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Effectifity and Cost Analysis of Omeprazole and Pantoprazole for Stress Related Mucosal Disease Prophylaxis in ICU Dyah Atmi Tri Sukengtyas; Tri Murti Andayani; L. Endang Budiarti
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 7, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.30119

Currently, the most effective therapeutic agent as a Stress Related Mucosal Disease (SRMD) prophylaxis therapy is the group of Proton Pump Inhibitor (PPI). In Indonesia, PPI agent most commonly used is pantoprazole and omeprazole, for they are already available in the form of injection and also available in generic product. This study aimed to determine the effectiveness and the therapy cost of omeprazole and pantoprazole used as a prophylaxis agent of SRMD. This study used observational analytic method using a retrospective cohort study. The subjects were patients in ICU of Bethesda Hospital in Yogyakarta with age ≥ 18 year old who received the therapy of omeprazole or pantoprazole as a prophylaxis of SRMD during January 2012 – September 2016 who meet the inclusion and exclusion criteria. The effectivity of therapy was seen by the bleeding events. The cost was calculated based on the amount of fee required by the patient, both the use of the medicine as a prophylaxis therapy of SRMD and for the bleeding therapy of SRMD. The value of Expected Monetary Value (EMV) was then calculated using the method of Decision Tree. Subject in this study were 152 patients, in which there were 76 patients on each group therapy of pantoprazole and omeprazole. The comparison between the number of patients who did not experience bleeding between group of pantoprazole and group of omeprazole is 85.5%: 81.6% (p = 0.512). The value of EMV in the pantoprazole group is Rp. 431.490,76, while the omeprazole group is Rp. 382.042,57. There is no difference in the effectivity between pantoprazole and omeprazole as a prophylaxis of SRMD, and the cost for SRMD prophylaxis is cheaper in the omeprazole therapy than in the pantoprazole therapy.

Comparison of Real Costs against the Price of INA-CBG's Ischemic Stroke in Bethesda Hospital Muslimah Muslimah; Tri Murti Andayani; Rizaldy Pinzon; Dwi Endarti
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 7, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.30289

Stroke is the leading cause of death and disability that includes disability mild, moderate and severe need of maintenance costs high. The purpose of this research is to know the characteristics of the patient, the comparison of real costs and fares INA CBG's ischemic stroke inpatient and outpatient in Bethesda HOSPITAL Yogyakarta. This research was conducted with observational analytic approach with cross sectional design based on the perspective of the hospital. The subject of research that meets the criteria of inclusion as much as 96 patients. Criteria for Inclusion include patient JKN, ischemic stroke of the first offensive, onset of less than 24 hours and non of the references. Observation period 1 October 2015 sd 31 March 2016 inpatients were observed 6 months in retrospective. Secondary data research data are sourced on the medical record, IFRS, and Technology Unit of RS. Analysis of statistical data by the method of Mann Whitney and Kruskal Wallis. Based on the characteristics of long hospitalizations, inpatient class there is significant influence (p < 0.05) against ischemic stroke patients real costs of hospitalization. The total real costs RS ischemic stroke of Rp 993,181,170 to 96 111 patients with inpatient visits so that the cost of Rp 8,947,578 per episode of hospitalization. Furthermore the Total cost of stroke ischemic amounting to Rp 139,165,150 with 211 outpatient visits so that the cost of Rp 659,550 per an outpatient episode. Real costs RS ischemic stroke than outpatient rates INA CBG's-2014 have significant differences. Similarly the real costs of hospitalization compared to price of INA-CBG's 2014 have significant differences in class i. In conclusion Fund fares INA-CBG's either outpatient or inpatient insufficient finance the care of patients ischemic stroke in Bethesda hospital Yogyakarta.

