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Analisis Efektivitas Biaya (Cost Effectiveness Analysis) Penggunaan Amitryptiline Dibandingkan Carbamazepine pada Pasien Nyeri Neuropatik (Studi Kasus Di Klinik Saraf Rumkital. Dr. Ramelan Surabaya) Qiyaam, Nurul; Rahem, Abdul; Pia, Dian Maria; Lestiono, Lestiono
JURNAL PHARMASCIENCE Vol 2, No 2 (2015): JURNAL PHARMASCIENCE
Publisher : JURNAL PHARMASCIENCE

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Abstract

ABSTRAK Nyeri neuropatik merupakan penyakit kronis yang memerlukan penanganan optimal, sehingga perlu memperhatikan aspek efektivitas dan biaya terapi. Efektivitas amitryptiline dan  carbamazepine untuk pengobatan nyeri neuropatik telah dibuktikan, tetapi belum  diketahui mana yang paling cost-effective. Penelitian ini dilakukan untuk menganalisis efektivitas biaya (cost-effectiveness) amitryptiline dan carbamazepine pada pasien nyeri neuropatik di klinik Saraf Rumkital dr. Ramelan Surabaya. Pengumpulan data dilakukan selama Februari-Mei 2014 didapatkan sebanyak 62 pasien. Metode penelitian Randomized Controlled Trial (RCT)  kemudian dilakukan analisis efektivitas biaya dengan menghitung nilai Average Cost-Effectiveness Ratio (ACER) masing-masing terapi. Pengukuran efektifitas terapi dilihat dari penurunan intensitas nyeri menggunakan Numerical Rating Scale (NRS) sebelum dan 4 minggu sesudah terapi. Berdasarkan hasil penelitian ini dapat disimpulkan bahwa terdapat perbedaan intensitas nyeri pre dan post pada terapi amitryptiline dan carbamazepine,akan tetapi tidak terdapat perbedaan efektifitas terapi dan nilai ACER antara amitryptiline dan carbamazepine. Biaya terapi amitryptilin (Rp.41.695) lebih murah dibandingkan carbamazepine (Rp.47.380) sehingga amitryptiline lebih menghemat biaya dari carbamazepine dengan efektivitas setara. Perbedaan biaya terapi hanya pada harga obat saja sehingga penelitian ini juga sesuai dengan metode Cost Minimation Analysis (CMA). Disarankan penelitian lebih lanjut cost-effectiveness menggunakan sampel yang lebih spesifik terkait penyebab nyeri neuropatik. Kata kunci :   nyeri neuropatik, amitryptiline, carbamazepine, cost-  effectiveness ABSTRACTNeuropathic pain is a chronic disease that requires optimum handling, so it needs to consider the aspects of the effectiveness and cost of treatment. Carbamazepine’s and amitryptiline’s effectiveness for the treatment of neuropathic pain has been demonstrated, but there were no data available regarding the cost-effectiveness between those medications. This study was conducted to analyze the cost-effectiveness  of amitryptiline and carbamazepine in patients with neuropathic pain in the Neurology Clinic in dr.Ramelan Navy Hospital  Surabaya. Data collection was conducted during February until May 2014, it was found as many as 62 patients. Randomized Controlled Trial studies (RCT) then was conducted to make a cost effectiveness analysis by the calculation of the value of Average Cost-Effectiveness Ratio (ACER) for each therapy.  Measurement of the effectiveness of therapy was obtained from a decrease in pain intensity using a Numerical Rating Scale (NRS) before and 4 weeks after therapy. Based on these results, it can be concluded that there was a difference in decreasing rate of pain intensity between pre and post amitryptiline and carbamazepine therapy, but there were no difference in therapeutic effectiveness and value of ACER between amitryptiline and carbamazepine. Cost of Amitryptiline therapy (Rp.41.695) was cheaper than Carbamazepine (Rp.47.380), so amitryptiline more cost- saving  than  carbamazepine with equal effectiveness. The difference is on the cost of the drug therapy alone so this study was also in accordance with the Cost Minimation Analysis (CMA). Further research suggested cost-effectiveness using a sample that is more specifically related to the causes of neuropathic pain.Keywords: neuropathic pain, amitryptiline, carbamazepine, cost-effectiveness
Pengaruh Patient Decision Aid terhadap Tingkat Pengetahuan, Sikap, Tindakan dan Hasil Klinis Pengobatan Penderita Diabetes Melitus Tipe 2 Suradnyana, I Gede M.; Rahem, Abdul; Aditama, Lisa
Indonesian Journal of Clinical Pharmacy Vol 7, No 2 (2018)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3118.277 KB) | DOI: 10.15416/ijcp.2018.7.2.89

