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"Penyakit pernapasan kronis menjadi salah satu penyakit tidak menular yang paling umum di seluruh dunia. Asma merupakan salah satu penyakit pernapasan kronis yang banyak diderita oleh masyarakat. Penyakit ini seringkali dikaitkan dengan beban yang besar. Asma yang tidak terkontrol berhubungan dengan peningkatan pengeluaran, peningkatan utilisasi pelayanan kesehatan dan penurunan produktivitas. Kondisi penyakit asma yang kronis memerlukan peranan pasien dalam pengendalian penyakit. Hal tersebut dapat dimungkinkan melalui adanya self-management. Perkembangan teknologi di masa kini dapat dimanfaatkan melalui penggunaan mHealth untuk mendukung penerapan self-management asma. Penelitian ini menggunakan metode literature review. Pencarian studi dilakukan dengan menggunakan online database yaitu PMC, ScienceDirect, dan LinkSpringer. Terdapat 13 studi yang termasuk ke dalam penelitian ini. Hasil penelitian ini menunjukkan bahwa sebanyak 11 studi menghasilkan perubahan positif yang signifikan dalam pengendalian asma yang dapat diketahui melalui asthma control, kualitas hidup, penggunaan SABA, symptom free days, dan CACG symptom benchmark. Selain itu, terdapat 4 studi yang menghasilkan perubahan positif dalam meningkatkan kepatuhan mengonsumsi obat. Sehingga, dapat dikatakan bahwa penggunaan mHealth efektif dalam penerapan self-management asma.

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Chronic respiratory diseases are becoming one of the most common non-communicable diseases worldwide. Asthma is one of the chronic respiratory diseases that many people suffer from. This disease is often associated with a large burden. Uncontrolled asthma is associated with increased spending, increased utilization of health services and decreased productivity. Chronic asthma conditions require the patient's role in Disease Control. This can possible through self-management. Technological developments in the present can be utilized through the use of mHealth to support the implementation of asthma self-management. This study uses the literature review method. Study searches were conducted using online databases namely PMC, ScienceDirect, and LinkSpringer. There are 13 studies included in this study. The results of this study showed that a total of 11 studies resulted in significant positive changes in asthma control that can be known through asthma control, quality of life, use of SABA, symptom free days, and CACG symptom benchmark. In addition, there are 4 studies that produce positive changes in improving adherence to asthma medication. Thus, it can be said that the use of mHealth is effective in the application of asthma self-management."

"Hipertensi merupakan salah satu faktor risiko penyakit kardiovaskular dan tergolong ke dalam penyakit kronis, dimana jika tidak dikelola dengan baik dapat menyebabkan komplikasi penyakit yang berujung pada kematian. Penanganan penyakit kronis perlu melibatkan peran aktif dari pasien yang dapat dilakukan melalui penerapan self-management. Dengan memanfaatkan perkembangan teknologi informasi dan komunikasi, self-management dapat difasilitasi melalui penggunaan mHealth. Oleh karena itu, penelitian ini bertujuan untuk mengetahui efektivitas mHealth dalam self-management hipertensi. Penelitian ini menggunakan metode literature review. Pencarian studi dilakukan dengan menggunakan online database yaitu PubMed, ScienceDirect, dan ProQuest. Terdapat 16 studi yang termasuk ke dalam penelitian ini. Hasil penelitian ini menunjukkan bahwa sebanyak 9 studi menghasilkan penurunan tekanan darah yang dinilai signifikan dan terdapat sebanyak 8 studi yang menunjukkan adanya perubahan positif pada pola hidup pasien. Sehingga, dapat dikatakan bahwa penggunaan mHealth efektif dalam penerapan self-management hipertensi.

