Djoko Wahyono
Fakultas Farmasi, Universitas Gadjah Mada, Yogyakarta

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Peningkatan Peran Apoteker dan Outcome Pasien Tuberkulosis Melalui Uji Coba Model Training-Education-Monitoring-Adherence-Networking (TEMAN) Apoteker Nanang M. Yasin; Djoko Wahyono; Bambang S. Riyanto; Ika P. Sari
Indonesian Journal of Clinical Pharmacy Vol 6, No 4 (2017)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1547.993 KB) | DOI: 10.15416/ijcp.2017.6.4.247

Abstract

Model Training-Education-Monitoring-Adherence-Networking (TEMAN) Apoteker memberikan ruang bagi apoteker yang telah mendapatkan pelatihan untuk melakukan intervensi melalui edukasi pasien tuberkulosis (TB), monitoring terapi, asesmen kepatuhan pasien dan kerjasama dengan tenaga kesehatan lain. Penelitian ini bertujuan untuk mengetahui dampak uji coba model TEMAN Apoteker terhadap peran apoteker dan outcome pasien TB. Penelitian terdiri atas 2 tahap yaitu pelatihan dan intervensi apoteker dengan jenis penelitian quasi experimental study dengan rancangan one group pretest-posttest design. Setelah mendapatkan pelatihan, apoteker melakukan intervensi pada saat kunjungan rutin pasien TB di puskesmas dan Rumah Sakit Khusus Paru Respira di DIY. Subjek penelitian yang dilibatkan meliputi petugas TB (apoteker dan programmer TB) dan pasien dengan diagnosis baru TB yang memenuhi kriteria inklusi, yaitu usia lebih dari 15 tahun, mendapatkan terapi obat anti tuberkulosis (OAT), bersedia mengisi kuesioner dan menandatangani informed consent. Kriteria eksklusinya adalah pasien multi drug resistance (MDR) TB; memiliki penyakit hepatik, psikiatrik (mental) dan disfungsi kognitif. Instrumen yang dikembangkan peneliti adalah kuesioner untuk mengukur tingkat pengetahuan petugas TB dan kuesioner untuk mengukur tingkat pengetahuan dan kepatuhan pasien TB. Analisis data menggunakan analisis deskriptif dan uji Wilcoxon sign rank. Adanya pelatihan efektif meningkatkan pengetahuan 37 petugas TB secara bermakna p=0,000 dari rerata 11,3±3,00 (kategori menengah) menjadi 16,3±2,31 (kategori tinggi). Sebanyak 40 (81,6%) pasien meningkat pengetahuannya secara bermakna (p=0,000) dan sebanyak 5 (10,2%) pasien meningkat kepatuhannya secara bermakna (p=0,034) setelah intervensi apoteker. Di sisi lain, dari total 49 pasien TB, sebanyak 29 (59,2%) pasien bertambah berat badannya, 100% konversi sputum, 33 (67,3%) kejadian adverse drug reactions (ADR), dan 8 (16,3%) potensi interaksi obat menjadi terdokumentasi melalui monitoring apoteker. Intervensi model TEMAN Apoteker meningkatkan peran apoteker dan outcome pasien TB.Kata kunci: Anti-tuberkulosis, apoteker, kepatuhan, edukasi, intervensi Enhancing Pharmacist’s Role and Tuberculosis Patient Outcomes Through Training-Education-Monitoring-Adherence-Networking (TEMAN) Pharmacist Model InterventionTraining-Education-Monitoring-Adherence-Networking (TEMAN) Pharmacist model provides opportunities for trained pharmacist to intervene through education of tuberculosis (TB) patient, therapy monitoring, assessment of patient’s adherence, and collaboration with other health professionals. The study aimed to determine the impact of TEMAN Pharmacist model intervention against the role of pharmacist and TB patient outcomes. The study design was a quasi-experimental study with one group pretest-posttest consisted of two phases: training and pharmacist intervention. After training, pharmacists intervene during regular visits TB patients in primary health care and Special Hospital Lung Respira in Yogyakarta. The research subjects were TB officer (pharmacist and TB programmers) and patients with newly TB diagnostic who met the inclusion criteria, i.e. patients aged 15 years or older, receiving antituberculosis therapy, and willing to fill out given questionnaires and signing a letter of approval for the study (informed consent). Meanwhile, the exclusion criteria were patients with multi-drug resistance (MDR) TB; have hepatic disease, psychiatry (mental), and cognitive dysfunction. The instrument developed was a questionnaire to measure the level of knowledge of TB officers and questionnaires to measure the level of knowledge and adherence of TB patients. The data were analyzed descriptively and by using Wilcoxon test. The training effectively improved the knowledge of participants significantly (p=0,000) on average 11.3±3.00 (intermediate category) to 16.3±2.31 (high category). A total of 40 (81.6%) TB patients increased their knowledge significantly (p=0,000) and 5 (10.2%) increased their adherence significantly (p=0,034) after the pharmacist’s intervention. Additionally, out of 49 patients, 29 (59.2%) patients increased body weight, 100% sputum smear conversion, 33 (67.3%) incidence of ADR, and 8 (16.3%) potential drug interactions were documented by the pharmacist monitoring. Intervention of TEMAN Pharmacist model improves the role of the pharmacist and the outcome of TB patients.Keywords: Adherence, antituberculosis, education, pharmacists, intervention
MODEL TEMAN APOTEKER: ALTERNATIF MODEL INTERVENSI APOTEKER BAGI PASIEN TUBERKULOSIS Nanang Munif Yasin; Djoko Wahyono; Bambang Sigit Riyanto; Ika Puspitasari
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 6, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.350

