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Jurnal Farmasi Klinik Indonesia

ijcp
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Published by Universitas Padjadjaran

ISSN : 23375701 EISSN : 2337 5701 DOI : -

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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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Articles 540 Documents

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Hubungan antara Pengetahuan, Sikap, dan Tindakan Gaya Hidup Sehat dengan Risiko Penyakit Kardiovaskular pada Orang Dewasa di Pedesaan di Daerah Istimewa Yogyakarta Aris Widayati; Fenty Fenty; Yunita Linawati
Indonesian Journal of Clinical Pharmacy Vol 8, No 1 (2019)
Publisher : Universitas Padjadjaran

Sindrom metabolik (SM) merupakan salah satu faktor risiko penyakit kardiovaskular (PKV). Gaya hidup tidak sehat cenderung meningkatkan kejadian SM dan PKV. Masyarakat pedesaan mempunyai akses sumber informasi tentang gaya hidup sehat yang relatif terbatas. Oleh karena itu, penelitian ini bertujuan mengeksplorasi hubungan antara pengetahuan, sikap, dan tindakan (PST) terkait gaya hidup sehat dengan risiko PKV di kalangan masyarakat pedesaan di D.I. Yogyakarta. Jenis penelitian ini adalah observasional analitik dengan desain potong lintang. Sampel penelitian direkrut secara non-random purposive di dua dusun yaitu Tanjung dan Dlingseng, Desa Banjaroyo, Kecamatan Kalibawang, Kabupaten Kulonprogo, D.I. Yogyakarta. Kriteria inklusi responden yaitu penduduk dewasa sehat berusia 30–75 tahun. Kriteria eksklusi yaitu wanita hamil dan responden yang datanya tidak lengkap. Data dikumpulkan pada Bulan Mei–Juni 2018. Data pengetahuan, sikap, dan tindakan terkait gaya hidup sehat (PST) dikumpulkan menggunakan kuesioner. Data faktor risiko PKV yaitu indeks massa tubuh (IMT), lingkar pinggang (LP), tekanan darah (TD), kadar gula darah puasa (GDP), dan kolesterol total (Chol) diperoleh melalui pengukuran. Data dianalisis secara deskriptif korelatif dengan Spearman correlation. Sebanyak 124 data responden dianalisis. Sebanyak 56,5% responden mempunyai tingkat pengetahuan tinggi, 66,1% sikap positif, dan 67,7% melakukan tindakan hidup sehat. Sebanyak 55,6% IMT responden termasuk obes general; 65% ukuran LP wanita dan 25% LP pria termasuk obes sentral; median TD sistol di atas normal dan diastol normal; median GDP dan kolesterol normal. Hasil yang diharapkan adalah PST dan faktor risiko PKV berkorelasi negatif. Namun, hasil analisis menunjukkan beberapa faktor risiko PKV berkorelasi positif dengan PST. Hal ini kemungkinan disebabkan oleh faktor social desirability bias, the phenomenon of intention not translated into action, dan recall bias pada pengukuran pengetahuan, sikap, dan tindakan.Kata kunci: Gaya hidup sehat, kardiovaskular, pedesaan, pengetahuan, sikap, tindakanAssociation between Knowledge, Attitude, and Practices of Lifestyle to Cardiovascular Disease Risk Factors among Adults in Rural Area of Yogyakarta, IndonesiaAbstractMetabolic syndrome (MS) is one of risk factors of cardiovascular disease (CVD). Unhealthy lifestyle tends to elevate the risk of MS. People in rural area might not have adequate access to information on healthy lifestyle. Hence, this study aimed to explore association between knowledge, attitude, and practices (KAP) on healthy lifestyle and cardiovascular (CVD) risk factors among rural adults in Yogyakarta Province. This is an observational analytic study with cross sectional design. Samples were recruited purposively in two sub-villages, i.e.: Tanjung and Dlingseng in Banjaroyo, Kalibawang, Kulonprogo. Inclusion criteria were healthy adult people in between 30 to 75 years old. Those who were pregnant and those who did not complete the data were excluded. Data collection was conducted during May to June 2018. Data on KAP were gathered using a questionnaire. Data on CVD risk factors were collected through measurements of body mass index (BMI), waist circumference (WC), blood pressure (BP), fasting blood glucose (FBG), and total cholesterol (Chol). Data were analyzed descriptively using Spearman correlation. Of the 124 respondents, 64.5% were female, 56.5% have high level of knowledge, 66.1% have positive attitude, and 67.7% have healthier lifestyle practices. The profiles of CVD risk factors are as follows: 55.6% are general obese; 65% of female’s WC and 25% of male’s WC are central obese; median systole is high, but diastole is normal; median FBG and Chol are normal. In this study, some of the risk factors have positive correlation with KAP. This might be caused by social desirability bias, the phenomenon of intention not translated into action, and recall bias in the KAP measurements. Keywords: Attitude, CVD risk factors, healthy lifestyle, knowledge, practice, rural

