More Frequent Use of Herbal Medicine Daily in Married and Divorced Women in Indonesia

Background: During the period of 2000-2006, the utilization of traditional medicine in Indonesia continued to increase. Data analysis was conducted to determine the profile of Indonesia's population using daily herbal medicine and the related factors. Methods: Analysis was conducted using the 2010 Basic Health Research Survey (Riset Kesehatan Dasar/Riskesdas) data covering a sub sample of people 15 years and older (179,227 people) in 33 provinces of Indonesia. Inclusion criteria limited the sub-sample to those people that use herbal medicine daily (7,847 persons) and those who have never used herbal medicine (81,415 persons). Individual level data included information on age, gender, marital status, educational attainment, employment, household expenditure per month, residence, etc. Results: Four point four percent (4.4%) of Indonesia's population uses herbal medicine daily. A larger proportion of the population buys traditional medicine products in a liquid dosage form than make herbal medicine at home, and most feel that they benefit from the use of herbal preparation. Married /divorce rather than unmarried subjects were 4.5-fold more likely to use herbal medicine daily [adjusted odds ratio (ORa)=4.42; 9% confidence interval (CI)=4.09-4.77). In term of residency, rural rather than urban residents were 2.2-fold more likely to use herbal medicine daily (ORa=2.18; CI=2.08-2.29), and female than male were 62% more likely to use herbal medicine daily (ORa=1.62; CI=1.55-1.70). Conclusion: Married or divorced, female residents were more likely to use herbal medicines daily. (Health Science Indones 2011;2:3-8

Kajian Implementasi Kebijakan Warung Obat Desa (Wod): Faktor Pendukung dan Penghambat

Warung Obat Desa (WOD) based on SK Menkes No. 983/Menkes/VIII/2004 about WOD implementation guide. The objective of this study was to assess the implementation of WOD policy and to find the supporting factor and constraint of the success of WOD implementation. The assessment was based on kualitatif method at community in 7 districts, Tangerang, Subang, Temanggung, Banjar, Lombok Barat, Konawe Selatan, and Denpasar Selatan. The data collected by indepth interview, health district manager and primary health care manager as information resources; the teacher, a community figure, a religion figure, a seller of medicine, cadre of health as information resources of Focussed Group Discussion, and observation of WOD activity. Data analysis was done by triangulasi. The results shown that the supporting factor of WOD were long distance from Primmary health care, drug seller and health services. In general the WOD implementation was implemented un successfully, WOD policy was not optimally, either in organizing, an organizer, management of medicine, medicine distribution, readinese of medicine, recording and reporting. We recommend that policy maker must have commitment, must supervise intensively, and consistent of the WOD programs

Kontribusi Kelengkapan Pengisian Formulir Rekonsiliasi Obat terhadap Penggunaan Obat Rasional pada Pasien Rawat Inap di RSU X Bekasi

Drug reconciliation is needed to get rational treatment therapy. The purpose of this study was to analyze the relationship between the completeness of filling out the form of drug reconciliation and rational drug use at Bekasi X Hospital. The study design used a cross-sectional comparative study to compare between 56 completed drug reconciliation forms and 133 incomplete drug reconciliation forms. Sampling is done in total sampling. The research sample that fulfilled the inclusion criteria was 189 forms (40.6%) of all (466) drug reconciliation forms in November 2015-end April 2016 at X Hospital Bekasi. Data was analyzed using Chi-square test. The results showed that the largest percentage of filling out drug reconciliation forms was incomplete (70.4%), carried out by the pharmacist (56.1%) and not signed by a doctor (63.5%). Percentage of rational drug use by 7.9%, with details: correct diagnosis 53.4%, correct indication 53.4%, correct selection of medicine 33.9%, correct dosage 8.5%, exactly how to administer 37.6%, on time giving 13.8% and correct time giving 14.8%. There is no significant relationship between the completeness of filling out the drug reconciliation form, the types of health workers, the presence/absence of a doctor's signature and rational drug use in inpatients (p> 0.05).Tthere is no significant relationship between the completeness of filling out the reconciliation form and rational drug use in inpatients at Bekasi X Hospital (p> 0.05

PARENTERAL ANTIBIOTIC USAGE PATTERNS AND EFFECTS OF INTRAVENOUS TO ORAL SWITCHING ON THE LENGTH AND COST OF HOSPITALIZATION

