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"Penelitian quasy experimental dengan pendekatan non equivalen control group design pre-pos test, bertujuan untuk mengidentifikasi pengaruh HBO terhadap perfusi perifer luka gangren pada penderita Diabetes mellitus di RSAL Dr. Ramelan Surabaya. Hasil penelitian pada 40 responden yang diambil secara consecutive sampling, menunjukan ada perbedaan yang signifikan antara perfusi perifer sesudah diberikan HBO pada kelompok intervensi dan kontrol (p=0,001), ada perbedaan yang signifikan antara perfusi perifer pada kelompok intervensi sebelum dan sesudah diberikan HBO (p=0,005). Disimpulkan Hiperbarik oksigen berpengaruh terhadap perfusi luka gangren pada penderita diabetes mellitus yang dinilai dari akral, CRT dan saturasi oksigen.

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This quasy experimental research with non equivalen control group design prepos test approach, purpose to identify HBO influence against peripheral perfusion of gangrene Diabetes mellitus patients in Dr. Ramelan Hospital, Surabaya. Resultof research on 40 respondents which taken by consecutive sampling, shown there is a significant differences on peripheral perfusion after given HBO group intervence and control (p=0,001). a significant differences on peripheral perfusion before and after given HBO group intervence and control (p=0,005). Concluded by Hyperbaric oxygen have an effect on peripheral perfusion of gangrene on diabetic mellitus patients from finger tips, CRT and oxygen saturation."

"[ABSTRAKGlobalisasi dan perkembangan teknologi menjadi salah satu factor terjadinya urbanisasi. Urbanisasi yang tidak terkendali menyebabkan berbagai masalah kesehatan pada masyarakat perkotaan, seperti Diabetes Mellitus Tipe 2 dan Hipertensi. Kedua penyakit tersebut disebabkan oleh gaya hidup dan pola makan masyarakat perkotaan yang tidak sehat. Lebih dari 26% masyarakat perkotaan menderita DM Tipe 2 dan hipertensi. Masalah psikosial yang biasa dialami oleh pasien dengan DM Tipe 2 dan hipertensi adalah ansietas. Ansietas adalah perasaan ketidaknyamanan dan kekhawatiran yang samar terhadap sesuatu yang mengancam. Intervensi yang dapat diberikan kepada pasien DM Tipe 2 dan hipertensi dengan ansietas adalah teknik relaksasi tarik napas dalam, distraksi, dan edukasi. Teknik relaksasi napas dalam dan edukasi pada klien terbukti dapat menurunkan rasa cemas dan tekanan darah pada klien.

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ABSTRACTGlobalization and technology development become the factors of urbanization. Uncontrolled urbanization makes many health problems towards urban people, such as Diabetes Mellitus Type 2 and hypertension. Those disease are caused by unhealthy lifestyle and eating habit of urban people. More than 26% of urban people suffered DM Type 2 and hypertension. Psychosocial problem that common occurred towards urban people whose DM Type 2 and hypertension is anxiety. Anxiety is discomfort feeling and unspecified apprehension caused by something threatening. Intervention that can give towards people with DM Type 2 and hypertension is deep breathing relaxation. Deep breathing relaxation can decrease anxiety level and blood pressure.;lobalization and technology development become the factors of urbanization. Uncontrolled urbanization makes many health problems towards urban people, such as Diabetes Mellitus Type 2 and hypertension. Those disease are caused by unhealthy lifestyle and eating habit of urban people. More than 26% of urban people suffered DM Type 2 and hypertension. Psychosocial problem that common occurred towards urban people whose DM Type 2 and hypertension is anxiety. Anxiety is discomfort feeling and unspecified apprehension caused by something threatening. Intervention that can give towards people with DM Type 2 and hypertension is deep breathing relaxation. Deep breathing relaxation can decrease anxiety level and blood pressure., lobalization and technology development become the factors of urbanization. Uncontrolled urbanization makes many health problems towards urban people, such as Diabetes Mellitus Type 2 and hypertension. Those disease are caused by unhealthy lifestyle and eating habit of urban people. More than 26% of urban people suffered DM Type 2 and hypertension. Psychosocial problem that common occurred towards urban people whose DM Type 2 and hypertension is anxiety. Anxiety is discomfort feeling and unspecified apprehension caused by something threatening. Intervention that can give towards people with DM Type 2 and hypertension is deep breathing relaxation. Deep breathing relaxation can decrease anxiety level and blood pressure.]"