Abstract

Diabetes melitus (DM) termasuk ke dalam empat besar penyakit kronis yang prevalensinya terus meningkat di seluruh dunia. Jumlah penderita DM di Indonesia pada tahun 2015 adalah sepuluh juta dan diperkirakan akan terus meningkat. Masalah yang dihadapi Indonesia dalam penanganan DM adalah kontrol gula darah yang buruk, tingkat pengetahuan pasien yang rendah tentang pengelolaan penyakit dan terapi, serta sangat sedikitnya puskesmas yang memiliki apoteker. Patient decision aid (PDA) secara substansial dan signifikan mampu meningkatkan pengetahuan pasien. PDA dirancang berdasarkan konstruk health belief model (HBM) dengan target peningkatan pengetahuan, sikap dan tindakan berkaitan manajemen DM tipe 2 (DMT2). Tujuan utama penelitian ini adalah untuk mengetahui pengaruh PDA terhadap tingkat pengetahuan, sikap, tindakan dan hasil klinis pengobatan. Penelitian ini bersifat pra-eksperimental satu kelompok dengan desain intervensi pretest-posttest yang melibatkan 28 penderita DMT2 berumur 21-65 tahun dan merupakan peserta BPJS Kesehatan yang berobat di Puskesmas I Denpasar Utara, serta belum pernah dirujuk ke fasilitas kesehatan lanjut. Subjek diberikan PDA sebagai intervensi dan hasil utama yang diukur adalah perubahan pengetahuan, sikap, tindakan dan kadar gula darah puasa. Penelitian ini menunjukkan terjadi peningkatan tingkat pengetahuan, sikap dan tindakan, serta penurunan kadar gula darah puasa subjek antara sebelum dan sesudah diberikan PDA. Pemberian PDA menyebabkan peningkatan signifikan (p<0,05) tingkat pengetahuan, sikap dan tindakan, serta penurunan signifikan kadar gula darah puasa.Kata kunci: Diabetes melitus tipe 2, kadar gula darah puasa, patient decision aid (PDA), pengetahuan, sikap, tindakanEffect of Patient Decision Aid on Level of Knowledge, Attitude, Practice and Clinical Outcome of Type 2 Diabetes Mellitus PatientsAbstractDiabetes mellitus (DM) is one of four major chronic diseases which prevalence continued to increase worldwide. The number of diabetes mellitus patients in Indonesia in 2015 were ten million and expected to increase. Several problems faced by Indonesia in handling DM were bad blood sugar control, low patient’s knowledge level about disease management and its therapy, and there are few primary health care that have pharmacist. Patient decision aid (PDA) was substantially and significantly able to increase patient’s knowledge. PDA was designed based on the construct of health belief model (HBM) with the target to increase knowledge, attitude, and action related with management of type 2 DM (T2DM). The main purpose of this research was to determine the effect of PDA to knowledge level, attitude, action, and clinical outcome treatment. This research used pre-experimental one group pretest-posttest design that involved 28 DMT2 patients aged 21-65 years old, were participants of Badan Penyelenggara Jaminan Sosial (BPJS) who got treatment at Puskesmas I Denpasar Utara and had never been referred to a further health care facility. The subjects were given PDA as intervention and main results measured were change of knowledge, attitude, action and fasting blood sugar level. Result of this research showed an increase in knowledge level, attitude, and action of the subjects, as well as decrease in subjects’ fasting blood sugar between before and after they had been given the PDA. Giving PDA caused a significant increase (p<0,05) in level of knowledge, attitude, and action, and significant decrease of fasting blood sugar.Keywords: Attitude, fasting blood sugar levels, knowledge, patient decision aid (PDA), practice, type 2 diabetes mellitus
The Impacts of Lifestyle Modification Education towards Cardiovascular Risk Profile Cokro, Fonny; Rahem, Abdul; Aditama, Lisa; Kristianto, Franciscus C.
Indonesian Journal of Clinical Pharmacy Vol 7, No 3 (2018)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (349.175 KB) | DOI: 10.15416/ijcp.2018.7.3.154

