ABSTRAKHipertensi merupakan faktor risiko utama terjadinya kematian akibat penyakit tidak menular di dunia. Dalam World Health Statistics tahun 2012, WHO melaporkan bahwa sekitar 51% dari kematian akibat stroke dan 45% dari penyakit jantung koroner disebabkan oleh hipertensi. Pasien dengan obsesitas, hipertensi, dan diabetes dapat memperburuk kualitas hidup pasien baik secara fisik dan status mental. Sehingga perlu dilakukan pengukuran untuk menilai kualitas hidup dengan European Quality of Life-5 Dimensions (EQ-5D) questioner. Penelitian ini bertujuan untuk mengetahui validitas dan reliabilitas EQ-5D versi Indonesia sebagai instrumen untuk mengukur kualitas hidup pasien hipertensi di Puskesmas Kotagede II Yogyakarta. Metode penelitian yang digunakan adalah observasional deskriptif. Pengambilan data dilakukan dengan menggunakan kuesioner yang dilakukan pada waktu tertentu. Instrumen yang digunakan dalam penelitian ini adalah EQ-5D yang sudah diterjemahkan ke dalam versi Indonesia. Populasi terjangkau dalam penelitian ini adalah semua pasien hipertensi di di Puskesmas Kotagede II Yogyakarta bulan Mei sampai Juni 2014. Sampel dalam penelitian adalah yang sesuai dengan kriteria inklusi dan kriteria eksklusi. Analisa terhadap validitas menggunakan validitas kontruk dengan metode pearson. Uji reliabilitas menggunakan metode Cronbach alpha coefficient. Analisa terhadap 51 pasien Hipertensi diperoleh hasil koefisien pearson korelasi diatas 0,30, sehingga dapat disimpulkan instrumen kuisioner EQ-5D versi Indonesia tersebut valid. Hasil Cornbach's α adalah 0.718 sehingga dapat disimpulkan instrumen kuisioner EQ-5D versi Indonesia tersebut reliable. Kata kunci: hipertensi, kualitas hidup EQ-5D kuisioner, validitas, reabilitas ABSTRACTHypertension is a major risk factor for the occurrence of deaths from non-communicable diseases in the world. In the World Health Statistics 2012, WHO reported that approximately 51% of deaths from stroke and 45% of coronary heart disease due to hypertension. Patients with obsesitas, hypertension, and diabetes can worsen patient's quality of life both physically and mental status. This study aims to assess the quality of life by the European Quality of Life-5 Dimensions (EQ-5D) questionnaire. This study aims to determine the validity and reliability of the EQ-5D in Indonesian version as an instrument for measuring the quality of life of patients with hypertension in the Health Center Kotagede II Yogyakarta. The method of this study was descriptive observational. Data were collected using a questionnaire conducted at a particular time. The instrument used in this study is the EQ-5D which has been translated into Indonesian. Affordable population in this study were all patients with hypertension in Health Center Kotagede II Yogyakarta at May to June 2014. The sample in this
Hypertension medication is taken for a long period and thus requires considerable costs. As antihypertensives vary in efficacy, research is needed to assess the cost effectiveness of medication, particularly between candesartan-amlodipine and candesartan-diltiazem combinations on hypertensive outpatients. This study applied a prospective cohort design with outcome observations for three months at a private hospital in Yogyakarta. The outcome used to gauge the cost effectiveness of medication was the achievement of the targeted blood pressure reduction after treatment. The cost effectiveness analysis was conducted through payer’s perspective, namely that of the social security agency (BPJS), with direct medical cost as the cost component measured. Cost effectiveness was analyzed using an average cost effectiveness ratio (ACER), calculated according to the ratio of cost to the outcome percentage of the blood pressure reduction target attainment, and an incremental cost effectiveness ratio (ICER) based on the ratio between differences in cost and outcome in both medication groups. The research subjects consisted of 33 patients, 24 of whom underwent medication with candesartan-amlodipine combination and 9 with candesartan-diltiazem. As many as 81.82% were female and 72.73% were within the age range of 51-70, while their most frequent complication was diabetes mellitus (48.48%). Results revealed the effectiveness of candesartan-amlodipine medication to be 58.33% with an ACER value of IDR 6,617, whereas that of candesartan-diltiazem was 22.22% with an ACER of IDR 29,733. The ICER value was IDR -7607, indicating that candesartan-amlodipine was categorically more cost-effective than candesartan-diltiazem.