Pengaruh Konseling Apoteker terhadap Pengetahuan dan Persepsi Pasien Penyakit Jantung Terapi Warfarin di RSUP Dr. Hasan Sadikin Bandung Norisca A. Putriana; Melisa I. Barliana; Keri Lestari
Indonesian Journal of Clinical Pharmacy Vol 6, No 4 (2017)
Publisher : Universitas Padjadjaran

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 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

Illness Perceptions and Quality of Life in Patients with Diabetes Mellitus Type 2 Dyah A. Perwitasari; Setiyo B. Santosa; Imaniar N. Faridah; Adrian A. Kaptein
Indonesian Journal of Clinical Pharmacy Vol 6, No 3 (2017)
Publisher : Universitas Padjadjaran

One of the treatment objectives in patients with type 2 diabetes mellitus (T2DM) is improving their quality of life (QoL). Illness perceptions are major determinant of QOL. This study was aimed to evaluate the QoL of T2DM patients with complications, and to examine the correlation between patients’ illness perceptions and QoL. We conducted a cross-sectional study in a private hospital in Yogyakarta, Indonesia from July to September 2015. We recruited adult patients with a diagnosis of T2DM with complications (ICD E.11) that has been diagnosed for at least 3 months. Illness perceptions were assessed with the Brief Illness Perception Questionnaire (BIPQ), and diabetes type 2 specific QoL with the Diabetes Quality of Life for Clinical Trial Questionnaire (DQLCTQ). Data was analyzed using Pearson correlation test. We recruited 51 T2DM patients. Female patients were dominant and most of the subjects experienced T2DM more than 5 years. The BIPQ scores indicated that patients had positive perceptions about T2DM and the treatment in all domains, except for coherence. Scores on the DQLCTQ showed that T2DM patients’ QoL is good, except for the self satisfaction and treatment effect. Statistically significant positive correlations were observed between BIPQ dimensions of personal control, treatment control and coherence and QoL domains (p<0.01). Moreover, the strong negative correlation were observed between consequences, concern and emotional response and QoL domains (p<0.01). However, 92% correlations are weak. Illness perceptions are correlated with T2DM patients’ QoL. Interventions aimed to get more adaptive illness perceptions may impact positively on QoL.Keywords: BIPQ, DQLCTQ, illness perceptions, Indonesia, QoL, T2DM Persepsi terhadap Penyakit dan Kualitas Hidup Pasien Diabetes Melitus Tipe 2 Salah satu tujuan terapi DM tipe 2 adalah memperbaiki kualitas hidup pasien. Persepsi terhadap penyakit merupakan penentu utama dari kualitas hidup. Tujuan penelitian ini adalah untuk mengevaluasi kualitas hidup pasien pada pasien DM tipe 2 dengan komplikasi serta mengetahui hubungan antara persepsi pasien dan kualitas hidup. Rancangan penelitian ini adalah potong lintang yang dilakukan di rumah sakit swasta di Yogyakarta. Subjek yang berpartisipasi dalam penelitian ini adalah pasien DM tipe 2 dewasa dengan komplikasi yang terdiagnosa minimal 3 bulan sebelum penelitian ini dimulai (ICD E11). Kualitas hidup diukur dengan Diabetes Quality of Life for Clinical Trial Questionnaire (DQLCTQ) dan persepsi pasien diukur dengan Brief Illness Perception Questionnaire (BIPQ). Sejumlah 51 pasien DM tipe 2 dengan komplikasi turut berpartisipasi dalam penelitian ini dari bulan Juli sampai September 2015. Mayoritas subjek adalah wanita dan sebagian besar pasien mengalami DM tipe 2 lebih dari 5 tahun. Skor domain BIPQ memperlihatkan bahwa pasien DM tipe 2 mempunyai persepsi yang positif terhadap penyakit dan pengobatannya pada semua domain kecuali koherensi. Skor domain DQLCTQ memperlihatkan bahwa pasien mempunyai kualitas hidup yang baik, kecuali domain kepuasan pribadi dan efek terapi (berturut-turut 55,6 dan 44,3). Korelasi kuat yang positif terlihat pada domain persepsi kontrol diri, kontrol terapi dan koherensi dengan semua domain kualitas hidup (p<0,01). Korelasi kuat yang negatif terlihat pada domain konsekuensi, kekhawatiran dan respon emosi dengan kualitas hidup (p<0,01). Sejumlah 92% korelasi BIPQ dan DQLCTQ adalah lemah. Persepsi pasien dan komplikasi dapat memengaruhi kualitas hidup pasien DM tipe 2. Intervensi yang bersifat memperbaiki persepsi pasien akan berdampak positif terhadap kualitas hidup.Kata kunci: BIPQ, DM tipe 2, DQLCTQ, Indonesia, kualitas hidup, persepsi