Abstract

Obesity is one of the risk factors of cardiovascular disease. The prevalence of obesity in Indonesia has increased in the last few years, therefore some efforts to reduce the risk is needed. In the current study, efforts are given through 3-week lifestyle modification education, with 3-month total of follow-up (from March to June 2014) and then the impacts on cardiovascular risk profile were observed and seen on 24 sedentary male workers in University of Surabaya with obese II. This study used before-after study design in order to see the impacts of the 3-week lifestyle modification education towards change of knowledge, dietary behavior, body mass index (BMI), waist circumference, and cardiovascular risk profile through various educational methods (face-to-face session, given recorder of face-to-face session, and combination of both methods). Statistical analysis was performed using Wilcoxon signed test. Result showed an increasing knowledge in face-to-face group (p=0.046). However, there were no significant changes in other variables (dietary behavior based on healthy diet indicator (HDI), BMI, waist circumference, and also cardiovascular risk profile) in all groups between before and after education intervention (p>0.05). In conclusion, lifestyle modification education given for 3 weeks did not reduce the cardiovascular risk profile on sedentary male workers with obese II. Longer term intervention and multicomponent program including behavior therapy may be needed to succeed lifestyle changes and reduce cardiovascular risk.Keywords: Behaviour, cardiovascular risk, education, knowledge, lifestyle modification Pengaruh Edukasi Gaya Hidup terhadap Perubahan Risiko Penyakit KardiovaskularAbstrakObesitas merupakan salah satu faktor risiko penyakit kardiovaskular. Prevalensi obesitas di Indonesia mengalami peningkatan beberapa tahun terakhir, sehingga diperlukan upaya untuk menguranginya. Pada penelitian ini, upaya dilakukan melalui pemberian edukasi gaya hidup yang dilakukan selama 3 minggu, dengan total follow-up sampai dengan 3 bulan dari bulan Maret hingga Juni 2014, kemudian dilihat dan diamati ada atau tidaknya penurunan risiko penyakit kardiovaskular pada 24 orang karyawan pria obese II di Universitas Surabaya. Penelitian ini memiliki rancangan before-after study design untuk menguji pengaruh edukasi gaya hidup yang diberikan selama 3 minggu terhadap variabel pengetahuan, perubahan perilaku, body mass index (BMI), lingkar perut, dan risiko penyakit kardiovaskular melalui berbagai metode pemberian edukasi (tatap muka, rekaman/recorder, dan kombinasi). Analisis dengan Wilcoxon signed test menunjukkan bahwa terdapat peningkatan pengetahuan hanya pada subgrup tatap muka (p=0,046). Tidak terdapat perubahan yang signifikan terhadap variabel lainnya (perubahan perilaku berdasarkan healthy diet indicator (HDI), BMI dan lingkar perut, serta risiko penyakit kardiovaskular) pada semua subgrup antara sebelum dan sesudah edukasi (p>0,05). Edukasi gaya hidup yang diberikan selama tiga minggu tidak memberikan penurunan risiko penyakit kardiovaskular pada karyawan pria obese II. Dibutuhkan intervensi jangka panjang dan program multikomponen yang memuat terapi perilaku untuk menyukseskan perubahan perilaku dan menurunkan risiko kardiovaskular.Kata kunci: Edukasi, gaya hidup, pengetahuan, perilaku, risiko kardiovaskular
PENGARUH BRIEF COUNSELING TERHADAP KADAR GULA DARAH PASIEN DIABETES MELITUS TIPE 2 DI RSUD DR. H. MOCH. ANSARI SALEH BANJARMASIN Metasartika, Valentina; Alfian, Riza; Pahlevi, Muhammad Reza; Rahem, Abdul
Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan Vol 3, No 2 (2018)
Publisher : Akademi Farmasi ISFI Banjarmasin

