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INDONESIA
Jurnal Farmasi Klinik Indonesia
Published by Universitas Padjadjaran
ISSN : 23375701     EISSN : 2337 5701     DOI : -
Core Subject :
Indonesian Journal of Clinical Pharmacy (IJCP) is a scientific publication on all aspect of clinical pharmacy. It published 4 times a year by Clinical Pharmacy Master Program Universitas Padjadjaran to provide a forum for clinicians, pharmacists, and other healthcare professionals to share best practice, encouraging networking and a more collaborative approach in patient care. Indonesian Journal of Clinical Pharmacy is intended to feature quality research articles in clinical pharmacy to become scientific guide in fields related to clinical pharmacy. It is a peer-reviewed journal and publishes original research articles, review articles, case reports, commentaries, and brief research communications on all aspects of Clinical Pharmacy. It is also a media for publicizing meetings and news relating to advances in Clinical Pharmacy in the regions.
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Analisis Kuantitatif 15-F2t-isoprostan dari Plasma Pasien Obstructive Sleep Apnea (OSA) dengan Metode Enzyme Linked Immunosorbent Assay (ELISA) menggunakan Teknik Ekstraksi Imunoafinitas Rusdi, Bertha; Gusdinar, Tutus; Fattah, Miswar
Indonesian Journal of Clinical Pharmacy Vol 1, No 1 (2012)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

15-F2t-isoprostan merupakan penanda stres oksidatif yang kadarnya dalam cairan biologis relatif rendah serta memiliki banyak isomer sehingga diperlukan ekstraksi sampel sebelum dilakukan pengukuran kadar. Metode ekstraksi yang digunakan diantaranya ekstraksi fase solid/Solid Phase Extraction (SPE) serta ekstraksi imunoafinitas. Perbaikan teknik ekstraksi SPE dan teknik ekstraksi imunoafinitas dilakukan untuk membandingkan hasil perolehan kembalinya. Pengukuran dilakukan dengan metode Enzyme Linked Immunosorbent Assay (ELISA). Penilaian efektivitas proses ekstraksi diamati melalui hasil perolehan kembali dari kedua teknik ekstraksi. Teknik ekstraksi dengan perolehan kembali tertinggi digunakan untuk mengukur kadar 15-F2t-isoprostan dari penderita Obstructive Sleep Apnea (OSA). Teknik ekstraksi imunoafinitas menghasilkan perolehan kembali 15-F2t-isoprostan yang cukup baik. Pada penderita OSA kadar 15-F2t-isoprostan dalam plasma cenderung tinggi sehingga memiliki risiko untuk menderita penyakit yang berhubungan dengan aktivitas biologis 15-F2t-isoprostan seperti arteriosklerosis.Kata kunci: 15-F2t-isoprostan, Solid Phase Extraction (SPE), ekstraksi imunoafinitas, ObstructiveSleep Apnea (OSA) Quantitative Analysis of Free 15-F2t-Isoprostane from Plasma of Obstructive Sleep Apnea Patients Using Enzyme Linked Immunosorbent Assay Method with Immunoaffinity Extraction TechniqueAbstract15-F2t-isoprostane is a biomarker in assessment of oxidative stress status that due to its relatively low concentration in biological fluid and also has many isomers, the 15-F2t-isoprostane sample need to be extracted prior to the quantifying processes. Extraction techniques commonly used to extract 15-F2t-isoprostane are solid phase extraction (SPE) and immunoaffinity extraction. Improvements to the SPE and immunoaffinity extraction techniques had been conducted, and the recovery results was then compared. The quantification of 15-F2t-isoprostane then was conducted using Enzyme Linked Immunosorbent Assay (ELISA) method. Then followed by the examination of the plasma recovery results. Extraction technique which had the highest recovery then was used to quantify 15-F2t-isoprostane from plasma of Obstructive Sleep Apnea (OSA) patients. Immunoaffinity extraction technique has a good recovery result. OSA patients have the tendency to have high 15-F2t-isoprostane concentrations in the plasma, therefore have a potential risk to get diseases related to the biological activities of 15-F2t-isoprostane, such as arteriosclerosis.Key words: 15-F2t-isoprostane, Solid Phase Extraction (SPE), immunoaffinity extraction, ObstructiveSleep Apnea
Heart-type Fatty Acid-Binding Protein (H-FABP) sebagai Penanda Biokimiawi untuk Membedakan Stroke Iskemik dan Hemoragik Halimah, Eli; Liswati, Evy; Sasmita, Erwin
Indonesian Journal of Clinical Pharmacy Vol 6, No 1 (2017)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (528.552 KB) | DOI: 10.15416/ijcp.2017.6.1.55