"Pekelja di kilang minyak tcrutama di lokasi bising mempunyai risiko tinggi menderita gangguan pcndcngaran sebagai penyakit akibat kelja. Pajanan kombinasi (bising, penyakit DM, hipcrtensi, DM dan hipertensi) dapat terjadi secara bersamaan pada seorang pekerja. Penelitian bertujuan untuk mengetahui hubungau dan kontribusi pajanan kombinasi terhadap teljadinya gangguan pendengaran. Dengan metode historikal kohor, data pekelja dari tahun 2002-2007, pcfnetapan kriteria gangguan pendengaran berdasarkan hasil audiogram pada frekuensi 4000 Hz > 25 dBA, status DM berdasarkan kriteria diagnostik PERKENI 2006 GDP 2126 mg/dL, status hipertensi herdasarkan JNC7 S 2140 mmHg dan D 290 mm!-Ig. Analisis statistik dengan univariat dan bivariat. Diperoleh hasil, insiden gangguan pendengaran berkisar antara 25.0% - 50.0% pada pekelja yang terpzgan bising, dengan distribusi responden menurut masing- masing pajanan kombinasi dan karakteristik responden (variabcl pcrancu: Lunur; rnasa kerja; merokok; dan pemakaian APT). Kesimpulan yang diperoleh dari uji statistik, baik variabel independen maupun vadabel perancu mempunyai p value > on, perbedaan tidak bermal-ma. Sehingga gambaran dan kontribusi faktor risiko penyakit DM dan hipcrtcnsi bclum dapat diketahui dengan jelas. Hal ini disebabkan beberapa keterbatasan penelitian diantaranya sampel yang mcmenuhi kriteria inklusi (140 responden) tidak memenuhi besar sampel minimal (287 responden}, informasi data yang diperoleh dari perusahaan tidak lengkap. Oleh karenanya saran bagi pemsahaan agar lebih memperhatikan sistem pencatatan, pelaporan, dan penyimpanan data., pemeriksaan audiometri, kesehatan berkala, pengukuran dosis pajanan, secara rutin dan berkcsinarnbungan sesuai kebutuhan, terulama bagi pekerja yang terpajan bising > 85 dBA, penertiban sertifikasi operator, kalibrasi alat oleh institusi yang bezwenang.

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Workers of refinery in noisy area have high risk to get hearing loss as occupation disease. Combined exposure (noise, DM, hypertension) can happen simultaneously on a worker. The purpose of this study is to find the relation and contribution of combined exposure on hearing loss. The study was using historical cohort, worker’s data from 2002 to 2007, hearing loss criteria definition based on audiograrn result with frequency 4000 Hz >25 dBA; DM status based on PERKENPS diagnosis in 2006 GDP 2 126 mg/dL, hypertension status based on JNC7 S 2 |20 mml-lg and D 2 90 mml-Ig. Statistical analysis was using univariat and bivariat.

The result is hearing loss incident on workers exposed by noise around 25.0% - 50.0%, with respondent’s distribution based on each combined exposure and respondent's characteristic (confounding variable : age, working period, smokind and the using of APT) We conclude by statiscal test, both independent variable and cofounding variable with P value > ot that there is insignificant dillerencetherefore, the illustration and contribution of DM and hypertension risk factor cannot be found clearly. It was caused by some limitations in the study such as inclusive criteria sample (140 respondents) didn't iillfil the quota of sample (287 respondents), incompleted company's clatas.

Therefore, we suggest that the company should pay more attention to data entry, data report and data saving, audiometric check-up, periodic medical check-up, exposure dosage measurement, regularly and continually based on needs, especially for workers exposed by noise > 85 dBA, regulation of operator certification, calibrated equipment by authorized institution."