Potensi interaksi obat adalah potensi aksi suatu obat diubah atau dipengaruhi oleh obat lain yang diberikan bersamaan. Interaksi obat didefinisikan sebagai fenomena yang terjadi ketika efek farmakodinamik dan farmakokinetik dari suatu obat berubah karena adanya pemberian obat yang lain. Interaksi obat dapat menyebabkan advers drug reaction apabila potensi terjadinya interaksi tersebut tidak diketahui sebelumnya upaya optimalisasi tidak dapat dilakukan. Tujuan penelitian ini adalah mengidentifikasi potensi interaksi obat pada pasien rawat inap penyakit
Hypertension and diabetes mellitus are the leading risk factors for cardiovascular diseases, which are increasing rapidly throughout the world. Hypertension is a non-communicable disease that remains a health problem in Indonesia, with a prevalence of up to 34.11% in 2018. This research was intended to identify cost-effective antihypertensive medication for inpatients with hypertension-diabetes mellitus and hypertensionheart failure. The research method used a retrospective cohort design and measured blood pressure (BP) 72 hours after treatment as the outcome of the observation. Based on a payer perspective, the medical expense was calculated from direct medical costs written in billing invoices. The research subjects were inpatients with hypertension-diabetes mellitus and hypertension-heart failure at a government hospital in Yogyakarta, Indonesia. In the cost-effectiveness analysis, Incremental Cost-Effectiveness Ratio (ICER) was calculated by dividing the difference in cost by the difference in the outcome of hypertension treatment.In the antihypertensive medication of hypertension-diabetes mellitus inpatients, angiotensin-receptor blockers/ calciumchannel blockers (ACB-CCB) were found to be more cost-effective than CCB with incremental costs of IDR 191,405/488,864 for every mmHg decrease of systolic/diastolic BP. Meanwhile, in the antihypertensive treatment of hypertension-heart failure inpatients, the combination of angiotensin-converting-enzyme inhibitors (ACEI) and diuretics was more cost-effective than ACEI-CCB (ICERs= IDR 8,303,483/-39,856,718 per mmHg) and ARB (ICERs= IDR 3,627,694/-2,380,075 per mmHg).In conclusion, ARB-CCB is a cost-effective medication for hypertension-diabetes mellitus inpatients, while ACEI-Diuretics offers a cost-effective hypertensive treatment for hypertension-heart failure inpatients.
Many factors can affect a person's quality of life, including therapy with antihypertensive drugs that often have uncomfortable side effects and lead to decreased quality of life. This study aimed to determine the statistical relationship between the characteristics and quality of life of hypertensive outpatients at a private hospital in Yogyakarta, Indonesia. This cross-sectional study used the EQ5D questionnaire to measure the quality of life of 56 respondents, who had met the inclusion criteria, after three months of antihypertensive therapy. The data were processed by scoring the questionnaire items and then converting the EQ5D dimensions to EQ5D Index based on the Malaysian value set. The data analysis also included descriptive statistics andchi-square test. The results showed that the quality of life, as represented by the EQ-5D index, ranged from 0.375 (lowest) to 0.933 (highest). The severe problems in the quality of life were identified in three dimensions, namely anxiety/ depression (7.14%), pain/discomfort (5.36%), and usual activities (3.57%). Meanwhile, difficulties were not found in the other two dimensions, namely self-care (89.29%) and mobility (55.36%). The results showed that the patients' characteristics, namely sex, age, employment, education, and complication, correlated with quality of life at different levels (p-values), i.e., 0.350, 0.418, 0.992, 0.726, and 0.099, respectively. As a conclusion, there is no significant relationship between patients' characteristics and quality of life (p-values> 0.05).
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