INTEGRATIVE MANAGEMENT OF HYPERTENSION, TYPE 2 DIABETES, AND NEUROPATHY IN A COMMUNITY-BASED PRIMARY CARE SETTING : FAMILY MEDICINE APPROACH TO MULTIMORBIDITY
DOI:
https://doi.org/10.31004/prepotif.v9i2.44021Keywords:
diabetes melitus tipe 2, hipertensi, kedokteran keluarga, neuropati perifer, pelayanan primerAbstract
Pasien lanjut usia dengan penyakit kronis ganda memerlukan pendekatan yang tidak hanya berfokus pada aspek klinis, tetapi juga mempertimbangkan dimensi psikososial dan lingkungan. Kedokteran keluarga menyediakan kerangka kerja holistik yang memungkinkan penatalaksanaan terintegrasi dan berkelanjutan dalam sistem pelayanan primer. Tujuan penelitian ini adalah untuk mendeskripsikan manajemen longitudinal seorang pasien perempuan usia 63 tahun dengan hipertensi, diabetes melitus tipe 2, dan neuropati perifer menggunakan pendekatan kedokteran keluarga. Diagnosis ditegakkan berdasarkan evaluasi klinis yang mencakup keluhan sensorik bilateral dan tekanan darah tinggi disertai glukosa darah sewaktu yang tidak terkontrol. Intervensi yang diberikan meliputi metformin, amlodipin, vitamin B12, serta edukasi nutrisi, aktivitas fisik, dan keterlibatan keluarga. Penambahan gabapentin dan glibenklamid dilakukan berdasarkan evaluasi gejala lanjutan. Evaluasi empat minggu menunjukkan penurunan kadar glukosa, tekanan darah yang stabil, serta kemandirian fungsional yang tetap terjaga. Penggunaan kerangka Mandala of Health mengidentifikasi kontribusi faktor biologis, spiritual, dan sosial terhadap kontrol penyakit. Skor APGAR menunjukkan disfungsi parsial pada keterlibatan emosional dan dukungan keluarga, sementara Coping Score dan SCREEM mengindikasikan keterbatasan ekonomi serta keterlibatan aktif dalam pengambilan keputusan kesehatan. Hasil ini menunjukkan bahwa integrasi penilaian biopsikososial dalam praktik kedokteran keluarga mendukung peningkatan kepatuhan, kontrol klinis, dan kualitas hidup pasien lansia dengan kondisi kronis kompleks.References
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