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Abstract

Diabetes melitus adalah salah satu penyakit kronis yang ditandai dengan kadar gula darah di atas nilai normal. Kadar gula darah yang tidak terkontrol dapat berkembang menjadi penyakit seperti penyakit jantung, gagal ginjal, dan stroke. Pasien diabetes melitus memerlukan intervensi dari farmasis untuk dapat mencapai luaran terapi berupa pengontrolan kadar gula darah dalam batas normal. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh pemberian brief counseling terhadap kadar gula darah pasien diabetes melitus tipe 2 di RSUD Dr. H. Moch. Ansari saleh banjarmasin.Penelitian ini menggunakan desain randomised controlled trial. Sejumlah 156 sampel dibagi menjadi dua kelompok acak yaitu 78 pasien yang mendapatkan intervensi (kelompok perlakuan) dan 78 pasien tidak mendapatkan intervensi (kelompok kontrol). Metode intervensi yang digunakan adalah brief counseling. Kriteria eksklusi pada penelitian ini adalah pasien dengan kondisi tuli, buta huruf dan tidak kooperatif. Data kadar gula darah yang dikumpulkan adalah kadar gula darah puasa yang diambil dari rekam medis pasien. Data kadar gula darah dianalisis dengan uji wilcoxon dan mann whitney.Hasil penelitian menunjukkan bahwa terjadi penurunan kadar gula darah puasa yang signifikan pada post study kedua kelompok (p &lt;0,05). Selisih penurunan kadar gula darah puasa antara kedua kelompok tidak memiliki perbedaan yang signifikan (p=0,16). Nilai penurunan kadar gula darah puasa kelompok kontrol dan kelompok perlakuan berturut-turut adalah 16,32 ± 11,56 mg/dL dan 16,87 ± 27,88 mg/dL. Kesimpulan pada penelitian ini adalah penurunan kadar gula darah puasa pasien diabetes melitus baik yang diberi intervensi brief counseling maupun yang tidak diberi intervensi tidak memiliki perbedaan.
Perbaikan Kualitas Hidup Pasien Diabetes Melitus Tipe 2 di RSUD Dr. H. Moch. Ansari Saleh Banjarmasin Dengan Intervensi Brief Counseling Pahlevi, Muhammad Reza; Rahem, Abdul; Metasartika, Valentina
Jurnal Ilmiah Manuntung Vol 4 No 1 (2018): Jurnal Ilmiah Manuntung
Publisher : jurnal ilmiah manuntung akademi farmasi samarinda

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Abstract

The study about the effect of brief counseling on quality of life of diabetes mellitus patients were conducted at RSUD Dr. H. Moch. Ansari Saleh Banjarmasin. This study using a randomized controlled trial design. Subjects who met the inclusion criteria were 156 patients randomly into two groups, 78 patients who received the intervention and 78 patients did not receive the intervention. Exclusion criteria were pregnancy patients, deaf, illiterate and uncooperative. The data collected by questionnaires Euro-Qol EQ-5D. The quality of life data were analyzed by multivariate statistic test. The result showed that the quality of life scores in the control group and the intervention group were both significantly increased with p &lt;0.05. Multivariate analysis both group at pre and median study were significant different, while at the post study was not significant different. There were improving quality of life of patients with diabetes mellitus who received the brief counseling is greater than patients who did not receive the intervention
PENINGKATKAN PEMAHAMAN KELOMPOK TANI TERHADAP PENGOBATAN TUBERCULOSIS DAN PENCEGAHANNYA MELALUI FOCUS GROUP DISCUSSION Rahem, Abdul; Utami, Wahyu; Hermansyah, Andi; Sukorini, Anila Impian; Rahayu, Titik Puji; Athiyah, Umi; Yuda, Ana; Sulistyarini, Arie; Wijaya, I Nyoman; Noorrizka V, Gusti; Priyandani, Yuni; Budiatin, Aniek Setiya; Aryani, Toetik; Zulkamain, Bambang Subakti
Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan Vol 9 No 1 (2024): JIIS
Publisher : Sekolah Tinggi Ilmu Kesehatan ISFI Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36387/jiis.v9i1.1727

Abstract

Tuberculosis was a cause of global morbidity and mortality. Sumenep Regency has a high number of TBC cases, namely in 2017 were 1,627 people and 1,709 people in 2018. The difficulty in overcoming them is mainly due to the public and drug managers' understanding regarding drug side effects. Therefore, it is necessary to increase their literacy regarding this matter. This research aims to analyze the influence of Focus Group Discussions on farmer group members' understanding of the treatment and prevention of tuberculosis. It also analyzes the understanding of community health center drug managers regarding the side effects of TBC drugs and how to deal with them. A quasi-experimental design, with a pretest – posttest design, was carried out on 49 members of the Bungbungan village farmer group and 39 community health center drug managers in Sumenep. The results showed that the farmer group understanding scores before and after the intervention were as follows: 6.02±1.19 and 6.69±1.46. for drug managers were 14.67±2.41 and 18.36±1.65. Conclusion The Focus Group Discussion had an impact on increasing understanding of the treatment and prevention of tuberculosis for farmer groups, and for community health center drug managers it had an impact on understanding the side effects of TBC drugs and how to deal with them.
ANALISIS BIAYA MEDIS LANGSUNG PASIEN BPJS BRONKOPNEUMONIA BALITA DI RAWAT INAP RUMAH SAKIT ISLAM SURABAYA ACHMAD YANI Wardhani, Dewanti; Nita, Yunita; Rahem, Abdul
Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan Vol 9 No 1 (2024): JIIS
Publisher : Sekolah Tinggi Ilmu Kesehatan ISFI Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36387/jiis.v9i1.1728