Analisis Kejadian Leukositosis Pasca Terapi Aminofilin Intravena Dibandingkan dengan Salbutamol Nebulasi pada Pasien Eksaserbasi Asma Amelia Lorensia; Zullies Ikawati; Tri M. Andayani; Daniel Maranatha; Mariana Wahjudi
Indonesian Journal of Clinical Pharmacy Vol 5, No 3 (2016)
Publisher : Universitas Padjadjaran

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

Hubungan Penurunan Nilai Densitas Mineral Tulang dengan Kepatuhan Terapi Metilprednisolon Pasien Artritis Reumatoid dan Lupus Eritematosus Sistemik Anisyah Achmad; Bagus P. P. Suryana; Niela Amalia
Indonesian Journal of Clinical Pharmacy Vol 7, No 2 (2018)
Publisher : Universitas Padjadjaran

Metilprednisolon merupakan glukokortikoid yang memiliki efek samping penurunan densitas mineral tulang (DMT). Tingkat kepatuhan berhubungan dengan terjadinya efek. Penelitian ini bertujuan untuk mengetahui hubungan penurunan nilai DMT dengan kepatuhan terapi metilprednisolon pada pasien artritis reumatoid dan lupus eritematosus sistemik. Penelitian ini dilakukan pada 43 pasien di Poliklinik Rheumatologi RSUD dr. Saiful Anwar Malang pada bulan Desember 2016–Januari 2017 dan termasuk penelitian deskriptif noneksperimental dengan analisis kualitatif dan kuantitatif menggunakan metode cross-sectional. Data diambil dari rekam medis pasien dan wawancara. Kriteria inklusi pada penelitian ini adalah perempuan berusia 31–50 tahun, menggunakan terapi metilprednisolon minimal selama 3 bulan serta memiliki data DMT. Kriteria eksklusi adalah menopause, riwayat fraktur tulang, merokok, mengonsumsi alkohol, sindrom cushing, hipertiroidisme, hiperparatiroidisme, gangguan kelenjar pituitari, dan osteoartritis serta mengonsumsi obat bifosfonat, heparin, anti-konvulsan, dan thiazid. Analisis data menggunakan uji korelasi Pearson dan regresi linier. Terdapat hubungan antara kepatuhan dengan area DMT Spine-L1 (r= –0,313; p=0,041), Spine-L2 (r= –0,349; p=0,022), Spine-L3 (r= –0,375; p=0,013), dan total spine (r = -0,380; p = 0,012). Metilprednisolon sensitif pada jaringan tulang trabekular yang menyusun area lumbar spine dibandingkan tulang kortikal. Hubungan rendah (r) antara tingkat kepatuhan dan DMT disebabkan sosial ekonomi, perawatan kesehatan, karakteristik penyakit, dan genetik. Kepatuhan terapi metilprednisolon menurunkan nilai DMT (lumbar spine) yang berakibat meningkatkan osteoporosis.Kata kunci: Artritis reumatoid, densitas mineral tulang, eritematosus sistemik, kepatuhan, lupus metilprednisolon The Relationship of Lowering the Values of Bone Mineral Density in Methylprednisolone Medication Adherence on Rheumatoid Arthritis and Systemic Lupus Erythematosus PatientsAbstractMethylprednisolone is a glucocorticoid which has a side effect of decreasing bone mineral density (DMT). The degree of compliance relates to the occurrence of effects. The objective of this study was to investigate the association of DMT impairment with adherence to methylprednisolone therapy in patients with rheumatoid arthritis (AR) and systemic lupus erythematosus (LES). The research was conducted to 43 patients in Rheumatology Polyclinic of dr. Saiful Anwar (RSSA) Malang. The study was conducted in December 2016–January 2017 and included nonexperimental description with qualitative and quantitative analysis using cross sectional method. The data were taken from the patient’s medical record and interview. The inclusion criteria in this research were women, aged 31–50 years, using metilprednisolon therapy for at least three months and have mineral bone density data. Exclusion criteria were menopause, history of bone fracture, smoking, alcohol consumption, cushing syndrome, hyperthyroidism, hyperparathyroidism, pituitary gland disorders, and osteoarthritis and taking drugs bisphosphonates, heparin, anti-convulsants, and thiazid. Data analysis used person correlation and linear regression. There was a significant correlation between adherence to the Spine-L1 DMT area (r= –0.313; p=0.041), Spine-L2 (r= –0.349; p=0.022), Spine-L3 (r = –0.375; p=0.013), and total spine (r= –0.380; p=0.012). Methylprednisolone is sensitive to trabecular bone tissue that makes up the lumbar spine area compared to cortical bone. The low association (r) between adherence and DMT is due to socioeconomic, health care, disease characteristics, and genetics. Compliance of methylprednisolone therapy decreases the value of DMT (lumbar spine) which increased in osteoporosis.Keywords: Bone mineral density, medication adherence, methylprednisolone, reumathoid arthritis, systemic lupus eythematosus