Abstract

Tingginya prevalensi tuberkulosis (TB) di Indonesia memerlukan keterlibatan apoteker dalam pelayanan pasien TB. Penelitian ini bertujuan untuk mengidentifikasi jenis pelayanan TB, mengembangkan model intervensi, dan mengembangkan tools dan rencana intervensi apoteker bagi pasien TB.   Penelitian ini merupakan jenis penelitian observasional yang terdiri dari tiga tahapan  yaitu focus grup discussion (FGD), pengembangan model intervensi, dan pengembangan tools dan rencana model intervensi apoteker. Instrumen yang digunakan adalah panduan FGD dan kuesioner pelayanan TB. FGD membahas pelayanan pada pasien TB dan dihadiri oleh apoteker dan programmer TB di puskesmas dan Rumah Sakit Khusus Paru Respira di Yogyakarta. Data FGD didukung oleh hasil kuesioner yang diisi sebelum FGD. Pengembangan  model intervensi terdiri dari tahap identifikasi kebutuhan pharmaceutical care, penentuan outcome, dan kompilasi akhir model intervensi apoteker. Pengembangan tools model intervensi apoteker berbasis berbagai literatur dan hasilnya dievaluasi oleh pakar.  Data penelitian dianalis secara deskriptif dan analisis kualitatif. Hasil FGD dan kuesioner menunjukkan bahwa keterlibatan apoteker masih terbatas dan hanya  4 (21%) yang pernah mendapatkan pelatihan TB. Semua petugas TB sudah melakukan edukasi namun materi yang diberikan sangat beragam dan belum terstruktur. Sebanyak 15 (78,9%) apoteker melakukan monitoring efek samping, 10 (52,6%) monitoring interaksi obat,  10 (52,6%) monitoring respon klinik,   16 (84,2 %)  monitoring kepatuhan pasien, 2 (10,5%) melakukan home care dan 18 (94,7%) telah berbagi peran dengan perawat. Melalui formulasi hasil studi pustaka, studi pendahuluan, dan FGD diperoleh rekomendasi bahwa peran apoteker dalam pelayanan TB dapat ditingkatkan melalui model intervensi yang mencakup 5 aspek penting yaitu training, education, monitoring, adherence, dan networking yang disingkat TEMAN Apoteker. Selanjutnya Model TEMAN Apoteker diterjemahkan dan dijabarkan dalam 6 bentuk tools yaitu modul, booklet, leaflet, poster, buku panduan pelaksanaan dan lembar dokumentasi pharmaceutical care. Model TEMAN Apoteker yang komprehensif dapat menjadi alternatif model intervensi dalam meningkatkan peran apoteker pada pelayanan pasien TB.
FACTORS THAT AFFECTING THE PHARMACY LOYALTY ON THE PHARMACEUTICAL WHOLESALER Dianita Rifqia Putri; Suci Paramitasari Syahlani; Djoko Wahyono
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 5, No 1
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.27

Abstract

The primary component for maintaining the long term sustainability of a company is customer loyalty. Many factorsaffect customer loyalty in the business-to-business relationship. This study aimed to determine the factors that affect the pharmacy loyalty to the pharmaceutical wholesaler.The study was obtained using questionnaire with 1-4 Likert scale. The sampling method was purposive sampling and the sample was 130 respondents. The questionnaire validaty was tested by factor analysis, while the reliability test was conducted usingCronbach’s Alpha. Data were analyzed using SEM-PLS (Structural Equation Modeling-Partial Least Square).The results showed that pharmaceutical wholesaler’s service quality had a positive effect on pharmacy satisfaction (p-value <0.001 and the path coefficient value = 0.566). Pharmacy satisfaction had a positive influence on pharmacy trust (p-value <0.001 andthe path coefficient value = 0.32), pharmacy commitment (p-value = 0.005 and the path coefficient value = 0.191), and pharmacyloyalty (p-value = 0.014 and the path coefficient value = 0.161). Pharmacy trust had a positiveinfluence on commitment pharmacy (p-value is 0.037 and the path coefficient value = 0.13) and a pharmacy loyalty toward the pharmaceutical wholesaler(p-value = 0.001 and the path coefficient value = 0.254). Commitment pharmacies had a positive effect on pharmacy loyalty (p-value= 0.034 and the path coefficient value = 0.134). To sum up, the most powerful factor among the three variables in influencingloyalty was pharmacy trust.Keywords: service quality, satisfaction, trust, commitment, loyalty