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All Journal Tropical Medicine Journal Jurnal Ilmu Kedokteran (Journal of Medical Science) Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Farmasi Klinik Indonesia Jurnal Ilmu Farmasi dan Farmasi Klinik (Journal of Pharmaceutical Science and Clinical Pharmacy) Jurnal Pengabdian Kepada Masyarakat (Indonesian Journal of Community Engagement) INDONESIAN JOURNAL OF PHARMACY Jurnal Farmasi Sains dan Komunitas JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Molucca Medica Indonesian Journal of Pharmacology and Therapy

Jarir At Thobari

Department Of Pharmacology And Therapy, Faculty Of Medicine, Public Health And Nursing, Gadjah Mada University, Yogyakarta, 55281, Indonesia

Author-ID : 403107

Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Sedative hypnotics use as the risk factor for fall incidents on geriatric patients Woro Rukmi Pratiwi, Christi Mambo, Jarir At Thobari,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 04 (2014)
Publisher : Universitas Gadjah Mada

Fall incident is one of geriatric syndromes that cause an increasing public health burden worldwide.The risk factors for falls incidents on geriatric patients have been identified included medicationuse. Benzodiazepine is a sedative hypnotic that found to be associated with an increase fallincidents. The aim of the study was to evaluate the influence of sedative hypnotics on the riskof fall incidents on geriatric patients. This was an observational study using cohort designinvolving 188 eligible geriatric patients comprising 94 patients who take sedative hypnotics and94 patients who not. All pasients then underwent a test for functional mobility and fall riskusing timed âup & goâ test (TUG). The subjects who take â¤ 20 seconds to complete the TUG wasconsidered to have low risk for fall incidents, whereas those who take >20 seconds was consideredto have high risk for fall incidents. The results showed that the use of sedative hypnotics, sex,and number of drugs taken were associated with fall incidents on geriatric patients. Geriatricpatients who use sedative hypnotics were 2.41 times higher at risk of fall incidents than thosewho not use sedative hypnotics (95%CI;1.12-5.17; p=0.023). Geriatric patients who takealprazolam were 2.78 times higher at risk of fall incidents compared to those who not take(95% CI: 1.49-5.19; p=0.028). Furthermore, female geriatric patients were 3.29 times higher atrisk of fall incidents compared to male geriatic patients (95%CI: 1.58-6.88; p=0.001) and theuse of â¥ 4 kinds of drugs were 2.76 times higher at risk of fall incidents compared to the use of<4 kinds of drugs (95%CI:1.21-6.29; p=0.015). In conclusion, sedative hypnotics is found tobe a risk factor for fall incidents on geriatric patients.

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

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 *, â¥4 kali kunjungan, dan â¥1 kali TD sistolik (TDS) â¥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 â¥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 80â90tahun, TDS finalâ¤160mmHg, rerata TDS â¤150mmHg, dan antihipertensi 1â3 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 specialistâs subjects with the following criteria: >18 years, âAskesâ -insured, â¥4 visits, and â¥1 visit with systolic blood pressure (SBP) â¥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 â¥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 80â90 years, final SBP â¤160mmHg, and mean â¤150mmHg, and 1â3 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

The effect of proton pump inhibitors and clopidogrel combination to the risk of recurrent stroke Ngatidjan, Endang Mahati Jarir Atthobari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 47, No 2 (2015)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Recurrent stroke is very common among stroke survivors. Clopidogrel is one of the drugs used in the prevention of recurrent stroke. Because clopidogrel may cause gastrointestinal bleeding, the use of proton pump inhibitors may elicite the side effect, but unfortunately this combination may interfere the antiplatelete activity of clopidogrel since both are metabolized by the same enzyme, liver CYP2C19. The aim of this study was to know the effect of proton pump inhibitors on the efficacy of clopidogrel in the prevention of recurrent stroke in Bethesda Hospital, Yogyakarta. This study was a case control study. The sample size of treatment case was 392 patients and control case was 784 patients. The case group was patients with recurrent stroke and the control group was the patients who come to outpatient clinics of Department of Neurology. In this study, matching was made for treatment and control groups on sex, age and their index date. The exposure of the combination was investigated in the last 6 months and categorized as current use (<2 month before index date) and recent use (2-6month before index date). Multivariate analysis showed that there was no association between clopidogrel and proton pump inhibitors to the risk of recurrent stroke OR 1.05 (95% CI 0.56-1.785). Omeprazole was the most used, although there was no significantly increased risk OR 0.46 (95% CI 0.56-3.70). The effect of proton pump inhibitors to the efficacy of clopidogrel has not been known yet in this study, because the amount of total sample that used the combination of this drug was too small.Keywords: clopidogrel - proton pump inhibitors - recurrent stroke - interaction

