ADHERENCE TO SECONDARY STROKE PREVENTION THERAPIES IN ISCHEMIC STROKE PATIENTS AT TEACHING HOSPITAL IN CENTRAL JAVA INDONESIA

Objective: Patients who survive from the first stroke have risk factors to be recurrent. Based on American Heart Association/American Stroke Association and PERDOSSI (Indonesian Neurologist Association), medications which are prescribed to reduce the risk of recurrent stroke as secondary stroke prevention therapies include antiplatelet/anticoagulant as well as antihypertensive and lipid lowering agent. Patients' adherence to the secondary stroke prevention therapies is important to reduce the recurrent stroke. Methods: This is a quantitative research and the data was collected retrospectively. The number of subjects of this study were 165 respondents. The participants were interviewed by researchers about their adherence to secondary stroke prevention by Modified Morisky Adherence Scale 8 (MMAS-8) questionnaire. Patients' adherence was stated as low (MMAS-8 score < 6); moderate (MMAS-8 score = 6-7) and high (MMAS-8 = 8). This research was taken at a teaching hospital in Central Java Indonesia.Results: Of 165 participants, 48 participants (29%) were categorized to have low adherence, 43 participants (26%) had moderate adherence, and 74 participants (45%) had high adherence to secondary stroke prevention therapies. The reasons for not adhering to the medications were felt better (34.1%), forgetfulness (18.7%), boredom (16.5%), lack of family support (8.8%), lack of time (6.6%), felt worse (5.5%), concern about side effects (3.3%), preference to Complementary Alternative Medicines (3.3%), and cost (3.3%).Conclusion: The number of patients who has high adherence to secondary stroke prevention was 45% and the most common reason why participants did not adhere to therapy was because they felt better (34.1%).  Â

Evaluasi Penggunaan Antibiotik Pada Pasien Penyakit Paru Obstruktif Kronik Eksaserbasi Akut Di Instalasi Rawat Inap RSUD Dr. Moewardi Tahun 2016-2017

Chronic Obstructive Pulmonary Disease (COPD) is a disease with limited air flow that is not completely reversible while exacerbation is a condition of a disease worsening. By 2020 the WHO estimates COPD to be the top three most common cause of death. One treatment of acute exacerbation of COPD is using of antibiotics. The inappropriate use of antibiotics can lead to treatment failure and resistance. The purpose of this study was to evaluate the use of antibiotics in patients with acute exacerbation of COPD at Dr. Moewardi Hospital in 2016-2017 based on parameters proper indication, proper patient, proper drug and proper dosage. This study was a non-experimental descriptive research category, retrospectively retrieved data by viewing medical records of patients with acute exacerbation of COPD. Sampling using purposive sampling method and obtained as many as 30 samples. The inclusion criteria of this study were patients with acute exacerbation of COPD who received antibiotics from 2016-2017 with complete medical record data. The exclusion criteria of this study were the patient died and there were other infections. The most commonly used antibiotics were ceftriaxone (33.3%), levofloxacin (16.7%), ciprofloxacin (6.7%), and co-amoxiclav (6.7%). Results of the evaluation of antibiotic drug use in 30 patients with acute exacerbations of COPD at Dr. Moewardi Hospital 2016-2017 was 83.3% proper indication, 80,0 % proper patient, 53,3 % proper drug, and 33,3 % proper dosage

Evaluasi Penggunaan Antibiotik Pada Pasien Dewasa Dengan Penyakit Gonore Di RS "X" Periode Januari 2013-Juli 2016

Gonorrhea is a sexually transmitted disease caused by the bacterium Neisseria gonorrhoeae can be treated using antibiotics. However, the use of antibiotics freely and irrational can cause antibiotic resistance so as to increase morbidity and mortality of a disease. One effort that can be done to prevent the occurrence of antibiotic resistance is by evaluating the rationality of its use. This study aims to determine the rationality of antibiotic use are reviewed through the proper indications, the right patient, the right medication and the right dosage. This research is non-experimental research conducted ervational data medical records of adult patients with gonorrhea outpatient Dr. Moewardi Surakarta Hospital period January 2013 to July 2016. The sample used is purposive sampling and analyzed by descriptive non analytic to describe the actual antibiotic use in adult patients with gonorrhea outpatient Dr. Moewardi Surakarta Hospital period January 2013-July 2016 and compared to a standard Manual Handling Sexually Transmitted Infections 2011 MoH RI. The results of the 88 cases studied, the antibiotics used in cases of gonorrhea are cefixime (58%), azithromycin (46.6%), xycycline (36.4%), ofloxacin (21.6%), levofloxacin (6.8 %), ciprofloxacin (4.6%), metronidazole and sefditoren (2.3%), ceftriaxone and chloramphenicol (1.1%), there were 88 cases (100%) the proper indications and appropriate patients, 47 cases (53.4 %) the right medicine, 41 cases (46.6%) the right dose, and which fulfills the rationality of 46.6%