Daya Terima Sediaan Puyer Racikan Obat Anti Tuberkulosis di Salah Satu Rumah Sakit di Bandung Widyastiwi Widyastiwi; Ganthina Sugihartina; Indro Pamudjo
Indonesian Journal of Clinical Pharmacy Vol 6, No 2 (2017)
Publisher : Universitas Padjadjaran

Di berbagai rumah sakit di Indonesia, praktik peracikan Obat Anti Tuberkulosis-Kombinasi Dosis Tetap (OAT-KDT) untuk anak dalam bentuk sediaan puyer masih dilakukan sampai saat ini. Meskipun memiliki masalah pada stabilitas dan kualitas sediaan, praktik peracikan puyer OAT tetap dilakukan sebagai upaya individualisasi dosis dan memudahkan pemberian obat pada pasien anak, sehingga diharapkan mampu meningkatkan daya terima pasien terhadap OAT. Daya terima pasien terhadap obat memiliki dampak yang signifikan terhadap kepatuhan yang akhirnya memengaruhi keberhasilan terapi. Penelitian ini bertujuan untuk mengetahui daya terima sediaan puyer racikan OAT dan keberhasilannya di salah satu rumah sakit di Bandung dan dilakukan pada bulan Maret hingga November tahun 2015. Desain penelitian adalah potong lintang dan sampel diambil dengan cara accidental sampling. Kriteria inklusi adalah pasien anak usia 0–14 tahun dengan diagnosis tuberkulosis dan menerima sediaan puyer racikan OAT. Data dikumpulkan melalui wawancara terpimpin menggunakan kuesioner tertutup yang tervalidasi dan reliabel mengenai penerimaan pasien ditinjau dari segi kepraktisan, rasa, dan bau obat. Responden adalah orang tua pasien anak sebanyak 50 orang. Hasil penelitian menunjukkan sediaan puyer racikan OAT diterima baik oleh 40,0% pasien, cukup diterima oleh 52,0% pasien, dan kurang diterima oleh 8% pasien. Faktor usia memengaruhi penerimaan pasien terhadap sediaan puyer racikan (r=0.338). Keberhasilan terapi dicapai oleh 94,6% pasien dengan lama pengobatan 6–9 bulan. Penelitian ini menghasilkan simpulan bahwa penggunaan sediaan puyer racikan dapat diterima baik oleh pasien dengan tingkat keberhasilan terapi yang tinggi. Sediaan puyer racikan merupakan bentuk sediaan yang disarankan untuk pasien anak karena dapat meningkatkan daya terima pasien anak terhadap OAT-KDT.Kata kunci: Daya terima, keberhasilan terapi, Obat Anti Tuberkulosis, puyer racikan Acceptability of Anti-Tuberculosis Compounded Medicines at a Hospital in BandungAbstractIndonesian government has provided anti-TB drugs as a fixed-dose combination to eradicate tuberculosis. For pediatric patients with swallowing problems, compounded medicine is a common solution despites its stability and quality problems. Compounded medicine prescribing is intended to improve patient acceptability of medicine. Patient acceptability, especially in pediatric, will play a significant role to increase patient’s adherence, and in a bigger picture, affect its efficacy. This study was aimed to determine the acceptability level of compounded medicines and its therapy outcomes at a hospital in Bandung. This study was conducted with a cross-sectional design using accidental sampling method. Inclusion criteria were pediatric patients aged 0–14 years who have diagnosed tuberculosis and received compounded medicines. Study was held in March until November 2015 at a hospital in Bandung. A valid and reliable questionnaire was provided as an instrument to interview respondents about practicality, taste, and a smell of medicines. Total of 50 patients’ parent had participated in this study as respondent. The results showed that compounded medicine was acceptable by pediatrics patients. Acceptability of compounded medicines was affected by age factor (r=0.338). Therapeutic success of compounded medicine was achieved by 94.6% of patients with 6–9 months duration of treatment. In conclusion, the use of compounded medicines are acceptable by patients with a satisfactory outcomes therapy.Keywords: Acceptability, anti-tuberculosis drugs, compounded medicines, therapy outcomes