Penilaian Properti Psikometrik Instrumen Kualitas Hidup (HRQol) pada Populasi Umum: Tinjauan Sistematik Restu Nur Hasanah Haris; Rahmat Makmur; Tri Murti Andayani; Susi Ari Kristina
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Quality of life (HRQoL) is a measure of a person's health in physical, spiritual, and emotional, and role functions in the society. Measurement of quality of life (HRQoL) is an important thing to understand and evaluate. Measurements are carried out not only on patients but also on the general population with the use of specific or generic instruments. The instrument used requires a psychometric properties test to ensure its validity and reliability. This article aims to conduct a systematic review of the psychometric properties of quality of life (HRQoL) instruments in the general population. Articles were collected in December 1st to 5th, 2018, from Pubmed and Google Scholar. The assessment was carried out using the checklist properties according to the cohen criteria and included the content validity, construct validity, internal consistency reliability, test-retest, ceiling effect and the level of credibility of the instruments. Among 80 articles obtained there were 24 articles that fulfilled the inclusion criteria. Short Form-36 (SF-36) instrument is the most widely used instrument in measuring the quality of life in the general population (26.6%). Some instruments have not been tested according to the criteria, while almost all instruments show a good level of validation of construct validity using convergent and discriminat validity with cronbach alpha values > 0.7. Test-retest reliability provides a good correlation. Some instruments show a ceiling effect. According to the assessment, the SF-36, SF-6D, EQ-5D, SF-12 and PedsQoL instruments are considered as established instruments. Further validation testing is needed to provide and support the measurement of subsequent quality of life (HRQoL) instruments.

Analysis of Cesarean Section Clinical Pathway Compliance at a Private Hospital in Yogyakarta Beta Haninditya; Tri Murti Andayani; Nanang Munif Yasin
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 1
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

This study aims to analyze the relationship between the compliance with the implementation of clinical pathways to therapeutic outcomes (ILO events, length of stay, pain intensity) and the total real cost of cesarean section patients. The study was conducted at a type C private hospital in Yogyakarta. This study is a non-experimental analytical study (observational analytic) with a cross sectional design using a retrospective data collection method and analyzed using Chi square test and non parametric regression test. Descriptive analysis for compliance with the implementation of clinical pathways was carried out by assessing the compliance of each care point contained in the clinical pathway section of the cesarean consisting of 12 points of care and will be grouped into two categories namely low compliance category with the average compliance value for clinical pathway <85% and good compliance with the average compliance value for clinical pathway ≥85%. Descriptions of adherence to the implementation of clinical pathway cesarean section each patient showed that as many as 686 patients (98%) had a good average compliance score and 14 patients (2%) had a low average compliance score. Outcome description 700 patients with cesarean section were found 1 patient experienced ILO, LOS according to clinical pathway (≤3 days) as many as 620 patients and 700 patients with pain scale ≤3. The results of the analysis of the relationship between the compliance and the implementation of the clinical pathway to the outcome of therapy (ILO events, length of stay, and pain intensity) showed the existence of a compliance relationship to the implementation of the clinical pathway with a value of p<0.05. The analysis of the relationship between the compliance to the implementation of the clinical pathway and the total real costs shows the relationship between the compliance with the implementation of the caesarean section clinical pathway at a type C private hospitals in Yogyakarta with the total real costs with p value of 0,000 and r value of 0.014.

The Correlation of Treatment Adherence with Clinical Outcome and Quality of Life in Patients with Type 2 Diabetes Syaiful Katadi; Tri Murti Andayani; Dwi Endarti
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 1
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Patients with diabetes mellitus (DM) are patients with a low level of treatment adherence. Low adherence is often the cause of treatment failure, so the risk of complications is higher and can affect the quality of life of patients. This study aimed to determine the relationship between treatment adherence to clinical outcomes and the quality of life of patients with type 2 DM. This study used a cross sectional design involving patients with type 2 DM who met the inclusion and exclusion criteria in three health centers in Bantul, Yogyakarta. Data on patient medication compliance was obtained using medication adherence report scale questionnaire (MARS-5), patient quality of life data using Short-Form 6 Dimensions questionnaire (SF-6D), data on fasting blood glucose levels (GDS / GDP) from medical records, socio demographic data obtained from respondents and medical records. The relationship between the level of adherence to clinical outcomes using Chi-square analysis while the relationship between the level of adherence to quality of life using Spearman Rho analysis. The total number of respondents involved was 179 patients, the majority had a low level of adherence (57%), clinical outcomes that had not been achieved (68.7%), and the average utility score was high (0.816). There was a relationship between medication adherence to clinical outcomes (P = 0.002; OR = 2.875). Similarly, between adherence to quality of life, there is a significant relationship (P = 0.006) with a weak correlation level (r = 0.204). Therefore, patients and Health professionals, especially pharmacists, need to pay attention to medication adherence to achieve optimal clinical outcomes and a better quality of life.

