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All Journal Pharmaciana: Jurnal Kefarmasian Jurnal Respirologi Indonesia Jurnal Ilmu Kefarmasian Indonesia Pharmaceutical Sciences and Research (PSR) Makara Journal of Health Research Eduvest - Journal of Universal Studies Holistik Jurnal Kesehatan
Santi Purna Sari
Faculty Of Pharmacy, Universitas Indonesia, Depok, West Java
Aerospace Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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The Impact of Medication Adherence on Total Treatment Costs in Patients with Non-Small Cell Lung Carcinoma Jessica Nathania; Santi Purna Sari; Yovita Diane Titiesari
Jurnal Respirologi Indonesia Vol 46 No 1 (2026)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v46i1.1024

Abstract

Background: Lung cancer is the leading cause of cancer-related death globally and ranks second in cancer incidence in Indonesia. Targeted therapies such as Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors (EGFR-TKIs) and Anaplastic Lymphoma Kinase (ALK) inhibitors are recommended for advanced-stage non-small cell lung cancer (NSCLC) but may be limited by high cost. This study aimed to assess the relationship between medication adherence—measured by the mean proportion ratio (MPR)—and total treatment costs, and to examine its association with patient-specific factors. Methods: This observational, cross-sectional study used secondary data from NSCLC patients treated with EGFR-TKIs or ALK inhibitors at a Cancer Center in Jakarta, Indonesia (January 2023-March 2025). Eighty-six eligible patients (aged ≥18 years) were diagnosed with NSCLC, confirmed by immunohistochemistry (EGFR or ALK-positive). MPR measured medication adherence and analysed using Mann-Whitney and chi-square tests using SPSS Version 23, with a value of P<0.05 being significant. Results: Among NSCLC patients, about 89.53% exhibited a high level of treatment adherence, with an MPR score ≥0.8. Most patients were female (62.8%), under 60 years old (51.2%), stage IV (74.4%), and had an EGFR exon 19 mutation (52.3%). Osimertinib (30.2%) and Afatinib (24.4%) were the most used therapies. Most patients reported no serious side effects (57.0%) and received caregiver support (57.0%). There was no significant association between medication adherence and treatment cost (P=0.955), nor patient-related factors. Conclusion: Approximately 9 out of 10 NSCLC patients adhere to treatment with EGFR-TKIs or ALK inhibitors. High levels of adherence did not significantly increase additional medical expenses that would raise the total cost of treatment. Further qualitative research is needed to explore adherence determinants.
Review: Cost Effectiveness Analysis And Its Implementation Regarding Hypertension Treatment Dini Nabilah; Santi Purna Sari; Marlina Dewiastuti
Eduvest - Journal of Universal Studies Vol. 4 No. 11 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i11.1420

Abstract

Healthcare financing involves the management of various efforts to mobilize, allocate, and spend health funds to ensure the implementation of health development aimed at achieving the highest possible level of public health. Hypertension, a non-communicable disease (NCD) continues to evolve and poses a serious public health issue and leads to an increasing health financing burden. Health Social Security Agency (BPJS) indicated direct medical costs of hypertension IDR 3 trillion in 2017 and 2018. The variety of first-line antihypertensive combinations due to the numerous recommended first-line antihypertensive combinations in various guidelines highlights the importance of pharmacoeconomic studies to determine the most cost-effective combination. This review article aims to further discuss the implementation of the CEA method as a basis for treatment selection or decision-making regarding hypertension treatment. The nifedipine 60 mg and candesartan 32 mg combination is deemed the best, achieving a blood pressure reduction of 23,8/16,5 mmHg (p<0,01) compared to placebo and monotherapy reductions of 5,3/6,7 mmHg. Additionally, the nifedipine GITS - candesartan combination reduces vasodilator side effects incidence to 18,3% compared to 23,6% for nifedipine monotherapy, including a lower incidence of headaches (5,5% vs. 11%).
The Factor Affecting Medication Adherence in Tuberculosis Patients: A Literature Review Daimah Wirdatus Sanaun Harahap; Retnosari Andrajati; Santi Purna Sari; Diah Handayani
Eduvest - Journal of Universal Studies Vol. 5 No. 1 (2025): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i1.1541