Gambaran Kepatuhan Pengobatan Pasien Diabetes Melitus Tipe 2 di Puskesmas Daerah Istimewa Yogyakarta Nur Rasdianah; Suwaldi Martodiharjo; Tri M. Andayani; Lukman Hakim
Indonesian Journal of Clinical Pharmacy Vol 5, No 4 (2016)
Publisher : Universitas Padjadjaran

Prevalensi diabetes melitus berdasarkan hasil riset kesehatan dasar (Riskesdas, 2013) tertinggi di Indonesia terdapat di provinsi DI Yogyakarta.terdapat di provinsi DI Yogyakarta. Diabetes melitus merupakan penyakit kronis yang membutuhkan pengobatan jangka panjang dan kompleks dimana salah satu penentu keberhasilan terapi bergantung pada kepatuhan penggunaan obat. Tujuan penelitian ini untuk mengetahui gambaran karakteristik pasien meliputi jenis kelamin, usia, tingkat pendidikan, durasi penyakit, komorbid, dan penggunaan ADO terhadap kepatuhan pasien diabetes melitus tipe 2. Penelitian ini menggunakan metode observasional dengan rancangan analisis potong lintang yang dilakukan secara retrospektif terhadap 123 pasien diabetes melitus tipe 2 rawat jalan di puskesmas daerah Yogyakarta pada bulan Agustus–September tahun 2015. Metode pengambilan sampel menggunakan teknik accidental sampling. Instrumen penelitian berupa lembar pengambilan data dan kuesioner Morisky Medication Adherence MMAS-8. Data dianalisis menggunakan Chi-Square. Hasil penelitian menunjukkan bahwa secara keseluruhan tingkat kepatuhan pasien diabetes melitus tipe 2 berada pada tingkat kepatuhan rendah. Hubungan antara pengaruh karakteristik pasien: jenis kelamin (p=0,275), usia (p=0,473), tingkat pendidikan (p=0,157), durasi penyakit (p=0,097), jumlah komorbid (p=0,79), dan ADO (p=0,401) terhadap tingkat kepatuhan tidak signifikan (p>0,05).Kata kunci: Diabetes melitus tipe 2, karakteristik pasien, kepatuhan The Description of Medication Adherence for Patients of Diabetes Mellitus Type 2 in Public Health Center Yogyakarta According to the Basic Health Research (Riskesdas 2013), the highest prevalence of diabetes mellitus in Indonesia is in Yogyakarta. Diabetes mellitus is chronic disease that needs the complex and a long term medical treatment, one of the success factor in the therapy depends on the patient adherence. The purpose of this research was to know and describe patient’s characteristics including gender, age, education, duration of the disease, comorbid, AOD usage through the adherence of type 2 diabetes mellitus. This research used an observational method with cross-sectional analysis that conducted retrospectively to 123 outpatients with diabetes mellitus type 2 in Yogyakarta Primary Health Care during August–September 2015. The sampling method the accidental sampling technique. Morisky Medication Adherence (MMAS) questionnaire was used and analyzed with Chi Square. The result of this research showed that the entirety of medication’s adherence level is low. The correlation between patients characteristic, gender (p=0.275), ages (p=0.473), educational level (p=0.157), disease’s duration (p=0.097), number of cormobid (p=0.79), and ADO (p=0.401) against the medication’s adherence level were not significant (p>0.05).Keywords: Adherence, diabetes mellitus type 2, patient characteristics