Abstract

Stroke merupakan sindrom neurologis yang bersifat akut yang terjadi karena adanya penurunan alirandarah yang disebabkan oleh terhambat atau pecahnya pembuluh darah otak (cerebrovaskular) yangmenyebabkan kerusakan jaringan otak. Berdasarkan patogenesisnya, terdapat dua jenis stroke, yaitustroke iskemik dan hemoragik, di mana penanganan pengobatan pada kedua jenis stroke tersebut sangatberbeda sehingga diperlukan diagnosis diferensial untuk membedakan kedua jenis stroke tersebut. Tujuanpenelitian ini yaitu untuk menentukan apakah Heart-type Fatty Acid-Binding Protein (H-FABP) dapatdijadikan sebagai parameter penanda biokimiawi untuk membedakan stroke iskemik dan hemoragik.Penetapan kadar H-FABP dilakukan dengan menggunakan serum darah dan dianalisis dengan metodeEnzyme Linked Immunosorbent Assay (ELISA) sandwich masing-masing menggunakan H-FABP testkit. Serum darah diambil dari 20 orang pasien stroke iskemik dan 18 orang pasien stroke hemoragikdari Instalasi Gawat Darurat (IGD), Unit Stroke dan Instalasi Rawat Inap di salah satu Rumah SakitUmum di Jakarta. Hasil penelitian menunjukkan bahwa kadar rata-rata H-FABP pada pasien strokeiskemik sebesar 9,07 ng/mL sedangkan pasien stroke hemoragik sebesar 18,54 ng/mL; secara statistikterdapat perbedaan kadar H-FABP yang signifikan antara pasien stroke iskemik dan hemoragik (α=0,05).Dengan demikian, Heart-type Fatty Acid-Binding Protein (H-FABP) dapat dijadikan sebagai salah satuparameter penanda biokimiawi untuk membedakan stroke iskemik dan hemoragik.
Pengaruh Kualitas Pelayanan dan Kepuasan Pelanggan terhadap Niat Beli Obat di Depo Farmasi Anggrek RSUP Dr. Hasan Sadikin, Bandung Pratiwi, Pratiwi; Muhtadi, Ahmad; Surahman, Emma
Indonesian Journal of Clinical Pharmacy Vol 5, No 1 (2016)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (294.859 KB) | DOI: 10.15416/ijcp.2015.6.1.47