"Latar belakang: Diabetes melitus tipe 2 merupakan penyakit yang menjadi masalah kesehatan masyarakat tidak hanya di Indonesia, namun juga di dunia karena prevalensinya yang terus meningkat. Hipertensi yang juga merupakan faktor risiko diabetes melitus tipe 2 memiliki prevalensi yang sangat tinggi di Indonesia. Tidak hanya itu, prevalensi kedua penyakit tersebut meningkat seiring bertambahnya usia, dimulai dari usia ≥40 tahun. Tujuan: Untuk mengetahui hubungan hipertensi dengan kejadian diabetes melitus tipe 2 pada populasi berusia ≥40 tahun di Indonesia. Metode: Penelitian ini menggunakan metode kuantitatif dengan desain studi cross sectional. Sumber data yang digunakan berasal dari hasil Riskesdas 2018. Terdapat sebanyak 15.026 partisipan berdasarkan kriteria inklusi dan eksklusi penelitian. Hasil: Prevalensi diabetes melitus tipe 2 dan hipertensi pada populasi berusia ≥40 tahun di Indonesia masing-masing sebesar 21,3% dan 51,8%. Terdapat hubungan yang signifikan secara statistik antara hipertensi dengan diabetes melitus tipe 2 pada populasi berusia ≥40 tahun di Indonesia (PR = 1,64; 95%CI: 1,526 – 1,763). Efek gabungan antara hipertensi dengan obesitas sentral memiliki risiko sebesar 2,07 kali lebih besar terhadap kejadian diabetes melitus tipe 2 setelah dikontrol oleh jenis kelamin dan obesitas. Kesimpulan: Terdapat hubungan antara hipertensi dengan kejadian diabetes melitus tipe 2 pada populasi berusia ≥40 tahun di Indonesia. Risiko diabetes melitus tipe 2 yang lebih tinggi terjadi pada orang yang mengalami hipertensi dan obesitas sentral. Saran: Perlu dilakukan deteksi dini diabetes melitus tipe 2 dan hipertensi sedini mungkin, terutama bagi penduduk yang berusia ≥40 tahun dan mengalami obesitas sentral.

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Background: Type 2 diabetes mellitus is a disease that is still a public health problem not only in Indonesia, but also in the world because of its increasing prevalence. Hypertension, which is also a risk factor for type 2 diabetes mellitus, has a very high prevalence in Indonesia. Not only that, the prevalence of both diseases also increases with age, starting from 40 years of age. Objective: To determine the relationship between hypertension and type 2 diabetes mellitus in a population aged ≥40 years in Indonesia. Methods: This study used a quantitative method with a cross sectional study design. The source of the data used comes from the results of Riskesdas 2018. There are 15.026 participants based on the inclusion and exclusion criteria of the study. Results: The prevalence of type 2 diabetes mellitus and hypertension in the population aged ≥40 years in Indonesia are 21,3% and 51,8%, respectively. There is a statistically significant relationship between hypertension and type 2 diabetes mellitus in the population aged ≥40 years in Indonesia (PR = 1,64; 95%CI: 1,526 – 1,763). The combined effect of hypertension and central obesity has a risk of 2,07 times greater for the type 2 diabetes mellitus after being controlled by gender and obesity. Conclusion: There is a relationship between hypertension and type 2 diabetes mellitus in the population aged ≥40 years in Indonesia. The risk of type 2 diabetes mellitus is higher in people with hypertension and central obesity. Suggestion: It is necessary to detect type 2 diabetes mellitus and hypertension as early as possible, especially for people aged ≥40 years and experiencing central obesity."

"The therapy for degenerative deseases such as hypertension and type 2 of diabetes mellitus may take a long time or even as long as patient's lifetime. The length of therapy process that patient should take, sometimes make them not be comply with their therapy instructions. Patient Counseling by pharmacist is one of the way to maintain or to increase their compliance to the therapy. The objective of this study was to know how far the patient counseling by Pharmacist influenced patient's knowledge and compliance on taking their medicine in Kimia Farma Pharmacy. Patient's compliance was measured by indirect methode ( interview using questioner as measure equipment ). Respondents were patients who bought medicine by prescription in Kimia Farma Pharmacy , Pasar Minggu as treatment sample and Kimia Farma Merdeka Bogor as control one. Sample were collected in August to October 2007. The result showed that there was significant difference of knowledge to hypertension and diabetes mellitus type 2 therapy between intervention group and control one ( p value = 0.039 ). There was also difference of adherence to hypertension and diabetes mellitus type 2 therapy between intervention group and control one ( p value = 0.002 ). The Pharmacist counseling influenced the knowledge ang adherence of respondents. "

