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Tri Murti Andayani

Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada

Author-ID : 3853310

Health Professions Medicine & Pharmacology Public Health

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Articles

Methods to Estimate Willingness-to-Pay Per Quality Adjusted Life Year as Cost-Effectiveness Threshold Tri Murti Andayani; Dwi Endarti; Susi Ari Kristina; Rifqi Rokhman
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 7, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.33255

Pharmacoeconomic studies, especially the cost-utility analysis method, require a cost-effectiveness threshold for interpretation of the cost-effectiveness ratios of the study. The cost-effectiveness threshold is determined by each country. Therefore, a study to determine the Willingness-To-Pay per Quality Adjusted Life Year (WTP per QALY) as cost effectiveness threshold for pharmacoeconomic studies is indispensable in Indonesia. The purpose of this study is to review the literature and to develop guidelines for estimating WTP per QALY as cost effectiveness threshold in pharmacoeconomic studies. Literature review was conducted using some electronic databases, such as MEDLINE, Pubmed, Science Direct, and Google Scholar. The study was conducted by holding survey on healthy population or patients. Estimated WTP per QALY are differentiated based on therapy for preventive, curative, and life saving or interventions that can prolong life expectancy. The study was conducted in three stages: measuring utility, measuring WTP, and combining WTP and utility values in WTP per QALY. Utility measurements are performed either with single or multi-attribute instruments, whereas WTP measurements use contingent valuation or discrete methods. Survey technique can be done with face to face interview, telephone, and internet. This research can be used as a guide in the development of methods to estimate WTP per QALY as cost effectiveness threshold in pharmacoeconomic studies.

Perbandingan EQ-5D-5L dan SF-6D Untuk Mengukur Index Utility Kesehatan Pada Populasi Umum di Yogyakarta Tri Murti Andayani; Dwi Endarti; Susi Ari Kristina; Anindya Rahmawati
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 10, No 1
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

The EuroQuality of life-5 dimension 5 level (EQ-5D-5L) and Short Form-6 Dimension (SF-6D) are the most widely used generic instruments for assessing utility as an outcome parameter in pharmacoeconomic studies. Different instruments cause different utility values and influence the decision making. The purpose of this study was to compare the utility score index measured using EuroQuality of life-5 dimension 5 levels (EQ-5D-5L) and Short Form-6 Dimension (SF-6D) in general population. The study was conducted cross sectional design in general population in the Yogyakarta. EQ-5D-5L and SF-6D questionnaires were given to 470 respondents to measure the utility score index. Differences of utility index scores based on demographic characteristics were analyzed using Mann Whitney and Kruskal Wallis test, while correlations between EQ-5D and SF-6D domains with utility scores were analyzed using Pearson Correlation. Limits of agreement were described by Bland and Altman Plot. The results of the study showed the utility scores measured using EQ-5D-5L, EQ-VAS, and SF-6D were 0.944 (SD = 0.093), 0.829 (SD = 0.089) and 0.915 (SD = 0.081) respectively. EQ-5D-5L and EQ-VAS can distinguish utility values based on age. There is a strong correlation (> 0.700) between the domain of mobility and pain with the EQ-5D-5L utility index, and the domain of physical function and pain with the SF-6D utility index. Ceiling effect of EQ-5D-5L (59%) is greater than SF-6D (22.4%). The Bland and Altman plot shows the difference in utility scores of EQ-5D-5L with SF-6D, SF-6D with EQ-VAS, and EQ-5D-5L with VAS, respectively at the limit of agreement 92.98%, 96 , 38%, and 95.74%. EQ-5D-5L can distinguish utility scores based on age, but showed higher ceiling effect. Both EQ-5D-5L and SF-6D showed a strong correlation between the domain of mobility (physical function) and pain with the utility score.

Pengaruh Program Pengendalian Resistensi Antimikroba terhadap Penggunaan Antibiotik Profilaksis pada Bedah Obstetri dan Ginekologi Winarni Winarni; Nanang Munif Yasin; Tri Murti Andayani
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 10, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

The incidence of surgical site infections (SSI) in obstetric and gynecological surgery is quite high. Rational prophylactic antibiotics in surgery are important strategies for the prevention of SSI. Antimicrobial Stewardship Program (ASP) for rational prophylactic antibiotic use has been carried out. This study aims to determine the rationality of the use of prophylactic antibiotics and incidence rate of SSI, the effect of ASP on the rationality of prophylactic antibiotics and clinical outcomes in obstetric and gynecology surgery. This study used a quasi-experimental pretest postest design without control group with retrospective data collection. Research time for 2 months from May to June 2019. The subjects of this study were obstetric and gynecology surgery patients at Pandan Arang Hospital Boyolali in 2018 who were divided into 2 groups: patients before the ASP and patients after the ASP with a total sample of 93 patients each group. An evaluation of the type, dose, time of administration, route of administration, and duration of prophylactic antibiotics were performed against the standard. Data analysis used the Pearson Chi-square test to see the relationship between rationality and clinical outcomes with ASP. The rationality of prophylactic antibiotic use increased from 0 (0%) cases before the ASP to 52 cases (55.9%) after the ASP. The SSI incidence rate before ASP was 9.7%, down to 4.3% after ASP. There was a significant relationship between the rationality of prophylactic antibiotics and ASP (p <0.05) but the relationship between clinical outcome (SSI incidence) and ASP was not significant (p> 0.05). The result of this study can be used to promote the implementation of ASP in other wards to increase rational use of antibiotics.

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