Faktor-faktor yang Memengaruhi Kepatuhan Pasien terhadap Terapi Antibiotik: Tinjauan Sistematis
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Latar Belakang: Resistensi antimikroba (AMR) adalah krisis kesehatan global yang diperparah oleh penyalahgunaan dan ketidakpatuhan terhadap terapi antibiotik. Karena terbatasnya bukti komprehensif mengenai faktor pendorong perilaku ini, tinjauan sistematis ini bertujuan mengidentifikasi dan mensintesis pendorong multifaktorial yang memengaruhi kepatuhan dan penyalahgunaan antibiotik oleh pasien di berbagai populasi. Metode: Berdasarkan pedoman PRISMA, pencarian literatur sistematis dilakukan untuk menyaring studi cross-sectional yang menilai kepatuhan, swamedikasi, dan penyalahgunaan antibiotik. Delapan belas studi memenuhi kriteria inklusi. Kualitas metodologis dievaluasi secara independen oleh dua peninjau menggunakan instrumen Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Hasil: Tinjauan ini mengidentifikasi faktor kompleks dalam lima domain: sosiodemografi, pengetahuan, terkait pengobatan, perilaku, dan sistem kesehatan. Pendidikan rendah, usia muda, dan kendala finansial secara konsisten memprediksi ketidakpatuhan. Kesenjangan pengetahuan juga sangat umum, terutama miskonsepsi bahwa antibiotik efektif untuk infeksi virus. Faktor terapi, seperti dosis yang sering dan durasi pengobatan panjang, menurunkan tingkat kepatuhan. Secara perilaku, penghentian terapi secara prematur saat gejala mereda memicu disimpannya sisa antibiotik. Selain itu, faktor sistem kesehatan, seperti mudahnya akses antibiotik tanpa resep dan kurangnya hubungan dokter-pasien yang berkesinambungan, turut memfasilitasi penggunaan yang tidak tepat. Kesimpulan: Kepatuhan pasien terhadap antibiotik dipengaruhi oleh interaksi kompleks faktor sosioekonomi, kognitif, dan struktural. Intervensi yang efektif harus bersifat multifaset, meliputi edukasi publik untuk meluruskan miskonsepsi, penyederhanaan regimen pengobatan oleh dokter, dan penegakan regulasi distribusi obat yang lebih ketat.
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