Abstract

Medication adherence is crucial for the successful treatment of tuberculosis (TB), a persistent global health issue that demands prolonged and rigorous therapy to achieve cure, prevent drug resistance, and reduce transmission rates within communities. Recent studies highlight predictors of effective treatment outcomes such as being a new TB case and being HIV-negative. There is a significant relationship between various psychosocial factors that influence treatment adherence, particularly among elderly TB patients, where adherence is characterized by complexity and multidimensionality. Factors like depression, anxiety, income levels, social support, patient status, and TB classification play critical roles in adherence. Understanding these factors is essential for optimizing treatment strategies and improving outcomes in TB management.
Literature Review on the Appropriateness of Medication Prescription in Chronic Kidney Disease Patients: Focus on Antibiotic Use Ariesa Oktamauri; Nadia Farhanah Syafhan; Santi Purna Sari
Eduvest - Journal of Universal Studies Vol. 5 No. 3 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i3.44784

Abstract

Chronic Kidney Disease (CKD) significantly impacts pharmacokinetics and pharmacodynamics, altering drug metabolism and excretion, thus increasing the risk of drug toxicity. CKD patients are more susceptible to infections, which contribute to significant morbidity and mortality. This underscores the importance of appropriate antimicrobials used in this population. This literature review explores recent findings on medication prescribing practices, dose adjustments, and factors affecting appropriateness, especially in antibiotic use for CKD patients. A comprehensive literature search was conducted using six databases to identify studies published from 2015 to 2024. Twenty-six studies were included. This literature review found that prevalence of inappropriate prescriptions in CKD patients ranges widely between 10% to 77.1% and from 30% to 34,9% specifically for antibiotic, with higher rates observed in outpatient settings compared to hospital environments. Antibiotics, antidiabetic agents, antihypertensive, nutraceuticals, and electrolytes are frequently inappropriately prescribed. Factors influencing inappropriate prescription include comorbidity, severity level of kidney disorder, age, and polypharmacy. The antibiotics most commonly prescribed inappropriately include cefazolin, meropenem, oral sulfamethoxazole-trimethoprim, nebulised colistin, vancomycin, and piperacillin-tazobactam. This study emphasizes the mixed and limited evidence regarding the clinical outcomes of antibiotics dose adjustments in CKD patients. While some studies suggest that antibiotics dose adjustments improve therapeutic outcomes and reduce adverse events, others show no significant impact. Further research is needed to understand the impact of this intervention, as these outcomes may be influenced by various factors. Enhanced education and collaboration between healthcare providers are critical to improving the accuracy of antibiotic prescriptions and ensuring patient safety in CKD management.
Challenges of Monitoring Blood Levels of Bedaquiline in Drug-Resistant Tuberculosis: A Narrative Review Nur Isra; Santi Purna Sari; Yahdiana Harahap; Raden Rara Diah Handayani
Eduvest - Journal of Universal Studies Vol. 5 No. 3 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i3.50267

Abstract

Bedaquiline, a second-line drug for drug-resistant tuberculosis (MDR-TB), is one of the latest generation drugs in the treatment of tuberculosis (TB). However, the challenge in determining the optimal dose and individual pharmacokinetic variability requires the implementation of Therapeutic Drug Monitoring (TDM). This article aims to evaluate the challenges of TDM bedaquiline through a narrative review of the current literature. Relevant articles were identified through computerized searches on PubMed and Google Scholar using a combination of keywords related to bedaquiline, pharmacokinetics, and TDM. Limited clinical data indicate a lack of standard exposure targets and reliable efficacy thresholds. Pharmacokinetic variability is influenced by factors such as age, weight, gender, genetics, comorbidities, and serum albumin. Technical challenges include the need for precise analytical methods and the accessibility of technology in clinical practice. The use of TDM for bedaquiline offers the potential to improve the efficacy of MDR-TB treatment, but more research is needed to address pharmacokinetic variability and develop standardized guidelines.
Profile of Drug-Resistant Tuberculosis Patients at Rumah Sakit Universitas Indonesia Depok Period October 2024 Suci Rizki Dumiarsih; Santi Purna Sari; Retnosari Andrajati; Diah Handayani
Eduvest - Journal of Universal Studies Vol. 5 No. 3 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i3.50269

Abstract

Indonesia has been one of the three countries in Asia that contributes to the highest case of Tuberculosis (TB) in the world. Tuberculosis itself counted as the top ten cause of death globally. Two of the challenges in controlling TB cases are the occurrence of drug-resistance strain and patients’ adherence. Drug-resistant TB has to be treated with the second line drugs of TB with higher risk of adverse events. Linezolid as one of the suggested drugs by WHO in the treatment may increase patients’ risk of cytopenia events. This study was conducted to represent the profile of drug-resistant TB obtained from Rumah Sakit Universitas Indonesia (RSUI) Depok period October 2024. Design of this study is a quantitative-descriptive where the data of patients obtained from the patients’ medical records in the period of October 2024. The findings of this study showed the total number of drug-resistant TB was 104 with 3 cases of HIV and 70 patients having Linezolid in their regimen. Most of the patients are male with mean of age 41.3 years. New cases and RR/MDR TB level are dominated while on the other hand there’s 9 cases of After Failure and 4 others are After Loss to Follow-up. Median values obtained for patients’ leukocytes, hemoglobin, and platelets are 7818.0, 11.9, 279.5 respectively.
Identification of Adverse Drug Reaction Incidents in Statin Use in Depok Hospital Inpatient Rizky Nurhikmah; Retnosari Andrajati; Santi Purna Sari
Eduvest - Journal of Universal Studies Vol. 5 No. 3 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i3.50934

