Raharni Raharni
Pusat Teknologi Intervensi Kesehatan Masyarakat. Badan Litbang Kesehatan. Kemenkes RI

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EVALUASI PERAN APOTEKER BERDASARKAN PEDOMAN PELAYANAN KEFARMASIAN DI PUSKESMAS Supardi, Sudibyo; Raharni, Raharni; Susyanti, Andi Leny; Herman, Max J.
Media Penelitian dan Pengembangan Kesehatan Vol 22, No 4 Des (2012)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | http://ejournal.litbang.depkes.go.id/index.php/MPK/article/view/2915

Abstract

Abstract The Government Regulation Number 51 on Pharmacy Practice states that dispensing prescriptions in a health facility, including the community health center, must be done by a pharmacist. In 2010 only ten percents of community health centers have a pharmacist. A cross sectional qualitative study has been done to obtain information on the role of pharmacist themselves in practicing in a community health center, and to obtain information on problem and barrier of the role of pharmacist. The study was carried out in Java, namely in cities of Tangerang, Bandung, Surabaya and Bantul District. Informants for in-depth interviews are District/City Health Office staff involved in the pharmacist assignment in a community health center and head of community health center, whereas for focus group discussion we invited pharmacists from District/City Health Office, community health center, school of pharmacy and regional pharmacists association. Descriptive data were analyzed qualitatively using triangulation method and temporary results were reviewed in a round table discussion in Jakarta with DG of Pharmaceutical Services and Medical Devices, Indonesian Pharmacist Association and Provincial Health Office of DKI Jakarta. Results of the study show that: 1. A. pharmacist is not available at all community health centers, as well as non-care community health centers, there are many prescription services performed by non-professional personnel. 2. The role of pharmacist in a community health center covers good drug management just like their job description, especially in prescription dispensing and drug use report. 3. The role of the pharmacist in pharmaceutical services: (a) information carried on the delivery of drugs prescription drugs to the patient, prior to clinic services began, and during a visit to posyandu posyandu toddlers and the elderly, (b) drug counseling is limited given the availability of time and there is no room , (c) visite the patient was done, either with the patients own doctor or maternity hospitalization, (d) home care have not been going well. 4. Issues related to pharmacists in community health centers is the availability and the number does not match to the workload, so that pharmaceutical care have not been going well due to limitations of time and effort. Also there are pharmacists feel less capable in providing drug information to other health professionals, especially medical specialist several health centers, so it is still necessary coaching and training. Keywords: pharmacist, Guideline of pharmaceutical care, community health center, drug management Abstrak Dalam Peraturan Pemerintah RI Nomor 51 tahun 2009 disebutkan pelayanan resep dokter di pelayanan kefarmasian (salah satunya puskesmas) harus dilakukan oleh apoteker. Data tahun 2010 menunjukkan hanya 10% puskesmas yang memiliki apoteker. Tujuan penelitian adalah mendapatkan informasi tentang peran apoteker di puskesmas dan permasalahan dalam pelayanan kefarmasian di puskesmas. Hasil penelitian diharapkan sebagai masukan bagi pihak yang terkait untuk meningkatkan ketersediaan apoteker dalam pelayanan kefarmasian di puskesmas. Penelitian potong lintang (cross sectional) dengan pendekatan kualitatif dilakukan terhadap instansi yang terkait dengan peran apoteker di puskesmas pada tahun 2011. Lokasi penelitian yang dipilih adalah Provinsi Banten, Jawa Barat, Daerah Istimewa Yogyakarta, dan Jawa Timur. Dari masing-masing provinsi diambil satu kota, yaitu Kota Tangerang, Kota Bandung, Kabupaten Bantul dan Kota Surabaya. Informan penelitian untuk wawancara mendalam adalah Dinkes Kabupaten/Kota dan Kepala Puskesmas, sedangkan peserta diskusi kelompok terarah adalah 12 apoteker yang mewakili Dinkes Kabupaten/Kota, puskesmas perawatan, Perguruan Tinggi Farmasi (PTF) dan Pengurus Daerah Ikatan Apoteker Indonesia (PD IAI). Analisis data secara deskriptif kualitatif dengan metoda triangulasi sumber data dan triangulasi metoda pengumpulan data. Hasil sementara disempurnakan dengan Round Table Discussion di Jakarta dengan mengundang nara sumber. Hasil studi adalah sebagai berikut : 1.  Apoteker belum tersedia di semua puskesmas perawatan, apalagi puskesmas non perawatan, sehingga pelayanan resep dikerjakan oleh tenaga non profesional. 2.  Peran apoteker dalam pengelolaan obat umumnya sudah berjalan, khususnya dalam pelayanan obat resep dan pembuatan LP-LPO bulanan. 3.  Peran apoteker dalam pelayanan kefarmasian: (a) informasi obat dilakukan pada saat penyerahan obat resep kepada pasien, sebelum pelayanan puskesmas dimulai, dan pada saat kunjungan ke posyandu balita dan posyandu lansia, (b) konseling obat dilakukan terbatas mengingat ketersediaan waktu dan belum ada ruangan, (c) visite pasien sudah dilakukan, baik dengan dokter maupun sendiri kepada pasien bersalin rawat inap, (d) home care belum berjalan dengan baik. 4.  Permasalahan yang terkait dengan apoteker di puskesmas adalah ketersediaan dan jumlah tidak sesuai dengan beban kerjanya, sehingga pelayanan kefarmasian belum berjalan baik akibat keterbatasan waktu dan tenaga. Juga ada apoteker merasa kurang mampu dalam memberikan informasi obat kepada tenaga kesehatan lain, khususnya dokter spesialis di beberapa puskesmas perawatan, sehingga masih diperlukan pembinaan dan pelatihan.   Kata kunci: apoteker, pelayanan kefarmasian, pengelolaan obat, puskesmas
Biaya Tambahan Yang Dibayar Pasien Rawat Jalan Akibat Penulisan Resep Tidak Sesuai Dengan Formularium Rumah Sakit Supardi, Sudibyo; Azis, Sriana; Herman, MJ.; Jamal, Sarjaini; Mun'im, Abdul; Raharni, Raharni
Majalah Ilmu Kefarmasian
Publisher : UI Scholars Hub

