Clinical outcomes: analysis of quality of life and direct medical costs of outpatient hypertensive patients at Panembahan Senopati Hospital, Indonesia 10.55131/jphd/2024/220111

Main Article Content

Anis Febri Nilansari
Rahmad A Hi Wahid
Fitri Andriani Fatimah

Abstract

Hypertensive patients need long-term therapy and control. Uncontrolled blood pressure can aggravate the incidence of hypertension and develop into a more dangerous disease that can have an impact on quality of life and medical costs. The study aimed to analyze the differences in clinical outcomes on quality of life and direct medical costs. The method employed was a cross-sectional study with 400 outpatient hypertensive patients in August 2023 at Panembahan Senopati Regional Hospital, Special Region of Yogyakarta, Indonesia. Data were collected by filling out questionnaires and observing medical and financial record data. Demographic data were analyzed descriptively and showed that the majority of female patients (65%), aged 46 - 65 years (51%) possessed a high school education (30%). Sixty-six percent of patients had hypertension with a duration of <5 years and 61% had comorbidities. This study attempted to measure the clinical outcomes on quality of life and direct medical costs of hypertensive patients. The EuroQol-5 Dimension (EQ-5D-5L) and Visual Analogue Scale (VAS) questionnaires were used to measure patients' quality of life. The data on direct medical costs included medications, laboratories, medical equipment, and administrative costs. Clinical outcome indicators were blood pressure measurements. The results showed that 316 of 400 patients showed uncontrolled clinical outcomes (79%) with an average score for a good quality of life based on the quality of life assessment with EQ5D5L and VAS and incurred direct medical costs of Indonesian Rupiah (IDR) 663,80. Based on the VAS measurement, there was a significant difference in quality of life between patients with controlled and uncontrolled clinical outcomes (p<0.001). Patients with controlled clinical outcomes had higher quality of life and incurred lower costs. Altogether, controlling hypertension in all patients with or without complications can be practical and cost-effective.

Article Details

How to Cite
1.
Nilansari AF, A Hi Wahid R, Andriani Fatimah F. Clinical outcomes: analysis of quality of life and direct medical costs of outpatient hypertensive patients at Panembahan Senopati Hospital, Indonesia: 10.55131/jphd/2024/220111. J Public Hlth Dev [Internet]. 2024 Jan. 24 [cited 2024 Apr. 21];22(1):145-56. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/266475
Section
Original Articles
Author Biographies

Anis Febri Nilansari, Department of Pharmacy, Faculty of Science and Technology, Universitas PGRI Yogyakarta, Yogyakarta, Indonesia

Department of Pharmacy, Faculty of Science and Technology, Universitas PGRI Yogyakarta, Yogyakarta, Indonesia

Rahmad A Hi Wahid, Department of Pharmacy, Faculty of Science and Technology, Universitas PGRI Yogyakarta, Yogyakarta, Indonesia

Department of Pharmacy, Faculty of Science and Technology, Universitas PGRI Yogyakarta, Yogyakarta, Indonesia

Fitri Andriani Fatimah, Faculty of Industry Halal, Universitas Nahdlatul Ulama, Yogyakarta

Faculty of Industry Halal, Universitas Nahdlatul Ulama, Yogyakarta

References

Maulidah K, Neni N, Maywati S. The Relationship between Knowledge, Attitudes and Family Support with Efforts to Control Hypertension in the Elderly in the Working Area of the Cikampek Community Health Center, Karawang Regency. J Kesehat Komunitas Indones. 2022;18(2):484–94.

Rifai M, Safitri D. Hypertension Education for Residents of Dukuh Gebang, Gunungkidul Regency. J BUDIMAS. 2022;04(02):1–6.

Puspita E. Factors Associated with Hypertension Sufferers’ Compliance in Undergoing Treatment. Univ Negeri Semarang. 2016;1–170.

Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223–37. doi: 10.1038/s41581-019-0244-2.

Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. J Clin Med. 2019;8(7):1–19. doi: 10.3390/ jcm8071065

Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;75(6):1334–57. doi: 10.1161/ HYPERTENSIONAHA.120.15026.

Alfian R, Lisdawati N, Putra AMP, Sari RP, Lailani F. Profile of Quality of Life and Blood Pressure of Outpatient Hypertension in Ulin General Hospital, Banjarmasin. J Ilm Manuntung. 2018;4(2):106.

Rachmawati Y, Perwitasari DA, Adnan. Validasi Kuesioner Sf-36 Versi Indonesia. Pharmacy [Internet]. 2014; 11(01):14–25. Available from: file:/// E:/Manuscripts/Enfermeria Clinica/Al Amin/Articles/Rachmawati 2014.pdf

Kaliyaperumal S, Hari SB, Siddela PK, Yadala S. Assessment of quality of life in hypertensive patients. J Appl Pharm Sci. 2016;6(5):143–7. doi: : 10.7324/ JAPS.2016.60522

Utari AB, Nurul Rochmah T. Burden of Disease Analysis of Hypertension in the Community in Kediri Regency. Indones J Public Heal. 2019;14(2):138.

Baroroh F, Fathonah SS. Direct Medical Costs for Outpatient Hypertension Therapy at X Hospital Yogyakarta. J Farm Sains dan Prakt. 2017;3(2):6–13.

