BackgroundAsthma is a chronic disease that requires indefinite long-term therapy. Many approaches have been developed to enable people with asthma to live as normally as possible. In medication therapy management, pharmacists could play important roles in supporting the everyday life of asthmatic patients, such as by providing education therapy management to ensure that patients achieve optimal therapeutic outcomes. A good collaboration between health care practitioners and patients will produce a better system in terms of therapeutic management, which will lead to health care cost savings related to emergency visits. Although the Government has made various efforts to manage asthma in Indonesia, without commitment and support from both patients and health care professionals, the expected outcomes cannot be achieved.ObjectiveThis study aims to evaluate the effectiveness of an educational intervention provided by pharmacists compared with that of usual care.MethodsA randomized controlled trial comparing usual care with an education session by pharmacists is underway. The intervention comprises a one-on-one education session of 60 minutes with a pharmacist comprising information regarding (1) asthma medication that has been used; (2) how to use asthma medication devices correctly; (3) asthma symptoms and how to prevent exacerbation of asthma; and (4) how to manage asthma triggers and environmental control measures. The primary outcome measure is change in asthma control, as measured using the Asthma Control Questionnaire. Secondary outcomes include changes in Asthma Quality of Life Questionnaire score, lung function, asthma-related health visits, days off from work or study, and oral corticosteroid use. Research assistants who are masked to the group allocation will collect outcome data at the baseline and every month for a 3-month period. Informed consent will be sought at enrollment and intention-to-treat analysis will be performed.ResultsThis study was funded in January 2017 and ethical approval was obtained in June 2017. The enrollment was started in August 2017, and about 72 participants have been enrolled. First results are expected to be submitted for publication in 2019.ConclusionsThis is the first study to evaluate the effectiveness of a pharmacist-guided asthma education session compared with that of usual care in Indonesia. If it is proven effective, this intervention program could improve asthma self-management by patients, which may reduce risks of poorly controlled asthma. This intervention could also be implemented in addition to the current usual care for patients with asthma.Trial RegistrationThai Clinical Trials Registry TCTR20171219001; http://www.clinicaltrials.in.th/index.php? tp =regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=3068 (Archived by WebCite at http://www.webcitation.org/73Ci5eKtv)International Registered Report Identifier (IRRID)DERR1-10.2196/10210
Konsep cantik di masyarakat salah satunya memiliki kulit putih dengan cara menggunakan produk pemutih dan pencerah kulit. Namun terdapat sejumlah produk pemutih yang mengandung bahan berbahaya. Pemilihan produk pemutih harus diperhatikan dengan baik dan benar. Tujuan penelitian ini adalah untuk mengetahui pengetahuan dan penggunaan masyarakat mengenai produk pemutih dan pencerah, serta hubungan antara tingkat pendidikan dan pengetahuan masyarakat mengenai produk pemutih dan pencerah. Penelitian dilakukan pada bulan September 2019 menggunakan metode survei, rancangan studi cross sectional dengan teknik purposive random sampling. Responden dalam penelitian adalah wanita berusia 16–35 tahun (n=130). Dari hasil penelitian diperoleh bahwa produk pemutih dan pencerah yang paling banyak digunakan adalah produk komersil teregistrasi BPOM dengan persentase 69,2% (92 responden). Tingkat pendidikan pengguna produk pemutih dan pencerah tertinggi adalah tingkat sarjana dan pascasarjana yaitu dengan persentase 64,6% (84 responden). Rata-rata skor yang didapatkan dari 130 responden adalah 3,8. Sebanyak 87 responden (67%) memiliki skor di bawah 4,6 yang dikategorikan memiliki pengetahuan rendah mengenai produk pemutih dan pencerah. Uji korelasi Spearman menujukkan terdapat hubungan antara tingkat pendidikan dengan pengetahuan responden mengenai produk pemutih dan pencerah (p=0,016). Responden dalam penelitian memiliki tingkat pengetahuan rendah mengenai produk pemutih dan pencerah serta terdapat hubungan antara tingkat pendidikan dengan pengetahuan tentang produk pemutih dan pencerah.
