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Abstrak :
Penelitian ini bertujuan membandingkan profil penggunaan obat khususnya jumlah jenis obat, jenis obat, dan biaya obat antara pasien yang dikelola secara terpadu dan yang dikelola secara konvensional. Penelitian dilakukan di ruang rawat penyakit dalam Instalasi Rawat Inap (IRNA) B RS Dr. Cipto Mangunkusumo. Hasil penelitian menunjukkan bahwa jumlah jenis obat yang dikelola secara terpadu sebanyak 9 obat, sedangkan yang dikelola secara konvensional sebanyak 11 obat. Jenis obat yang banyak digunakan pada kedua kelompok adalah golongan antibakteri untuk penggunaan sistemik. Biaya obat yang dikelola secara terpadu adalah Rp 1.925.787, sedangkan yang dikelola secara konvensional adalah Rp 4.727.477. Uji statistik Mann-Whitney menunjukkan ada perbedaan bermakna antara jumlah jenis obat dan biaya obat antara kedua kelompok. Sedangkan jenis obat tidak ada perbedaan secara bermakna antara kedua kelompok. The study purposes were to compare the drug usage, in term of the number of drugs, type, and cost of drugs between the patients managed by interdisciplinary team and managed conventionally. This study was conducted at internal medicine ward of IRNA B of Cipto Mangunkusumo Hospital. The number of drugs managed by interdisciplinary team were 9 drugs, whereas those are managed conventionally were 11 drugs. The most commonly used in both groups was systemic antibacterial drug. The cost of drugs in group of interdisciplinary team was Rp 1,925,787, whereas in group of conventional team was Rp 4,727,477. Mann-Whitney statistics test showed a significant difference of the number of drugs and the cost of drugs between the two groups. Whereas it was not significantly different in type of drug between the two groups.

Abstrak :
Resistensi bakteri terhadap antibakteri merupakan salah satu penyebab mengapa penggunaannya harus dievaluasi. Penelitian ini bertujuan untuk mengetahui apakah ada perbedaan yang bermakna dalam peresepan antibakteri yang bakterinya sudah resisten antara sebelum dan sesudah pemberian informasi pola kepekaan kuman ditinjau dari tingkat konsumsi. Penelitian dilakukan dengan metode deskriptif analitis dan pengumpulan data secara retrospektif terhadap data penggunaan antibakteri periode Januari-Maret 2006 (sebelum informasi) dan April-Juni 2006 (sesudah informasi). Hasil penelitian menunjukkan terjadinya penurunan tingkat konsumsi antibakteri yang bakterinya sudah resisten yang dihitung dalam persentase DDD dari 64,2% sebelum informasi menjadi 60,5% sesudah informasi. Uji statistik menunjukkan bahwa ada penurunan persentase DDD secara bermakna setelah pemberian informasi pola kepekaan kuman. ......Antibacterial resistance is one of the reasons why the use of antibacterial agents must be evaluated. The objective of this study was to examine whether there was change of antibacterial usage after dissemination of information on sensitivity pattern based on consumption rate. The method of this study was descriptive analytical. Data were collected from antibacterial usage records over period of January-March 2006 (before dissemination of information) and April-June 2006 (after dissemination of information). The result of the study showed that there was a statistically significant decline in the usage of antibacterial that the bacteria already resistant in DDD percentage from 64,2% before dissemination of information to 60,5% after dissemination of information.

Abstrak :
Surgical site infections are the second most frequent nosocomial infection after catheter infection. They are associated with increase morbidity and mortality, iength of stay in hospital and cost of care. Antibiotic prophylaxis use is addressed to reduce incidence of surgical site infection. The aim of this research was to find out the pattern of antibiotic prophylaxis use; incidence of surgical site infection; association between antibiotic prophylaxis use and incidence of surgical site infection; and other factors that influence the incidence of surgical site infection. This research was carried out in Dr. Cipto Mangunkusumo Hospital Jakarta and it was a retrospective study with cross-sectional design. A total of 220 samples had been taken proportional randomly according to the type of surgery division from 1,841 medical records in 2005. The result showed that the most antibiotic prophylaxis frequently used was cephalosporin (first and third generation). followed by phosphomycin and metronidazole. Most of the patients were given antibiotic prophylaxis in inappropriate time and the duration of use was more than one day. This study found that the incidence of surgical site infection was 8.6% with the highest percentage occurred at orthopedic surgery (23.3%). Statistically, there was no relationship of class. Timing and duration of antibiotic prophylaxis use with incidence of surgical site infection. Adherence of antibiotic prophylaxis use to hospital guideline was not influenced the incidence of surgical site infection. Multivariate analysis with logistic regression analysis showed that the incidence of surgical site infection were influenced by the type of surgery (OR=2.6) and the use of antibiotics during hospitalization prior to surgery (OR=3.2). The conclusion of this research were the incidence of surgical site infection relatively high and class. timing, duration and adherence to hospital guideline of antibiotic prophylaxis use did not influence it. The wound contaminated and the use antibiotics during hospitalization prior to surgery were risk factors for surgical site infection. It was recommended that the hospital management revise the currently used surgical antibiotic prophylaxis guideline which is no longer relevant to the current situation.

