Type 2 diabetes is a chronic disease occurring in ever increasing numbers worldwide. It contributes significantly to the cost of health globally; however, its management remains in the most part less than optimal. Patients must be empowered to self-manage their disease, and they do this in partnership with health care professionals. Whilst the traditional role of the pharmacist has been centered around the supply of medicines and patient counseling, there is an evergrowing body of evidence that pharmacists, through a range of extended services, may contribute positively to the clinical and humanistic outcomes of those with diabetes. Further, these services can be delivered cost-effectively. This paper provides a review of the current evidence supporting the role of pharmacists in diabetes care, whilst providing a commentary of the future roles of pharmacists in this area.

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the author's institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. b s t r a c tBackground: The burgeoning health burden in Indonesia requires strengthening primary care services through interprofessional collaboration. Purpose: to explore factors contributing to interprofessional collaboration within health centres Indonesia. Methods: Eight focus group discussions involving a range of health professionals from health centres were conducted in four districts in East Java, Indonesia. Thematic analysis was used to generate findings. Results: Collaborative practices in Indonesian health centres are directly affected by health professional interactions (personnel level) e hierarchy and lack of role understanding have been reported as barriers to the interactions. These factors are in turn affected by health centre's environment (organisational level) and the Government legislation/policy (health system). The health centre's environment included organisation's culture, team management, physical space, as well as communication and coordination mechanisms. Conclusions: Factors contributing to collaborative practices in this setting were complex and intertwined. Structuring collective actions or strategies would be required to address the identified collaborative issues.

Background Diabetes is an emerging chronic disease in developing countries. Currently the management of diabetes in developing countries is mainly hospital or clinic based. With burgeoning numbers of patients with diabetes, other models need to be evaluated for service delivery in developing countries. Community pharmacists are an important option for provision of diabetes care. Currently, data regarding practices of community pharmacists in diabetes care have been limited to developed countries. Objectives To evaluate current community pharmacy-based services and perceived roles of pharmacists in type 2 diabetes care, and characteristics (pharmacist and pharmacy) associated with current practice. Setting Community pharmacies in a developing country setting (Surabaya, Indonesia). Methods A questionnaire was administered to pharmacists managing a random sample of 400 community pharmacies in Surabaya, Indonesia. Current practice and pharmacists' perceived roles were rated using Likert scales, whilst an open-ended question was used to identify priority roles. Logistic regression models determined characteristics associated with current practice. Results A response rate of 60 % was achieved. Dispensing (100 %) and education on how to use medications (72.6 %) were common current pharmacy practices. More than 50 % of pharmacists were supportive towards providing additional services beyond dispensing. The highest priorities for services beyond dispensing were education on medications [i.e. directions for use (58.6 %) and common/ important adverse effects (25.7 %)], education on exercise (36.5 %), education on diet (47.7 %), and monitoring medication compliance (27.9 %). Facilitators identified were: being perceived as part of a pharmacist's role (for all priority services), pharmacies with more than 50 diabetes customers per month (for diet education), and pharmacists' involvement in diabetes training (for compliance monitoring). The key barrier identified was lower pharmacist availability (for diet education as well as compliance monitoring). Conclusions Most community pharmacies in Surabaya, Indonesia have only provided a basic service of dispensing for type 2 diabetes patients. Many pharmacists believed that they should extend their roles particularly regarding patient education and monitoring. The development of pharmacist professional roles would assist in managing the burgeoning burden of diabetes. The identified facilitators/barriers provide baseline data to support the development of community pharmacy-based diabetes services.

Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities.

Kasus pneumonia yang disebabkan oleh severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) yang disebut coronavirus diseases 2019 (COVID-19) oleh World Health Organization (WHO) merupakan sebuah tragedi dalam dunia kesehatan secara global. Tata laksana yang tepat dan cepat diharapkan dapat menyelamatkan nyawa pasien. Sampai tulisan ini dibuat, belum terdapat satu jenis obat yang secara resmi diizinkan penggunaannya untuk terapi COVID-19. Kajian literatur ini bertujuan untuk 1) memaparkan tata laksana pengobatan dan 2) mendaftar serta menjelaskan alternatif obat yang dapat digunakan untuk SARS-CoV-2. Proses penelusuran artikel dalam kajian pustaka ini dilakukan pada sebuah database, yakni PubMed dengan kombinasi kata kunci (("corona virus") OR ("covid-19") OR ("SARS-CoV-2")) AND (("treatment") OR ("therapy")). Hasil kajian ini menunjukkan bahwa tata laksana pasien dengan COVID-19 dapat berbeda antar-setting dan negara dengan mempertimbangkan ketersediaan sumber daya, khususnya obat. Pedoman terapi WHO dan pedoman di Indonesia saat ini merekomendasikan supportive therapy untuk penanganan COVID-19, antara lain: terapi untuk gejala yang terjadi, pemberian oksigen, penggunaan antibiotik, terapi cairan, penggunaan vasopresor, dan tindakan medis (termasuk pemasangan ventilator) untuk menyelamatkan nyawa pasien. Belum terdapat obat khusus yang direkomendasikan untuk menekan replikasi SARS-CoV-2. Beberapa jenis obat yang potensial bermanfaat untuk SARS-CoV-2 antara lain: klorokuin atau hidroksiklorokuin, arbidol, ribavirin, favipiravir, lopinavir/ritonavir, remdesivir, oseltamivir, dan interferon. Namun sampai dengan tulisan ini dibuat, terdapat keterbatasan bukti penelitian dengan desain yang baik yang dapat digunakan untuk menarik kesimpulan terkait superioritas suatu jenis obat tertentu dibandingkan dengan alternatif yang lain. Dalam kondisi menunggu hasil penelitian dengan desain penelitian yang baik, penggunaan obat yang memiliki bukti efektivitas (walaupun belum baik) atau diduga efektif, perlu dioptimalkan untuk menyelamatkan nyawa pasien, khususnya mereka yang dalam kondisi parah.