Hubungan Tingkat Pengetahuan terhadap Outcome Klinik Pasien Diabetes Melitus Tipe 2 Laksmy Anggun Larasati; Tri Murti Andayani; Susi Ari Kristina
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Diabetes is a chronic disease that requires good therapeutic management and self care to achieve optimal glycemic target. The important barrier to achieve good glycemic control is a lack of knowledge about optimal glycemic targets. The purpose of this study was to determine the relationship of the level of knowledge to clinical outcome of type 2 diabetes mellitus in Yogyakarta and Bantul primary health care. This was an observational study with a cross sectional design. The sampling technique was done by accidental sampling for patients visiting the primary health care from October to December 2018 that involved 200 type 2 diabetes mellitus patients who were included in the inclusion criteria. The level of knowledge was measured by the Diabetes Knowledge Questionnaire (DKQ)-24 which had 24 questions and the clinical outcome was obtained from laboratory measurement data as well as from medical record data when the patient was in routine control. Sociodemographic data were analyzed descriptively. The relationship between the level of knowledge and clinical outcomes was analyzed using chi square. The results showed that the knowledge level score had an average value of 12. The most incorrect answer was in etiology and diabetes self care, which is eating too much sugar and sweet foods is the cause of diabetes (97%), exercise regularly increasing the need of hormone insulin or diabetes medication (82%), the insulin reaction is caused by too much food (84%) and diabetics should clean the wound with betadine and alcohol (88%). There were 106 (53%) patients who achieved good glycemic control. Chi square test showed no relationship between the level of knowledge of clinical outcomes (p = 0.328). The result of this study may become a material and education content evaluation in diabetic patients.

Gambaran Kualitas Hidup pada Pasien Diabetik Retinopati Berdasarkan Tingkat Keparahan Visus Novita Dhewi Ikakusumawati; Dewi Magistasari; Novena Adi Yuhara; Tri Murti Andayani; Supanji Supanji; Susi Ari Kristina
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 10, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Diabetic retinopathy (DR) is one of the microvascular complications of diabetes mellitus (DM) which incidence increases with the high prevalence of DM. The presence of these complications will affect quality of life, especially vision-related. The purpose of this study was to determine the quality of life in RD patients assessed using the VFQ-25 and EQ-5D questionnaires, and to determine the of quality of life based on the visual acuity (VA) severity. This study was an observational study in outpatient with diabetic retinopathy during October 2018 – Januari 2019 period, in RSUP dr. Sardjito and RS Mata Dr. YAP, Yogyakarta. The design of this study was cross sectional which observed quality of life and vision. Quality of life was measured by specific for vision instrument (NEI-VFQ-25) and generic instrument (EQ-5D-5L). The number of patients in this study were 100 patients with an average age of 55 years, the most frequent type of RD was 84% proliferative RD. The average quality of life scores in RD patients measured using the VFQ-25 and EQ-5D utility questionnaires were 64.1 ± 16.2 and 0.61 ± 0.24, respectively. Based on VFQ-25, the most affected subscales were driving, dependence, and role difficulties subscale. Meanwhile, domains that have the most problems with the EQ-5D were pain / discomfort and anxiety / depression (78%). The total VFQ-25 score decreased with increasing visual severity, i.e. normal / mild (n = 19) 73.50 ± 15.08; moderate (n = 15) 68.14 ± 15.33; and severe (n = 66) 60.48 ± 15.64. The EQ-5D utility score showed a similar pattern, with scores of 0.66 ± 0.27 (normal / mild); 0.65 ± 0.22 (medium); and 0.59 ± 0.24 (severe); respectively. The higher severity of visual acuity so the quality of life become lower.