Sterilitas Instrumen Pakai Ulang di Ruang Penyimpanan Unit Luka Bakar (ULB) Salah Satu Rumah Sakit di Kota Bandung Insan S. Kurniawansyah; Sohadi Warya; Hegandari S. Rahayu; Dionice L. Y. Putri
Indonesian Journal of Clinical Pharmacy Vol 4, No 2 (2015)
Publisher : Universitas Padjadjaran

apabila sterilitasnya tidak terjaga. Proses penyimpanan dan perlakuan terhadap instrumen pakai ulang adalah faktor utama dalam menjaga sterilitas instrumen. Prevalensi infeksi nosokomial di ruang unit luka bakar (ULB) salah satu rumah sakit di Kota Bandung ternyata cukup tinggi sehingga dilakukan penelitian mengenai sterilitas instrumen pakai ulang yang disimpan di ruangan tersebut. Penelitian ini bertujuan untuk dapat menekan angka kejadian infeksi nosokomial, yang salah satunya disebabkan oleh tidak sterilnya instrumen pakai ulang yang digunakan di ruang penyimpanan ULB yang akhirnya dapat menjamin keamanan atau keselamatan pasien. Metode penelitian yang digunakan adalah observasional laboratorik dengan tahapan yaitu penyiapan alat, bahan dan ruangan, pengujian sampel penelitian, dan analisis data. Hasil penelitian menunjukkan bahwa ruang penyimpanan ULB berpengaruh secara signifikan terhadap sterilitas instrumen pakai ulang, ruang CSSD 15,47 kali lebih steril dibanding ruang ULB. Adapun pengaruh lama penyimpanan terhadap sterilitas instrumen pakai ulang diketahui bahwa semakin lama waktu penyimpanan maka sterilitas instrumen semakin berkurang. Pihak rumah sakit diharapkan melakukan penyimpanan dan penggunaan instrumen di ULB tidak lebih dari tujuh hari sebagai usaha dalam mengurangi kejadian infeksi nosokomial di rumah sakit.Kata kunci: Infeksi nosokomial, instrumen pakai ulang, uji sterilitas, unit luka bakar (ULB)The Reusable Instrument Sterilities Stored in the Burn Care Unit at a Hospital in BandungReusable instruments may be a vector for the transmission of nosocomial infections if found contaminated or the sterility are not maintained. The process of storage and treatment towards the reusable instruments are the crucial factors to ensure the sterility of the reusable instruments. The prevalence of nosocomial in the Burns Unit (BU) at a Hospital in Bandung reveals outstanding values and thus has been chosen for this research. This research aimed to suppress the incidence of nosocomial infections, one of which is caused by not sterile of reusable instruments in the storage space BU which can get patient safety ultimately. The laboratory observational was used for this research with steps are preparing tools, materials and test room, sample test, and data analysis. The results found that the storage area in BU had a significant effect on the sterility of the instruments and it was deduced that the CSSD was 15.47 times more sterile than Burns Unit. Time of storage also affected the sterility of the instruments as it was found that the longer the storage time, the possibility of the reusable instruments remaining sterile are decreased. The hospital is expected to keep the instrument in ULB not more than seven days to efforts in reducing the incidence of nosocomial infections in hospitals.Key words: Burns unit (BU), nosocomial infection, reusable instrument, sterility test

Efek Ekstrak Daun Singawalang (Petiveria alliacea) dalam Menurunkan Kadar Glukosa Darah melalui Peningkatan Ekspresi AMPK-α1 pada Tikus Model Diabetes Melitus Arifa Mustika; Roostantia Indrawati; Gadis M. Sari
Indonesian Journal of Clinical Pharmacy Vol 6, No 1 (2017)
Publisher : Universitas Padjadjaran