IMPACT OF ANTIMICROBIAL STEWARDSHIP PROGRAM ON THE USE OF ANTIBIOTICS IN PNEUMONIA PATIENTS AT TEACHING HOSPITAL IN SURAKARTA INDONESIA

Objective: Antibiotic resistance is a serious problem worldwide. One cause of antibacterial resistance is the inappropriate use of antibiotics. Thestudy of antibiotic use in hospitals found that 30–80% were not based on indications. Antimicrobial Stewardship Programs (ASP) was developed tocontrol antimicrobial resistance. This study aims to evaluate the impact of ASP in pneumonia patients qualitatively and quantitatively pre-post ASPapplied.Methods: This research is a non-experimental study. Data were taken from the medical records of pneumonia patients and analyzed qualitativelyusing the Gyssens method and quantitatively using the Defined Daily Dose (DDD) method. Sampling was conducted through purposive sampling andresults were described descriptively.Results: During the study period, 96 samples were obtained with 48 data pre-ASP and 48 data post-ASP. The results of the qualitative analysis usingthe Gyssens method show an increase in the prudent use of antibiotics from 31.25% to 62.5% pre-post ASP, respectively. Quantitative evaluationshows a decrease of antibiotic use pre-post ASP from 90.84 DDD/100 patients-days to 61.42 DDD/100 patients-days.Conclusion: The ASP can improve the quality of antibiotic use in pneumonia patients quantitatively and qualitatively

Profil Pelayanan Swamedikasi Oleh Apoteker Di 6 Apotek Kota Surakarta

Self-medication is a person's effort to treat his own disease. Self-medication often causes medication errors due to inappropriate selection and use of drugs. The role of pharmacists is needed in providing self-service to the community. This study aims to find out the description of self-service and application of pharmaceutical services standards at pharmacies. This research is an observational study with purposive sampling method. Respondents are pharmacists as manager (APA) and pharmacists as companion (Aping) at pharmacies that have given research permits. Data collection was carried out by observation or direct observation of pharmacists in several pharmacies in Surakarta City. Data analysis was carried out descriptively. Based on the selection and use of drugs, most visitors ask for medication for coughs and flu. Self-medication is mostly carried out by women 52.74% and the most is done by visitors aged 31-40 years 39.04%. Self-medication was carried out in initiative as much as 52.05% and self-medication recommended by pharmacists was 47.95%. Based on the use of drugs, visitors most often asked for cough medicine 30.82% and flu, which was 25.34%. Pharmacists have not been optimal in conducting self-service, either digging up visitor information or implementing fixed procedures and self-medication counseling techniques

Evaluasi Penggunaan Antibiotik Pada Balita Dengan Diare Akut Di Instalasi Rawat Inap Rsud Dr. Moewardi Periode September-Desember 2015

Diarrhea is one of the most disease with high morbidity and mortality of children under five years in the Worldwide with 3 million death annually. The cause of acute diarrhea is various, it can be caused by viruses, bacterias and pathogens. Antibiotics can used to treatment acute diarrhea but not all of diarrhea should be given with antibiotics. Antibiotics are only useful for patient with blood diarrhea (dysentery), cholera and other infectious diseases. The purpose of this study were to describe and evaluate the use of antibiotics in infant patients with acute diarrhea in Dr.Moewardi Hospital period September until December 2015. This study was a non-experimental study (observational),the data were obtained rFetrospectively from patient’s medical records. Evaluation of the use of antibiotics was seen from right indication, right drug, right patient, right dose and frequency then the right of duration based on Pelayanan Kesehatan Anak di Rumah Sakit 2009 and empirical treatment of acute infectious diarrhea 2006 standart treatment. The results of this research on acute diarrhea with diagnosis dysentery and acute diarrhea at Dr. Moewardi hospital antibiotic that being used is ampicillin (31,43%), amoxicillin (20%), metronidazole (17,14%), cefotaxime (11,43%), Kotrimoksazol (5,71%) and Cefixime (2,86%). The results of evaluation antibiotics is right indication (85,71%), right patient (87,71%), right drug (52,28%), the right dose and frequency (34,28%), right duration (34,28%), and rationality (34,28% )

Analisis Interaksi Obat Pada Pasien Sindrom Koroner Akut Di Rumah Sakit X Tahun 2016

Acute coronary syndrome is cardiovascular problem which caused by rate of hospital treatment and high rate of death in the progress developed country and developing country. Acute coronary syndrome is a condition that appear by reduction and stoppage bloodstream to the heart immediately. Either factor which can make this disease worsen is drug interactions. Drug interactions can cause endanger, increase drug toxicity or reduce the efficacy. The aims of this research was to know incidency of potential drug interactions to the patient of accute coronary syndrome at hospital X 2016 and drug cardiovascular which has used for mediciation. The type of research was non-experimental according to datas without doing the treatment to subject test with analysis descriptive design. Sample of the research was 64 patients. The result of this research was obtained by drug of cardiovascular which has used antiangina, antikoagulant, antiplatelet, Ace-inhibitor, beta bloker, antagonis angiotensim II, anti aritmia, and antagonis calcium. The potential drug interactions was as much as 58 (90,6%) of 64 patients, by the category of major significance 44 cases (25,55%),moderat significance 116 cases (67,4%), and minor category significance of 12 interactions (7,0%)