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Hypertension is one of the risk factors for cardiovascular disease and is classified as a chronic disease, which if not managed properly will cause complications of the disease that lead to death. The management of chronic diseases have to involve an active role from the patient which can be done through the application of self-management. Self-management can be facilitated by the use of mHealth which utilizes development in information and communication technology. Therefore, this study aims to determine the effectiveness of mHealth in hypertension self-management. This study uses a literature review method. The study search was conducted using online databases, namely PubMed, ScienceDirect, and ProQuest. There are 16 studies included in this study. The results of this study indicate that 9 studies resulted in a decrease in blood pressure which was considered significant and there were as many as 8 studies that showed positive changes in the patient's lifestyle. Thus, it can be inferred that the use of mHealth is effective in the application of hypertension self-management."

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Diabetes merupakan permasalahan kesehatan yang masih banyak terjadi di dunia dan jenis diabetes yang banyak diderita adalah diabetes tipe 2. Diabetes yang tidak terkendali dapat menyebabkan komplikasi. Upaya yang dapat dilakukan untuk mengendalikan diabetes tipe 2 adalah dengan memberikan perawatan kesehatan berkelanjutan oleh petugas kesehatan dan melakukan self-management. Self-management dapat diterapkan dengan menggunakan perkembangan teknologi informasi dan komunikasi, yaitu dengan  Mobile Health (mHealth). Oleh karena itu, penelitian ini bertujuan untuk mengetahui efektivitas mhealth dalam self-management diabetes tipe 2. Penelitian ini menggunakan metode literature review. Pencarian studi dilakukan melalui online database PubMed, ScienceDirect dan Cochcrane dengan kata kunci “mHealth” OR “mobile health” AND “self-management diabetes” OR “Self-care diabetes”. Dan ditemukan 15 total studi yang terinklusi. Keefektivitasan dinilai dari perubahan yang nyata pada hasil. Sebanyak 6 studi menunjukkan adanya penurunan kadar Hb1Ac yang signifikan dan sebanyak 5 studi menjukan adanya perubahan yang signifikan pada pola hidup pasien. Sehingga, dapat dikatakan bahwa penggunaan mHealth efektif dalam self-management diabetes.

 

 

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Diabetes is a health issue that still occurs in the world and the type of diabetes that is suffered is type 2 diabetes. Uncontrolled diabetes can cause complications. The efforts to control type 2 diabetes is by providing a continuity health care by health workers and self-management. Self-management can be applied using information and communication technology developments, that is by using Mobile Health (mHealth). Therefore, this study aims is to see the effectiveness of health in self-management of type 2 diabetes. This study used a literature review method. The study search was carried out through the PubMed, ScienceDirect and Cochcrane online database with the keywords "mHealth" OR "mobile health" AND "diabetes self-management" OR "Self-care diabetes". And found 15 total studies. The effectiveness is assessed from real changes in results. A total of 6 studies showed a significant decrease in Hb1Ac levels and as many as 5 studies showed significant changes in the patient's lifestyle. So, it can be said that the use of mHealth is effective in diabetes self-management.

 

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"Penelitian kegunaan makrolid pada asma eksaserbasi menunjukkan bahwa di samping memiliki efek antimikroba, makrolid juga memiliki aktivitas sebagai imunomodulator. Penelitian ini bersifat kuasi-eksperimental untuk menilai efek klaritromisin yang diberikan secara intravena dilanjutkan terapi oral klaritromisin pada 37 pasien asma eksaserbasi akut yang disebabkan infeksi saluran napas selama periode Januari sampai dengan Desember 2005. Pasien asma akut ringan dan sedang yang memenuhi kriteria diberikan klaritromisin intravena 2 x 500 mg selama maksimal 5 hari dilanjutkan klaritromisin oral 2 x 500 mg selama 7 hari. Dilakukan evaluasi perbaikan klinis sesuai skor serangan asma, dan arus puncak ekspirasi (APE). Sesudah 10 hari, hasil pengobatan menunjukkan perbaikan signifikan perbaikan skor serangan asma dan APE pagi dan sore sebelum dan sesudah pengobatan pada 35 subjek yang diteliti, sedangkan hari sulih didapatkan kurang dari 3 hari pada 21 subjek dan 3-5 hari pada 14 subjek. Kuman yang paling banyak ditemukan adalah golongan S. β-haemolyticus dan Streptococcus sp. Disimpulkan bahwa pengobatan dengan klaritromisin intravena yang dilanjutkan secara oral dapat memberikan perbaikan gejala klinis dan nilai APE pada eksaserbasi asma akibat infeksi saluran napas.

