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All Journal Tropical Medicine Journal Jurnal Kesehatan Masyarakat Indonesia Jurnal Kebijakan Kesehatan Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Pharmaciana: Jurnal Kefarmasian Jurnal Sains dan Teknologi Farmasi Indonesian Journal of Biotechnology JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) INDONESIAN JOURNAL OF PHARMACY Syntax Literate: Jurnal Ilmiah Indonesia Jurnal Ilmu Kefarmasian Indonesia PREPOTIF : Jurnal Kesehatan Masyarakat JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Sciences of Pharmacy Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) Borneo Journal of Pharmacy Indonesian Journal of Pharmacology and Therapy

Erna Kristin

Fakultas Kedokteran Universitas Gadjah Mada

Author-ID : 260539

Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Computer Science & IT Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Public Health Social Sciences Other

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PENGARUH DIABETES MELLITUS TERHADAP RESISTENSI ASPIRIN PADA PASIEN STROKE ISKEMIK DI RUMAH SAKIT BETHESDA YOGYAKARTA Hardi Astuti Witasari; Rizaldy Taslim Pinzon; Erna Kristin
Pharmaciana Vol 4, No 2 (2014): Pharmaciana
Publisher : Universitas Ahmad Dahlan

The secondary prevention of ischemic stroke can be implemented by giving aspirin.However, some cases of aspirin resistance have been found. The purpose of this study was toexamine the influence of diabetes mellitus on the risk of aspirin resistance in ischemic strokepatients at Bethesda Hospital Yogyakarta. This study was using a nested case-control studydesign. The Cases group was subjects who resistance to aspirin therapy. The control group wassubjects who response to aspirin therapy. The factors that affect the incidence of aspirinresistance were analyzed by bivariate analysis chi square test. The proportion of diabetesmellitus in resistant group was bigger than the aspirin responsive group. Its odds ratio (OR) was1.605 (95% CI, 0.641 to 4.017) (p=0.155). Conclusion: Ischemic stroke patients at BethesdaHospital Yogyakarta with diabetes mellitus were not proved to have a bigger risk of aspirinresistance than the patients without diabetes mellitus.

Analysis of Prices of Patented Medicines Listed In The National Formulary and E-Catalogue In Pusat Jantung Nasional (RSPJN) Harapan Kita Hospital, â€œDharmaisâ€ Cancer Hospital, and Pusat Otak Nasional Hospital (RSPON), Jakarta Province Sari Mutiarani; Prih Sarnianto; Erna Kristin
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Cost control of drugs plays an important role in the implementation of the Health Insurance Program and one of the efforts related to this is the through the drug selection process in National Formulary (Fornas) and the determination of drug prices in e-catalogue to obtain drugs, especially patented drugs, at affordable prices without reducing the quality of health service. This study aims to analyze the decline in drug prices during the patent period that listed in Fornas and e-catalogue and the savings in drugs costs during the patent period at the hospital and the factors that influence the decline in drug prices. In this descriptive study, secondary data was taken crosswise from the information management system in three special hospitals in Jakarta - RSPJN Harapan Kita, "Dharmais" Cancer Hospital and RSPON- which listed in Fornas and used during January 2019 - June 2020, and drug price list according to the e-Catalogue and the regular in that period. The results showed a decrease in the price drugs that were still in patent period when they were listed in Fornas and e-Catalogue compared to the price of regular market by 55,1%. The Price rediction that occurred has resulted in savings in drug costs during the patent period at RSPJN Harapan Kita by 47,2%, RSPON (55,3%) and the â€œDharmaisâ€ Cancer Hospita (36,1%). Drug tax value, NIE publication year, and type of drug therapy class that tend to cause drug prices to fall higher in addition to the impact of the implementation of Fornas in RSPON, RSPJN Harapan Kita, and "Dharmais" Cancer Hospital.