Abstract

Kualitas pelayanan dengan dimensi bukti langsung, daya tanggap, kehandalan jaminan, dan empati dapat memengaruhi kepuasan pelanggan yang selanjutnya berujung pada niat membeli pelanggan. Berdasarkan laporan bulanan instalasi farmasi hanya sekitar 30% pasien yang membeli obat di depo farmasi Anggrek dari pasien yang berkunjung ke Poliklinik Spesialis Anggrek RSUP Dr. Hasan Sadikin. Penelitian ini bertujuan untuk mengetahui pengaruh kualitas pelayanan dan kepuasan pelanggan terhadap niat beli pelanggan di depo farmasi Anggrek RSHS. Metode yang digunakan adalah metode survei analitik dengan rancangan penelitian potong lintang. Sampel yang digunakan sebanyak 200 pasien yang terdiri dari 104 pelanggan dengan lebih dari satu kali kunjungan dan 96 pelanggan yang satu kali kunjungan ke poliklinik tersebut. Pengumpulan data menggunakan kuesioner dan dianalisis menggunakan aplikasi Smart PLS V 2.0. Kualitas pelayanan berpengaruh terhadap kepuasan pelanggan dengan dengan nilai t-hitung 12,755 (lebih besar dari t tabel 1,983). Kepuasan pelanggan berpengaruh terhadap niat beli dengan nilai t-hitung 5,012 (lebih besar dari t tabel 1,983). Kualitas pelayanan berpengaruh terhadap niat beli dengan nilai t-hitung 1,455 (lebih kecil dari t tabel 1,983). Kualitas pelayanan memengaruhi pelanggan sehingga pelanggan tidak berniat membeli obat di depo farmasi yaitu ketidakteresediaan konseling, waktu tunggu yang lama, kebutuhan akan ruang konseling khusus, ruang tunggu yang luas, dan kelengkapan obat.Kata kunci: Kepuasan pelanggan, kualitas pelayanan, niat beli Influence Service Quality and Customer Satisfaction towards Drug Purchase Intention in Anggrek Outpatient Pharmacy Depo at Hasan Sadikin Hospital The quality of service is an evaluation which focused on customer’s awareness about a structural construction of a service or product that involves 5 main aspects which are tangibility, empathy, responsiveness, reliability and assurance. Based on monthly reports of pharmacy installation only about 30% of patients buy drugs in the Anggrek out patient depo out off patients visiting Anggrek out patient specialist clinic in Dr. Hasan Sadikin Hospital. The aim of this study is to determine the effect of service quality and customer satisfaction to purchase intention in the Anggrek out patient depo Hasan Sadikin hospital at Bandung. The method used in this study is analytical survey with cross sectional design. The samples used were 200 patients, consist of 104 customers who have visited more than one times and 96 first visit costumer to this clinic. Data was collected using a questionnaire and analyzed using Smart PLS V 2.0 software. The results of this study showed that the service quality with tangible dimensions, reliability, responsiveness, assurance, and empathy are affecting the customer satisfaction with a score of 12.755 t-count (greater than t-table 1.983 ) and a positive value of the original sample of 0.800. Customer satisfaction affecting the customer purchase intentions with t-count is greater than t-table values of 5.012 and 0.726 of the original positive sample. While the service quality does not directly influence customer purchase intention with the t-test is smaller than t-table is 1.455 and the negative of the original sample -0.287. Some of service quality influence customers that causes not purchasing drugs from the out patient depo there are effect of unavailability of counseling, long waiting time of service, the need for special counseling room, a spacious waiting room, and the completeness of drug availability.Key words: Customer satisfaction, purchase intention, quality of service
Kultur Kuman dari Berbagai Pasien Sepsis Dewasa Pradipta, Ivan S.
Indonesian Journal of Clinical Pharmacy Vol 2, No 1 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Penelitian ini bertujuan memberikan informasi sumber infeksi sepsis dan hasil kultur mikroba dari berbagai spesimen pasien sepsis yang bermanfaat dalam meningkatkan ketepatan terapi antibiotik. Studi observasional prospektif dilakukan di bangsal rawat inap penyakit dalam, sebuah rumah sakit negeri di Yogyakarta, pada bulan September–November 2008. Populasi penelitian adalah pasien yang terdiagnosis sepsis yang dirawat inap pada periode dan tempat penelitian berlangsung, dengan kriteria pasien dewasa umur 15–60 tahun dan terdiagnosis sepsis. Hasil penelitian menunjukkan 42 pasien terdiagnosis sepsis, 26 pasien masuk ke dalam kriteria subjek penelitian. Perlakuan kultur bakteri dilakukan pada 22 subjek penelitian dan empat subjek penelitian tidak dilakukan. Jumlah perlakuan kultur sebanyak 46 perlakuan kultur dari berbagai spesimen, yaitu darah (27), pus (5), urin (4), sputum (3), cairan pleura (1), swab tenggorokan (1), swab ulkus (1) dan 4 perlakuan tidak dapat ditelusuri hasilnya. Hasil kultur menunjukkan 16 (34,8%) perlakukan kultur teridentifikasi mikroba dan 30 (66,2%) hasil kultur menunjukkan tidak teridentifikasi mikroba. Mikroba yang terdeteksi yaitu Staphylococcus coagulase negative, Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli, Proteus mirabilis, Streptococcus alfa. Staphylococcus coagulase negative merupakan organisme yang paling banyak terdeteksi pada spesimen pasien sepsis.Kata kunci: Sepsis, kultur bakteri, patogen sepsis, bakteremia Microbial Culture from Various Specimens of Adult Sepsis PatientsThis study aimed to provide information about pattern of microbial culture from the isolate adult sepsis patients that beneficial in identifying pathogen and antibiotics selection in septic patients. Observational prospective study from September–November 2008 was carried out in ward of internal mediciene at an Public Hospital, Yogyakarta, Indonesia. The population study were adult sepsis patients that hospitalized in research period. The criteria of subject population were sepsis adults patients aged 15–60 years that hospitalizad in research period. As many as 42 patients that found as septic patient, there were twenty six patients included as a subject population. As many as 22 patients get the microbial culture treatment wtih 46 episode microbial culture from the various specimens, i.e blood (27), pus (5), urine (4), sputum (3), pleura fluid (1), throat swab (1), ulcus swab (1) and not identified (4). Culture test showed that 16 (34,8%) culture test was positive results and 30 (66,2%) was negative results. There were Staphylococcus coagulase negative, Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli, Proteus mirabilis, Streptococcus alfa. Staphylococcus coagulase negative organism that detected in culture test from various specimens. Staphylococcus coagulase negative is the common organism which detected from the specimens of sepsis patients.Key words: Sepsis, microbial culture, sepsis pathogen, bacteremia
Pengaruh Konseling Apoteker terhadap Pengetahuan dan Persepsi Pasien Penyakit Jantung Terapi Warfarin di RSUP Dr. Hasan Sadikin Bandung Putriana, Norisca A.; Barliana, Melisa I.; Lestari, Keri
Indonesian Journal of Clinical Pharmacy Vol 6, No 4 (2017)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (587.367 KB) | DOI: 10.15416/ijcp.2017.6.4.282