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Abstract

Almost all district public hospital already has their own formulary. The aims of study are to obtain percentage of noncompliance with the public hospital formulary, to obtain the average additional cost be paid by outpatients as a result of noncompliance with the hospital formulary, and to obtain the average of the outpatient's ability to pay for treatment. A cross sectional study has been carried out to 120 patients in RSU Kabupaten K and 100 patients in RSU Kabupaten B. Subjects of the study were adult outpatients with TB, hypertension and diabetes. Data were collected by well-trained district public hospital staff in interviewing patients. The questioner was first tried out to patients at RSU Kota Jakarta Timur. Data were analyzed by cost analysis. Results of the study are difference in drug item with formulary in RSU Kabupaten K is 66,7% for TB, 96,6% for hypertension; where as in RSU Kabupaten B 44,8% for TB, 82,3% for hypertension and 76,7% for diabetes. Average additional cost that must be paid by outpatients per encounter in RSU Kabupaten K is Rp 10.060 for TB, Rp 26.552 for hypertension; while in RSU Kabupaten B is Rp 5.818 for TB, Rp 8.956 for hypertension and Rp 15.218 for diabetes. The average outpatient's ability to pay for treatment in RSU Kabupaten K is Rp 19.807 and in RSU Kabupaten B is Rp 15.301, which are both less than outpatient treatment cost per encounter.
Eksplorasi Pelayanan Informasi Yang Dibutuhkan Konsumen Apotek Dan Kesiapan Apoteker Memberi Informasi Terutama Untuk Penyakit Kronik Dan Degeneratif Handayani, Rini Sasanti; Gitawati, Retno; Muktiningsih, S.R; Raharni, Raharni
Majalah Ilmu Kefarmasian Vol. 3, No. 1
Publisher : UI Scholars Hub

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Abstract

Currently, the prevalence of degenerative diseases in Indonesia is increased. The degenerative and chronic diseases need life-long treatment as well as changes in life style. On the other hand, long-life treatment using drugs will develop risks of adverse drug reactions or the possibilities of drug-drug interactions. In these circumstances, the role of a pharmacist is important to providing drug information and counselling, and patient education. However, there is evidence that pharmaceutical care in almost all pharmacies (drug dispensaries) in Indonesia is still “drug-oriented”. Drug information is not adequate and is provided by pharmacy assistants (technicians). In order to implement pharmaceutical care practice that meets the “Standard Competence for Pharmacy Practice” as well as consumer’s expectation, we need to know what is the exactly consumer’s expect in pharmaceutical care, particularly in drug information, and how is the commitment of the pharmacists to provide drug information of degenerative and chronic diseases in pharmaceutical care. For those reasons, a field survey has been carried out in Jakarta, Yogyakarta and Makassar to explore the consumer/patient’s opinions and needs for pharmaceutical care. A focus group discussion has also been done to explore the pharmacist commitment to provide drug information in pharmaceutical care practice. As a result, there is an indication of a discrepancy between the consumer/patient’s need for drug information and the commitment of pharmacists to provide drug information. Consumers have need for more drug information for all aspects including adverse drug reactions, drug interaction, what to do if adverse reaction occurred, duration of any treatments etc., not only drug indication and administration. On the other hand, pharmacists still need more knowledge and continuing education, particularly in pharmacotherapy and pharmacology of drugs used for degenerative and chronic diseases.