Effect of aspirin resistance with dyslipidemia against VerifyNOW® measurement in Bethesda hospital Yogyakarta Hardi astuti witasari; Rizaldy Taslim Pinzon; Erna Kristin
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 7, No 2, (2015)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol7.Iss2.art2

Background: Aspirin is first line drug of choice to prevent ischemic stroke. However, some cases are found occuring of aspirin resistance. Objective: This study was to examine the effect of dyslipidemia on the risk of antiplatelet resistance with VerifyNOW ® at Bethesda Hospital Yogyakarta. Method: This research was observational analysis using a nested casecontrol study design. The subjects were ischemic stroke patients who underwent tests of platelet function by VerifyNOW® (Accumetrics, San Diego, CA, USA). The Case group was ischemic stroke patients who has history of aspirin resistance. The control group was ischemic stroke patients who response on aspirin therapy. Both groups were analyzed and compared to the state of dyslipidemia. Results: Bivariate analysis on the incidence of aspirin resistance indicate that dyslipidemia had OR = 0.979 (95% CI; 0.378 to 2.531), p = 0.572. Hypercholesterolemia had OR = 0,909 (CI 95%; 0,377-2,190) p = 0,500; hypertrigliceride had OR = 0,838 (CI 95%; 0,331-2,119) p = 0,409; abnormal HDL had OR = 1,468 (CI 95% 0,564-3,817) p = 0,238; abnormal LDL had OR = 0,937 (CI 95% 0,374-2,345) p = 0,500. Patient factors such as age >55 years (p = 0.168) and female gender (p = 0.226) showed a nonsignificant results. Conclusion: Ischemic stroke patients at Bethesda Hospital Yogyakarta who had dyslipidemia were not evident to have a greater risk of aspirin resistance than ischemic stroke patients who did not undergo dyslipidemia.

The Impact of Lean Management Implementation on Inpatient Discharge Prescription Services at Pertamina Central Hospital Hermawati, Ajitya Kurnia; Kristin, Erna; Firman, Firman
Jurnal Kesehatan Masyarakat Indonesia Vol 19, No 3 (2024): Juli - September 2024
Publisher : Universitas Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26714/jkmi.19.3.2024.25-31

Background: The lead time of inpatient discharge prescription services affects the overall discharge process. In 2022, lead times at Pertamina Central Hospital's Inpatient Pharmacy varied, requiring continuous efforts to meet target times and avoid disrupting discharge plans. This research aims to evaluate the impact of lean management on reducing these lead times. Methods: The study employs a combined quantitative and qualitative research design with an action research approach. It was conducted from March 4 to May 8, 2023, involving pharmacists, pharmaceutical technical personnel, compounders, and pharmacy couriers. Data analysis included measuring lead time changes pre- and post-lean management implementation and narrative analysis of qualitative findings. Results: After implementing lean management, the lead time for non-compounded prescriptions decreased from 42.6 to 25 minutes, with value added ratio (VAR) increasing from 18.9% to 27%. For compounded prescriptions, lead time dropped from 67 to 45.7 minutes, and VAR rose from 25.2% to 37.9%. The Mann-Whitney U test confirmed the significant difference in average lead time. Conclusion: The implementation of lean management in inpatient discharge prescription services has been proven to improve lead time and increase process efficiency (VAR).

ANALISIS MANFAAT IMPLEMENTASI CLINICAL PATHWAY SECTIO CESAREA TERHADAP TAGIHAN MEDIS (MEDICAL BILL) DI RUMAH SAKIT IBU DAN ANAK CEMPAKA AZ-ZAHRA KOTA BANDA ACEH Mahady, Taufik Wahyudi; Kristin, Erna; Djasri, Hanevi
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 2 (2025): AGUSTUS 2025
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v9i2.48351