Background The prevalence of diabetes mellitus continues to increase every year, including in Indonesia. To prevent complications of diabetes mellitus, patients need to adhere to therapy. The aim of this study was to assess patient adherence to diabetes mellitus drug therapy at Tanjung Karang Primary Health Care Center, Mataram. Methods A total of 60 participants were recruited in April–May 2019. The inclusion criteria of respondents were patients who were diagnosed with diabetes mellitus, treated at Tanjung Karang Primary Health Care Center for more than 1 month, and aged at least 18 years. Assessment of adherence to therapy was carried out using a validated questionnaire, which was the Adherence to Refill Medication Scale (ARMS) questionnaire. The scale used was the Likert scale (1–4) with a score range of 12–48. The higher the total score, the lower the compliance. Results The average age of the respondents was 54.97 years. The average ARMS score was 19.52 ± 5.688 with the lowest score of 12 and the highest score of 33. Among all respondents, only 8.3% had good adherence (total score of 12). Based on the subscales, the average score for refilling medicine and intentional nonadherence in taking medicine was 7.18 ± 2.383, the unintentional nonadherence in taking medicine was 8.13 ± 2.764, and the persistence in refilling medicine was 4.12 ± 1.738. Conclusions Patient medication adherence to the treatment of diabetes mellitus needs to be improved. An approach through healthcare professionals can be achieved so that the therapeutic outcome will be achieved.
Objectives Diabetes Mellitus (DM) is a group of insulin metabolism disorder that affects the socio-economic conditions of the community. The cost of treating diabetes in 2019 was USD 760 billion and by 2045 there are predicted to be 700 million people living with diabetes. The purpose of this systematic review was to provide an overview of the economic burden caused by Diabetes Mellitus for the government, health care providers, and for the community. Methods This systematic review was carried out by considering the related studies about the cost of illness, evaluation of disease costs, or therapeutic costs for various types of diabetes mellitus that were published in both English and Indonesian. The search engines PUBMED, DOAJ, SCOPUS, SCIENCE DIRECT, and GOOGLE SCHOLAR were used without date published restrictions. Results A systematic search identifies 18 eligible studies conducted in various regions in Indonesia. The study was retrospective with variation in their perspectives and methods to estimate the diabetes cost. Drug cost was the major contributor to direct medical cost followed by complications cost while other cost was affected by transportation cost, productivity losses, and time spent by family accompanying patients. Conclusions Diabetes mellitus creates a significant financial burden and affects the health care system as well as the individual and society as a whole. Research about the cost of diabetes in the future should be carried out on a large scale in order to get a more specific cost estimation.
Background: Drug sampling and testing in the context of post-marketing control is an important component to ensure drug safety in the supply chains. The results are used by the Indonesian National Agency for Drug and Food Control (NA-FDC) for conducting public warnings, evaluating the Good Manufacturing Practice (GMP) and Good Distribution Practice (GDP) implementation, and enforcing the law against drug violation.Objective: This study aimed to identify and analyze drug distribution patterns to provide an overview of drug sampling in the public sector. Methods: The data was collected from Balai Besar Pengawas Obat dan Makanan (BBPOM) Palangka Raya’s database. The collected data were the drug sampling data from Integrated Information Reporting Systems (IIRS) application from 2014 to 2018. Next, we employed CRISP-DM methodology to analyze the data and to identify the pattern. K-means clustering model was selected for data modeling.Results: The dataset contained five attributes, i.e., drug name, therapeutic classes, district/city, sample category, and evaluation of drug surveillance. The drug distribution pattern formed three clusters. First cluster contained 522 drug items in eight therapeutic classes and spread over ten districts, second cluster contained 1542 drug items in five therapeutic classes and spread over five districts, and third cluster contained 503 drug items in eleven therapeutic classes and spread across nine districts.Conclusion: To conclude, the applied data mining technique has improved the decision on the drug sampling planning. It also provides in-depth information on the improvement of drug post-marketing control performance in Central Kalimantan Province.Keywords: Clustering, CRISP-DM, Data Mining, Drug distribution patterns, Drug quality control, Drug sampling
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