Cost Effectiveness Analysis of Rivaroxaban Compared to Warfarin and Aspirin for Stroke Prevention Atrial Fibrillation (SPAF) in the Indonesian healthcare setting Dwiprahasto, Iwan; Kristin, Erna; Endarti, Dwi; Pinzon, Rizaldy Taslim; Yasmina, Alfi; Thobari, Jarir At; Pratiwi, Woro Rukmi; Kartika, Yolanda Dyah; Trijayanti, Christiana
Indonesian Journal of Pharmacy Vol 30 No 1, 2019
Publisher : Faculty of Pharmacy Universitas Gadjah Mada, Yogyakarta, Skip Utara, 55281, Indonesia

Main drugs used in the prevention of stroke among atrial fibrillation (AF) patients are antiplatelets (aspirin) and oral anticoagulants (OAC). OAC therapy can be difficult to administer due to drug and food interactions, adds the burden of required blood monitoring, narrow therapeutic window, and requirements for dose titration. Rivaroxaban is a single-dose oral anticoagulant which does not require blood monitoring, dose titration or has dietary interactions. Phase III clinical data from the ROCKET trial have recently been reported the non-inferiority of rivaroxaban over warfarin for the prevention of strokes in AF patients. To develop an economic model evaluating the clinical and cost-effectiveness of rivaroxaban for the prevention of stroke in non-valvular AF patients in the Indonesian health care settings. We conducted cost effectiveness analysis from the perspective of payer (national health insurance). Effectiveness data used the international data from previous RCT and network metaanalysis studies. Costs data used local data of Indonesia from national health insurance’s reimbursement tariffs. Markov model was used, comprised of health and treatment states describing the management and consequences of AF. The main analysis was based on data from the phase III trials. Three months was used as cycle length. The time horizon was set at patients’ lifetime (20 years). Costs and outcomes were discounted at a 3% annual rate. Subgroup analysis and extensive sensitivity analysis was conducted. Willingness to pay (WTP) threshold in Indonesia was set as 3 times GDP of Indonesia in 2015, equal about IDR 133,375,000 per quality-adjusted life year (QALY). Base case rivaroxaban vs warfarin has ICER of IDR 141,835,063per QALY at the current cost of rivaroxaban IDR 23,500 and ICER of 130,214,687 per QALY at the proposed cost of rivaroxaban IDR 22,000. One-way sensitivity analysis showed that the key drivers of cost-effectiveness were the utility decrement applied to stable warfarin patients, discontinuation/subsequent discontinuation rates for rivaroxaban, and discontinuation/subsequent discontinuation rates for warfarin. The probabilistic sensitivity analysis suggested that rivaroxaban was cost-effective compared to warfarin in about 45% of cases at the WTP per QALY. Rivaroxaban with the proposed price of IDR 22,000 was considered to be more cost-effective when compared to warfarin.

HUBUNGAN FAKTOR KOMORBIDITAS, INTENSIFIKASI TERAPI, DAN PENGENDALIAN TEKANAN DARAH Rita Suhadi; Jarir Atthobari; Bambang Irawan; Iwan Dwiprahasto
Jurnal Farmasi Sains dan Komunitas (Journal of Pharmaceutical Sciences and Community) Vol 10, No 1 (2013)
Publisher : Sanata Dharma University

Abstract: Background: Therapy intensification (TI) is the most important factor in bloodpressure control among the adherent patients. The TI is the physician prescription behavior toadd the item(s) and/or the dosage of hypertensive medicine when the patients' BP was ?10mmHgabove the target. Comorbid patients have 10mmHg lower BP target. Aims: to evaluate the effectof comorbidity on TI score and blood pressure control; and to correlate the variables of TI and BPcontrol. Method: retrospective cohort study done in 4 hospitals in Yogyakarta for 5 months. Thesubjects of age 18 years, hypertensive out-patient covered with Askes insurance, and ?1 visitwith uncontrolled BP were included. Hemodialysis subjects were excluded. Subjects weregrouped into with/without comorbid. The BP profile was analyzed with T-test, repeatedmeasurement Anova, and odds ratio. Results: subjects consisted of without (WO) (n=268) vs.with comorbid (W) (n=401) patients. Comorbid subjects had older age, more male proportionand more visits (p0.05). The profiles of final SBP/DBP in WO vs. W subjects were as follow:148.9/89.1 (WO) vs. 143.8/86.1mmHg (W) (p0.05); TI score (-) 0.360.26 (WO) vs. (-)0.380.24 (W) (p0.05); the final SBP: worse BP control 20.9 (WO) vs.16.2% (W), notcontrolled in all visits 38.1 vs. 45.9%, improved 17.5 vs. 23.9%, and good controlled in all visit23.5 vs.13.2%; proportion of subjects reached BP target 40.7% (WO) vs. 37.4% (W) (p0.05);the different of final minus target SBP: (-)9.018.5 vs. (-)13.917.4mmHg (p0.05); correlationbetween TI and variables of SBP (p0.05) with the coefficient (r) at 0.4-0.6 (medium).Conclusion: comorbidity had no effect on TI score; but subjects with comorbid had worse BPcontrol (p0.05); TI score correlated in medium level with SBP.Keywords: Comorbidity Factor, Therapy Intensification, Blood Pressure Control