Abstrak :
Hipertensi dan diabetes melitus menjadi salah satu faktor risiko kejadian kardiovaskuler. Tidak terkontrolnya hipertensi dapat menyebabkan perburukan kesehatan dan ekonomi pada penderitanya. Kombinasi terapi antihipertensi dinilai adekuat untuk mencapai target tekanan darah <140/90 mmHg. Obat antihipertensi golongan ACEI, ARB, dan CCB merupakan terapi yang sesuai untuk pasien dengan diabetes melitus tipe 2 dan harganya bervariasi. Penelitian sebelumnya menunjukkan bahwa golongan ARB lebih cost-effective dibandingkan yang lainnya. Tujuan penelitian ini adalah untuk menganalisis efektivitas biaya dari kombinasi terapi amlodipin-kandesartan dibandingkan dengan amlodipin-ramipril pada pasien hipertensi dengan diabetes melitus tipe 2. Penelitian cross-sectional ini dilakukan di RSUPN dr. Cipto mangunkusumo dengan menggunakan rekam medis pasien tahun 2017-2019. Subjek penelitian yang memenuhi kriteria inklusi sebanyak 87 pasien. Pasien dibagi menjadi dua kelompok: kelompok yang mendapat terapi amlodipin-kandesartan dan kelompok yang mendapat terapi amlodipin-ramipril. Analisis efektivitas biaya diperoleh dari perhitungan biaya medik langsung, menghitung efektivitas terapi berdasarkan jumlah pasien yang mencapai target tekanan darah <140/90 mmhg, serta menghitung nilai ACER. Kombinasi amlodipin-kandesartan memiliki efektivitas terapi 48.9%, sedangkan efektivitas terapi amlodipin-ramipril 45,2%. Nilai ACER kelompok amlodipin-kandesartan dan kelompok amlodipin-ramipril adalah Rp. 1.604.736,2 per efektivitas and Rp 1.811.278,8 per efektivitas. Dapat disimpulkan bahwa amlodipin-kandesartan lebih cost-effective dibandingkan amlodipin-ramipril.

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Hypertension and diabetes mellitus are risk factors for cardiovascular events. Uncontrolled hypertension can cause health and economic burdens in patients. The combination of antihypertensive therapy is considered adequate to achieve the targeted blood pressure <140/90 mmHg. Antihypertensive drugs class such as ACEIs, ARBs, and CCBs are appropriated therapies for patients with type 2 diabetes mellitus and the price differences. Previous studies have shown that the ARBs are more cost-effective than others. The aim of this study was to analyze the cost-effectiveness of combination of amlodipine-candesartan compared to amlodipine-ramipril in hypertensive patients with type 2 diabetes mellitus. This cross-sectional study was conducted at Dr. Cipto Mangunkusumo Hospital by using patient medical records in 2017-2019. Research subjects who met the inclusion criteria were 87 patients. Patients were divided into two groups: group receiving amlodipine-candesartan and group receiving amlodipine-ramipril. Cost effectiveness analysis obtained from the calculation of direct medical costs, calculated the effectiveness of therapy based on the number of patients who reached the target blood pressure <140/90 mmHg, and calculated the value of ACER. Amlodipine-candesartan has a therapeutic effectiveness of 48.9%, while the effectiveness of amlodipine-ramipril is 45.2%. The ACER value of the amlodipine-candesartan group and the amlodipine-ramipril group were Rp 1,604,736.2 per effectiveness and Rp 1,811,278.8per effectiveness. To conclude, amlodipine-candesartan is more cost-effective than amlodipine-ramipril.