Angka tindakan Sectio Caesarea (SC) terus meningkat secara global, termasuk di Indonesia yang telah melebihi ambang batas ideal WHO (10–15%) dengan prevalensi lebih dari 20% di beberapa wilayah. Di RSIA Cempaka Az-Zahra Banda Aceh, jumlah pasien SC tercatat sebanyak 263 kasus pada tahun 2022 dan 2023. Clinical Pathway (CP) diyakini dapat menurunkan variasi pelayanan, memperpendek lama rawat inap (Length of Stay/LOS), dan mengendalikan biaya perawatan. Menilai tingkat kepatuhan terhadap CP, variasi layanan, efisiensi biaya, serta dampaknya terhadap mutu pelayanan tindakan SC. Penelitian ini menggunakan desain cross-sectional dengan pendekatan kuantitatif, menggunakan data sekunder rekam medis tahun 2022–2023. Parameter yang dianalisis mencakup kepatuhan terhadap CP, LOS, variasi pelayanan, dan total tagihan medis. Hasil dari penelitian ini Tingkat kepatuhan CP pada tahun 2023 mencapai 92,4%. Variasi layanan masih ditemukan, namun tidak signifikan (p = 0,999). Rata-rata LOS menurun dari 2,73 hari (2022) menjadi 2,69 hari (2023) (p = 0,317). Rata-rata biaya meningkat dari Rp9.906.681 menjadi Rp10.160.713 (p < 0,001). Namun, pasien yang patuh terhadap CP menunjukkan biaya perawatan yang lebih rendah. Komponen biaya terbesar adalah kamar operasi (45,2% di 2022; 47,2% di 2023), sementara biaya obat-obatan menurun dari 11,9% menjadi 7,8%. Kesimpulan Implementasi Clinical Pathway pada tindakan SC berkontribusi terhadap efisiensi biaya dan peningkatan konsistensi layanan, meskipun belum seluruh indikator menunjukkan perubahan signifikan. Optimalisasi pelaksanaan CP tetap diperlukan untuk peningkatan mutu dan kendali biaya rumah sakit.

ANALISIS FAKTOR YANG BERPENGARUH TERHADAP MORTALITAS PASIEN INTENSIVE CARE UNIT (ICU) DI RSUD Dr. SOEDIRMAN KEBUMEN Diah Ayu Putriyanti; Kristin, Erna; Ratmasari, Dewi
Journal of Health Service Management Vol 28 No 03 (2025)
Publisher : Departemen of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpk.v28i03.22366

Background: The ICU patient mortality rate is an indicator of hospital service quality. The ICU mortality rate at Dr. Soedirman Kebumen Regional General Hospital over the last five years has been over 40%. This rate is higher compared to the national ICU patient mortality rate in Indonesia, which is 27.6%. Objective: To identify factors influencing ICU patient mortality and to develop recommendations for an ICU mortality reduction program at Dr. Soedirman Kebumen Regional General Hospital. Methods: This study employed a mixed-methods research design with a sequential explanatory approach. Quantitative data were obtained from the medical records of ICU patients from July 2024 to December 2024. Qualitative data were gathered through in-depth interviews (management group) and focus group discussions (doctors and nurses). Quantitative data were analyzed using chi-square and Fisher's exact tests, as well as multivariate logistic regression. Qualitative data were analyzed using thematic analysis. Results: The study included 278 subjects, of whom 126 (45.3%) died in the ICU. Factors identified as significantly influencing ICU patient mortality at Dr. Soedirman Kebumen Regional General Hospital were age (p-value = 0.001), type of diagnosis (p-value = 0.008), Glasgow Coma Scale (GCS) score (p-value <0.001), use of mechanical ventilation (p-value <0.001), and length of stay (p-value = 0.004). The use of mechanical ventilation was the variable with the most significant influence on ICU patient mortality (p = 0.001, OR 43.73, 95% CI 15.84-120.72). Qualitative results suggested several programs to reduce ICU patient mortality, including: re-socialization of ICU admission criteria, activation of palliative care, improvement of human resources competency, multidisciplinary team collaboration, periodic evaluation of Early Warning System (EWS) implementation, evaluation of culture examination procedures, and initiation of High Care Unit (HCU) establishment. Conclusion: Age, type of diagnosis, Glasgow Coma Scale (GCS) score, use of mechanical ventilation and length of stay are factors influencing ICU patient mortality at Dr. Soedirman Kebumen Regional General Hospital. Given these factors contributing to the high ICU mortality rate, it is crucial for the hospital management to enhance service quality by implementing strategies to reduce ICU patient mortality at Dr. Soedirman Kebumen Regional General Hospital. Keywords: Intensive Care Unit, ICU, ICU mortality, determinants of ICU mortality, mortality reduction

Evaluasi Penggunaan Antibiotik dengan Metode Kuantitatif pada Pasien Pneumonia Rawat Inap di Rumah Sakit Nusa Tenggara Barat Khairani, Sondang; Ramadaniati, Hesty Utami; Sarnianto, Prih; Kristin, Erna; Anggriani, Yusi
JURNAL ILMU KEFARMASIAN INDONESIA Vol 21 No 2 (2023): JIFI
Publisher : Faculty of Pharmacy, Universitas Pancasila