Compliance Pengguna Antihipertensi di RSUP DR. SARDJITO Yogyakarta (Periode Juli 2006- Juni 2009) Dimas Pramita Nugraha; Iwan Dwiprahasto; Jarir At Thobari
Jurnal Ilmu Kedokteran Vol 8, No 2 (2014): Jurnal Ilmu Kedokteran
Publisher : Fakultas Kedokteran Universitas Riau

Hypertension is the second largest of the 10 diseases on an outpatient at a hospital in Indonesia. The poor complianceto therapy of hypertension is a major cause of uncontrolled blood pressure. The aim of this study is to determinecompliance antihypertension on patient at DR. Sardjito hospital Yogyakarta. This study was designed with aretrospective cohort study design using a database of participants claimed prescribing health insurance (ASKES) inthe DR. Sardjito hospital using antihypertensive drugs. Compliance measured with medication possession ratio (MPR).Data was analysed by chi- square and logistic regression statistic. From 8.011 patients, compliance of antihypertensivedrugs during the first year is 7,6%. Analysis for compliance showed that the type of antihypertensive diuretics aremore compliance compare with angiotensin II receptor blockers, ACE inhibitors, calcium channel blockers and betablockers. Combination therapy (20,7%) is more compliance than monotherapy ( 4,1%), as well as drugs administration1 time a day (8,2%) is more compliance than drug administration 2 times (2,5%) and 3 times a day (3%). Theproportion of compliance in antihypertensive users at DR. Sardjito hospital classified as less good. Compliancepattern indicates that therapy is not continuous, the longer the use of antihypertensive therapy, the higher thediscontinuous therapy.

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

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

Laboratory Testing of Transovarial Transmission in Aedes Aegypti Mosquito Guntur Benedict Hutadjulu; Sitti Rahmah Umniyati; Jarir At Thobari
Tropical Medicine Journal Vol 2, No 1 (2012): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

Introduction: Ae. aegypti is one of the vectors causing Dengue Hemorrhagic Fever (DHF) that feeds on human blood suffering from DHF and transmit it to another healthy human. The ability of Dengue Virus (DENV) to survive in nature is due to 2 mechanisms i.e. horizontal transmission among viremic vertebratae infected by Aedes mosquitos and vertical (transovarial) transmission from infected female mosquito to another generation.Objectives: To know the differences between next generation’s viral carriage, percentage ofmosquito descendants carrying DENV, and the distribution of DENV in its infected mosquitos.Methods: Study design was a quasi experimental posttest-only design with control group. The study was conducted on 53 second-generation female Ae. aegypti mosquitos which are grouped into treatment and control groups. Dengue Viral antigen in both groups were detected by immunohistochemistry method using Streptavidin Biotin Peroxidase Complex (SBPC) in paraffin embedding preparation of mosquitos aged 1-7 days. Fisher exact test was used to compare proportion of virus detected in moaquitos between 2 groups.Results: The virus detected in second generation of DEN-infected and uninfected mosquitos were 100% and 85.7%, respectively. The virus was distributed from day 1 to 7 in all organs such as brains, thorax, salivary gland, gastric epithelial cells, and ovarium of the infected mosquitos. Similar distribution was not detected in control mosquitoes.Conclusion: There was no difference in next mosquito generation’s transovarial infection among DENV-infected and uninfected Ae. aegypti mosquitos.Keywords: Ae. aegypti mosquito; Dengue virus (DENV); transovarial transmission; immunohistochemistry method, Streptavidin Biotin Peroxidase Complex (SBPC).