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Abstractn addition to its antimicrobial activity, macrolides have an immunomodulatory effect that may be beneficial to patients with asthma. This quasi-experimental study aimed to determine the effect of intravenous clarithromycin followed by oral administration in 37 patients with acute exacerbations asthma caused by respiratory tract infection during January - December 2005. Patients with mild to moderate exacerbations of asthma with respiratory tract infection meeting the inclusion and exclusion criteria were given intravenous clarithromycin 2 x 500 mg/day for not more than 5 days and followed by oral clarithromycin 2 x 500 mg/day for 7 days. Outcome variables were improvement of clinical symptoms according to the asthma exacerbation score and peak expiratory flow rate (PEFR). After 10 days, treatment resulted significant improvement in total asthma exacerbation score and morning PEFR in 35 patients enrolled this project. Based on clinical improvement and laboratory findings, the number of days required for intravenous clarithromycin was less then 3 days for 21 subjects, 3-5 days in 14 subjects. The most common causative pathogens were S. β-haemolyticus and Streptococcus sp. It was concluded that clarithromycin improved clinical symptoms and PEFR in exacerbation of asthma caused by respiratory tract infection. "

"Latar belakang: Asma merupakan penyakit ditandai peradangan saluran napas kronik. Satu dari tiga kasus tidak memberikan respon adekuat. Modalitas alternatif terapi  asma adalah magnesium inhalasi. Inhalasi magnesium memiliki efek samping sistemik minimal. Oleh karena itu, peran magnesium inhalasi perlu diteliti lebih lanTujuan: Penelitian bertujuan untuk mengetahui efektivitas dan keamanan pemberian magnesium inhalasi pada pasien dewasa mengalami  asma akut.Metode: Penelusuran literatur dilakukan dua peneliti independen melalui: PubMed/ MEDLINE, Google Scholar, ProQuest, dan Cochrane dengan kata kunci “magnesium inhalasi” dan “serangan asma” dalam bahasa Inggris dan Indonesia. Pencarian manual dan snowballing dilakukan di portal data nasional. Studi yang dimasukkan adalah uji acak terkontrol mengenai perbandingan magnesium inhalasi dengan terapi standar pada serangan asma akut. Penilaian efektivitas berdasarkan parameter readmisi, tanda vital, perbaikan klinis, serta fungsi paru, sedangkan keamanan berdasarkan parameter efek samping. Protokol telaah sistematis didaftarkan pada PROSPERO.Hasil: Lima artikel diikutsertakan dalam telaah sistematis. Dua artikel diikut-sertakan menilai aspek  readmisi. Tiga studi  menilai hubungan magnesium terhadap tanda vital pasien. Dua studi menilai tingkat keparahan penyakit dan perbaikan klinis. Studi menunjukkan tidak terdapat hubungan bermakna pemberian magnesium inhalasi pada aspek readmisi pasien (RR 1; IK 95% 0.92 - 1,08; p= 0,96), dan saturasi oksigen (MD  1,82; IK 95%: -0.89 - 4.53; p= 0.19). Ada penurunan bermakna laju napas pasien  (MD -1,72; IK 95% -3,1 -0.35; p= 0.01), dan perbaikan gejala pada pasien  (RR 0.29; IK95% 0.18 - 0.47; p <0.001). Ada peningkatan bermakna efek samping pasien magnesium inhalasi (HR 1.56; IK 95% 1.05 – 2.32; p= 0.32). Efek samping relatif ringan  berupa hipotensi dan rasa mual. Kesimpulan: Magnesium inhalasi memperbaiki  klinis pasien asma terutama gejala, laju napas, dan fungsi paru.  Magnesium inhalasi dikatakan aman jika diberikan pada pasien, namun hati-hati penggunaan pada pasien hipotensi.