Abstract

Warfarin merupakan turunan dari kumarin, yang sudah biasa diresepkan sebagai antikoagulan oral untuk mengobati atau mencegah penyakit-penyakit trombotik. Tujuan dari penelitian ini yaitu untuk menganalisis pengaruh konseling apoteker terhadap pengetahuan dan persepsi pada pasien penyakit jantung pengguna warfarin. Penelitian ini dilaksanakan pada bulan Juli 2012–Februari 2014 di Poli Jantung RSUP Dr. Hasan Sadikin, Bandung. Desain penelitian berupa mixed method. Data kualitatif digunakan untuk mendukung data kuantitatif, dengan metode kualitatif berupa analisis konten dengan cara wawancara. Metode kuantitatif berupa quasi-eksperimental dengan kelompok kontrol pre-post test design. Analisis data penelitian menggunakan uji Wilcoxon dan uji Mann-Whitney dengan level signifikansi p≤0,05 dan analisis multivariat. Hasil penelitian menunjukkan bahwa terdapat pengaruh konseling apoteker terhadap pengetahuan (p<0,05) dan persepsi (p<0,05). Konseling apoteker dapat memperbaiki pengetahuan dan persepsi pasien terapi warfarin.Kata kunci: Konseling, pengetahuan, persepsi, warfarin The Influence of Pharmacist’s Counseling on Knowledge and Perception on Cardiac Patient Warfarin Management at Dr. Hasan Sadikin Hospital BandungWarfarin is a derivate of coumarin, which is usually prescripted as an oral anti-coagulant for treatment and prevention of thromboembolic disorders. The aim of this research was to analyse the influence of pharmacist’s counseling on knowledge and perception on warfarin management. This research was conducted from July 2012 until February 2014 in Cardiac Polyclinic Dr. Hasan Sadikin General Hospital, Bandung. This research used mixed method design. Qualitative data was obtained using content analysis with interview method and used to complete quantitative data. Quantitative method used a quasi-experimental method with control groups and pre-post test design. Data was collected by prospective method and analysed using Wilcoxon and Mann-Whitney test at significance level p≤0.05 and multivariate analysis covariate. The result of this research is pharmacist’s counseling affected knowledge (p<0.05) and perception (p<0.05). Pharmacist’s counseling can improve knowledge and perception on warafarin therapy.Keywords: Counseling, knowledge, perception, warfarin
Pengaruh Penilaian Prestasi Kerja dan Kompensasi terhadap Kinerja Tenaga Teknis Kefarmasian Non-PNS Instalasi Farmasi RSUP Dr. Hasan Sadikin Winarni, Rina; Muhtadi, Ahmad; Surahman, Emma
Indonesian Journal of Clinical Pharmacy Vol 5, No 4 (2016)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (630.742 KB) | DOI: 10.15416/ijcp.2016.5.4.278

