitas hidup adalah aktivitas olahraga (r=0,233), tingkat keparahan penyakit (r=0,464), dan komplikasi motorik (r=0,329). Berdasarkan hasil penelitian, dapat disimpulkan bahwa kualitas hidup pasien Parkinson tidak dipengaruhi oleh jenis pengobatan, namun dipengaruhi secara independen oleh aktivitas olahraga, tingkat keparahan penyakit, dan komplikasi motorik.
Kata kunci: Komplikasi motorik, kualitas hidup, levodopa, Parkinson
Evaluation of Health-related Quality of Life in Patients with Parkinson’s Disease: A Levodopa-based Therapy Approach
Abstract
Levodopa has been the golden choice in the treatment of Parkinson’s disease (PD) for more than 40 years. The administration of levodopa is often combined with other drugs to increase its bioavailability and effectiveness. However, long-term use of levodopa has been proven to cause side effects of motor complications that may reduce health-related quality of life (HRQoL). The purpose of this study was to determine the effect of levodopa with combination therapy on HRQoL and identify factors related to quality of life. This study was conducted by a cross-sectional design. The research subjects were out-patients with PD in Arifin Achmad Pekanbaru Hospital, Dr. Hasan Sadikin Bandung Hospital, Cibabat Cimahi Hospital, and Dr. Salamun Bandung Hospital during the period of July to December 2018. Thirty-three subjects with minimum one year of treatment containing levodopa were assessed using an Indonesian-translated version of The 39-item Parkinson’s Disease Questionnaire (PDQ-39). Mean score of PDQ-39 between treatments were calculated and the subgroup analyses (by baseline characteristics and occurrence of adverse events) were conducted using the same approach. The comparation of mean score of PDQ-39 were analysed statistically using independent T-test and one way ANOVA. Bivariate analysis revealed there was no significant changes in mean score of PDQ-39 between treatment with levodopa combination (p=0.262). Based on the result of multivariate analysis, variables that independently correlated to patient’s quality of life were exercise (r=0.233), severity (r=0.464), and motor complications (r=0.329). Results suggest that total HRQoL in patients with PD was not significantly affected by variation of treatment but independently correlated to exercise, disease severity, and motor complications.
Keywords: Levodopa, motor complications, Parkinson’s disease, quality of life
Keywords
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DOI: https://doi.org/10.15416/ijcp.2019.8.4.246
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