Evaluasi Kualitas Hidup Pasien Kanker Serviks yang Mendapat Regimen Kemoterapi Cisplatin-Vinkristin-Bleomisin dan Carboplatin-Paklitaksel Suwendar Suwendar; Achmad Fudholi; Tri Murti Andayani; Herri S. Sastramihardja
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 10, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.44475

Cervical cancer is one type of cancer with a high prevalence in women. Quality of life of someone with cervical cancer will decrease. Quality of life can also decrease because of chemotherapy regimens. The purpose of this study was to evaluate the impact of cisplatin-vincristine-bleomycin and carboplatin-paclitaxel regimens on the quality of life of patients. Through this research how the difference in quality of life of patients with cervical cancer before and after chemotherapy could be known. Additionally, the differences impact on the quality of life of the two regimens also were observed. The study was conducted by using cross sectional design in hospitalization patients. Data were taken prospectively by conducting field observations. Measuring the quality of life was done using the EORTC QLQ-C30 questionnaire. Differences of domain values before and after chemotherapy in each regimen were analyzed by paired t-test (p <0.05). Quality of life difference between two regimens were analyzed by unpaired t test (p<0.05). The results showed that there was an increasing trend of the value of the functional domain, impairment of symptoms domain and an increase in the value of global health status domain after three cycles of chemotherapy of two regimens, except the symptoms of nausea and vomiting and loss of appetite that showed an increasing trend. Patients who received cisplatin-vincristine-bleomycin regimen showed a significant increasing (p = 0.009) in decreased of appetite symptom’s scores. No significant differences in the quality of life of patients who delivered chemotherapy regimen of cisplatin-vincristine-bleomycin compared to carboplatin-paclitaxel regimen.

Pengaruh Self-Care terhadap Kadar Glukosa Darah Puasa Pasien Diabetes Melitus Tipe-2 Syahrizal Ramadhani; Arie Fidiawan; Tri Murti Andayani; Dwi Endarti
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Diabetes Mellitus (DM) is a chronic hyperglycemic condition which may affect all aspects of life of the sufferer, and it can be life threatening. This problem can be minimized by doing self-care. Self-care has an influence on glycemic control, prevention of complications due to uncontrolled blood glucose and improving the quality of life for people with diabetes mellitus. This study aimed to determine the effect of self-care on fasting blood glucose of type 2 diabetics. This type of research was observational with cross-sectional design. The inclusion criteria for the study were patients with a diagnosis of diabetes mellitus aged > 18-year-old, treatment at a health center >8 weeks, had records of the last blood glucose fasting ≤1 month before the interview, while the exclusion criteria were patients who refused to participate and patients who could not communicate. Self-care measurement uses the Diabetes Self-Care Management Question (DSMQ) instrument. The number of respondents from this study was 115 people where 79,1% of respondents had a good level of self-care and 47% of respondents with fasting glucose levels that had not been achieved. The data were analyzed using Chi-square test. From this study, it was found that self-care had an effect on fasting blood glucose (OR=3,349, P<0,05). The lowest value of self-care in this study is the domain of physical activity and health-care, therefore patient motivation needs to be improved by exercise and routine check-up because self-care is one of the important factors that could control blood glucose levels.

Pengaruh Pelayanan Kefarmasian di Rumah pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Wilayah Kota Yogyakarta Nur Rasdianah; Suwaldi Martodiharjo; Tri Murti Andayani; Lukman Hakim
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 10, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

The increasing prevalence of diabetes mellitus (DM) in Indonesia requires participation of all parties including pharmacists. This study aims to determine the impact of the implementation of home pharmacy service guidelines for patients with type 2 diabetes mellitus on the level of knowledge, medication adherence, therapeurical satisfaction and glycemic control. This study used a quasi-experimental design with one group pre-test and post-test design involving 37 patients with type 2 diabetes mellitus who met the requirements of inclusion and exclusion criterias. The Diabetes Knowledge Questionnaire (DKQ-24) and the Diabetes Medication Satisfaction Tool (DMSAT) were used for collecting the data. Patient adherence was measured using a pillcount method and fasting blood sugar levels (FSB) data were obtained from the laboratory results. The study was conducted in two community health centers and patient’s home in the Yogyakarta Municipality area. The data were analysed using Wilcoxon and Spearman test. The results showed the change of the level of knowledge, medication adherence, therapeutic satisfaction and glycemic control before and after intervention of pharmacy services at home. The average decreasing of fasting blood sugar levels 17.09 mg/dL ± 1.43

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