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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.

Analisis Biaya Penyakit Stroke Pasien Jaminan Kesehatan Nasional di RSUD Blambangan Banyuwangi Zulfa Mazidah; Nanang Munif Yasin; Susi Ari Kristina
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Cost analysis of chronic diseases in health care facilities during JKN is needed as quality and cost control. Stroke is a high cost, volume, and risk, catastrophic disease that can cause an increase in medical expenses, which requires special attention. The purpose of this study is to provide an overview of real costs and cost components, providing an overview of the direct medical costs and tariff packages of INA-CBGs based on the type of stroke, and the factors that affect direct medical costs. This study is a descriptive-analytic observational study according to the hospital perspective. Data was taken retrospectively. The subjects of the study were adult JKN patients who were aged ≥18 years old with a stroke diagnosis that entered the inclusion criteria. The research variables included age, gender, type of stroke, comorbidity, hospitalization class, length of stay (LOS), and real costs. Data analysis used univariate, bivariate and multivariate analysis. The research results obtained total real costs of Rp. 1,525,236,503 with an average cost of Rp. 4,872,960, the largest cost component was the cost of drugs and BMHP Rp. 402,248,555 (27.21%). The real cost of hemorrhagic strokes is Rp. 572,969,865 and the INA-CBGs tariff package is Rp. 483,804,000, the real cost of ischemic stroke is Rp. 1,107,055,700. There were significant differences in real cost from class factors and length of stay (p-value <0.005). The concluded that the INA-CBGs tariff package is insufficient to finance hospitalized patients with hemorrhagic strokes (-Rp89.165,865), but sufficient for ischemic stroke (+Rp.154,789,069).

Perceived Harm and Addictiveness of e-Cigarette: A Systematic Review Susi Ari Kristina; Ni Putu Ayu Linda Permitasari; Ahmad Intihan; Dima Nurrohmah Hayati; Kharisma Aprilita Rosyidah
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

The popularity of electronic nicotine delivery systems (ENDS), also known as e-cigarette, has been growing rapidly in the past years. Therefore, it is also important to explore how e-cigarette users perceive its harm and addiction risk. The aim of this study is to review and determine perceived harm and addictiveness of e-cigarette among e-cigarette users. We conducted a systematic review for published articles in English that had reported about perceived harm and addictiveness of e-cigarette published during year 2008 to 2018. Relevant studies were located through an extensive search from three electronic databases (PubMed, Science Direct, and Cochrane Database of Systematic Reviews) and Google Scholar on October 2018. Key terms used were “perceived harm”, “perceived risk”, “harm and addictiveness”, “belief”, “electronic cigarette”, “e-cigarette”, and “vaping”. A result of 88 studies were retrieved and reviewed. After further inspection of references from the collected studies, only 5 selected studies met all inclusion criteria. The final studies consisted of three cross-sectional studies, one longitudinal, and one prospective study. E-cigarette were perceived harmless and less addictive than cigarettes among its users with many predictors associated, including sex, age, race, education, advertisement and health belief for smoking cessation. Compared to non-users, e-cigarette users were significantly less likely to worry about the health risks, either its harm or addictiveness. E-cigarette was perceived harmless and less addictive than tobacco cigarettes. Further study about e-cigarette profile is particularly important to design public health messages that accurately interpret the scientific data on the potential harm and addictiveness of e-cigarette.

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.

A Scoping Review of Disposal of Unused Medicines in Take-Back Programs Mufti Alifia Rahmadani; Susi Ari Kristina
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 11, No 1
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.61343

Unused medicines in the household cause many problems. Medicines take-back programs were established to prevent inappropriate medicines disposal, abuse, accidental poisoning, and help reduce the number of unused medicines in households. A literature search using the keywords “unused AND medicine”, “disposal AND unused AND medicine”, “reasons AND medicine AND disposal”, “medicine AND take-back program” and “cost AND medicine AND take-back program” in PubMed, Science Direct, Scopus and Google Scholar. Articles published in 2010 – 2020 in English report the medicine take-back program with the number of medicines and/or reasons for the return and/or economic value of medicines collected in the medicines take-back program. A total of 16 articles were included in the criteria for this systematic review. Medicines take-back program was majority-owned in the US (69%). Two programs focus on returning controlled medicines. Gastrointestinal, respiratory, cardiovascular, antimicrobial and non-narcotic analgesic were the most common of all medicines returned. The expired medicine and treatment discontinuation by (doctors/prescribers) were the most reason medicine was returned to the medicines take-back program. The total cost of all medicines returned topped $1,118,020. Medicines take-back program was an essential solution to the inappropriate medicine disposal problem. Good coordination was required between the government and other authorities.This medicine take-back issues can help solve the problems of medicine use, storage, and disposal that lead to the country's economy.

Association between obesity and depression among women in Indonesia: A questionnaire based study Susi Ari Kristina; Nur Aini Mardea; Suci Hanifah
Journal of Global Pharma Technology Volume 12 Issue 09 (2020) Sept. 2020
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.57 KB)

Obesity is a global public health issue and the prevalence of obesity is growing worldwide every year. Studies have been performed since the early 1970s on the association between obesity and depression or other psychological disorders. In Indonesia, however, only a small number of studies have been carried out. The aim of this study was to examine whether obesity was associated with depression in a sample of women with overweight and obesity based on their BMI, anti-obesity treatment experience, and age among women in one province in Indonesia. Women aged 18 years and older who were selected from fitness centers in urban area of Yogyakarta province and self-reported BMI categorized as overweight and obese were eligible to participate. Voluntary participation in study survey was consented. A set of questionnaire consisting demographic characteristics and depression symptoms was developed and validated. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9), with a score of ≥10 used to indicate severe depression. Respondents who classified as overweight mostly had minimal depression level (33.58%) and none had severe depression level, whereas respondents who classified as obese mostly had moderate depression level (44.74%) and 3.95% had severe depression level. This study found that BMI, experience of using anti-obesity drugs, and age of respondents were significantly affected PHQ-9 score. Thus, these factors determined the level of depression among women surveyed. The study reported significant association between obesity and depression among women. This association depends on BMI, anti-obesity treatment experience, and age variables. Approaches to public health to reduce the burden of obesity or depression have to consider the strong link between these two common conditions.