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Background:  Asthma is a disease characterized by chronic airway inflammation. Asthma occurs to many people worldwide. One third of asthmatic case did not respond adequately to standard therapy (Short Acting Beta Agonist, Anticholinergic, Corticosteroid). One of alternative treatment of asthma is inhaled magnesium.  Theoretically, inhaled magnesium is thought to have less systemic side effect and could act directly to respiratory tract. However, the role of inhaled magnesium therapy is not established yet.

Objective: This review is made to evaluate the effectiveness and safety of nebulized magnesium in adult with acute asthma attack.

Methods: Literature search was conducted by two independent investigators through online databases: PubMed/MEDLINE, Cochrane, ProQuest, and Google scholar using the keywords “inhaled magnesium” and “asthma” in English and Indonesian. Manual searches and snowballing were carried out through national data portals and medical faculty e-libraries. Journal articles included in this study are randomized controlled trials that observed inhaled magnesium in adult with acute asthma attack. All the protocol of this systematic review has been registered in PROSPERO.

Result: There are five articles included in this review. Two of them evaluate the effect of magnesium in term of readmission, three of the studies measures effect of magnesium in vital sign, and two of them evaluate the effect of magnesium in term of severity of asthma There is no significant difference in readmission rate and oxygen saturation in magnesium group compared to control (RR 1; 95% CI 0.92 to 1,08; p= 0,96 and MD 1,82; 95% CI -0.89 to 4.53; p= 0.19, respectively). There is significant reduction of respiratory rate and clinical severity in magnesium (MD -1,72; 95% CI   -3,1 to 0.35; p= 0.01, RR 0.29; 95% CI 0.18 to 0.47; p <0.001, respectively). There was a higher risk of side effect in magnesium group (HR 1.56; 95%CI 1.05 to 2.32; p= 0.03). However, the side effect is relatively mild such as hypotension and nausea.

Conclusion: Inhaled magnesium improves clinical outcome for patient with asthma attack especially lung function, improvement of clinical outcome, and lung function. Moreover, Inhaled magnesium is considered safe to be given to asthmatic patient. However, the inhaled magnesium is given with caution in patient with hypotension."

"Terapi penyakit asma dengan inhaled corticosteroid (ICS) dosis tinggi yang berjangka panjang berpotensi menimbulkan efek samping. Salah satu pendekatan yang dapat dilakukan adalah menggunakan senyawa turunan tumbuhan sebagai alternatif. Fisetin merupakan senyawa flavonoid yang menunjukkan berbagai efek farmakologis. Hambatan utama keberhasilan terapi dengan fisetin adalah bioavailabilitas yang rendah dan lipofilisitas yang tinggi. Beberapa pendekatan digunakan untuk meningkatkan bioavailabilitas obat dengan lipofilisitas tinggi, yaitu menggabungkan obat ke dalam matriks lipid. Solid lipid microparticles (SLM) adalah metode mikroenkapsulasi obat ke dalam lipid yang memungkinkan pelepasan obat terkendali, peningkatkan stabilitas obat, dan tetap aman bagi tubuh. Penelitian ini bertujuan untuk mendapatkan formulasi solid lipid microparticle fisetin dry powder inhalation fisetin berbasis lipid Glyceryl tristearate serta surfaktan Poloxamer 188 dan Tween 80 sebagai obat terapi inhalasi penyakit asma. Pada penelitian ini, peneliti telah mengamati variasi kandungan obat, konsentrasi surfaktan, dan kecepatan putar. Serbuk inhalasi menghasilkan ukuran 1,2 – 4 µm dan menunjukkan 34% antiinflamasi pada konsentrasi 1.000 ppm. Selain itu, persentase yield formulasi berada dalam rentang 81 – 96%, drug loading 2 – 5%, dan entrapment efficiency 82 – 87%. Profil pelepasan menunjukkan sistem pelepasan sustained release. Formulasi yang terbaik adalah FIS6 dengan variasi kandungan obat, surfaktan, dan kecepatan putar paling tinggi.

