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"Latar BelakangGangguan kepribadian ambang (GKA) berhubungan dengan masalah interpersonal, ketidakstabilan emosi, masalah citra diri, dan impulsif dengan risiko tinggi perilaku bunuh diri. Saat ini, masih kekurangan data prevalensi GKA di Indonesia. Oleh karena itu, penelitian ini akan memberikan data pasien GKA di RSCM dan mengevaluasi kepatuhan penatalaksanaan GKA terhadap Panduan Praktik Klinis (PPK).MetodePenelitian ini akan berbentuk studi deskriptif retrospektif potong-lintang dan dilakukan menggunakan data sekunder berupa rekam medis yang didapat dari klinik psikiatri pasien dewasa RSCM. Evaluasi akan ditinjau dengan menggunakan formulir kepatuhan PPK yang dikembangkan oleh RSCM dan dianalisis secara kuantitatif dan kualitatif.HasilSebagian besar pasien GKA yang dirawat di rumah sakit berada dalam kelompok usia 18 hingga 29 tahun, yaitu 88,9% dari total sampel. Sebagian besar pasien GKA yang dirawat di RSCM adalah perempuan sebanyak 91,7% (33 dari 36) pasien. Sebagian besar pasien memiliki gangguan bipolar (69,4%) sebagai diagnosis Axis 1, atau gangguan depresi (27,8%). Sebanyak 94,5% pasien mendapatkan antipsikotik atipikal. Semua pasien (100%) dalam penelitian ini menunjukkan ketaatan yang lengkap terhadap parameter struktural dan proses, yaitu mengikuti lebih dari 80% aspek yang diuraikan dalam PPK. Namun, hanya 24 pasien (66,7%) yang memenuhi kriteria respons yang baik, termasuk skor risiko bunuh diri rendah dan tidak terjadi insiden.KesimpulanSebagian besar pasien GKA yang dirawat di RSCM adalah perempuan dewasa muda. Terdapat tingkat kepatuhan tinggi terhadap PPK pada pasien GKA rawat inap RSCM.

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Introduction

Borderline personality disorder (BPD) is associated with interpersonal problems, emotional instability, self-image issues, and impulsivity with a high risk of suicidal behavior. There are no BPD prevalence data in Indonesia. Therefore, this research will provide data of BPD patients in RSCM and evaluate the adherence of the managements according to Clinical Practice Guideline (CPG).

Method

This will be a cross-sectional retrospective descriptive study and conducted using secondary data from database of department of psychiatry in RSCM. The evaluation will utilize the CPG’s adherence form and analyzed in quantitative and qualitative methods. Result

The majority of hospitalized BPD patients were in the age group of 18 to 29 years around 88.9% of the total sample. The population of hospitalized BPD patients mostly are females that accounts for 91.7% (33 of 36) of the patients. There are patients diagnosed with bipolar disorder (69.4%) and depressive disorder (27.8%). Most of BPD patients (94.5%) were administered atypical antipsychotics. All 36 patients (100%) in the study shows complete adherence to the structural and process parameters by following more than 80% of the aspects in the CPG. Despite the high level of adherence to the CPG, only 24 patients (66.7%) fulfilled good outcome criteria, including low suicide risk score and no incident.

Conclusion

Most of hospitalized BPD patients were young females. High level of adherence to the CPG was observed among hospitalized BPD patients in RSCM. Further study should identify the risk factors associated with poor treatment response."

"Latar BelakangSkizofrenia merupakan salah satu gangguan mental paling berat yang menimbulkan resiko jangka panjang. Tatalaksana yang komprehensif dikembangkan dalam panduan praktik klinis (PPK) yang ditetapkan oleh berbagai institusi, termasuk RSUPN Dr. Cipto Mangunkusumo. Namun, melihat rendahnya angka remisi, implementasi PPK di RSCM patut dipertanyakan. Penelitian ini akan mengevaluasi kesesuaian pelayanan berdasarkan PPK dalam pengobatan orang dengan skizofrenia (ODS) di RSCM.MetodeStudi ini akan dilakukan dengan metode cross-sectional, observasional retrospektif menggunakan data sekunder dari rekam medis ODS di bangsal psikiatri dewasa di RSCM. Data tersebut akan diintegrasikan ke dalam formulir penilaian kesesuaian pelayanan berdasarkan PPK dan dianalisis dengan mixed method.HasilTerdapat 52 (20.16%) ODS dirawat inap dari 258 pasien di bangsal jiwa dewasa RSCM di 2022. Dari 38 subjek, 23 (60.5%) pasien berada di kisaran umur 18-29, 29 (76.3%) adalah laki-laki, 33 (86.8%) belum menikah, 38 (100%) menggunakan BPJS/JKN untuk pembiayaan, 24 (63.2%) komorbid dengan kelainan dari axis III, 28 (73.7%) tidak patuh dengan pengobatan, dan 2 (5.3%) mengalami readmisi dalam 30 hari setelah pulang dari perawatan. Setelah mengevaluasi kepatuhan manajemen terhadap PPK, ditemukan 37 (97.4%) memiliki ketaatan penuh, sedangkan 1 (2.6%) ketaatan parsial. Namun, di antara 37 yang taat penuh, hanya 30 (81,1%) yang mencapai ketiga kriteria target luaran. KesimpulanPelayanan skizofrenia di bangsal jiwa dewasa RSCM memiliki ketaatan kepada PPK dengan baik, di mana hampir semua pasien ditangani dengan kepatuhan penuh.