Community-based training provides a potential strategy to improve community knowledge of medications. Findings from this study should inform strategies for a broader uptake amongst local communities in Indonesia.

ABSTRAK Diabetes Mellitus (DM) merupakan suatu kelompok penyakit metabolik dengan karakteristik hiperglikemia yang terjadi karena kelainan sekresi insulin , kerja insulin atau kedua-duanya. Semakin majunya teknologi dan ilmu pengetahuan pada dekade terakhir di bidang DM maka edukasi dianggap sebagai cara yang terpenting dalam perawatan pasien DM. Edukasi merupakan salah satu pilar pengelolaan DM yang bertujuan memberikan pengetahuan mengenai penyakit, pencegahan, penyulit dan penatalaksanaan diabetes kepada pasien dan keluarga. Farmasis merupakan salah satu tenaga kesehatan yang turut memiliki tanggung jawab dalam meningkatkan pengetahuan pasien terhadap pengobatan salah satunya melalui pemberian edukasi. Penelitian ini menggunakan One – Group Pre test-Post test Design. Penelitian ini bertujuan untuk mengetahui efektivitas edukasi dari perbedaan nilai pengetahuan dan glikemik kontrol sebelum dan sesudah pemberian edukasi pada pasien rawat jalan RS Anwar Medika dari Januari-Maret 2018 dengan sampel 117 pasien Pengukuran peningkatan skor pengetahuan diukur dengan kuesioner pengetahuan, glikemik kontrol diukur dengan penurunan nilai GDA. Analisis kuantitatif dilakukan dengan menggunakan uji Wilcoxon signed rank menunjukkan terdapat perbedaan nilai pengetahuan dan glikemik kontrol dengan signifikansi sebesar 0.000 (p<0,005) sehingga dalam hal ini edukasi dapat berperan penting dalam peningktan pengetahuan dan glikemik kontrol Kata kunci: Diabetes Mellitus, Edukasi, Pengetahuan, Glikemik kontrol, Pasien Rawat Jalan   ABSTRACT Diabetes mellitus (DM) is a group of metabolic diseases with characteristics of hyperglycemia that occur due to abnormal insulin secretion, insulin action or both. The more dvanced technology and science in the last decade in the field of DM, education is considered as the most important way in the care of DM patients. Education is one of the pillars of DM management which aims to provide knowledge about disease,prevention,complication and management of diabetes to patients and families. Pharmacist is one of the health workers who has responsibility in increasing the patient’s knowledge of treatment, one of which is through the provision of education. This research uses One – Group Pre Test Post Test Design. This study aims to determine the effectiveness of education from differences in the value of knowledge and glycemic control before and after giving education to outpatients in Anwar Medika Hospital from January to March 2018 with a sample of 117 patients. With a decrease in GDA value. Quantitative analysis carried out using the Wilcoxon signed rank test showed there were differences in the value of knowledge and glycemic control with a significance of 0.000 (p < 0.005) so that in this case education could play an important role in increasing knowledge and glycemic control. Keywords: Diabetes Mellitus, Education, Knowledge, Glycemic control, Outpatient

Background. Diabetes is an emerging chronic disease in developing countries. Its management in developing countries is mainly hospital/clinic based. The increasing diabetes burden in developing countries provides opportunities for community pharmacists to deliver a range of services. Since the management of diabetes requires the patient’s own involvement, it is important to gain their views in order to develop pharmacy-based diabetes services. Studies on diabetes patients’ views have been limited to developed countries.Objectives. To investigate, within a developing country setting (Indonesia), current use of pharmacy services by type 2 diabetes patients, and to evaluate their views regarding community pharmacists’ roles, and the characteristics that influence their views.Methods. A questionnaire survey was conducted within 10 purposefully selected community pharmacies in Surabaya, Indonesia. Each pharmacy recruited approximately 20 patients seeking antidiabetic medications. Usage of pharmacy services was identified using binary responses (‘yes’/‘no’) and views on pharmacists’ roles were rated using Likert scales; an open-ended question was used to identify patient perceived priority roles. Logistic regression models were used to determine characteristics associated with patients’ views.Results. A total of 196 pharmacy patients with type 2 diabetes responded (58.3% response rate). Most patients used community pharmacies for dispensing (100%) and education on how to use medications (79.6%). There were mixed views towards pharmacists providing services beyond dispensing. The highest priorities identified were from the ‘patient education’ domain: education on medications (i.e., directions for use (64.5%), storage (26.6%), common/important adverse effects (25.5%)); and the ‘monitoring’ domain: monitoring medication compliance (37.3%). Patients with higher incomes or who were working were less supportive of these expanded services, whereas patients who previously used a service, those with risk factors for complications or having poor/unknown glycaemic control were more supportive.Conclusions. Community pharmacies in Surabaya, Indonesia in this study were mainly utilised for dispensing. However, many type 2 diabetes patients using these pharmacies report limited monitoring of blood glucose levels and poor glycaemic control, which indicates an opportunity for greater pharmacist involvement. Yet for this to occur, patients’ limited expectations of pharmacists roles will need to be broadened. Characteristics influencing these views should inform the development of pharmacy-based diabetes services in the environment of the burgeoning burden of diabetes.