Singawalang (Petiveria alliaceae) adalah tumbuhan yang banyak ditemukan di Indonesia dan secara empiris digunakan oleh penduduk untuk mengobati diabetes melitus. Hingga saat ini, penelitian tentang pengaruh dan mekanisme ekstrak daun Singawalang dalam menurunkan kadar glukosa darah belum banyak dilakukan. Tujuan penelitian ini adalah untuk mengetahui pengaruh ekstrak daun Singawalang terhadap penurunan kadar glukosa darah dan ekspresi AMPK-α1 pada hati. Jenis penelitian ini adalah penelitian eksperimental dengan rncangan acak lengkap. Penelitian dilakukan di Laboratorium Farmakologi dan Terapi dan Laboratorium Patologi Anatomi Fakultas Kedokteran Universitas Airlangga pada bulan April–Agustus 2015. Hewan coba tikus strain Rattus norvegicus dibuat model diabetes melitus, diinduksi dengan Streptozotocin. Sebanyak 25 tikus model diabetes melitus dibagi secara acak menjadi 5 kelompok. Kelompok perlakuan 1, 2 dan 3 adalah kelompok yang memperoleh ekstrak daun Singawalang dengan dosis 90 mg/kgbb, 180 mg/kgbb dan 360 mg/kgbb. Kelompok kontrol positif adalah kelompok yang memperoleh metformin dengan dosis 150 mg/kgbb dan kontrol negatif adalah kelompok tikus yang memperoleh vehikulum. Ekstrak dan metformin diberikan sehari sekali, personde selama 14 hari. Pada hari ke-15 setelah terapi, tikus diperiksa kadar glukosa darah dan dieuthanasia untuk diambil organnya. Ekspresi AMPK-α1 dinilai menggunakan imunohistokima. Data yang terkumpul dianalisis dengan ANAVA dan Wilcoxon (α=0,05). Hasil penelitian menunjukkan adanya perbedaan kadar glukosa darah yang bermakna antara kontrol negatif dengan dosis 90 mg/kgbb, dosis 360 mg/kgbb, dan kontrol positif, antara dosis 180 mg/kgbb dengan dosis 360 mg/kgbb dan kontrol positif. Analisis terhadap ekspresi AMPK-α1 pada hati tikus menunjukkan perbedaan yang bermakna antara dosis 180 mg/kgbb dengan dosis 360 mg/kgbb dan kontrol positif. Simpulan dari penelitian ini adalah ekstrak Singawalang dapat menurunkan kadar glukosa darah pada tikus model diabetes melitus melalui aktivasi AMPK-α1.Kata kunci: AMPK-α1, diabetes melitus, kadar glukosa darah, Singawalang Effect of Petiveria alliacea Leaves Extract in Decreasing Serum Level of Blood Glucose Level Through Activation of AMPK-α1 in Diabetes Mellitus Rat ModelsAbstractSingawalang (Petiveria alliaceae) is a medicinal herb that is used traditionally as folk medicine for various diseases. The plant has been used as an antidiabetic agent in Indonesian society. Until now, the effect and mechanism of action of Petiveria alliaceae as antidiabetic agent is not clear. The aim of the study was to determine the effect of Petiveria alliaceae to blood glucose level and to identify expression of AMPK-α1 in rat liver. The research was experimental study with randomized and was conducted at Laboratory Pharmacology and Therapy, and Laboratory Patology Anatomy, Faculty of Medicine, Universitas Airlangga, on April until August 2015. Twenty five male rats were injected by Streptozotocin to create diabetic rat models and randomly divided into 5 groups. The group 1, 2 and 3 are treatment groups that were given the ethanol extract of Petiveria alliaceae at dose 90 mg/kgbw, 180 mg/kgbw, and 360 mg/kgbw, orally, once daily for fourteen days. The fourth group is a negative control who were given distilled water and the fifth group is a positive control who were given metformin at dose 150 mg/kgbw. On the 15th day, blood glucose level were measured by glucometer and the rats were sacrificed to collect the liver. Expression of AMPK-α1 were assessed by immunohistochemistry. Data were analyzed by ANAVA and Wilcoxon (α=0,05). The results have been showed that there were significant differences in glucose blood level between negative control with the group were given the extract at dose 90 mg/kgbw, 360 mg/kgbw and positive control, between dose 180 mg/kgbw with dose 360 mg/kgbw and positive control. A significant differences of expression of AMPK-α1 showed between dose 180 mg/kgbw with dose 360 mg/kgbw and positive control. The conclusion of this study was the extract ethanol of Singawalang leaves reduce blood glucose level in diabetes mellitus rat models through increase in the expression of AMPK-α1.Keywords: AMPK-α1, blood glucose level, diabetes mellitus, Singawalang

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