Fadillah A, Ramadhani J, Erlianti K, Hasniah H. Cost of Illness Analysis of Hypertension at Praya Regional General Hospital, NTB. Al Ulum J Sains Dan Teknol. 2021;6(2):104.

Xiao M, Zhang F, Xiao N, Bu X, Tang X, Long Q. Health-related quality of life of hypertension patients: A population-based cross-sectional study in Chongqing, China. Int J Environ Res Public Health. 2019;16(13). doi: 10.3390/ijerph16132348.

Goldberg H., Baniel J., Mano R., Rotlevy G., Kedar D. YO. Orthotopic neobladder vs. ileal conduit urinary diversion: A long-term quality-of-life comparison. Urol Oncol. 2016;34(3): 121.e1-121.e7. doi: 10.1016/j.urolonc. 2015.10.006.

Choi H, Park JY, Bae JH, Tae BS. Health-related quality of life after radical cystectomy. Transl Androl Urol. 2021;9(6):2997–3006. doi: 10.21037/tau.2020.02.01.

Indonesia MOHRO. Basic Health Research (Riskesdas). 2018.

Province YSR. Yogyakarta Special Region Province Health Data Book for 2022. 2023.

Neilson T. King of charcoal: Japanese create new life for dying industry. Vol. II, Inwood Magazine. 2011.

Susanto Y, Alfian R, Rahim Z, Karani. Validity and Reliability Test of the Indonesian EQ-5D Questionnaire to Measure the Quality of Life of Chronic Kidney Failure Hemodialysis Patients. J Ilm Manuntung. 2018;4(1):41–7.

Siregar HD. The Relationship between the Level of Compliance and the Quality of Life of Heart Failure Patients at Dr. Mintoharjo Naval Hospital. Universitas Muhammadiyah Prof.Dr.Hamka; 2019.

Alshammari SA, Alajmi AN, Albarrak RA, Alaqil AB, Alsaeed GK, Alzayed MZ, et al. Quality of Life and Awareness of Hypertension Among Hypertensive Patients in Saudi Arabia. Cureus. 2021;13(5). doi: 10.7759/ cureus.14879.

Gudmundsdottir H, Høieggen A, Stenehjem A, Waldum B, Os I. Hypertension in women: Latest findings and clinical implications. Ther Adv Chronic Dis. 2012;3(3):137–46. doi: 10.1177/2040622312438935.

Fatima S, Mahmood S. Combatting a silent killer - the importance of self-screening of blood pressure from an early age. EXCLI J. 2021;20:1326-7. doi: 10.17179/excli2021-4140.

Sawicka K, Szczyrek M, Jastrzebska I, Prasal M, Zwolak A, Daniluk J. Journal of pre-clinical and clinical research. J Pre-Clinical Clin Res. 2011; 5(2):43–6.

Masenga SK, Kirabo A. Hypertensive heart disease: risk factors, complications and mechanisms. Front Cardiovasc Med. 2023;10:1205475. doi: 10.3389/fcvm.2023.1205475.

Fuchs FD, Whelton PK. High Blood Pressure and Cardiovascular Disease. Hypertension. 2020;75(2):285–92. doi: 10.1161/HYPERTENSIONAHA. 119.14240.

Balqis S. The Relationship Of Long Illness With Drinking Compliance Medication For Hypertension Patients In Dusun Depok Ambarketawang Gamping Sleman Yogyakarta. Universitas Aisyiyah Yogyakarta; 2018.

Algabbani FM, Algabbani AM. Treatment adherence among patients with hypertension: findings from a cross-sectional study. Clin Hypertens. 2020;26:18. doi: 10.1186/s40885-020-00151-1.

Fischer, M.A., Baessler H, Schunkert. Renin Angiotensin System and Gender Differences In The Cardiovascular System. Cardiovasc Res. 2002; 53: 672–7. doi: 10.1016/s0008-6363(01) 00479-5.

Yoon SS, Burt V, Louis T, Carroll MD. Hypertension among adults in the United States, 2009-2010. NCHS Data Brief. 2012;(107):1–8.

Patil M, Hedaoo RP, Shah RP, Tauseef SM, Marzo RR, Ching SM, et al. Assessment of Health-Related Quality of Life Among Male Patients With Controlled and Uncontrolled Hypertension in Semi Urban India. Inq (United States). 2023; 60.

Lolo WA, Citraningtyas G, Mpila DA, Wijaya H, Poddar S. Quality of Life of Hypertensive Patients Undergoing Chronic Disease Management Program during the COVID-19 Pandemic. Kesmas (National Public Heal Journal). 2022;17(4):264–9.

Ghimire S, Pradhananga P, Baral BK, Shrestha N. Factors Associated With Health-Related Quality of Life among Hypertensive Patients in Kathmandu, Nepal. Front Cardiovasc Med. 2017; 4:69. doi: 10.3389/fcvm.2017.00069.

American Academy of Actuaries. Prescription Drug Spending in the U.S. Health Care System: An Actuarial Perspective [Internet]. 2018. Available from: www.actuary.org

Amira C, Okubadejo N. Antihypertensive pharmacotherapy in a developing economy: pattern, acquisition costs and conformity to international guidelines in a tertiary-care setting. J Hum Hypertens. 2006; 20(11):894. doi: 10.1038/sj.jhh. 1002080.