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All Journal Pharmaciana: Jurnal Kefarmasian JPSCR : Journal of Pharmaceutical Science and Clinical Research
Zullies Ikawati
Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
Environmental Science Medicine & Pharmacology Public Health

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Predictors of Blood Pressure Target Achievement in Tolaki and Muna Ethnic Groups Undergoing Candesartan Cilexetil Monotherapy: A Quasi-Experimental Study Mesi Leorita; Zullies Ikawati; Agung Endro Nugroho; Ismail Setyapranoto
JPSCR: Journal of Pharmaceutical Science and Clinical Research Vol 10, No 3 (2025)
Publisher : Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/jpscr.v10i3.110176

Abstract

Therapy adherence, sociodemographic factors, and lifestyle are factors that influence the achievement of blood pressure targets in hypertensive patients. This study aims to compare and examine the impact of therapy adherence, Sociodemographic, ethnicity, and lifestyle on the achievement of blood pressure targets in hypertensive patients of Muna and Tolaki ethnicities undergoing candesartan cilexetil monotherapy. This study employed a quasi-experimental design with a comparison group approach. A total of 147 patients were selected via consecutive sampling and categorized by ethnicity: Tolaki (n = 75) and Muna (n = 72). Both groups received a standardized dose of Candesartan Cilexetil (8 mg). The primary outcome was the change in blood pressure from baseline (pretest) to day 30 (posttest). Adherence, monitored via pill count, along with sociodemographic and lifestyle factors, was analyzed as a covariate to ensure a robust evaluation of the treatment's clinical impact across both ethnic groups. There was no significant difference in therapy adherence between participants of both ethnicities (p = 0.78). However, Tolaki participants experienced a greater reduction in 30-day systolic and diastolic blood pressure compared to Muna participants (p = 0.00). Furthermore, a greater percentage of Tolaki participants achieved blood pressure therapy targets (76%) compared to Muna participants (15.28%) (p < 0.001). Multivariate logistic regression analysis revealed that two variables that most significantly influence the attainment of blood pressure objectives are ethnicity (Tolaki ethnicity) (OR 21.44, 95% CI 6.69–53.40, and p=0.00) and a high level of therapy adherence (OR 10.89, 95% CI 2.96–40.07, and p=0.00). Ethnicity and therapy adherence are two important factors that need to be considered in efforts to achieve blood pressure therapy targets in the Tolaki and Muna tribes undergoing candesartan cilexetil monotherapy.
Reliability and risk classification agreement of digital HYPOGLYRISK: implications for standardized medication safety services Made Krisna Adi Jaya; Zullies Ikawati; Fita Rahmawati; Nanang Munif Yasin
Pharmaciana Vol. 16 No. 2 (2026): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/pharmaciana.v16i2.32020

Abstract

Hypoglycemia caused by medications is still a major safety issue for people with type 2 diabetes who are in an ambulatory therapy. To support pharmacists lead interventions, structured risk stratification is needed. The Medication-Related Hypoglycemia Risk Score Assessment Tool (HYPOGLYRISK) has been subjected to psychometric validation and digital development. However, its reproducibility among practitioners is crucial prior to broader implementation. This study assessed the inter-rater reliability and risk classification concordance of the digital HYPOGLYRISK instrument among practicing pharmacists. A methodological reliability and agreement study was performed with 46 licensed pharmacists who independently evaluated three standardized simulated patient cases categorized as low, moderate, and high risk using a digital platform. We used the intraclass correlation coefficient to look at the inter-rater reliability of total scores and the descriptive method to look at categorical agreement. The reliability test showed almost perfect agreement, with an intraclass correlation coefficient of 0.995 (95% confidence interval: 0.988-0.999). There was no difference in how the raters classified the risk categories for any case. There was perfect agreement for the clinical risk factor part, but there was a small difference in numbers for the behavioral medication safety part in the moderate-risk case, which involved 8.7% of raters. This did not change the final risk categorization. There was no misclassification between extreme risk categories. These results show that the digital HYPOGLYRISK tool gives very consistent scores and stable risk stratification across pharmacists. This finding supports its use as a standardized tool for pharmacist-led medication safety services in ambulatory diabetes care.
Co-Authors Agung Endro Nugroho Fita Rahmawati Ismail Setyapranoto Made Krisna Adi Jaya Mesi Leorita Nanang Munif Yasin