Abstract

Bronchopneumonia is a type of disease that attacks the lungs, often occurring in the bronchi and alveoli, which is caused by viruses, bacteria or fungi. Bronchopneumonia is the most frequently diagnosed infectious disease at the Surabaya Achmad Yani Islamic Hospital in 2022. The aim of the research is to determine the real direct medical costs of toddler bronchopneumonia and the components that make up real direct medical costs. The research uses an observational research design. Data collection was carried out in October 2023 by reviewing medical record data of patients who met the inclusion criteria during the period January 2023-March 2023. The research subjects consisted of 172 patients. The research results show that the real direct medical costs for toddler bronchopneumonia based on the perspective of the Surabaya Achmad Yani Islamic Hospital during the period January 2023-March 2023 are IDR. 463,267,781 with an average cost per patient of Rp. 2,693,417. The largest component of real direct medical costs is the component of use of hospital facilities at 34.87% and the component of costs for medicines and consumable medical materials at 34.06%. Cost analysis is very important so that patient treatment costs become more effective and efficient.
Pembiayaan Pasien Skizofrenia Paranoid Mahanggi, Oktarina; Rahem, Abdul; Nita, Yunita
Journal of Telenursing (JOTING) Vol 5 No 2 (2023): Journal of Telenursing (JOTING)
Publisher : Institut Penelitian Matematika, Komputer, Keperawatan, Pendidikan dan Ekonomi (IPM2KPE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31539/joting.v5i2.7325

Abstract

This study aims to determine the burden of direct medical costs on paranoid patients at Tombulilato Regional Hospital and the factors influencing direct medical costs. The method used in this research was retrospective, using medical record data and details of direct medical costs. The results of this research are that the total direct medical costs of inpatient schizophrenia patients are IDR. 523,028,500, with the most significant accommodation cost being the room cost of Rp. 184,190,000 because the patient's length of stay is very strongly related to direct medical costs. The conclusion is that the total direct medical costs incurred amounted to Rp. 523,028,500 with the relationship between the length of hospital stay and direct medical expenses. Keywords: Direct medical costs, influencing factors, schizophrenia
Profil Pengelolaan Obat dan Ketersediaan Obat Kunnu, Hasbi; Rahem, Abdul; Utami, Wahyu
Journal of Telenursing (JOTING) Vol 5 No 2 (2023): Journal of Telenursing (JOTING)
Publisher : Institut Penelitian Matematika, Komputer, Keperawatan, Pendidikan dan Ekonomi (IPM2KPE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31539/joting.v5i2.7417

Abstract

This study aimed to determine the profile of drug management and the availability of drugs hinge on 40 items of national indicator drugs at Enrekang’s Public Health Centers. This research method uses an observational descriptive study was conducted at a total of 14 public health centers in Enrekang Regency. A data collection sheet for the availability of 40 national indicator drug items in 2021 and an observational sheet were used as the research instrument. This study found that most of the public health centers in Enrekang Regency managed their drugs in the good category with a percentage of planning at 64.3%, procurement at 100%, reception at 100%, storage at 57.1%, distribution at 71.4%, destruction and withdrawal at 92.9%, control at 71.4%, administration of recording and reporting at 57.1%. Based on category, the availability percentage of 40 national indicator drug items at Enrekang’s Public Health Centers was safe at 56%, empty at 4.4%, less at 10.5%, and excess at 29.1%. In conclusion, most of the public health centers in Enrekang Regency managed their drugs in the good category, the availability of drugs in Enrekang’s Public Health Centers with a safe category is only 56%. Keywords: Drug Availability, Drug Management, Public Health Center
Analisis Pelaksanaan Konseling oleh Apoteker di Apotek Komunitas Khandy, Evanda Ratna Thalia; Utami, Wahyu; Rahem, Abdul
Journal of Telenursing (JOTING) Vol 5 No 2 (2023): Journal of Telenursing (JOTING)
Publisher : Institut Penelitian Matematika, Komputer, Keperawatan, Pendidikan dan Ekonomi (IPM2KPE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31539/joting.v5i2.7808

Abstract

This study aims to analyze factors that influence the implementation of counseling by pharmacists in community pharmacies in the Malang Regency area. The method used was observational research carried out cross-sectionally using a questionnaire instrument. The research results show a significant relationship (p<0.05) for each independent variable with the implementation of counseling. In conclusion, the availability of infrastructure is the variable that has the most decisive influence on the performance of counseling by pharmacists, followed by the variables of attitude, knowledge, and policy. Keywords: Pharmacist, Pharmacy, Counseling, Pharmaceutical Services