Complementary-Therapy Use, Neuropathic Screening Status, and Quality of Life in Patients with Hypertension or Diabetes: A Pre–Post Observational Study / Penggunaan Terapi Komplementer, Status Skrining Neuropatik, dan Kualitas Hidup pada Pasien Hipertensi atau Diabetes: Studi Observasional Pre–Post

Introduction: Peripheral neuropathy contributes to pain, functional impairment, and reduced quality of life in patients with diabetes mellitus and hypertension. This study evaluated changes in neuropathic screening status and quality of life during the use of complementary therapies alongside standard pharmacotherapy. Methods: This uncontrolled pre-post observational study included 147 patients at RSUD Nurdin Hamzah: 65 with hypertension and 82 with diabetes mellitus. Neuropathic characteristics and quality of life were assessed using the Douleur Neuropathique 4 (DN4) and WHOQOL-BREF, respectively. Paired DN4 observations were analyzed using the Wilcoxon signed-rank test, while associations with WHOQOL-BREF domains were analyzed using chi-square or likelihood-ratio tests. Results: After one month, DN4-positive screening decreased from 100% to 96.9% in the hypertension group and from 100% to 63.4% in the diabetes group. Paired DN4 observations differed significantly in both groups (p<0.001). No significant associations were found between complementary-therapy modalities and the physical, psychological, social, or environmental WHOQOL-BREF domains (all p>0.05). Conclusion: DN4 screening status improved during combined standard pharmacotherapy and self-selected complementary-therapy use, particularly among patients with diabetes, without a corresponding association with quality-of-life domains.

Pendahuluan: Neuropati perifer berkontribusi terhadap nyeri, gangguan fungsi, dan penurunan kualitas hidup pada pasien diabetes melitus dan hipertensi. Penelitian ini mengevaluasi perubahan status skrining neuropatik dan kualitas hidup selama penggunaan terapi komplementer bersama farmakoterapi standar. Metode: Studi observasional pre-post tanpa kelompok kontrol ini melibatkan 147 pasien di RSUD Nurdin Hamzah, terdiri atas 65 pasien hipertensi dan 82 pasien diabetes melitus. Karakteristik neuropatik dan kualitas hidup dinilai menggunakan Douleur Neuropathique 4 (DN4) dan WHOQOL-BREF. Pengamatan DN4 berpasangan dianalisis dengan uji Wilcoxon signed-rank, sedangkan hubungan dengan domain WHOQOL-BREF dianalisis menggunakan uji chi-square atau likelihood ratio. Hasil: Setelah satu bulan, proporsi skrining DN4-positif menurun dari 100% menjadi 96,9% pada kelompok hipertensi dan dari 100% menjadi 63,4% pada kelompok diabetes. Pengamatan DN4 berpasangan berbeda bermakna pada kedua kelompok (p<0,001). Tidak ditemukan hubungan bermakna antara modalitas terapi komplementer dan domain fisik, psikologis, sosial, maupun lingkungan WHOQOL-BREF (seluruh p>0,05). Kesimpulan: Status skrining DN4 membaik selama penggunaan farmakoterapi standar bersama terapi komplementer pilihan sendiri, terutama pada pasien diabetes, tanpa hubungan yang sejalan dengan domain kualitas hidup.