Peningkatan Peran Apoteker dan Outcome Pasien Tuberkulosis Melalui Uji Coba Model Training-Education-Monitoring-Adherence-Networking (TEMAN) Apoteker - Yasin, Nanang M.; Wahyono, Djoko; Riyanto, Bambang S.; Sari, Ika P. (Indonesian Journal of Clinical Pharmacy, 2017)
Model Training-Education-Monitoring-Adherence-Networking (TEMAN) Apoteker memberikan ruang bagi apoteker yang telah mendapatkan pelatihan untuk melakukan intervensi melalui edukasi pasien tuberkulosis (TB), monitoring terapi, asesmen kepatuhan pasien dan kerjasama dengan tenaga kesehatan lain. Penelitian ini bertujuan untuk mengetahui dampak uji coba model TEMAN Apoteker terhadap peran apoteker dan outcome pasien TB. Penelitian terdiri atas 2 tahap yaitu pelatihan dan intervensi apoteker dengan jenis penelitian quasi experimental study dengan rancangan one group pretest-posttest design. Setelah mendapatkan pelatihan, apoteker melakukan intervensi pada saat kunjungan rutin pasien TB di puskesmas dan Rumah Sakit Khusus Paru Respira di DIY. Subjek penelitian yang dilibatkan meliputi petugas TB (apoteker dan programmer TB) dan pasien dengan diagnosis baru TB yang memenuhi kriteria inklusi, yaitu usia lebih dari 15 tahun, mendapatkan terapi obat anti tuberkulosis (OAT), bersedia mengisi kuesioner dan menandatangani informed consent. Kriteria eksklusinya adalah pasien multi drug resistance (MDR) TB; memiliki penyakit hepatik, psikiatrik (mental) dan disfungsi kognitif. Instrumen yang dikembangkan peneliti adalah kuesioner untuk mengukur tingkat pengetahuan petugas TB dan kuesioner untuk mengukur tingkat pengetahuan dan kepatuhan pasien TB. Analisis data menggunakan analisis deskriptif dan uji Wilcoxon sign rank. Adanya pelatihan efektif meningkatkan pengetahuan 37 petugas TB secara bermakna p=0,000 dari rerata 11,3Â±3,00 (kategori menengah) menjadi 16,3Â±2,31 (kategori tinggi). Sebanyak 40 (81,6%) pasien meningkat pengetahuannya secara bermakna (p=0,000) dan sebanyak 5 (10,2%) pasien meningkat kepatuhannya secara bermakna (p=0,034) setelah intervensi apoteker. Di sisi lain, dari total 49 pasien TB, sebanyak 29 (59,2%) pasien bertambah berat badannya, 100% konversi sputum, 33 (67,3%) kejadian adverse drug reactions (ADR), dan 8 (16,3%) potensi interaksi obat menjadi terdokumentasi melalui monitoring apoteker. Intervensi model TEMAN Apoteker meningkatkan peran apoteker dan outcome pasien TB.Kata kunci: Anti-tuberkulosis, apoteker, kepatuhan, edukasi, intervensiÂ Enhancing Pharmacistâs Role and Tuberculosis Patient Outcomes Through Training-Education-Monitoring-Adherence-Networking (TEMAN) Pharmacist Model InterventionTraining-Education-Monitoring-Adherence-Networking (TEMAN) Pharmacist model provides opportunities for trained pharmacist to intervene through education of tuberculosis (TB) patient, therapy monitoring, assessment of patientâs adherence, and collaboration with other health professionals. The study aimed to determine the impact of TEMAN Pharmacist model intervention against the role of pharmacist and TB patient outcomes. The study design was a quasi-experimental study with one group pretest-posttest consisted of two phases: training and pharmacist intervention. After training, pharmacists intervene during regular visits TB patients in primary health care and Special Hospital Lung Respira in Yogyakarta. The research subjects were TB officer (pharmacist and TB programmers) and patients with newly TB diagnostic who met the inclusion criteria, i.e. patients aged 15 years or older, receiving antituberculosis therapy, and willing to fill out given questionnaires and signing a letter of approval for the study (informed consent). Meanwhile, the exclusion criteria were patients with multi-drug resistance (MDR) TB; have hepatic disease, psychiatry (mental), and cognitive dysfunction. The instrument developed was a questionnaire to measure the level of knowledge of TB officers and questionnaires to measure the level of knowledge and adherence of TB patients. The data were analyzed descriptively and by using Wilcoxon test. The training effectively improved the knowledge of participants significantly (p=0,000) on average 11.3Â±3.00 (intermediate category) to 16.3Â±2.31 (high category). A total of 40 (81.6%) TB patients increased their knowledge significantly (p=0,000) and 5 (10.2%) increased their adherence significantly (p=0,034) after the pharmacistâs intervention. Additionally, out of 49 patients, 29 (59.2%) patients increased body weight, 100% sputum smear conversion, 33 (67.3%) incidence of ADR, and 8 (16.3%) potential drug interactions were documented by the pharmacist monitoring. Intervention of TEMAN Pharmacist model improves the role of the pharmacist and the outcome of TB patients.Keywords: Adherence, antituberculosis, education, pharmacists, intervention