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All Journal JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Wenny Putri Nilamsari
Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
Chemistry Education Health Professions Medicine & Pharmacology Other

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Exploring Side Effects of Warfarin in Outpatients at Tertiary Hospital in Indonesia Fatimatuz Zahra Oviary Satryo; Dewi Wahyuni; Budi Suprapti; Wenny Putri Nilamsari; Mochamad Yusuf Alsagaff; Dewi Makmuroh Nurul Qomar Purnamawati; Bambang Subakti Zulkarnain
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 12 No. 2 (2025): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v12i22025.142-150

Abstract

Background: Patients with atrial fibrillation, venous thromboembolism, valvular disease, cardioembolic stroke, and acute myocardial infarction are prescribed the oral anticoagulant warfarin to treat thrombi. To guarantee its efficacy and safety, anticoagulants must be closely monitored. Furthermore, warfarin has a narrow therapeutic index, which increases the risk of side effects, particularly in the early stages of treatment. Objective: This study aimed to analyze the incidence of warfarin side effects in outpatients at Dr. Soetomo General Hospital. Methods: A retrospective cross-sectional design was adopted for outpatients at the Cardiology Department of Dr. Soetomo General Hospital from March to May 2023. Data were collected on the incidence of side effects in outpatients who received warfarin for a minimum of one month through an interview process. Other data, including age, sex, duration of warfarin therapy, comorbidities, and INR at the last scan, were extracted from medical records. The Chi-Square test was used to examine the data. Results: The results showed that 88 patients (42.7%) had side effects of bleeding (126 events). These included gum bleeding (22.3%), hematoma (20.4%), melena (7.7%), menometrorrhagia (2.4%), epistaxis (1.9%), hematuria (1.5%), hematemesis (1.0%), hemoptysis (1.0%), spontaneous venous bleeding  (1.0%), hematochezia (0.5%), hemostasis during blood sampling  (0.5%), tongue bleeding  (0.5%), and subconjunctival bleeding  (0.5%). Conclusion: The incidence of side effects during warfarin treatment was high, accounting for approximately 42.7% of cases. Furthermore, one patient experienced more than one side effect.
Medication Adherence, Quality of Life, and Rehospitalization in Post-Acute Coronary Syndrome Patients Yustiana; Wenny Putri Nilamsari; Hendri Susilo; Dinda Monika Nusantara Ratri; Fatresye Mariati Bawole
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 12 No. 2 (2025): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v12i22025.195-207

Abstract

Background: Post-ACS patients often face an increased likelihood of mortality, rehospitalization, and diminished quality of life as a consequence of poor medication adherence. Objective: This study aimed to evaluate the level of adherence to medication in post-ACS patients and its relationship with quality of life and rehospitalization rates. Methods: A cross-sectional, observational, single-center, prospective study conducted at Universitas Airlangga Teaching Hospital, Surabaya. Compliance with medication was evaluated using the Adherence Refill Medication Scale-7 (ARMS-7) questionnaire, while quality of life was measured using the Short Form-36 (SF-36) Quality of Life questionnaire. Rehospitalization rates were obtained through direct interviews and medical record observations within 45 days of hospital discharge. Results: In total, 39 patients participated in this study, with overall adherence rates of 35.89% for all prescribed medications, 53.85% for antiplatelets, 38.46% for statins, 55.56% for beta-blockers, and 58.06% for ACEIs/ARBs. Among the quality-of-life dimensions, social functioning had the highest score (93.01 ± 15.89), whereas physical role functioning had the lowest score (40.39 ± 35.18). Within 45 days of hospital discharge, 26% of the patients experienced rehospitalization. Statistical analysis indicated a positive correlation between adherence to all prescribed medications and physical role functioning in relation to QoL (p = 0.038). In addition, overall medication adherence was negatively correlated with the risk of rehospitalization (p = 0.019). Conclusion: Total medication adherence was associated with improved physical function and rehospitalization events. Providing education can lead to better therapeutic outcomes, improved quality of life, and reduced rehospitalization in patients.
Pharmacist-Led Tailored Interventions to Adress Medication-Adherence Barriers and Improve Health-Related Quality of Life in Patients with Heart Failure: A Prospective Pre-Post Study Zahrah Tatta Ramadhanty; Deny Wilson Amanda Sitorus; Wenny Putri Nilamsari; Hendri Susilo; Mochamad Yusuf Alsagaff; Khusnul Fitri Hamidah; Ching Siang Tan; Khalid Ahmad Ali Al Sunaidar
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 13 No. 2 (2026): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Nonadherence to heart failure (HF) therapy affects mortality and hospitalization. Pharmacists play a crucial role in addressing barriers to adherence; however, the implementation of tailored, patient-specific interventions has not been explored. Objective: To evaluate changes in medication adherence and health-related quality of life (QOL) following a pharmacist-led, barrier-spesific intervention among outpatients with chronic heart failure.  Methods: This prospective, single-centre, one-group pre-post study was conducted at the Cardiology and Vascular Polyclinic of a secondary hospital in Indonesia. Patients were observed over two months and received educational interventions, medication reminders, and simplified medication instructions. Medication adherence was assessed using the ARMS-7, while QOL was measured using SF-36. The McNemar test was used to assess medication adherence, and the Wilcoxon test was used to evaluate QOL improvement. Results: Forty participants completed the study, with more than half being male (aged < 60 years). The results indicated that forgetting to get prescriptions filled (85%) and forgetting to take medication (17.5%) were the major barriers to adherence to medication. Eighty percent of patients showed improved medication adherence (p < 0.05). Physical, mental, and social functions improved the most (p < 0.05). Conclusion: The findings underscore the effectiveness of a tailored intervention in significantly improving medication adherence and QOL among patients with HF, highlighting its ability to address specific barriers.
Co-Authors Bambang Subakti Zulkarnain Budi Suprapti Ching Siang Tan Deny Wilson Amanda Sitorus Dewi Makmuroh Nurul Qomar Purnamawati Dewi Wahyuni Dinda Monika Nusantara Ratri Fatimatuz Zahra Oviary Satryo Fatresye Mariati Bawole Hendri Susilo Hendri Susilo Khalid Ahmad Ali Al Sunaidar Khusnul Fitri Hamidah Mochamad Yusuf Alsagaff Mochamad Yusuf Alsagaff Yustiana Zahrah Tatta Ramadhanty