Abstrak :
ABSTRAK
Diabetes mellitus (DM) tipe 2 diketahui sebagai salah satu masalah kesehatan yang memberikan beban ekonomi yang cukup besar pada sistem pelayanan kesehatan di seluruh dunia. Bervariasinya penggunaan terapi obat akan mengakibatkan adanya perbedaan dalam efektivitas dan biaya terapi, sehingga perlu dilakukan analisis efektivitas-biaya. Tujuan dari penelitian ini adalah menganalisis efektivitas-biaya terapi kombinasi metformin-insulin dan metformin-sulfonilurea pada pasien rawat jalan dengan DM tipe 2. Penelitian ini menggunakan desain studi kohort, pengambilan data dilakukan secara retrospektif di RSUPN Dr. Cipto Mangunkusumo menggunakan rekam medik pasien rawat jalan dengan DM tipe 2 dari tahun 2016-2019 dan data billing rumah sakit. Efektivitas terapi (∆HbA1c) dan biaya medis langsung antara kedua kelompok dibandingkan. ∆HbA1c antara kelompok metformin-insulin dan kelompok metformin-sulfonilurea tidak memiliki perbedaan yang bermakna secara statistik (rerata perbedaan 0,123%; p=0,608). Sedangkan median biaya medis langsung kelompok metformin-insulin lebih tinggi dibandingkan kelompok metformin-sulfonilurea (p < 0,001). Hasil analisis efektivitas-biaya menunjukkan bahwa terapi kombinasi metformin-sulfonilurea lebih cost-effective dibandingkan kombinasi metformin-insulin.

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ABSTRACT
Type 2 diabetes mellitus (DM) has been recognized as one of the health problems that imposes economic costs to health care systems around the world. Variation of drug therapy will result in differences in effectiveness and cost of therapy, thus cost-effectiveness analysis has been regarded paramount. The purpose of this study is to analyze the cost-effectiveness of metformin-insulin and metformin-sulfonylurea combination therapy in outpatients with type 2 DM. This cohort study was conducted retrospectively at RSUPN Dr. Cipto Mangunkusumo using medical records of outpatients with type 2 DM from 2016-2019 and hospital billing. The effectiveness of therapy (∆HbA1c) and direct medical costs between the two groups were compared. ∆HbA1c between the metformin-insulin group and the metformin-sulfonylurea group did not have statistically significant differences (mean difference 0,123%; p=0,608). While the median of direct medical costs of the metformin-insulin group was higher than metformin-sulfonylurea group (p < 0.001). The results of the cost-effectiveness analysis showed that the combination therapy of metformin-sulfonylurea was more cost-effective compared to the combination of metformin-insulin.

Abstrak :
Konseling pasien pulang yang dijalankan dengan fungsi pelayanan apoteker yang dijalankan di RSCM dapat menyebabkan perbedaan pengetahuan obat dan kepuasan pasien. Tujuan penelitian ini adalah untuk membandingkan pengetahuan obat dan kepuasan pasien setelah diberikan konseling pulang oleh apoteker dengan fungsi pelayanan yang berbeda. Metode penelitian yang dilakukan studi potong lintang (crosssectional study) menggunakan kuesioner yang telah diuji validitas dan reliabilitasnya. Subyek penelitian adalah pasien pulang rawat inap gedung A bagian penyakit dalam RSCM periode Februari – Maret 2020 sebanyak 60 responden. Data yang didapatkan dianalisis secara univariat dan bivariat menggunakan SPSS. Hasil penelitian menunjukkan tidak ada perbedaan pengetahuan obat dan kepuasan pasien secara signifikan pada statistik (p= 0,605, OR = 1,495; p= 1,000, OR = 2,071). Kesimpulan penelitian ini adalah tidak ada perbedaan pengetahuan obat dan kepuasan pasien setelah diberikan konseling oleh apoteker pelayanan yang berbeda. ......Discharge counseling carried out by different functions of the pharmacist services performed at RSCM could impact patient’s knowledge and satisfaction. This research aims are to compare patient’s knowledge and satisfaction after being given discharge counseling by both pharmacists with different service functions. The research method used was a cross-sectional study using a questionnaire that had been tested for validity and reliability. The research subjects were inpatient hospitalized that would be discharged in building A in the internal medicine section of the RSCM from February to March 2020 with total 60 respondents. The data obtained were analyzed by univariate and bivariate using SPSS. The results showed the differences of patient’s knowledge and pastient’s satisfaction is not statistically significant (p = 0,605 OR = 1,495; p = 1,000 OR = 2,071). The conclusion of this research is there was no differences in patient’s knowledge and satisfaction after being given discharge counseling by different pharmacist services.