Abstract

Kinerja adalah hasil kerja secara kualitas dan kuantitas yang dicapai oleh seorang pegawai. Penelitian ini bertujuan untuk mengetahui pengaruh penilaian prestasi kerja dan kompensasi terhadap kinerja pegawai Tenaga Teknis Kefarmasian Non-PNS Instalasi Farmasi. Metode yang digunakan adalah metode survei analitik dengan rancangan potong lintang. Sampel yang digunakan 102 karyawan instalasi farmasi kompetensi Tenaga Teknis Kefarmasian dengan status kepegawaian Non-PNS. Pengumpulan data menggunakan kuesioner dan dianalisis menggunakan analisis jalur. Hipotesis pertama penilaian prestasi kerja memengaruhi kinerja (t hitung 4,038 > t tabel 1,984). Hipotesis kedua adalah kompensasi memengaruhi kinerja (t hitung 3,739 > t tabel 1,984). Hipotesis ketiga adalah penilaian prestasi kerja memengaruhi kompensasi (t-hitung 10,208 > t tabel 1,984). Penilaian prestasi kerja dan kompensasi berpengaruh sebesar 51,68% terhadap kinerja pegawai. Penilaian prestasi kerja dan kompensasi masing‑masing berpengaruh sebesar 27% dan 24,68% sedangkan 48,32% merupakan variabel lain yang tidak diteliti. Kinerja Tenaga Teknis Kefarmasian Non-PNS Instalasi Farmasi RSUP Dr. Hasan Sadikin dipengaruhi oleh penilaian prestasi kerja dan kompensasi dengan total pengaruh sebesar 51,68%.Kata kunci: Kinerja, kompensasi, penilaian prestasi kerja, tenaga teknis kefarmasianThe Impact of Performance Appraisal and Compensation to Performance of Pharmacy Technical Personnel Non-Civil Servants at Hasan Sadikin Hospital Abstract Performance is the result of the quality and quantity of work achieved by an employee. This study aimed to determine the effect of performance appraisal and compensation to performance of Pharmacy Technical Personnel Non Civil Servants. This study used analytic survey with cross-sectional study design. The sample are 102 pharmacy employees. Data was collected by using questionnaires and analyzed using path analysis. The first hypothesis is the performance appraisal affect the performance (t value 4,038 > t table 1.984). The second hypothesis is the compensation affects the performance (t value 3.739 > t table 1.984). The third hypothesis is the performance appraisal affects the compensation (t value 10.208 > t table 1.984). Performance appraisal and compensation affected employee performance by51.68%. Performance appraisal and compensation affected employee performance by 27% and 24.68% respectively, while 48.32% is other variable that is not investigated. Performance of Pharmacy Technical Personnel Non Civil Servants in RSUP DR. Hasan Sadikin is influenced among others by the performance appraisal and compensation with a total effect of 51.68%.Keywords: Compensation, performance, performance appraisal, pharmacy technical personnel
Reseptor Vitamin D (VDR) dan Phosphatidylinositol 3-Kinase (PI3K) Secara Independen Memengaruhi Diferensiasi Adenokarsinoma Kolorektal Erida, Yulie; Aminah, Hermin; Yulianti, Herry; Hernowo, Bethy S.
Indonesian Journal of Clinical Pharmacy Vol 4, No 4 (2015)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1017.921 KB) | DOI: 10.15416/ijcp.2015.4.4.264