"Penyakit Ginjal Kronik memberikan berbagai dampak buruk pada tingkat individu maupun nasional dan prevalensinya mengalami kenaikan. Skripsi ini bertujuan untuk mengetahui prevalensi dan faktor dominan Penyakit Ginjal Kronik pada usia produktif (19-60 tahun) di Indonesia tahun 2018 dari analisis data Riskesdas 2018. Penelitian ini menggunakan desain cross sectional dan dilakukan pada bulan Maret-Juli 2023. Populasi penelitian adalah penduduk usia produktif (19-60 tahun) di Indonesia dengan jumlah sampel sesuai kriteria inklusi dan eksklusi sebanyak 9400 orang. Variabel penelitian terdiri dari karakteristik demografi (usia dan jenis kelamin), penyakit tidak menular (diabetes melitus, hipertensi, dan obesitas), serta gaya hidup (merokok, konsumsi minuman berkarbonasi, konsumsi minuman berenergi, dan aktivitas fisik). Data penelitian dianalisis secara bivariat dan multivariat menggunakan uji chi square dan binary logistic regression. Prevalensi Penyakit Ginjal Kronik pada usia produktif (19-60 tahun) di Indonesia tahun 2018 adalah 1,7%. Hasil uji statistik menunjukkan ada hubungan antara usia (p=0,000), diabetes melitus (p=0,001), hipertensi (p=0,000), obesitas (p=0,004), serta konsumsi minuman berkarbonasi (p=0,047) dengan kejadian penyakit ginjal kronik pada usia produktif (19-60 tahun). Hasil uji statistik multivariat menunjukkan bahwa usia OR 3,709 (95% CI: 2,325-5,919) merupakan faktor paling dominan berhubungan dengan kejadian Penyakit Ginjal Kronik pada usia produktif (19- 60 tahun) di Indonesia tahun 2018. Saran utama yang dapat diberikan untuk mengurangi kejadian Penyakit Ginjal Kronik pada usia produktif, yaitu mengoptimalkan program pencegahan Penyakit Tidak Menular (PTM), termasuk Penyakit Ginjal Kronik dan faktor-faktornya.

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Chronic Kidney Disease has various impacts at the individual and national levels. The prevalence of this disease is also rising. This thesis aims to determine the prevalence and dominant factors of Chronic Kidney Disease in productive age (19-60 years old) in Indonesia in 2018 from the 2018 Riskesdas data analysis. This study was conducted in March-July 2023 using a cross-sectional design. The study population was Indonesian at productive age (19-60 years old) with a total sample of 9400 people. The study variables include demographic characteristics (age and gender), non-communicable diseases (diabetes mellitus, hypertension, and obesity), and lifestyle (smoking, consumption of carbonated drinks, consumption of energy drinks, and physical activity). The data were analyzed using chi-square and binary logistic regression. The prevalence of Chronic Kidney Disease in productive age (19-60 years) in Indonesia in 2018 was 1.7%. Bivariate analysis showed that there was a relationship between age (p=0.000), diabetes mellitus (p=0.001), hypertension (p=0.000), obesity (p=0.004), and carbonated drinks consumption (p=0.047) with the incidence of chronic kidney disease at productive age (19-60 years old). Multivariate analysis shows that age OR 3.709 (95% CI: 2.325-5.919) is the most dominant factor associated with the incidence of Chronic Kidney Disease in productive age (19-60 years) in Indonesia in 2018. Based on the evidence, the suggestion to prevent Chronic Kidney Disease is to optimize Non-Communicable Disease (NCD) prevention programs, including Chronic Kidney Disease and its factors."