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Long-term high-dose inhaled corticosteroid (ICS) for asthma therapy has the potential to cause side effects. One approach that can be taken is to use plant-derived compounds as an alternative. Fisetin is a flavonoid compound that exhibits various pharmacological effects. The main obstacle to successful therapy with fisetin is its low bioavailability and high lipophilicity. Several approaches are used to increase the bioavailability of drugs with high lipophilicity is to incorporate the drug into the lipid matrix. Solid lipid microparticles (SLM) is a method of microencapsulating drugs into lipids that allows the drug to be released slowly, improves drug stability, and remains safe for the body. This study has obtained a fisetin SLM formulation as dry powder inhalation with Glyceryl Tristearate as lipid as well as Poloxamer 188 and Tween 80 as the surfactants. The dry powder inhalation is in the form of inhaled therapy drugs for asthma. This study also observes variations in drug content, surfactant concentration, and rotational speed. The inhalation powder has a particle size ranged 1,2 – 4 µm and showed 34% anti-inflammatory at a concentration of 1,000 ppm. In addition, the yield is in the range of 81 – 96%, drug loading is 2 – 5%, and entrapment efficiency is 82 – 87%. The winning profile shows the sustain release pulmonary drug delivery profile. The best formulation is FIS6 with the highest variation of drug, surfactant, and rotational speed."

"Bronchial asthma : a guide for practical understanding and treatment, sixth edition, is a fully updated version of a widely respected classic on the diagnosis and management of asthma. Discussing the disorder in all relevant patient groups, including a variety of patient subpopulations, this invaluable title continues to emphasize the definition, medications, and practical use of asthma treatment plans. Importantly, this comprehensive reference also discusses the common side effects found in the full range of medications used for asthma treatment. "

"Smoking has detrimental effects on asthma sympom control and response to treatment and is prevalent among astma patients in South Korea. The aim of study is to determine the prevalence of smoking among asthma patients in South Korea and to compare the medication regimens of astma patients who do and do not smoke. Methods: A cross-sectional survey was conducted from August 2010 to January 2011. Participating physicians (N=25) recorded demographic and clinical data on all astma patients presenting during the study period (N=2,032), and then recruited a subset of patients (N=500) for the survey such that half were self-reported current smokers. Recruited patients were between the ages of 18 and 60. In South Korea, physicians are well aware of the smoking status of their patients. However smoking status did not affect the prescribed medication regimens of this population of asthma patients."

"Diagnosis dan dukungan perawatan merupakan salah satu faktor utama dalam hal perawatan kesehatan. Metode tradisional diagnosis secara tatap muka antara pasien dan dokter dalam rangka monitoring dan menjaga kestabilan kesehatan sudah mulai sulit untuk dilakukan. Hal ini dikarenakan banyaknya hambatan-hambatan yang muncul, baik hambatan finansial, geografi, dan waktu. Teknologi informasi khususnya telekomunikasi dapat membantu mengatasi permasalahan tersebut, yang secara tidak langsung akan dapat membantu pengembangan sistem kesehatan di sebuah negara. Salah satu solusi yang dapat digunakan adalah penerapan m-Health pada sistem kesehatan. m-Health didefinisikan sebagai sebuah penggunaan mobile communications and network technologies dalam melakukan perawatan kesehatan. Pola penerapannya menggunakan mobile phone sebagai point-of-care device. Hanya saja, penerapan sebuah teknologi baru dalam suatu negara tidak dapat begitu saja dilakukan. Terdapat faktor-faktor yang perlu diperhatikan agar penerapan teknologi baru dapat berjalan secara optimal. Penelitian bertujuan untuk mengetahui sejauh mana kelayakan penerapan m-Health untuk diagnosis dan dukungan perawatan kesehatan pada negara berkembang dengan menggunakan studi kasus negara Indonesia. Penelitian ini dilakukan dengan menggunakan metodologi causal comparative terhadap penerapan m-Health di negara maju. Analisis kelayakan akan dilakukan terhadap empat aspek, yakni aspek ekonomi, teknologi, sosial, serta organisasi.