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Introduction

Schizophrenia is amongst the most severe mental disorders which poses a long-term up to a lifetime risk. Comprehensive management strategies were established in clinical practice guidelines (CPG) by institutions, including RSUPN Dr. Cipto Mangunkusumo. However, with the low rate of remissions, the implementation of CPG in RSCM is questioned. This research will evaluate the guideline adherence in the management for people with schizophrenia (PWS) in RSCM.

Method

An observational, retrospective cross-sectional study will be conducted using the secondary data from medical records of PWS in the adult psychiatric units in RSCM. The data will be integrated into an evaluation form of guideline adherence and analysed in mixed methods.

Result

There are 52 (20.16%) hospitalised PWS out of 258 patients in the RSCM adult psychiatric unit in 2022. Out of 38 subjects, 23 (60.5%) patients were in the age range of 18-29, 29 (76.3%) were males, 33 (86.8%) were not married, 38 (100%) were aided by BPJS/JKN for their hospitalisation fee, 24 (63.2%) had comorbidities from axis III, 28 (73.7%) were not compliant to medication, and 2 (5.3%) experienced readmission within 30 days after discharge. After evaluating the adherence of their management to CPG, we found 37 (97.4%) were in full adherence, while 1 (2.6%) is partially adherence. However, among the 37 that were in full adherence, only 30 (81.1%) achieved all three criteria of the target outcome.

Conclusion

The schizophrenia management in the RSCM adult psychiatric unit was in good adherence to the CPG, wherein almost all patients were managed in full adherence."

"Latar BelakangSkizofrenia merupakan salah satu gangguan mental paling berat yang menimbulkan resiko jangka panjang. Tatalaksana yang komprehensif dikembangkan dalam panduan praktik klinis (PPK) yang ditetapkan oleh berbagai institusi, termasuk RSUPN Dr. Cipto Mangunkusumo. Namun, melihat rendahnya angka remisi, implementasi PPK di RSCM patut dipertanyakan. Penelitian ini akan mengevaluasi kesesuaian pelayanan berdasarkan PPK dalam pengobatan orang dengan skizofrenia (ODS) di RSCM.MetodeStudi ini akan dilakukan dengan metode cross-sectional, observasional retrospektif menggunakan data sekunder dari rekam medis ODS di bangsal psikiatri dewasa di RSCM. Data tersebut akan diintegrasikan ke dalam formulir penilaian kesesuaian pelayanan berdasarkan PPK dan dianalisis dengan mixed method.HasilTerdapat 52 (20.16%) ODS dirawat inap dari 258 pasien di bangsal jiwa dewasa RSCM di 2022. Dari 38 subjek, 23 (60.5%) pasien berada di kisaran umur 18-29, 29 (76.3%) adalah laki-laki, 33 (86.8%) belum menikah, 38 (100%) menggunakan BPJS/JKN untuk pembiayaan, 24 (63.2%) komorbid dengan kelainan dari axis III, 28 (73.7%) tidak patuh dengan pengobatan, dan 2 (5.3%) mengalami readmisi dalam 30 hari setelah pulang dari perawatan. Setelah mengevaluasi kepatuhan manajemen terhadap PPK, ditemukan 37 (97.4%) memiliki ketaatan penuh, sedangkan 1 (2.6%) ketaatan parsial. Namun, di antara 37 yang taat penuh, hanya 30 (81,1%) yang mencapai ketiga kriteria target luaran. KesimpulanPelayanan skizofrenia di bangsal jiwa dewasa RSCM memiliki ketaatan kepada PPK dengan baik, di mana hampir semua pasien ditangani dengan kepatuhan penuh.

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Introduction

Schizophrenia is amongst the most severe mental disorders which poses a long-term up to a lifetime risk. Comprehensive management strategies were established in clinical practice guidelines (CPG) by institutions, including RSUPN Dr. Cipto Mangunkusumo. However, with the low rate of remissions, the implementation of CPG in RSCM is questioned. This research will evaluate the guideline adherence in the management for people with schizophrenia (PWS) in RSCM.

Method

An observational, retrospective cross-sectional study will be conducted using the secondary data from medical records of PWS in the adult psychiatric units in RSCM. The data will be integrated into an evaluation form of guideline adherence and analysed in mixed methods.