"Latar Belakang: Penyakit arteri perifer (PAP) merupakan salah satu komplikasi makrovaskular pada penyandang diabetes melitus tipe 2 (DMT2) yang menimbulkan tingkat morbiditas dan mortalitas yang tinggi. Hingga saat ini, belum ada telaah sistematis dan komprehensif mengenai faktor risiko kejadian PAP pada penyandang DMT2.Tujuan: Mengetahui efek estimasi kumulatif dari berbagai faktor risiko kejadian penyakit arteri perifer pada penyandang diabetes melitus tipe 2.Metode: Telaah sistematis dan mata-analisis ini disusun berdasarkan standar PRISMA.Penelusuran literatur secara sistematis dan komprehensif dilakukan pada PubMed/MEDLINE, ProQuest, dan EMBASE, untuk mencari studi kohort dan kasus kontrol yang melaporkan faktor risiko PAP pada DMT2. Selain itu kami juga melakukan penelusuran terhadap grey literature. Risiko bias tiap studi yang diinklusi dinilai menggunakan the Newcastle-Ottawa Scale. Data dianalisis menggunakan RevMan versi 5.4 untuk mencari efek estimasi kumulatif dari tiap faktor risiko.Hasil: Didapatkan 10 studi yang dimasukkan ke dalam telaah sistematis ini, dengan total 73.834 pasien DMT2. Semua studi memiliki kualitas baik berdasarkan Newcastle-Ottawa Scale. Hubungan yang bermakna secara statistik terhadap kejadian PAP pada DMT2 didapatkan pada kelompok dengan usia ≥ 70 tahun (OR 3.44; IK 95% 2.11, 5.62), durasi diabetes ≥ 5 tahun (OR 1.81; IK 95% 1.24, 2.64), riwayat penyakit jantung koroner (OR1.55; IK 95% 1.30, 1.83), hipertensi (OR 1.43; IK 95% 1.10, 1.86), dan peningkatan LDL (OR 2.51; IK 95% 1.38, 4.56). Semua bukti temuan memiliki tingkat keyakinan moderate (GRADE rating)Kesimpulan: Usia ≥ 70 tahun, durasi diabetes ≥ 5 tahun, riwayat penyakit jantung koroner, hipertensi, dan peningkatan LDL merupakan faktor risiko kejadian PAP pada DMT2

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Background: Peripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM), which cause serious rate of

morbidities and mortality. To date, there have not been any systematic and comprehensive review regarding the risk factors of incidence of PAD in T2DM populations.

Objective: Our study aims to analyze the pooled effect estimates of each risk factors of PAD incidence in T2DM populations. factors of PAD incidence in T2DM populations.

Methods: This systematic review and meta-analysis was conducted using the PRISMA standard. A systematic and comprehensive literature searching was conducted in

PubMed/MEDLINE, ProQuest, and EMBASE database, to obtain any cohort or casecontrol studies reporting the risk factors of PAD incidence in T2DM populations. We also

conducted searching on gray literature and hand-searching. We assessed risk of bias using

Newcastle-Ottawa Scale assessment tool. The pooled effect estimates of each risk factors was analyzed using RevMan version 5.4.

Results: Ten studies were included in this review comprising 73834 T2DM patients in total. All the studies had good quality based on Newcastle-Ottawa Scale. Significant association with the incidence of PAD in T2DM was found in the group of age ≥ 70 years

old (OR 3.44; 95% CI 2.11, 5.62), diabetes duration ≥ 5 years (OR 1.81; 95% CI 1.24, 2.64), coronary artery disease history (OR 1.55; 95% CI 1.30, 1.83), hypertension (OR

1.43; 95% CI 1.10, 1.86), and increased LDL (OR 2.51; 95% CI 1.38, 4.56). All the evidence has moderate certainty (GRADE rating).

Conclusion: Age ≥ 70 years old, diabetes duration ≥ 5 years, coronary artery disease history, hypertension dan increased LDL are significant risk factors of PAD incidence in T2DM population."