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AbstractDiagnosis and treatment support is one of the main factors in health care. Traditional methods of diagnosis in person between patients and physicians in order to monitor and maintain health stability is getting hard to do. This is because many of the obstacles that arise, whether financial constraints, geography, and time. Telecommunications in particular information technology can help overcome these problems, which will indirectly help the development of health systems in the country. One solution that can be used is the application of m-Health in the health system. m-Health is defined as the use of mobile communications and network technologies in the conduct of health care. Pattern application is using mobile phones as point-of-care device. Only, the application of a new technology in a country can not simply be done. There are factors that need to be taken to ensure that the application of new technologies can run optimally. The study aims to determine the extent to which the feasibility of applying the m-Health for the diagnosis and support for health care in developing countries by using a case study of Indonesia. The research was conducted using causal comparative methodology for the application of m-Health in developed countries. Feasibility analysis will be conducted on four aspects, namely the economic, technological, social, and organizational."

"Terjadinya peningkatan pengguna aplikasi seluler mendorong peluang untuk mempermudah konsultasi kesehatan melalui telemedicine di era pandemi COVID-19. Di Indonesia sendiri terjadi peningkatan penggunaan telemedicine selama pandemi COVID19. Namun, setelah pandemi COVID-19, masyarakat cenderung akan berkonsultasi secara offline kembali karena ketika berkonsultasi pada telemedicine masyarakat akan merasa beresiko karena tidak dapat bertemu dokter secara langsung dan layanan online seringkali menimbulkan isu-isu privasi. Rasa ketidakpastian dan beresiko dapat dikurangi dengan membangun kepercayaan masyarakat melalui proses trust transfer. Oleh karena itu, penelitian ini memiliki tujuan untuk mengetahui faktor-faktor yang dapat memengaruhi trust transfer agar masyarakat tetap berlanjut menggunakan layanan konsultasi telemedicine walaupun pandemi COVID-19 telah berakhir. Kemudian dilakukan penyebaran survei kepada masyarakat Indonesia yang sedang atau pernah berkonsultasi menggunakan aplikasi telemedicine dan mendapatkan 457 responden valid. Penelitian ini merupakan penelitian kuantitatif menggunakan analisis PLS-SEM dengan bantuan program SmartPLS. Hasil penelitian menunjukkan bahwa trust in doctor dipengaruhi oleh perceived reputation, telemedicine quality, dan familiarity. Kemudian trust in telemedicine dipengaruhi oleh disposition to trust dan telemedicine quality. Sedangkan trust in technology dipengaruhi oleh perceived reputation, telemedicine quality, dan familiarity. Selanjutnya trust in doctor dan trust in technology berpengaruh secara positif terhadap trust in telemedicine services namun tidak berpengaruh secara langsung terhadap continuance intention. Selain itu, satisfaction dan perceived usefulness berpengaruh positif secara langsung terhadap continuance intention.

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The increase in mobile application users encourages opportunities to facilitate health consultations through telemedicine in the era of the COVID-19 pandemic. In Indonesia, there has been an increase in the use of telemedicine during the COVID-19 pandemic. However, after the COVID-19 pandemic, people tend to consult offline again because when consulting on telemedicine, people will feel risky because they cannot meet doctors in person and online services often cause privacy issues. The sense of uncertainty and risk can be reduced by building public trust through the trust transfer process. Therefore, this study aims to determine the factors that can affect trust transfer so that people continue to use telemedicine consulting services even though the COVID-19 pandemic has ended. Then the survey was distributed to the Indonesian people who were or have been consulted using the telemedicine application and got 457 valid respondents. This research is quantitative research using PLS-SEM analysis with the help of the SmartPLS program. The results showed that trust in doctor was influenced by perceived reputation, telemedicine quality, and familiarity. Then trust in telemedicine is influenced by disposition to trust and telemedicine quality. Meanwhile, trust in technology is influenced by perceived reputation, telemedicine quality, and familiarity. Furthermore, trust in doctor and trust in technology have a positive effect on trust in telemedicine services but do not directly affect continuance intention. In addition, satisfaction and perceived usefulness have a direct positive effect on continuance intention."