Abstract

Terapi target (targeted therapy) pada karsinoma kolorektal merupakan terapi alternatif yang diharapkan memberikan hasil yang lebih baik diantaranya dengan pemberian metabolit aktif vitamin D, yaitu calcitriol dan inhibitor Phosphatidyl Inositol 3 Kinase (PI3K). Penelitian ini bertujuan untuk mengetahui korelasi imunoekspresi VDR dan PI3K terhadap derajat diferensiasi adenokarsinoma kolorektal. Penelitian ini menggunakan desain potong lintang dengan analisis kategorik dari 30 blok parafin adenokarsinoma kolorektal (kelompok low grade dan high grade masing-masing 15 kasus) dari Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran/RSUP Hasan Sadikin Bandung. Analisis Lambda menunjukkan bahwa imunoekspresi VDR dan PI3K masing-masing memengaruhi diferensiasi adenokarsinoma kolorektal (p=0,029, p=0,0225, R= 0,533). Berdasarkan nilai p, PI3K lebih kuat daripada VDR dalam memengaruhi derajat diferensiasi. Analisis Spearman menunjukkan imunoekspresi VDR dan PI3K tidak terbukti berkorelasi dengan diferensiasi (p=0,186, p>0,05, R: 0,248) secara bersamaan/simultan. Imunoekspresi VDR dan PI3K berkorelasi positif dengan kelompok low grade. Disimpulkan bahwa VDR tidak menggunakan jalur MAPK bersama-sama dengan PI3K dalam memengaruhi diferensiasi adenokarsinoma kolorektal.Kata kunci: Adenokarsinoma kolorektal, diferensiasi, imunoekspresi PI3K, imunoekspresi VDRVitamin D Receptor (VDR) and Phosphatidylinositol 3-Kinase (PI3K) Independently Affected Colorectal Adenocarcinoma Differentiation Targeted therapy in carcinoma colorectal such as is as calcitriol and Phosphatidyl Inositol 3 Kinase (PI3K) is an alternative therapy for better treatment outcome. The aim of this study was to determine the correlation between VDR and PI3K immunoexpression with the degree of differentiation (grading) in colorectal adenocarcinoma. Cross-sectional, categorical analysis of 30 paraffin blocks of colorectal adenocarcinoma (low and high grade group, 15 cases each) obtained from Department of Pathology Faculty of Medicine, Universitas Padjadjaran/Dr Hasan Sadikin General Hospital Bandung. Analysis of Lambda showed that immunoexpression of VDR and PI3K affected differentiation of colorectal adenocarcinoma (p=0.029, p=0.0225, R=0.533). Based on p value, PI3k is stronger than VDR in influencing the degree of differentiation. Spearman analysis showed that simultaneous immunoexpression of VDR and PI3K was not shown to correlate with differentiation (p= 0186, p<0.05, R: 0.248). Positive immunoexpression of VDR and PI3K correlates with low-grade group. It can be concludes that VDR does not use the MAPK pathway together with PI3K to affect differentiation of colorectal adenocarcinoma.Keywords: Colorectal adenocarcinoma, differentiation, PI3K immunoexpression, VDRImmunoexpression
Pengaruh Ketaatan Terapi Pasien pada Luaran Penyakit Terkait Kardiovaskular Suhadi, Rita
Indonesian Journal of Clinical Pharmacy Vol 3, No 4 (2014)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (281.122 KB) | DOI: 10.15416/ijcp.2014.3.4.114

Abstract

perubahan pola hidup sebagai hasil persetujuan pasien terhadap rekomendasi penyedia layanan kesehatan.Persistensi terapi merupakan keberlanjutan terapi meliputi durasi pasien tidak meninggalkan terapinya.Ketaatan terapi pasien dipengaruhi oleh faktor sistem kesehatan, pasien, sosioekonomi, terapi, dan kondisi penyakit. Artikel ini bertujuan untuk mengevaluasi penelitian-penelitian terkait ketaatan terapi yang meliputi definisi, prevalensi, faktor-faktor, intervensi untuk ketaatan, dan dampak ketaatan terhadap luaran terapi. Penelitian-penelitian yang diulas dipilih secara purposive dari database jurnal dan situs website terpercaya. Berdasarkan hasil ulasan ditemukan bahwa intervensi nonfarmakologi tidak konsisten hasilnya terhadap peningkatan ketaatan, demikian juga dampak ketaatan terhadap luaran terapi hasilnya bervariasi mulai dari tidak berefek sampai dengan efek ringan dan kuat. Luaran ketaatan meskipun tidak pasti, peningkatan ketaatan tetap diperlukan untuk memastikan obat digunakan dan bekerja dengan baik pada pasien. Hasil positif ketaatan yang ditemukan misalnya pasien yang taat akan mengalami perbaikan prognosis pada pasien hipertensi. Ketidaktaatan terapi pasien dapat meningkatkan kematian, lebih banyak pasien terpaksa masuk rumah sakit, dan memerlukan tambahan biaya terapi yang lebih besar.Kata kunci: Intervensi nonfarmakologi, ketaatan terapi, luaran terapi, persistensi terapiThe Effect of Patient Medication Adherence on the Outcome of Cardiovascular-Related DiseasesLong-term adherence is affected by the patient behavior to medicine administration, diet management, and/or life-style changes as the result of the patients’ concordance to the health-providers’ recommendations. Therapy persistence is defined as the medication sustainability of the patients or the duration without discontinue of the therapy. Patients’ medication adherence is affected by health care system, patients socioeconomics, therapies, and disease condition factors. This article aimed to evaluate the studies on medication adherence including the definition, prevalence, affecting factors, intervention to increase adherence, and the outcome therapy due to adherence. Purposive method was performed to select the articles from reliable journal database and websites. The result showed that there was inconsistent result of nonpharmacological intervention to enhance the medication adherence; the effect of adherence on therapeutic outcome was found from no and mild effect to intense effect. Though the effect of adherence on therapeutic outcome was inconsistent, efforts to increase adherence should be implemented to ensure that the patients get appropriate administration of the medicine. Medication adherence improved prognosis among hypertensive patients, meanwhile nonadherence increased the patients’ mortality rate, hospital admission, and cost of therapy.Key words: Medication adherence, nonpharmacological intervention, therapy outcome, therapypersistence
Analisis Kejadian Leukositosis Pasca Terapi Aminofilin Intravena Dibandingkan dengan Salbutamol Nebulasi pada Pasien Eksaserbasi Asma Lorensia, Amelia; Ikawati, Zullies; Andayani, Tri M.; Maranatha, Daniel; Wahjudi, Mariana
Indonesian Journal of Clinical Pharmacy Vol 5, No 3 (2016)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (320.986 KB) | DOI: 10.15416/ijcp.2016.5.3.149