"ABSTRAK Rujuk Balik merupakan program BPJS yang bertujuan untuk mengendalikan serta mengelola penyakit-penyakit kronis termasuk Diabetes Melitus dan Hipertensi. pengobatan terhadap pasien penyakit kronis tersebut diberikan seumur hidup sehingga hal ini tentu saja dapat mengakibatkan adanya peningkatan biaya pelayanan kesehatan.Sesuai dengan Permenkes No. 28 tahun 2014 BPJS menerapkan prinsip kendali mutu dan kendali biaya dengan cara memberikan pelayanan secara berjenjang, efektif dan efisien. Salah satu program yang mewakili konsep tersebut adalah Program Rujuk Balik (PRB). Dengan adanya Program Rujuk Bali diharapkan dapat meningkatkan aksesibilitas, kualitas pelayanan kesehatan dan efisiensi biaya. Program rujuk balikseharusnya memudahkan pelayanan promotif preventif terhadap penyakit Diabetes Mellitus dan Hipertensi. Namun, pada pelaksanaannya, program Rujuk Balik di Rumah Sakit IMC Bintaro masih jauh dibawah target capaian Nasional. Hal ini akan berdampak kepada penumpukan pasien poli internist dan juga menjadi resiko atas kekosongan persediaan obat di rumah sakit. Dalam menganalisis implementasi pelaksanaan program rujuk balik diabetes mellitus dan hipertensi dilakukan dengan menggunakan teori kebijakan Van Horn Van Meter serta Edward III dengan variable : Standard dan Tujuan Kebijakan; Sumber Daya; Komunikasi antar Organisasi; Karateristik Agen Pelaksana; DisposisiImplementor ; Lingkungan Social Ekonomi dan Politik.Hasil penelitian menunjukan adanya kekosongan obat di FKTP, tidak adanya link pendataan secara system diantara Rumah Sakit dan FKTP, sosialisasi serta koordinasi yang kurang diantara BPJS, Rumah Sakit dan FKTP menjadi hambatan dalam pelaksanaan program rujuk balik diabetes mellitus dan hipertensi di Rumah Sakit IMC, Bintaro

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ABSTRACT

Back-Refferal is a BPJS program that aims to control and manage chronic diseases including Diabetes Mellitus and Hypertension. The treatment of patients with chronic diseases is given for long term periods and lead to an increase the cost of health

services. In accordance with Permenkes No. 28 of 2014 BPJS applies the principles of quality control and cost control by providing services in stages, effective and efficient. One program that represents the concept is Back Referral Program (BRP). With the

existence of the Back-Referral Progra is expected to improve accessibility, quality of health services and cost efficiency. The referral program should facilitate preventive promotive services for Diabetes Mellitus and Hypertension. However, the implementation of Back-Referral Program in IMC Bintaro Hospital was still far below

the National achievement target. This will have an impact on the accumulation of patients in internist station and also be a risk for drugs availabilities supplies in hospitals.

In analyzing the implementation of the program of back-refferal program diabetes mellitus and hypertension was carried out using the policy theory of Van Horn Van Meter and Edward III with variables: standard and policy objectives; resource; Communication between organizations; Characteristics of implementing agents;

Implementor Disposition; Socio-economic and political environment.

The results showed that there was a drug shortage in the FKTP, there was no system data link between the Hospital and FKTP, lack of socialization and coordination among BPJS, hospitals and FKTP as obstacles in implementing back-refferal program diabetes

mellitus and hypertension in IMC Hospital, Bintaro"

"Standar pelayanan kefarmasian yang diatur dalam PMK No. 73 Tahun 2016 merupakan pedoman yang harus diimplementasikan di apotek untuk mengoptimalkan kesehatan di komunitas. Laporan ini mendeskripsikan implementasi pelayanan kefarmasian dan pengkajian resep pasien diabetes melitus tipe 2 dan hipertensi di apotek kimia farma 002 periode november 2022. Berdasarkan hasil observasi dan wawancara kepada petugas apotek dapat disimpulkan pelaksanaan kegiatan pengelolaan sediaan farmasi, alat kesehatan, dan BMHP di Apotek Kimia Farma 002 sudah cukup baik dan sesuai dengan PMK No. 73 Tahun 2016. Pengkajian yang dilakukan pada satu resep belum memenuhi aspek kelengkapan resep, yaitu aspek administratif dan pertimbangan klinis. Petugas apotek perlu menghubungi pihak dokter atau rumah sakit untuk mengkonfirmasi resep. Berdasarkan hasil observasi dan wawancara kepada petugas apotek dapat disimpulkan pelaksanaan kegiatan pelayanan swamedikasi di Apotek Kimia Farma 002 sudah cukup baik. Penggalian informasi pasien yang dilakukan sudah sesuai dengan literatur. Berdasarkan hasil observasi dan wawancara kepada petugas apotek dapat disimpulkan pelaksanaan kegiatan PIO sudah cukup baik dan sesuai dengan PMK No. 73 Tahun 2016, namun tidak didokumentasikan dengan baik.