Evaluasi Penggunaan Obat Analgetik Pada Pasien Osteoartritis di Instalasi Rawat Jalan RSUD Dr. Moewardi Surakarta Tahun 2015

Osteoarthritis (OA) is a chronic rheumatic disease that is a major cause loss of physic function and disability. Osteoarthritis may affect several joints in the neck, hips, knees, five bones in the fingers and toes. Prevalention osteoarthritis in Indonesia reached 36.5 million people in 2007 where the majority patients are elderly. Osteoarthritis patients feel pain that will affect on reduced quality of life’s patients. The purpose of this study are to describe and evaluate analgesic prescription in patients with osteoarthritis at Dr. Moewardi Surakarta Hospital in 2015 based on parameters proper indication, proper patient, proper drug and proper dosage. This study was a non experimental research. Data was obtained retrospectively from medical records of patients with osteoarthritis. Data was descriptively analyzed one hundred patients were included as sample by purposive sampling method. Inclusion criteria of this study was patient’s with osteoarthritis who accept analgesics prescription in 2015 with complete medical record. Exclusion criteria of this study was pregnant patients. An overview of analgesic use in osteoarthritis patients starting from the highest are paracetamol (42%), sodium diclofenac (38%), meloxicam (10%), metampiron (3%), mefenamic acid (4%), ibuprofen (2%) and celecoxib (1%). The result of this study is 100% proper indications, 71% proper patient, 71% proper drug and the 55% proper dosage

Faktor-Faktor Yang Berpengaruh Terhadap Kepatuhan Minum Obat Pasien Diabetes Mellitus Tipe 2 Di RSUD Dr. Moewardi Periode Oktober 2016–Maret 2017

Type 2 diabetes mellitus is a metabolic disease marked by increased levels of glucose caused by resistance to the hormone insulin. Diabetes mellitus is a disease cronys chronically so that compliance with medication is crucial in the therapeutic treatment of diabetes mellitus and lowers the risk of complications. This research aims to know the factors that influence on patient medication adherence to diabetes mellitus type 2 in the RSUD Dr. Moewardi. The methods used for this research a cross sectional with purposive samplingtechnique. The number of samples in the study of 98 outpatient diabetes mellitus type 2 in the RSUD. Dr. Moewardi that do control in October 2016 to March 2017. The instruments used in this study was a questionnaire. Data analysis in bivariat and multivariate. Bivariat analysis usedchi square test and calculation of value OR (Odd Ratio). While multivariate analysis using logistic regression. The results showed that the factors that influence on patient medication adherence to diabetes mellitus type 2 in the RSUD Dr. Moewardi are the frequency of drug (p-value = 0,04 dan OR = 4,656) and sex(p-value = 0,063 dan OR = 2,803). Factors which do not affect drug compliance of type 2 diabetes mellitus patients in the RSUD Dr. Moewardi are the number of medications(p-value = 0,049 dan OR = 2,448), age(p-value = 1,000 dan OR = 1,169), duration of use of the drug(p-value = 0,375 dan OR = 1,572), and complications(p-value = 0,476 dan OR = 0,669)

Hubungan Tingkat Pengetahuan dengan Ketepatan Penggunaan Obat Analgetik pada Swamedikasi Nyeri Gigi di Masyarakat Kabupaten Sukoharjo

Dental pain is a disease that usually affects the pulp or tissue around the teeth. Dental pain includes mild pain that is easily recognizable for signs and symptoms, it encourages a person to do his own treatment without the help of a health professional or often called self care. Self care should be in accordance with the patient's condition and saturate the parameters of right indication, right drug, right dose, and right patient. This study aims to determine the relationship of knowledge level with the accuracy of the use of drugs to self care dental pain conducted by the community. Sampling in this study cluster sampling counted 154 respondents. Non experimental research conducted on Sukoharjo district community with comparatif method. Retrieval of data byretrospectively. Data were analyzed using cross sectional design and tested using SPSS test by chi square test. The results obtained in this study is the result of the level of knowledge of the average society belonging to the category enough value 57.79%, the accuracy of the use of analgesic drugs as much as 39 respondents accurate and inappropriate respondents use analgesic drugs as much as 115 respondents, The use of analgesic drugs on self care tooth pain shows a correlation between the level of knowledge and the use of analgesic drugs on self care tooth pain characterized by p value 0,000. Keyword : Tooth pain, analgesic use drug, knowledge, self car