Abstract

Salbutamol adalah terapi lini pertama untuk mengatasi gejala eksaserbasi asma. Aminofilin sudah tidak digunakan karena merupakan obat rentang terapi sempit yang sering menimbulkan adverse drug reaction (ADR). Kedua terapi tersebut dapat menimbulkan peningkatan kadar leukosit terkait ADR yang dapat memengaruhi terapi lain. Penelitian ini bertujuan membandingkan kejadian leukositosis antara terapi salbutamol nebulasi yang merupakan terapi lini pertama dengan aminofilin intravena yang sering digunakan di beberapa tempat untuk terapi eksaserbasi asma. Metode yang digunakan adalah kuasi eksperimental dengan pengukuran profil leukosit darah sebelum dan sesudah intervensi. Penelitian ini dilaksanakan pada bulan Januari 2014–Juni 2015 di beberapa rumah sakit di Surabaya, Indonesia. Kejadian leukositosis terkait ADR pada kelompok aminofilin (n=2) dengan nilai skala naranjo sebesar 6 poin yang kemungkinan besar merupakan ADR. Perubahan profil darah yang terjadi pada kedua pasien hanya pada kadar leukosit saja sedangkan data darah lainnya normal. Oleh karena itu, profil darah pada penggunaan kedua terapi dalam eksaserbasi asma perlu dipantau secara berkesinambungan agar tidak memengaruhi rekomendasi penambahan terapi lainnya.Kata kunci: Aminofilin, eksaserbasi asma, leukositosis, salbutamolPost-Therapy Leukocytosis Events After Intravenous Aminophylline Compared to the Nebulized Salbutamol in Asthma Exacerbations Patients Salbutamol known as the first-line therapy for asthma exacerbations symptoms relieving. Aminophylline are now no longer used because of its narrow therapeutic range of drugs and frequently provoking adverse drug reaction (ADR). Both of these therapies can lead to ADR-related leukocytes level increasing that interfere the concurrent therapies. This study was aimed to compare the state of leukocytosis after therapy with salbutamol nebulizer therapy as the first-line therapy with intravenous aminophylline for the treatment of asthma exacerbations. Quasi experimental method was used in this study, with blood leukocytes profile measure before and after the intervention body temperature measurement as data supplement. This research was conducted in January 2014–June 2015 at several hospitals in Surabaya, Indonesia. The incidence of ADRs associated leukocytes in aminophylline group (n=2) with a value scale naranjo by 6 points, most likely ADR. Significant difference found only in leukocyte level in two patient. More biomarkers profiles should be monitored assording to concurrent therapies for asthma exacerbation.Keywords: Aminophyiline, asthma exacerbation, leukocytosis, salbutamol
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (414.518 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

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