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The standard of pharmaceutical services regulated in Ministerial Decree No. 73 of 2016 is a guideline that must be implemented in pharmacies to optimize community health. This report describes the implementation of pharmaceutical services and the assessment of prescriptions for patients with type 2 diabetes mellitus and hypertension at Chemist Pharmacy 002 during the period of November 2022. Based on the results of observations and interviews with pharmacy staff, it can be concluded that the implementation of the management of pharmaceutical preparations, medical devices, and health supplies at Chemist Pharmacy 002 is already quite good and in accordance with Ministerial Decree No. 73 of 2016. The assessment conducted on a prescription did not meet the completeness aspects of a prescription, namely administrative aspects and clinical considerations. Pharmacy staff need to contact doctors or hospitals to confirm the prescription. Based on the results of observations and interviews with pharmacy staff, it can be concluded that the implementation of self-medication services at Chemist Pharmacy 002 is already quite good. Patient information gathering is in accordance with the literature. Based on the results of observations and interviews with pharmacy staff, it can be concluded that the implementation of Pharmaceutical Care Program activities is already quite good and in accordance with Ministerial Decree No. 73 of 2016, but it is not well documented."

"Pemantauan Terapi Obat (PTO) adalah salah satu kegiatan Farmasi klinis yang merupakan peran apoteker di Rumah Sakit menurut PMK no.72 tahun 2016. Peran fundamental apoteker adalah mengidentifikasi ROTD yang potensial maupun aktual, memecahkan masalah ROTD aktual, dan mencegah ROTD yang potensial terjadi. Berdasarkan Global Status Report on NCD World Health Organization (WHO) pada tahun 2010, Diabetes Melitus menduduki peringkat ke-6 penyakit yang menyebabkan kematian. Peningkatan insidensi penyakit DM diiringi dengan peningkatan komplikasi dan penyakit penyerta seperti komplikasi neuropati (63,5%), retinopati (42%), nefropati (7,3%), makrovaskuler (16%), mikrovaskuler (6%), luka kaki diabetik (15%) (Purwanti, 2013). Pengamatan pada Pasien Rawat Inap dengan diagnosa Diabetes Melitus disertai dengan penyerta Ulcer DM perlu dilakukan untuk memantau terapi obat yang diterima oleh pasien tetap sesuai dengan ketentuan yang berlaku dan mencegah terjadinya ROTD akibat komplikasi dari pemakaian obat yang banyak. Pemantauan terapi obat dilakukan dengan metode PCNE untuk memastikan akar permasalahan (cause) yang menyebabkan masalah (problem). Berdasarkan pengamatan yang dilakukan, ditemukan empat permasalahan yang selanjutnya diselesaikan dengan pemberian rekomendasi kepada dokter terkait pemilihan obat.

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Medication Therapy Monitoring (MTM) is one of the clinical pharmacy activities that falls under the role of pharmacists in hospitals, as stated in Ministerial Regulation No. 72 of 2016. The fundamental role of pharmacists is to identify potential and actual Drug-Related Problems (DRPs), resolve actual DRPs, and prevent potential DRPs from occurring. According to the World Health Organization's (WHO) Global Status Report on Non-Communicable Diseases (NCD) in 2010, Diabetes Mellitus ranked 6th among the diseases causing death. The increasing incidence of diabetes is accompanied by an increase in complications and comorbidities such as neuropathy (63.5%), retinopathy (42%), nephropathy (7.3%), macrovascular (16%), microvascular (6%), and diabetic foot ulcers (15%) (Purwanti, 2013). Observations on hospitalized patients diagnosed with Diabetes Mellitus, accompanied by Diabetic Ulcers, need to be conducted to monitor the medication therapy received by patients in accordance with applicable regulations and to prevent DRPs resulting from the use of multiple medications. Medication therapy monitoring is performed using the PCNE method to ensure the identification of the root cause that leads to a problem. Based on the observations conducted, four problems were identified and subsequently addressed by providing recommendations to the relevant doctor regarding medication selection."