ABSTRAKPengetahuan dan kepatuhan pengobatan yang rendah menjadi salah satu faktor yang berperan dalam tidak terkontrolnya hipertensi. Penelitian ini bertujuan untuk mengetahui pengaruh home pharmacy care terhadap tingkat pengetahuan, kepatuhan, outcome klinik, dan kualitas hidup pasien hipertensi peserta Prolanis. Rancangan penelitian menggunakan kuasi ekperimental, dengan desain penelitian pretes-postes with control group. Bentuk home pharmacy care berupa edukasi dan konseling dengan alat bantu leaflet yang melibatkan pasien hipertensi peserta prolanis di Puskesmas Klaten yang masuk kriteria inklusi dan eksklusi. Instrumen yang digunakan adalah kuesioner HK-LS, ASRQ dan kuesioner SF-36. Untuk menganalisis antar variabel digunakan uji Mann-Withney. Dari total 78 responden terbagi menjadi 39 kelompok kontrol dan 39 kelompok intervensi. Setelah dilakukan Intervensi home pharmacy care menunjukan bahwa kelompok intervensi memiliki nilai yang lebih baik dibandingkan dengan kelompok kontrol. Pada kelompok intervensi menunjukan ada peningkatan pengetahuan pasien dengan Δ3,2 dan (p=0,000), terjadi peningkatan kepatuhan dengan Δ-0,72 dan (p=0,000), terjadi penurunan tekanan darah sistolik dengan Δ-11,69 (p=0,000) dan Δ diastolik -7,56 dan (p=0,000) dan kualitas hidup pasien meningkat dengan nilai Δ2,17 nilai (p=0,001). Intervensi home pharmacy care memperbaiki semua aspek variabel yang diteliti dalam penelitian ini. ABSTRACTKnowledge and low compliance of medication become one factor that plays a role in uncontrolled hypertension. This study aimed to determine the effect of home pharmacy care on the level of knowledge, compliance, clinical outcome, and life quality of hypertension patients of Chronic Disease Management Programme (Prolanis) participants. The design of the study used quasiexperimental, with research design pretest and posttest with the control group. The form of home pharmacy care is education and counseling with assistive leaflet devices involving hypertensive patients of Prolanis in the Klaten Primary Health Care, who entered the inclusion and exclusion criteria. The instruments that used were the HK-LS questionnaire, ASRQ, and SF-36 questionnaire. To analyze between variables used the Mann-Withney test. Of the total, 78 respondents divided into 39 control groups and 39 intervention groups. After the intervention of home pharmacy care shows that the intervention group has a better value than the control group. In the intervention group, there was an increase in the knowledge of patients with Δ3.2 (p=0,000), an increase in adherence to Δ-0.72 (p=0,000), a decrease in systolic blood pressure with Δ -11.69 (p=0,000) and Δ diastolic -7.56 (p=0,000) and the patient's quality of life increased by Δ2,17 (p=0,001). Home pharmacy care interventions improve all aspects of the variables examined in this study.

Background The determinants of medication adherence in people with diabetes may differ between populations of an area due to social environment, cultural beliefs, socioeconomic conditions, education, and many other factors differences. Objective Therefore, this study aims to explore, identify and classify the determinants of medication adherence in several Asian regions. Methods A systematic literature review was conducted to gain insight into the determinants of medication adherence. Seven relevant databases (EBSCO, ProQuest, PubMed, ScienceDirect, Scopus, Wiley, dan Taylor and Francis) and hand searching methods were conducted from January 2011 to December 2020. Keywords were compiled based on the PICO method. The selection process used the PRISMA guidelines based on inclusion, and the quality was assessed using Crowe’s critical assessment tool. Textual summaries and a conceptual framework model of medication adherence were proposed to aid in the understanding of the factors influencing medication adherence. Results Twenty-six articles from countries in several Asian regions were further analyzed. Most studies on type 2 diabetes patients in India used the MMAS-8 scale, and cross-sectional study is the most frequently used research design. The medication adherence rate among diabetic patients was low to moderate. Fifty-one specific factors identified were further categorized into twenty-three subdomains and six domains. Furthermore, the determinants were classified into four categories: inconsistent factors, positively related factors, negatively related factors, and non-associated factors. In most studies, patient-related factors dominate the association with medication adherence. This domain relates to patient-specific demographics, physiological feelings, knowledge, perceptions and beliefs, comorbidities, and other factors related to the patient. Several limitations in this review need to be considered for further research. Conclusion Medication adherence to diabetic therapy is a complex phenomenon. Most determinants produced disparate findings in terms of statistical significance. The identified factors can serve various goals related to medication adherence. Policymakers and health care providers should consider patient-related factors.