Breast cancer awareness and breast screening practice among women in Yogyakarta Susi Ari Kristina; Nada Nisrina Salsabila
Journal of Global Pharma Technology Volume 12 Issue 06 (2020) June 2020
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (315.615 KB)

Background: Low public knowledge and understanding, contributing to late diagnosis, has identified cancer morbidity and mortality from breast cancer. This study was designed to describe breast cancer knowledge and awareness and evaluate breast screening practice among Yogyakarta women. Methods: A cross-sectional study of 350 low socioeconomic women in rural and urban Yogyakarta areas was conducted using a validated self-designed structured questionnaire. Analyzing data using descriptive statistics. Results: A vast majority of respondents knew that breast cancer is a severe disease (85.14%) and can be detected as early as possible (60.00%). Genetic and family cancer history was the best accepted risk factor for breast cancer (61.43%), followed by oral contraception (44.57%), radiation (31.43%), smoking (28.86%) and alcohol intake (21.71%). Over half of respondents (65.14%) correctly identified niple and color discharge as one of the symptoms of breast cancer, followed by breast lump (60.00%), breast swelling (56.29%) and breast fluid (44.57%). While 56.57 percent of respondents had heard of breast self-examination ( BSE) and mammography, only 26.86 percent of respondents had regularly performed BSE, and only 28.00 percent of respondents reported daily mammography. A large proportion of respondents (72.86%) never diagnosed breast cancer. Conclusion: In Yogyakarta, the study reported inadequate breast cancer awareness and poor breast screening practice among women with low socioeconomic status aged 20-50 years. Health care professionals are fairly required to educate women about breast cancer and promote early detection and breast cancer screening programs to prevent and reduce breast cancer incidence and mortality.

Electronic Cigarettes Use Characteristics Among Smokers in Indonesia Susi Ari Kristina
Journal of Global Pharma Technology Volume 12 Issue 06 (2020) June 2020
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (418.116 KB)

Background: Vape also known as an electronic cigarette that included a set of battery-operated equipment that smoker used to breathe an aerosol, typically conceiving nicotine, flavorings, and other chemicals, and becoming one of the types of a developed cigarette. This study aims to explore the risks and benefits of using electronic cigarettes and investigate factors affecting smokers' use of electronic cigarettes. Methods: This research was a cross-sectional model for Yogyakarta adults using a validated self-administered questionnaire. The questionnaire is divided into three parts: sociodemographic characteristics, smoking, perception of risk-benefit. Data were descriptively and inferentially analyzed using the Chi-square test to investigate factors affecting risk and benefit perception of smokers using electronic cigarettes. Results: Results showed that 133 (66.5 percent) were vape users, and 67 (33.5 percent) were tobacco smokers. Most tobacco smokers and vape users in Yogyakarta province have a high perception of electronic cigarette risk-benefit. Respondent characteristics (age, last education, smoking status) significantly influenced the benefit perception of electronic cigarettes, and smoking status on respondent characteristics also significantly influenced the risk perception among smokers of electronic cigarettes (p

Awareness of Chronic Kidney Disease among General Adult Population in Indonesia Susi Ari Kristina; Laksmy Anggun Larasati; Suci Hanifah
Journal of Global Pharma Technology Volume 12 Issue 06 (2020) June 2020
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.231 KB)

Background: Chronic kidney disease (CKD) is rapidly becoming a major problem for developing countries such as Indonesia in terms of complicated management such as hemodialysis, continuous ambulatory peritoneal dialysis (CAPD) or high-cost renal transplantation. In its initial stages, early diagnosis and management of CKD may help avoid or delay disease progression. This study aimed to assess CKD's awareness and knowledge in Indonesia's general population. Methods: Cross-sectional research design was performed among the general adult population in Yogyakarta province. Recruiting participants using a convenience sample. A pre-validated questionnaire consisted of two parts, demographic features and CKD information. A logistic bivariate regression was used to identify independent CKD predictors, and p-value

A survey of quality of life among elderly population in Yogyakarta: A questionnaire-based study Dani Hanif Koncoro; Susi Ari Kristina
Journal of Global Pharma Technology Volume 12 Issue 06 (2020) June 2020
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar

Indonesia, as one of the world's developing countries, faced a demographic transition. Indonesian people's life expectancy has risen over time. It imposed the escalating elderly population in Indonesia. Quality of Life ( QoL) was an important assessment to be measured in the elderly as many comorbidities involved. This research aimed at determining QoL among the elderly population and QoL-related factors. A questionnaire-based survey was conducted among 210 elderly participants attending Yogyakarta's Elderly Community Services (Poslansia). QoL was evaluated using WHOQOL-BREF. Socio-demographic variables were analyzed using a questionnaire. Data was analyzed using SPSS version 22. QoL score differences among elderly characteristics were analyzed using Mann Whitney test. QoL score among respondents showed dimensions of social relationships had the lowest score among domains (QoL score 46.78 ± 10.72). Participants with spouses had better QoL scores than widowed participants (p 0.032). Participants who had better QoL scores than smoker participants (p

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