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Pengaruh Pemberian Umpan Balik Tekanan Darah kepada Dokter terhadap Perubahan Biaya Terapi Pasien Hipertensi Rita Suhadi; Jarir At Thobari; Bambang Irawan; Iwan Dwiprahasto
Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (515.236 KB) | DOI: 10.15416/ijcp.2015.4.3.186

Abstract

Suatu penelitian intervensi analitik telah dilakukan dengan tujuan untuk mengevaluasi cost-effectiveness terapi pasien rawat jalan hipertensi di empat rumah sakit (RS) di Kota Yogyakarta. Penelitian dilakukan dengan metode grafik scatter-plot; aksis-X dan aksis-Y menunjukkan selisih tekanan darah (TD) dan biaya antar kelompok. Pemberian umpan balik TD diberikan kepada dokter spesialis perlakuan sebanyak empat kali setelah informed consent, sementara dokter kontrol menjalani terapi secara alamiah. Pasien dari dokter subjek >18tahun, menerima antihipertensi, Askes *, ≥4 kali kunjungan, dan ≥1 kali TD sistolik (TDS) ≥140mmHg diikutkan penelitian. Data terapi, TD, dan biaya terapi pasien dikumpulkan selama 8 bulan secara prospektif sejak intervensi pertama dari catatan medik pasien dan klaim pembayaran RS kepada Askes. Seluruh biaya terkait hipertensi dan kardiovaskular dengan perspektif RS diikutkan analisis. Data diperoleh dari rekam medik dan klaim biaya terapi oleh RS kepada PT. Askes. Hipotesis: proporsi pasien di kuadran kanan grafik mencapai ≥90%. Kuadran kanan menunjukkan TDS perlakuan lebih baik. Hasil penelitian menunjukkan pasien perlakuan (n=379) dan kontrol (n=266) tidak berbeda bermakna untuk umur, jender, TD, dan jumlah antihipertensi. Pasien perlakuan memiliki TD diastolik lebih baik, biaya antihipertensi per kunjungan lebih tinggi (p<0,05) tetapi sama untuk obat kardiovaskular serta biaya total (p>0,05). Proporsi pasien kuadran kanan sebesar 56,2%. Analisis subgrup pada perempuan, tanpa umur 80–90tahun, TDS final≤160mmHg, rerata TDS ≤150mmHg, dan antihipertensi 1–3 item diperoleh proporsi kuadran kanan 66,9% tetapi belum mencapai 90%. Pemberian umpan balik TD kepada dokter meningkatkan proporsi pasien di kuadran kanan meskipun belum mencapai proporsi yang diharapkan.*Askes pada saat sekarang ini sudah berubah menjadi Jaminan Kesehatan Nasional oleh BPJSKata kunci: Biaya terapi, cost-effectiveness, hipertensi, umpan balik tekanan darah kepadadokterThe Effect of Blood Pressure Feedback Intervention to Doctors on the Change of the Hypertensive Patient Therapy CostAn analytical intervention study has been done with the aim to evaluate the therapy cost-effectiveness among the hypertensive ambulatory patients at four hospitals in Yogyakarta city. The study was done with the scatter-plot method; x-axis and y-axis were for the difference of blood pressure and therapy cost between groups respectively. Blood pressure feedback intervention was delivered monthly for four times to the specialists in the intervention group since the informed-consent approval. The control specialists preceded the natural practice. The included patients were the specialist’s subjects with the following criteria: >18 years, “Askes” -insured, ≥4 visits, and ≥1 visit with systolic blood pressure (SBP) ≥140mmHg. The medication profile, BP level, and therapy cost profile were collected prospectively for eight months since the first intervention from medical record and the hospital claim to Askes. All hypertensive and cardiovascular therapy cost with the hospital perspective were included in the analysis. Hypothesis: the patient proportion in the right quadrants of the graph reached ≥90%. The right quadrantsof graph indicated lower mean SBP of intervention group. The result showed that the intervention (n=379) and control (n=266) groups were similar for age, gender, BP, and items of antihypertensive medicine. The intervention group had only improved diastolic BP and higher antihypertensive medicine cost (p<0.05), but similar for cardiovascular medicine and the total therapy cost (p>0.05). Patients in the right quadrant were 56.2%. Sub-group analysis for female only, without 80–90 years, final SBP ≤160mmHg, and mean ≤150mmHg, and 1–3 antihypertensive items resulted 66.9% of right-quadrant patients but it was lower than 90%. Feedback intervention improved the proportion of patients in the right-quadrants of the graph though it was lower than the expected proportion.Keywords: Blood pressure feedback to physicians, cost effectiveness analysis, cost of therapy, hypertension
EVALUASI “THE RULE OF HALVES” KASUS HIPERTENSI PADA RESPONDEN DI DELAPAN DUSUN BAGIAN SELATAN SLEMAN YOGYAKARTA Rita Suhadi; Greta Paulina; Chatarina Danik Wijayanti; Lusia Dewi; Antonia Adeleide Anutopi; Fransisca Tielman
Berkala Ilmiah Kedokteran Duta Wacana Vol 1, No 2 (2016): BERKALA ILMIAH KEDOKTERAN DUTA WACANA
Publisher : Faculty of Medicine Universitas Kristen Duta Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1040.281 KB) | DOI: 10.21460/bikdw.v1i2.16

