The Effectiveness and Safety of Favipiravir in COVID-19 Hospitalized Patients at Tertiary Referral Hospital, Bali, Indonesia

COVID-19 is a major public health problem, with still questionable specific cure. Favipiravir is a COVID-19 antiviral that is potentially a therapy for COVID-19. This study aimed to analyze its effectivity and safety in moderate to critical hospitalized patients. This study was a retrospective cohort in a tertiary referral hospital in Denpasar City, Bali Province, Indonesia, from August 2020 to January 2021. There was a total of 192 patients; 96 in the favipiravir group and 96in the non-favipiravir group (remdesivir/oseltamivir). Effectivity was measured by assessing the clinical condition at the end of the isolation period of 14 days. The favipiravir group showed better clinical conditions than the non-favipiravir group (79.2% vs. 56.3%; adjusted RR = 2.196; 95% CI = 1.084 – 4.451; p-value= 0.029), seen from being free of fever and respiratory problems. Stratification analysis demonstrated that the clinical improvement was significantly differentin the severe/critical group in favor of favipiravir (RR = 1.573; 95% CI = 1.139-2.172). The most common non-serious adverse events (AE) found in the use offavipiravir were gastrointestinal disturbances (12.5%). In brief, favipiravir is effective in severe/critical cases, and less serious AE were found in its use. Appropriate treatment is expected to help in reducing the public health burden

Cognitive Function in Type 2 Diabetes Mellitus Patients Taking Metformin and Metformin-Sulfonylurea

The most prescribed antidiabetic drugs in Indonesian primary health care are metformin or a combination of metformin and sulfonylurea. Studies on metformin have shown various impacts on cognitive decline in patients with type 2 diabetes mellitus, whereas sulfonylurea has been shown to reduce this impact. This study aimed to compare the impacts of metformin and metformin-sulfonylurea on cognitive function and determine what factors affected it. This cross-sectional study was conducted at Pasar Minggu Primary Health Care involving 142 type 2 diabetes mellitus patients taking metformin or metformin-sulfonylurea for > 6 months and aged > 36 years. Cognitive function was assessed using the validated Montreal Cognitive Assessment Indonesian version. The effects of metformin and metformin-sulfonylurea on cognitive decline showed no significant difference, even after controlling for covariates (aOR = 1.096; 95% CI = 0.523–2.297; p-value = 0.808). Multivariate analysis showed age (OR = 4.131; 95% CI = 1.271–13.428; p-value = 0.018) and education (OR = 2.746; 95% CI = 1.196–6.305; p-value = 0.017) affected cognitive function. Since a lower education and older age are likely to cause cognitive decline, health professionals are encouraged to work with public health experts to address these risk factors for cognitive function

Pendidikan dan Pelatihan untuk Peningkatan Kompetensi Apoteker terkait Telefarmasi: Scoping Review

Antihypertensive and antidiabetic drugs in chronic kidney disease (CKD) patients undergoing hemodialyThe high demand for telepharmacy services led to the urge for proper training and education to enhance its quality. This review aimed to assess the implementation and outcomes of telepharmacy training and education programmes. This scoping review was conducted on ScienceDirect, Sage Journal, SpringerLink, and Google Scholar databases using keywords “training” OR “education” AND “telepharmacy,” “training” OR “education” AND “digital competency” AND “pharmacy.” Only English-written articles published between 2000 – 2023, original research and brief report were included in this review. Eight of 171 articles met the criteria and the study’s objectives. Those studies discussed telepharmacy learning programmes for pharmacy students in the USA (5 articles), UAE (2 articles), and Malaysia (1 article). The learning methods included didactic learning, case-based study, simulation/roleplay, and clerkship employing technological tools. Rubrics, quizzes, questionnaires, and objective structured clinical examination (OSCE) were used as assessment methods. All studies reported improved students’ knowledge, perceptions, and telepharmacy competencies. In conclusion, the telepharmacy learning programmes have effectively upgraded students’ knowledge and skills by various methods at every level. However, there remains a considerable need for evidence on suitable training for pharmacists to improve their telepharmacy competencies and service quality.Peningkatan kebutuhan pelayanan telefarmasi mengarah pada urgensi pendidikan dan pelatihan telefarmasi untuk meningkatkan kualitas layanannya. Tujuan dari artikel ini adalah mengkaji implementasi program pendidikan dan pelatihan telefarmasi serta output yang dihasilkan. Kajian scoping dilakukan pada literatur dari pangkalan data ScienceDirect, Sage Journal, SpringerLink, dan Google Scholar menggunakan kata kunci “training” atau“education” dan “telepharmacy,” “training” atau “education” dan “digital competency” AND “pharmacy.” Hanya artikel berbahasa Inggris, dipublikasikan pada periode 2000 – 2023 serta merupakan hasil riset dan laporan singkat yang diikutsertakan pada kajian ini. Delapan dari 171 artikel yang ditemukan memenuhi kriteria inklusi dan tujuan kajian. Studi tersebut membahas implementasi dan evaluasi program pendidikan terkait telefarmasi di negara Amerika (5 artikel), Arab (2 artikel), dan Malaysia (1 artikel). Metode pembelajaran yang digunakan meliputi paparan, pembelajaran berbasis kasus, simulasi/roleplay, dan magang menggunakan berbagai media teknologi. Metode penilaian menggunakan rubrik, kuis, kuesioner, dan objective structured clinical examination (OSCE). Seluruh penelitian melaporkan peningkatan pengetahuan, persepsi dan kompetensi telefarmasi mahasiswa. Dapat disimpulkan bahwa program pembelajaran terkait telefarmasi efektif untuk meningkatkan pengetahuan dan kemampuan mahasiswa dengan berbagai metode pada setiap tingkat. Namun, masih sangat dibutuhkan bukti program pelatihan yang sesuai bagi apoteker untuk meningkatkan kompetensi dan kualitas pelayanan telefarmasi