Diabetes mellitus is a chronic metabolic disorder that is characterized by hyperglycemia. Diabetes mellitus need appropriate therapeutic management, because it can cause complications. On of the services that can do to improve diabetes control is Medication Therapy Management (MTM). MTM is a new service that will help pharmacist to improve patient adherence and quality of life. This study aims to determine the effect of based services MTM on treatment adherence and quality of life in patients with diabetes mellitus. This study was an experimental study using a quasi-experimental with one group pretest and posttest design which was conducted in Tegalrejo, Jetis and Gedontengen Health Center Yogyakarta City. Variables measured were medication adherence using the Morisky-Green Levine Medication Adherence Scale (MGLS) questionnaire and quality of life using Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ) before and after MTM services. The effect of MTM on medication adherence was analyzed using Wilcoxon test and the effect of MTM on quality of life using Paired T-Test. The patients participate in this study were 20 people, with average score of adherences before application of MTM was 2.20±0.410 to 1.80±0.616 after the application of MTM (P=0.005) and the average of the patient's quality of life was 73.82±7.918, increased to 76.42±5,623 after MTM service (P=0.033). Statistically mean, there is a difference in adherence and quality of life before and after MTM services. Therefore, it can be concluded that MTM-based services performed by pharmacists have a significant effect on improving medication adherence and quality of life for DM patients. Moreover, it can facilitate monitoring patient therapy, and identification of problems related to the treatment.

Cost analysis of chronic diseases in health care facilities during JKN is needed as quality and cost control. Stroke is a high cost, volume, and risk, catastrophic disease that can cause an increase in medical expenses, which requires special attention. The purpose of this study is to provide an overview of real costs and cost components, providing an overview of the direct medical costs and tariff packages of INA-CBGs based on the type of stroke, and the factors that affect direct medical costs. This study is a descriptive-analytic observational study according to the hospital perspective. Data was taken retrospectively. The subjects of the study were adult JKN patients who were aged ≥18 years old with a stroke diagnosis that entered the inclusion criteria. The research variables included age, gender, type of stroke, comorbidity, hospitalization class, length of stay (LOS), and real costs. Data analysis used univariate, bivariate and multivariate analysis. The research results obtained total real costs of Rp. 1,525,236,503 with an average cost of Rp. 4,872,960, the largest cost component was the cost of drugs and BMHP Rp. 402,248,555 (27.21%). The real cost of hemorrhagic strokes is Rp. 572,969,865 and the INA-CBGs tariff package is Rp. 483,804,000, the real cost of ischemic stroke is Rp. 1,107,055,700. There were significant differences in real cost from class factors and length of stay (p-value <0.005). The concluded that the INA-CBGs tariff package is insufficient to finance hospitalized patients with hemorrhagic strokes (-Rp89.165,865), but sufficient for ischemic stroke (+Rp.154,789,069).

ABSTRAKHipertensi hingga kini masih menjadi masalah kesehatan di dunia. Terapi yang diberikan kepada pasien hipertensi biasanya dilakukan dalam jangka panjang. Pengobatan hipertensi yang dilakukan sesuai dengan kondisi pasien. Penelitian ini bertujuan untuk mengetahui gambaran pola penggunaan obat antihipertensi pada pasien rawat inap di RSUD Panembahan Senopati. Penelitian dirancang dengan metode deskriptif crosssectional. Subyek penelitian ialah pasien hipertensi rawat inap yang memenuhi kriteria inklusi. Objek pada penelitian ini adalah rekam medis pasien rawat inap hipertensi periode bulan Oktober 2016- Juli 2017. Hasil penelitian menunjukkan bahwa dari 53 pasien yang memenuhi kriteria inklusi, sebanyak 38 pasein (71,8 %) menjalani pengobatan antihipertensi secara politerapi, sedangkan hanya 15 pasien (28,2 %) menjalani pengobatan monoterapi. Pengobatan monoterapi yang paling banyak dipakai golongan diuretik yaitu Furosemid sebanyak 6 pasien (11,3%), sedangkan penggunakan obat politerapi yang paling banyak dipakai yaitu Valsatan+ Amlodipin sebanyak 13 pasien ( 24,5%). Secara keseluruhan, golongan obat yang paling banyak digunakan adalah golongan Calcium Chanel Blocker dengan jenis terbanyak adalah Amlodipin, dilanjutkan golongan Diuretik yaitu Furosemid, dan golongan ARB yaitu Valsartan. Penelitian ini disimpulkan bahwa penggunaan obat sebagian besar politerapi dan secara umum penggunaan obat antihipertensi yang dipakai terdiri dari 6 golongan obat yaitu diuretik, ACE inhibitor, Angiotensin Receptor Blocker, ẞ- blocker. Kata kunci: Pola Penggunaan Obat; Antihipertensi; Rawat Inap. ABSTRACTHypertension is a health problem in the world. Therapy given to hypertensive patients is usually done in the long run. Hypertension treatment is carried out according to the patient's condition. This study aims to determine the pattern of the use of antihypertensive drugs in inpatients at Panembahan Senopati Hospital. The study was designed using descriptive cross sectional method. The subjects of the study were hypertensive inpatients who met the inclusion criteria. The object of this study was the medical record of hypertensive inpatients for the period October 2016-July 2017. The results showed that of 53 patients, 38 patients (71.8%) used antihypertensive treatment by polytherapy, whereas only 15 patients (28.2%) used monotherapy treatment. The most used monotherapy treatment of diuretics is Furosemide with 6 patients (11.3%), while the most used polytherapy drugs are Valsatan + Amlodipin with 13 patients (24.5%). Overall, the most used group of drugs is the Calcium Chanel Blocker with the most types, Amlodipine, followed by the Diuretic group, Furosemide, and the ARB group, Valsartan. This study concluded that the use of drugs is mostly polytherapy and in general the use of antihypertensive drugs used consists of 6 classes of drugs namely diuretics, ACE inhibitors, Angiotensin Receptor Blockers, ẞ-blockers. Keywords: Drug Use Patterns; Anti-hypertension; Inpatient.