Abstract

Pendahuluan: Prevalensi (50%), kesadaran (25%), terapi (12,5%), dan pengendalian (6,25%) hipertensi ditemukan pada populasi berdasarkan the rule of halves (the rule). Penelitian ini bertujuan untuk membandingkan proporsi subyek hasil penelitian dengan yang ada pada the rule. Metode: Survei analitik cross-sectional dilakukan dengan cluster random-sampling pada 8 dusun di bagian selatan Kabupaten Sleman Yogyakarta. Kriteria inklusi meliputi responden ≥ 40 tahun dan menandatangani informed-consent; sementara responden yang hamil diekslusi. Data dikumpulkan dengan wawancara dan tekanan darah, berat badan, dan tinggi badan diukur. Perbandingan proporsi subyek dibandingkan the rule dengan uji-Z (p < 0,05); perbandingan umur; body mass index (BMI), dan tekanan darah sistolik/diastolik antara kelompok hipertensi dan tidak hipertensi dianalisis dengan uji-t p < 0,05. Hasil: Subyek (N = 1602) memiliki umur 54,3 ± 11,8 tahun; BMI 23,0±4,2kg/m2; dan tekanan darah 141,3/83,8±23,1/12,3mmHg. Proporsi subyek berturut-turut terdiri dari 49,3%; 29,3%; 19,0%; dan 3,6% untuk prevalensi; sadar; terapi; dan pengendalian hipertensi. Subyek memiliki prevalensi yang sama dengan the rule (p > 0,05); sadar dan terapi hipertensi lebih banyak dibandingkan the rule (p < 0,05); tetapi pengendalian hipertensi lebih sedikit proporsinya dibandingkan the rule (p < 0,05). Kelompok hipertensi memiliki tekanan darah (159,0/89,8mmHg) berbeda bermakna dengan tidak hipertensi (124,1/78,0mmHg); sama antara yang sadar dan tidak sadar hipertensi; sama antara terima terapi dan tidak terapi; tetapi berbeda bermakna pada kelompok dengan tekanan darah terkendali (131,3/81,4mmHg) dan tidak terkendali (161,1/90,5mmHg). Kesimpulan: Subyek memiliki prevalensi yang sama; lebih tinggi bermakna untuk sadar dan terapi hipertensi; tetapi lebih rendah untuk pengendalian hipertensi bila dibandingkan the rule of halves.
Five Methods Comparison of 10 Years Cardiovascular Disease Risk Estimation in the Community in Sleman-Yogyakarta Clarentia Dwivani; Herlina Herlina; Karina Harijadi; Budianto Budianto; Rita Suhadi
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 8, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.34469