Association of hydrazine and SGPT level two hours after drug administration at the end of intensive phase treatment of pulmonary tuberculosis patients Ave Olivia Rahman; Jarir At Thobari; Mustofa Mustofa
Tropical Medicine Journal Vol 2, No 2 (2012): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: Isoniazid in the regiment treatment of pulmonary tuberculosis patients causes side effects. Hepatotoxicity is one of the isoniazid’s side effects that need medical attention. Isoniazid-induced hepatotoxicity has no correlation with high level of isoniazid in plasma. However, several animal studies show it has an association with hydrazine, a metabolite of isoniazid. The role of hydrazine in isoniazid-induced hepatotoxicity among tuberculosis patients is unclear.Objective: The aim of this study was to analyze the correlation of hydrazine and serum glutamic-pyruvic transaminase (SGPT) levels at two hours after drug administration in the end of intensive phase treatment of pulmonary tuberculosis patients.Methods: This was an observational study with cross-sectional design. Fifty eight newly diagnosed pulmonary tuberculosis patients were enrolled in this study. Venous blood sampling was collected at two hours after drug administration in the end of intensive phase treatment. SGPT level was measured by an automatic chemical analyzer. Hydrazine level was measured by using high-performance liquid chromatography (HPLC). Statistical significance was analyzed using correlation test.Results and Discussion: The incidence of hepatotoxicity was 3.4% and about 8.6% patients had elevated SGPT at two hours after drug administration in the end of intensive phase treatment. There was no correlation between hydrazine level and SGPT levels in this study. These results indicated that hepatotoxicity or minimal liver damage in some patients might occur in the administration of standard dose isoniazid. It might be caused by isoniazid’s metabolites itself, or various other factors.Conclusions: There was no correlation between hydrazine level and SGPT levels at 2 hours after drug administration in the end of intensive phase treatment in this study.

Sedative hypnotics use as the risk factor for fall incidents on geriatric patients Christi Mambo; Jarir At Thobari; Woro Rukmi Pratiwi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 04 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Fall incident is one of geriatric syndromes that cause an increasing public health burden worldwide.The risk factors for falls incidents on geriatric patients have been identified included medicationuse. Benzodiazepine is a sedative hypnotic that found to be associated with an increase fallincidents. The aim of the study was to evaluate the influence of sedative hypnotics on the riskof fall incidents on geriatric patients. This was an observational study using cohort designinvolving 188 eligible geriatric patients comprising 94 patients who take sedative hypnotics and94 patients who not. All pasients then underwent a test for functional mobility and fall riskusing timed “up & go” test (TUG). The subjects who take ≤ 20 seconds to complete the TUG wasconsidered to have low risk for fall incidents, whereas those who take >20 seconds was consideredto have high risk for fall incidents. The results showed that the use of sedative hypnotics, sex,and number of drugs taken were associated with fall incidents on geriatric patients. Geriatricpatients who use sedative hypnotics were 2.41 times higher at risk of fall incidents than thosewho not use sedative hypnotics (95%CI;1.12-5.17; p=0.023). Geriatric patients who takealprazolam were 2.78 times higher at risk of fall incidents compared to those who not take(95% CI: 1.49-5.19; p=0.028). Furthermore, female geriatric patients were 3.29 times higher atrisk of fall incidents compared to male geriatic patients (95%CI: 1.58-6.88; p=0.001) and theuse of ≥ 4 kinds of drugs were 2.76 times higher at risk of fall incidents compared to the use of<4 kinds of drugs (95%CI:1.21-6.29; p=0.015). In conclusion, sedative hypnotics is found tobe a risk factor for fall incidents on geriatric patients.

Co-Authors A.A. Ketut Agung Cahyawan W Ady Bagus Indrianto Agung Endro Nugroho Al Razi Sena Alfi Yasmina Alfi Yasmina Anggit Dewi Rahayu Anggoro Budi Hartopo Annisa Setiyaningrum Anwar Santoso Asal Wahyuni Erlin Mulyadi Ave Olivia Rahman Bambang Irawan Chandra, Lukman Ade Christi Mambo David Dwi Putera Deva Bachtiar Dimas Pramita Nugraha Dwi Indria Anggraini Dyah Aryani Perwitasari Endang Mahati Erna Kristin Faridatun Khasanah Fatma Othman Gdara Guntur Benedict Hutadjulu Hari Agus Sanjoto Hendrik Hendrik Indwiani Astuti Iwan Dwiprahasto Iwan Dwiprahasto Iwan Dwiprahasto Johan Kurnianda Jonathan Hasian Haposan Lucia Kris Dinarti Luhur Pribadi Lukman Ade Chandra Maemonah, Maemonah Mardiah Suci Hardianti Mustofa Mustofa Nailatul Arifah Ngatidjan Ngatidjan Pompini Agustina Sitompul Pratiwi, Woro Rukmi Pratiwi, Woro Rukmi Rafika Mutia Sari Rita Suhadi Rizaldy Pinzon Rizki Amalia Gumilang Sari, Rafika Mutia Shofya Indraguna Siahaya, Presli Glovrig Sitti Rahmah Umniyati Sutarman S Syahru Agung Setiawan Teguh Triyono Togi Junice Hutadjulu Tri Asti Isnariani Tri Murti Andayani Tri Murti Andayani Trijayanti, Christiana Ully Adhie Mulyani Umi Sa'adatun Nikmah Wahyu Damayanti Yanri Wijayanti Subronto Yati Soenaro Yati Soenaro Yati Soenarto Yolanda Dyah Kartika Zulpadly, M Fiqri

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