Result

There are 52 (20.16%) hospitalised PWS out of 258 patients in the RSCM adult psychiatric unit in 2022. Out of 38 subjects, 23 (60.5%) patients were in the age range of 18-29, 29 (76.3%) were males, 33 (86.8%) were not married, 38 (100%) were aided by BPJS/JKN for their hospitalisation fee, 24 (63.2%) had comorbidities from axis III, 28 (73.7%) were not compliant to medication, and 2 (5.3%) experienced readmission within 30 days after discharge. After evaluating the adherence of their management to CPG, we found 37 (97.4%) were in full adherence, while 1 (2.6%) is partially adherence. However, among the 37 that were in full adherence, only 30 (81.1%) achieved all three criteria of the target outcome.

Conclusion

The schizophrenia management in the RSCM adult psychiatric unit was in good adherence to the CPG, wherein almost all patients were managed in full adherence."

"Latar BelakangSistitis akut non komplikata (SANK) adalah kondisi urologis tersering pada perempuan dan umumnya dikelola oleh dokter umum. Meskipun Panduan Tatalaksana Infeksi Saluran kemih dari Ikatan Ahli Urologi Indonesia (IAUI) telah tersedia, terdapat variasi dalam praktik klinis sehari-hari. Penelitian ini bertujuan untuk mengevaluasi kesesuaian antara manajemen dan panduan tatalaksana SANK oleh dokter umum di Indonesia. MetodePenelitian ini merupakan studi observasional potong lintang yang dilakukan dari November 2023 hingga April 2024 melalui survei daring kepada dokter umum di Indonesia. Survei ini mengevaluasi demografi dokter dan pasien, modalitas diagnostik, serta tatalaksana SANK. Data dari 385 dokter umum dianalisis menggunakan statistik deskriptif.HasilSebagian besar dokter umum melakukan anamnesis (98,7%) dan pemeriksaan fisik (92,4%) untuk diagnosis. Gejala tersering yang dilaporkan adalah disuria (75,8%) dan nyeri suprapubik (72,1%). Urinalisis sering digunakan (82,8%), sementara dipstik urin (9,6%) dan kultur urin (7%) jarang diterapkan. Sebanyak 96,6% dokter umum meresepkan antibiotik, dengan ciprofloxacin sebagai pilihan paling umum (77,6%). Penggunaan antibiotik lini pertama yang dianjurkan IAUI seperti nitrofurantoin dan fosfomisin trometamol sangat rendah, diresepkan oleh kurang dari 2% dokter. Selain itu, 59,5% dokter umum meresepkan pengobatan non-antibiotik, dengan analgesik sebagai yang tersering (68,5%).KesimpulanPenelitian ini menunjukkan beberapa kesesuaian antara manajemen SANK oleh dokter umum dengan panduan tatalaksana IAUI, namun masih terdapat ketidaksesuaian dalam pemilihan antibiotik lini pertama. Oleh karena itu, dibutuhkan optimalisasi penyediaan fasilitas dan obat untuk SANK yang dicakup oleh Jaminan Kesehatan Nasional dan sosialisasi panduan di tingkat layanan primer.

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Introduction

Acute uncomplicated cystitis (AUC), a prevalent urological condition among women, is predominantly managed by general practitioners (GPs). Despite clinical guidelines provided by Indonesian Urology Association (IUA), variations in management practices persist. This study aims to evaluate the concordance between management approaches and guideline employed by GPs in Indonesia for AUC.

Method

A cross-sectional observational study was conducted from November 2023 to April 2024 through an online survey targeting GPs across Indonesia. The survey assessed GP and patient demographics, diagnostic practices, and management pattern. Data from 385 GPs were analyzed using descriptive statistics.

Results

Most general practitioners performed anamnesis (98.7%) and physical examinations (92.4%) for diagnosis. The most frequently reported symptoms were dysuria (75.8%) and suprapubic pain (72.1%). Urinalysis was commonly used (82.8%), while urine dipstick (9.6%) and urine culture (7%) were less frequently applied as additional tests. Antibiotics were prescribed by 96.6% of general practitioners, with ciprofloxacin being the most common choice (77.6%). The use of first-line antibiotics recommended by the IAUI guidelines, such as nitrofurantoin and fosfomycin trometamol, was very low, prescribed by less than 2% of practitioners. Additionally, 59.5% of general practitioners prescribed non-antibiotic treatments, with analgesics being the most common (68.5%).

Conclusion

The findings of this study reveal that while several aspects of AUC management by GPs are already in accordance with IUA guidelines, discrepancies remain, particularly in the selection of first-line antibiotics for AUC treatment. Therefore, it is necessary to optimize the provision of facilities and drugs for SANK covered by the National Health Insurance and socialize the guidelines at the primary care level."