Abstract

One of the adverse drug reactions that occur in patients who receive treatment therapy is drug side effects. Statins are the first choice in cholesterol-lowering therapy. Although statins are safe and well tolerated, they have the potential for side effects. The purpose of this study is to determine the prevalence of adverse drug reactions, the incidence of adverse drug reactions that occur, and the probability score of adverse drug reactions based on the Naranjo Algorithm instrument in patients with inpatient atherosclerosis cardiovascular disease who use statin therapy at RSUI. The method used in this study is a prospective observational descriptive method with observation through patient interviews and medical record data collection as well as causality analysis using the Naranjo Algorithm. The results of this study were obtained from 116 patients who used statin therapy in the RSUI inpatient room in accordance with the inclusion and exclusion criteria. Of the 116 patients, as many as 14 patients (12.07%) experienced adverse drug reactions statins. Adverse drug reactions felt included shoulder pain (3.40%), nausea (2.60%), muscle pain (1.70%), blurred vision, difficulty sleeping, chest palpitations, joint pain, dizziness and body aches as much as 0.9% each. The total probability score of the Naranjo algorithm is a probable score of 5-8 in 7 patients (50%) and a possible score of 1-4 (50%).
An Cost-effectiveness analysis of antihypertensive therapy: nifedipine SR–candesartan compared with amlodipine–ramipril in hypertensive patients at Ciracas Regional Hospital Dini Nabilah; Santi Purna Sari; Marlina Dewiastuti
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.v16i2.30714

Abstract

Hypertension is one of the main causes of mortality and morbidity in Indonesia and generally occurs asymptomatic and thus frequently referred to as the silent killer. Long-term therapy is essential, as uncontrolled hypertension can worsen the health and economic status of those affected. First-line therapies recommended by the Joint National Committee’s Eighth Report (JNC 8) include thiazide diuretics, Angiotensin-Converting Enzyme (ACE) inhibitors, Angiotensin II Receptor Blockers (ARBs), and Calcium Channel Blockers (CCBs). The aim of this study was to analyze cost-effectiveness nifedipine sustained release-candesartan compared to amlodipine-ramipril in hypertensive patients. This study was a cross-sectional with primary data obtained from medical records and structured questionnaires prospectively for utility value and adherence level. Total sample of eighty-six outpatients with hypertension fulfill inclusion and exclusion criteria and based on analysis showed that intervention (43 patients) and comparator (43 patients) groups are matching. The results showed that the efficacy of achieving blood pressure control with the nifedipine SR-candesartan combination, as per JNC 8 guidelines, was 48.8% with an Average Cost Effectiveness (ACER) of IDR 6,374. In comparison, the amlodipine-ramipril combination achieved an efficacy of 34.9% with an ACER of IDR 7,421 (p=0.19). The utility gained by patients in the intervention group was higher compared to the comparator group (p=0.004). Hence, it can be concluded that the nifedipine SR-candesartan combination is more cost-effective compared to the amlodipine-ramipril combination.
Efektivitas intervensi apoteker terhadap optimalisasi terapi opioid dan manajemen nyeri pada pasien kanker: A literature review Rizky Farmasita Budiastuti; Santi Purna Sari; Retnosari Andrajati; Nadia Farhanah Syafhan
Hik Vol. 19 No. 5 (2025): Volume 19 Nomor 5
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i5.872