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35814/jifi.v21i2.1449

Abstract Overuse of antibiotics is a public health challenge that can lead to antimicrobial resistance. To reduce the occurrence of antibiotic resistance, it is necessary to evaluate the use of antibiotics to determine the rational use of drugs using quantitative methods, namely the ATC /DD method. The purpose of the study was to determine the use of antibiotics and describe the pattern of antibiotic use in inpatients at West Nusa Tenggara Hospital using the ATC /DD method and DU90%. The research method is a cross-sectional study design with retrospective data collection on adult pneumonia patients hospitalized in the period Januari-December 2019 and 2022, data obtained from medical records. The results of the study met the inclusion criteria of 218 patients with the majority being male 117 (53.67%) and the most age > 65, namely 66 (30.28%). Antibiotic use has a total DDD value of 185.56 DDD/100 days of care with the highest antibiotic DDD value being ceftriaxone which is 104.00 DDD/100 days of hospitalization while antibiotics that are included in the DU 90% are ceftriaxone, levofloxacin, cefoperazon and meropenem. Conclusion the most antibiotics used were ceftriaxone 104.00 DDD/100 days of length of stay.

Effects of Switching Dose, Dose Variation, and Warfarin Interaction on the Incidence of Stroke Recurrence in Stroke Patients with Atrial Fibrillation Fauzi, Lailla Affianti; Kristin, Erna; Pinzon, Rizaldy Taslim; Kushartanti, Bernadeta Margareta Wara; Arovah, Novita Intan
Borneo Journal of Pharmacy Vol. 7 No. 3 (2024): Borneo Journal of Pharmacy
Publisher : Institute for Research and Community Services Universitas Muhammadiyah Palangkaraya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33084/bjop.v7i3.6603

Atrial fibrillation (AF) significantly increases the risk of stroke, necessitating anticoagulation therapy. Warfarin, a commonly prescribed anticoagulant regimen, requires careful monitoring to ensure patient safety. This study aimed to assess the impact of dose switching, dose variation, and potential interactions with warfarin on the incidence of stroke recurrence in stroke patients with AF. The study retrospectively analyzed the treatment records of stroke patients with AF in outpatient settings over one year. The subjects comprised 314 patients who received warfarin prescriptions at two Indonesian Hospitals from January 1, 2015, to December 31, 2019. Out of these patients, 50 had recorded data regarding dose adjustments, variations, and interactions. They were divided into two groups: a case group (n=11) with stroke recurrence and a control group (n=39) without recurrence. Statistical analysis, including chi-square tests and odds ratio calculations, revealed that both warfarin dose switching (OR=7.6) and dose variation (OR=6.6) significantly influenced the incidence of stroke recurrence. It implies that inconsistencies or alterations in warfarin dosing substantially elevate the likelihood of experiencing another stroke, potentially due to inadequate anticoagulation leading to clot formation. Interestingly, the analysis of drug interactions did not significantly impact stroke recurrence. In summary, the recurrence of stroke in patients with AF is notably influenced by warfarin dose adjustments and variations rather than drug interactions. This study highlights the critical importance of precise dosing strategies and vigilant monitoring to enhance the efficacy of anticoagulant therapy in this high-risk population.

Quality and Potency of Government-subsidized Antibiotics in Hospitals Across Jakarta, Indonesia Khairani, Sondang; Ramadaniati, Hesty Utami; Sarnianto, Prih; Kristin, Erna; Anggriani, Yusi
Sciences of Pharmacy Volume 3 Issue 1
Publisher : ETFLIN Publishing House

