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Journal : JURNAL FARMASIMED (JFM)

Association Between Drug Related Problems and Outcomes of Tuberculosis Patients at Citra Husada Hospital Jember Lutvi Anggraeni; Fifteen Aprila Fajrin; Afifah Machlaurin; Irma Prasetyowati; Angga Mardro Rahardjo
Jurnal FARMASIMED (JFM) Vol 8 No 2 (2026): Jurnal Farmasimed (JFM)
Publisher : Fakultas Farmasi Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/4h3axm73

Abstract

Background: Tuberculosis (TBC) remains a major global challenge. In Indonesia, the success rate for Drug-Sensitive Pulmonary TB (DS-TBC) treatment is still below target, often linked to Adverse Drug Reaction (ADR) and Drug Related Problem (DRP). The complexity of regimens and polypharmacy increases the risk of DRPs, which are strong predictors of treatment failure. Objective: This study aimed to identify DRPs and analyze their relationship with the clinical outcomes of DS-TBC. Method: A retrospective cohort study was conducted on 281 DS-TBC patients recorded at Citra Husada Hospital Jember from January 2020 to December 2023. Data were collected from medical records and the TBC Information System (SITB). DRPs were identified using the PCNE V9.1 classification, focusing on dose inappropriateness, drug interactions, and ADR. Outcomes were categorized as successful (cured/treatment completed) or unsuccessful. Result: Data analysis included descriptive statistics, bivariate analysis using Chi-Square, and multivariate analysis using Binary Logistic regression with a significance p < 0,05. The result of this study is that patients were predominantly male (55.16%), aged 46-65 years, with a treatment completion rate of 82.21%. DRPs were found in 84.34% of patients, dominated by drug interactions (79%) and ADRs (35.23%), although the accuracy of anti-TB drug dosage was 100%. In multivariate analysis, age ≥65 years was associated with a decreased likelihood of successful treatment (aOR 0.367), while respiratory tract medication administration was associated with an increased likelihood of successful treatment (aOR 2.477). The overall relationship between DRPs and outcome was not statistically significant. Conclusion: Sociodemographic factors (age) and clinical symptom management (respiratory therapy) play the most crucial roles in determining the treatment outcome. Effective pharmaceutical intervention is suggested to mitigate the impact of DRPs on treatment failure. More aggressive clinical management is necessary for elderly patients.
Cost-Effectiveness Analysis (CEA) of Adjunctive Hyperbaric Oxygen Therapy to Standard Wound Care Alone in Diabetic Foot Ulcer (DFU) Herdian Pradana; Afifah Machlaurin; Ayik Rosita Puspaningtyas; Fifteen Aprila Fajrin; Ainur Rokhmah
Jurnal FARMASIMED (JFM) Vol 8 No 2 (2026): Jurnal Farmasimed (JFM)
Publisher : Fakultas Farmasi Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/8z370a41

Abstract

Background: Diabetic foot ulcer (DFU) is a chronic complication of diabetes mellitus that is associated with high treatment costs and an increased risk of amputation. Hyperbaric oxygen therapy (HBOT) has been used as an adjunctive therapy to improve wound healing, yet evidence regarding its cost-effectiveness in Indonesia remains limited. Aim: This study aimed to evaluate the cost-effectiveness of HBOT compared with standard care in patients with DFU. Methods: A retrospective observational analytic study was conducted involving 80 DFU patients treated at RS Paru Jember between January 2024 and September 2025, consisting of 37 patients receiving standard care with HBOT and 43 patients receiving standard care without HBOT. Result: Clinical outcomes assessed included wound status, pain status, duration of healing, and incidence of amputation. Cost analysis was performed from the hospital perspective using direct medical costs, and cost-effectiveness was evaluated using the Incremental Cost-Effectiveness Ratio (ICER). The results showed that the HBOT group had a significantly higher proportion of wound healing compared with the non-HBOT group (21.62% vs 4.63%) and a lower rate of wound deterioration (2.7% vs 20.93%) (p=0.001). Although the mean total treatment cost was lower in the HBOT group than in the non-HBOT group (IDR 11,737,388 vs IDR 14,177,692), the difference was not statistically significant (p=0.118). ICER analysis demonstrated negative values for all evaluated outcomes, including wound healing, pain improvement, healing within six months, and prevention of amputation, indicating cost savings. Conclusion:  HBOT as an adjunctive therapy for DFU provides better clinical outcomes with lower overall treatment costs and may be considered a cost-effective and economically favorable intervention.