Abstract

Background: Cancer pain remains a significant clinical challenge, with a high prevalence across various disease stages. Opioids are the mainstay for moderate to severe pain management but carry risks of dependence, tolerance, and serious side effects, necessitating careful supervision. Purpose: To review the effectiveness of pharmacist interventions in managing opioid use among cancer pain patients. Method: A literature search was conducted using two approaches: keyword-based searches through electronic databases (Google Scholar and Scopus) and the snowballing technique. Keywords included "cancer pain," "opioid," "pharmacist intervention," and "breakthrough pain," combined with Boolean operators. After identifying primary articles, backward and forward snowballing was performed to find additional relevant studies. All articles were screened based on predefined inclusion and exclusion criteria. Results: The review demonstrates that pharmacist interventions can improve pain control by up to 40%, reduce opioid-related side effects such as constipation by up to 50%, and enhance patient adherence to therapy. In Indonesia, however, barriers such as limited access to strong opioids, low patient education levels, and minimal pharmacist involvement in multidisciplinary teams remain significant challenges. Conclusion: Pharmacists play a strategic role in cancer pain management, particularly in optimizing pain control, minimizing opioid dependence, and managing adverse effects. Their active involvement in multidisciplinary teams enhances patients' quality of life and reduces inappropriate opioid use. Strengthening policies, providing continuous professional development, and conducting context-specific research are essential to optimize pharmacist contributions in Indonesia.   Keywords: Cancer Pain; Opioids; Pain Management; Pharmacist Intervention.   Pendahuluan: Nyeri kanker merupakan tantangan klinis utama dengan prevalensi tinggi pada berbagai tahap penyakit kanker, dan opioid menjadi terapi lini utama untuk nyeri sedang hingga berat. Namun, penggunaannya memiliki risiko ketergantungan, toleransi, serta efek samping serius, sehingga diperlukan pengawasan ketat. Tujuan: Untuk meninjau literatur terkait efektivitas intervensi apoteker dalam pengelolaan penggunaan opioid pada pasien nyeri kanker. Metode: Pencarian literatur dilakukan dengan dua pendekatan, yaitu pencarian menggunakan kata kunci melalui basis data elektronik (Google scholar dan Scopus) serta teknik snowballing. Kata kunci yang digunakan meliputi: "cancer pain", "opioid", "pharmacist intervention", dan "breakthrough pain", yang dikombinasikan menggunakan operator Boolean. Setelah diperoleh artikel utama, dilakukan teknik snowballing secara backward dan forward untuk menemukan studi relevan. Semua artikel yang diperoleh diseleksi berdasarkan kriteria inklusi dan eksklusi. Hasil: Tinjauan menunjukkan bahwa intervensi apoteker dapat meningkatkan efektivitas terapi nyeri hingga 40%, menurunkan kejadian konstipasi sebagai efek samping hingga 50%, serta meningkatkan kepatuhan pasien terhadap regimen terapi. Namun, di Indonesia, implementasi peran apoteker masih menghadapi hambatan seperti keterbatasan akses opioid kuat, kurangnya edukasi pasien, dan rendahnya keterlibatan apoteker dalam tim multidisiplin. Simpulan: Dari tinjauan ini menunjukan bahwa intervensi apoteker terbukti memiliki kontribusi strategis dalam pengelolaan nyeri kanker, khususnya melalui pengendalian nyeri yang lebih efektif, pencegahan ketergantungan opioid, dan manajemen efek samping yang lebih terstruktur. Keterlibatan apoteker dalam tim multidisiplin dapat meningkatkan kualitas hidup pasien dan menurunkan risiko penggunaan opioid yang tidak tepat. Namun, untuk mengoptimalkan peran ini, diperlukan dukungan kebijakan, pelatihan berkelanjutan, serta riset lebih lanjut dalam konteks lokal untuk menjawab tantangan implementasi di Indonesia.   Kata Kunci: Intervensi Apoteker; Nyeri Kanker; Opioid; Pengelolaan Nyeri.
Co-Authors . Azizahwati Abdul Mun&#039;im Abdul Mun'im Abdul Munim ABDUL MUN’IM Ardi Findyartini Ari Estuningtyas Ariesa Oktamauri Azizahwati Azizahwati Azizahwati Azizahwati Daimah Wirdatus Sanaun Harahap Diah Handayani Dian Ayubi Diandra Andina Ratimanjari Diandra Andina Ratimanjari, Diandra Andina Diantha Soemantri DINI KUSUMANINGTYAS Dini Nabilah Dini Nabilah Evi Martha Fadlina Chany S Fadlina Chany Saputri Hanny Handiyani HJ Freisleben HJ Freisleben, HJ Imono A. Donatus Jessica Nathania Juheini Amin Juheini Amin K.J, Wahyu Atmaja MARIA BINTANG Marlina Dewiastuti Marlina Dewiastuti Nadia Farhanah Syafhan Nur Isra Raden Rara Diah Handayani Retnosari Andrajati Retnosari Andrajati Retnosari Andrajati Retnosari Andrajati Rizky Farmasita Budiastuti Rizky Nurhikmah Rusmalita Febriana Sari Sari, Rusmalita Pebriana Sri Wulandah Fitriani Sri Wulandah Fitriani, Sri Wulandah Suci Rizki Dumiarsih tri wahyuni Tri Wahyuni Wahyu Atmaja K J Yahdiana Harahap Yovita Diane Titiesari