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58920/sciphar0301198

Several pharmaceutical companies have long complained that the price of medicines that win the e-catalogue tender is too low, in some cases even below the cost of production. However, it should not be a concern that only pharmaceutical products with regulation of Indonesian food and drug (BPOM) distribution licenses are eligible for the price tender, as they are of good quality. This study aims to determine the quality and potency of three antibiotic drugs based on their highest utilization (DU 90%) in pneumonia patients at two hospitals, A (ceftriaxone, azithromycin tablet) and B (ceftriaxone, levofloxacin infusion) compared to brand name. The quality of the samples was evaluated following the Indonesian Pharmacopoeia 6th Edition (FI-VI). Antibiotic potency was assessed using the Plate-Cylinder Method with K. pneumonia from human and S. pneumonia ATCC 10015 as the test bacteria evaluated following CLSI. All samples meet the criteria of FI-VI antibiotic content, weight uniformity, dissolution. Antibiotic potency all samples test S.pneumonia and K.pneumonia were sensitive but ceftriaxone test with K.pneumonia was resistance. All antibiotic tablets and injections studied met the requirements of the Indonesian Pharmacopoeia Edition 6 for active medicinal ingredient content, dosage weight uniformity, and dissolution. All drugs from hospitals (INN) have lower antibiotic potency than branded drugs. This highlight the importance of conducting microbiological testing on antibiotic preparations.

The affected factors of loss to follow up (LFU) among HIV patients with antiretroviral therapy (ART) in Dr. Sardjito General Hospital, Yogyakarta, Indonesia Sri Purwaningsih; Yanri Wijayanti Subronto; Erna Kristin
Indonesian Journal of Pharmacology and Therapy Vol 1 No 1 (2020)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.481

HIV infection is a global issue which is related to the increasing cases of HIV and AIDS in various countries including in Indonesia. Antiretroviral therapy (ART) that addressed for reducing the virus proliferation is not always followed by good medication adherence among patients. The ART loss to follow up (LFU) is a common problem in Indonesia. However, information concerning the affected factors of LFU among HIV patients with ART is limited. This study aimed to investigate the affected factors of LFU among HIV patients in the early two years of ART. A retrospective cohort study was conducted in Dr. Sardjito General Hospital, Yogyakarta among 369 medical records of HIV patients that met the inclusion and exclusion criteria. The inclusion criteria were HIV patients who started ART in January 2008 to December 2012, aged > 17 years with a complete medical records. The data of sociodemography and medical status patients were obtained from medical record, ART, and pharmacy register of the patients. Patient characteristics observed in this study included demographic factors such as age, sex, residence, education level, risk factors, and also medical status factors such as clinical stage, tuberculosis (TB) co-infection, functional status, and CD4 cell counts. The data were analyzed using Kaplan Meier and Cox Proportional Hazard. The results showed that patients with TB co-infection in early therapy and working functional status were significant factors of LFU (p<0.05). Patients without TB co-infection were half as much protected from LFU compared to patients with TB infection (HR=0.50; 96%CI: 0.34-0.75). It can be concluded that TB coinfection in early therapy and working fuctional status are the significant factors that influenced the LFU incidents in the two years of early therapy.

Co-Authors Agastya, Agastya Alfi Yasmina Alfi Yasmina Alfi Yasmina Anak Agung Ayu Niti Wedayani Anak Agung Gede Sugianthara Bustami, Mursyid Diah Ayu Putriyanti Dwi Indria Anggraini Em Sutrisna Eri Supriyanti Erwin Astha Triyono Eti Nurwening Sholikhah Firman Firman Gregorius Nesi Hanevi Djasri Hardi Astuti Witasari Hermawati, Ajitya Kurnia Indwiani Astuti iwan Dwiprahasto Iwan Dwiprahasto Iwan Dwiprahasto Jarir At Thobari Kushartanti, Bernadeta Margareta Wara Lailla Affianti Fauzi Mahady, Taufik Wahyudi Mustofa Mustofa Ngatidjan Ngatidjan Ni Made Dwi Sandhiutami Novita Carolia Novita Intan Arovah Pratiwi, Woro Rukmi Prih Sarnianto Ramadaniati, Hesty Utami Ratih Puspita Febrinasari Ratih Puspita Febrinasari Ratmasari, Dewi Rizaldy Pinzon Rizaldy Taslim Pinzon Rizaldy Taslim Pinzon S.Farm., M.Farm., Apt, Sondang Khairani Sari Mutiarani Sarnianto, Prih Sri Purwaningsih Sri Purwaningsih Sumardi - Sunarto Ang Susanto, Agnes Susanto, Agnes Trijayanti, Christiana Yanri Wijayanti Subronto Yanri Wijayanti Subronto Yolanda Dyah Kartika Yusi Anggriani

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