Abstract

Cardiovascular disease is the highest cause of death with total of 17.5 million deaths in the world. Nowadays there have beenexists many methods to calculate the risk of cardiovascular disease within the next 10 years, 5 of them are Framingham Risk Score (FRS) BMI and Cholesterol, Pooled Cohort Equations (PCE), CV Risk Calculator, and Systematic Coronary Risk Evaluation (SCORE). The aim of this study waiss to compare the 5 methods of 10-year risk of cardiovascular disease based on mean values, risk categories, and statin recommendation. This observational analytic study was done with cross-sectional design. There were 169 respondents in Sleman, Yogyakarta who participated to this study. Normality of risk measurement data was performed using Kolmogorov-Smirnov test and comparative test was performed using Repeated ANOVA. Both proportion of risk categorization and statin therapy was calculated using the Marginal Homogeneity test. The average risk of  FRS (BMI and Cholesterol), PCE, CV Risk Calculator, and SCORE were 14,6±11,7% (medium risk), 13,3±11,3% (medium risk), 6,8±6,4% (medium risk), 6,8±6,4% (medium risk), and 2,6±3,5% (medium risk).  There were significant differences from the comparison between among methods on mean values and risk categories (p <0.01), except on PCE with FRS BMI (p=0.11) and PCE with CVRiskcalculator (p = 1.00). Comparison of statin therapy recommendation among FRS Cholesterol with PCE, FRS Cholesterol with SCORE, and PCE with FRS BMI methods showed significant differences (p <0.01), whereas FRS Cholesterol with FRS BMI and PCE with SCORE were not significantly different (p = 0,06 and p = 0,05).
THE EFFECT OF HEALTH INSURANCE ON ASTHMA CONTROL IN RESPONDENTS WITH ASTHMA IN YOGYAKARTA, INDONESIA Rita Suhadi; Fenty Fenty; Dita Maria Virginia; Christianus Heru Setiawan
Jurnal Farmasi Sains dan Komunitas (Journal of Pharmaceutical Sciences and Community) Vol 15, No 2 (2018)
Publisher : Sanata Dharma University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (651.753 KB) | DOI: 10.24071/jpsc.001176

Abstract

Asthma is a chronic disease with recurrent breath shortness. Until now, there is no particular therapy to cure the disease and long-term treatment is needed to control the disease. Health insurance has the benefit to support the asthma therapy. This study aimed to assess the effect of health insurance on the asthma control based on Asthma Control Test (ACT) score. The study was done with a cross-sectional design on respondents with asthma who agreed to sign informed consent forms in Yogyakarta. The asthma respondents (n=36) were selected non-randomly, consisting of 23 respondents with health insurance, including universal health coverage or UHC (n=15), UHC and private insurance (n=7), and private insurance only (n=1). The ratio and categorical data were analyzed with the independent T-test or Mann-Whitney test and chi-square statistics, respectively. The study demonstrated that the profiles and number of medicines were similar between groups, except for lower smoking proportion among health insurance groups; the respondents with and without health insurance had the median ACT score at 22 (partial control) and 15 (bad control) respectively, though the scores were not statistically different. Conclusion: the asthma respondents with and without health insurance were not statistically different in the asthma control.
THERAPY ADHERENCE OF 40-75 Y.O. HYPERTENSION RESPONDENTS USING MORISKY INSTRUMENT IN NGEMPLAK, SLEMAN, DIY (STUDY ON AGE, DEMOGRAPHY, SOCIAL, AND LIFE-STYLE FACTORS) Jasmine, Millatina; Oktawati, Nurjati Dwi; Damasari, Puspa Raras; Suhadi, Rita
Jurnal Farmasi Sains dan Komunitas (Journal of Pharmaceutical Sciences and Community) Vol 14, No 2 (2017)
Publisher : Sanata Dharma University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (597.689 KB) | DOI: 10.24071/jpsc.00533

Abstract

Hypertension is systolic blood pressure (SBP) ?140mmHg and/or diastolic blood pessure (DBP) ?90mmHg. The risk factors of hypertension consist of age, life-style, demographic, and social factors. The risk factors have a significant association with antihypertension adherence. Adherence is the suitability of patient behavior to the prescribers recommendations. Morisky instrument can be used to measure the level of hypertension therapy adherence. The aims of this study were to assess respondents profile and therapy adherence based on age, life-style, demographic, social factors among the subjects in Ngemplak, Sleman, Daerah Istimewa Yogyakarta (DIY). Total respondents were 63 respondents. The observational study was done with cross-sectional design. Technique for determining the location used random sampling, data were collected by door to door in the villages of Morangan, Jimat, and Jelapan. Data analysis used chi square with 95% confidence level. There were 23.8% good adherent and 76.2% poor adherent subjects to antihypertensive medication. There was no significant difference between age, life-style, demographic, and social factors to the level of hypertension therapy adherence. However, it was found that controlled blood pressure (p-value0.01) were significantly associated with therapy adherence. This study also found that SBP at age 60-75 years and 40-59 years was significantly different (p-value 0.05).