Objective: The prolonged use of intravenous antibiotics might increase the length and cost of hospitalization. The research objective, therefore, was toevaluate the effect of switching antibiotics on the length of hospital stay and hospitalization cost. The prospective cohort research design was adopted.The inclusion criteria were in patients who had received intravenous antibiotics.Methods: The sample comprised 39 patients who switched antibiotics as an exposed group and 39 patients who did not switch as an unexposedgroup. The data were collected using the patient medical records and the financial data from the hospital information system. The Mann–Whitney testand Chi-square or Fisher's exact test was applied in the analysis.Results: The results revealed that the antibiotics most commonly switched were intravenous ceftriaxone (83.3%) and oral cefixime (94.8%). From thefive switching patterns observed, the most common switch was from intravenous ceftriaxone to oral cefixime in patients with acute gastroenteritis.All antibiotics were administered in accordance with the National Formulary (NF) guidelines. Only metronidazole (5 mg/ml dose) was inconsistentwith NF. Switching antibiotics did not impact the length of hospital stay and hospitalization cost; however, comorbidities did have an influence here.Conclusions: Further, switching antibiotics impacted the duration over which intravenous antibiotics were administered and the cost of antibiotics

Kajian Kebijakan tentang Informasi dan Pelayanan Obat yang Mendukung Pengobatan Sendiri di Masyarakat

Abstract Self-medication is the use of medicines by someone to treat pain complaints or self-recognizable symptoms and some chronic diseases that a doctor has diagnosed by. The purpose of the study is to obtain information about the problems and the role of pharmaceutical institutions in medicine information and services supporting self-medication in the community. The research design used a descriptive study in the form of policy studies and legislation related to medicine information and services in self-medication. Data sources are policies and legislation regarding medicine information and services regarding self-medication. The results of the study indicate: the problem of self-medication is there are no laws and regulations specifically regulate self-medication along with technical instructions on the role of each pharmaceutical institution. The problem with medicine information is that the central government program in providing medicine information has not been followed up by many district/ city health offices; people tend to buy medicines at retail in illegal medicine services facility, so they cannot read the information on the medicine packaging; and there are still many medicine advertisements in the mass media that have not provided objective and complete medicine information. The problem of medicine service policy is the lack of supervision, so that there are many illegal medicine service facilities in the community and lack of presence of pharmacy personnel in medicine information and services at pharmacies and drug stores. It is recommended that the Ministry of Health establish legislation and norms, standards, procedures and criteria for self-medication as a basis for government pharmaceutical institutions, private sector and professional organizations to support them. Abstrak Pengobatan sendiri adalah penggunaan obat oleh seseorang untuk mengobati keluhan sakit atau gejala yang dapat dikenali sendiri dan beberapa penyakit kronis yang pernah didiagnosis dokter. Tujuan kajian adalah mendapatkan informasi tentang permasalahan dan peran institusi farmasi dalam informasi obat dan pelayanan obat yang mendukung pengobatan sendiri di masyarakat. Rancangan penelitian menggunakan studi deskriptif berupa kajian kebijakan dan peraturan perundang-undangan terkait informasi obat dan pelayanan obat dalam pengobatan sendiri. Hasil kajian menunjukkan permasalahan pengobatan sendiri adalah belum ada peraturan perundangan yang khusus mengatur pengobatan sendiri beserta petunjuk teknis peran masing-masing institusi farmasi. Permasalahan dalam informasi obat adalah program pemerintah pusat dalam pemberian informasi obat belum ditindaklanjuti oleh semua Dinas Kesehatan kabupaten/kota; masyarakat cenderung membeli obat secara eceran di sarana pelayanan obat ilegal, sehingga tidak dapat membaca informasi pada kemasan obatnya; dan masih banyak iklan obat di media massa yang belum memberikan informasi obat yang objektif dan lengkap. Permasalahan dalam pelayanan obat adalah kurangnya pengawasan, sehingga banyaknya sarana pelayanan obat ilegal di masyarakat dan kurangnya kehadiran tenaga kefarmasian dalam informasi dan pelayanan obat di apotek dan toko obat. Disarankan agar Kementerian Kesehatan menetapkan peraturan perundangan-undangan dan norma, standar, prosedur, dan kriteria tentang pengobatan sendiri sebagai dasar bagi institusi farmasi pemerintah, swasta, dan organisasi profesi mendukungnya

RELATIONSHIP BETWEEN PROTON-PUMP INHIBITOR USE AND LOWER BLOOD MAGNESIUM LEVELS

Objective: The aim of this study was to determine whether and to what degree proton-pump inhibitor (PPI) use affects blood magnesium levels.Methods: We performed a cross-sectional comparative study with consecutive sampling technique from June to October 2016. This study comparedblood magnesium levels of patients using PPIs (lansoprazole and omeprazole) with those of patients not taking PPIs. The total sample was 184 patients.Data collected included questionnaires and medical records. Statistical analysis was performed with the unpaired t-test, Mann–Whitney U-test, andone-way analysis of variance.Results: The average magnesium level in patients using PPIs was 2.08±0.21 mg/dL, whereas the average magnesium level in patients not using PPIswas 2.27±0.38 mg/dL, a statistically significant difference (p<0.001). Magnesium levels were significantly lower in patients using PPIs for >1 yearand in patients using omeprazole (p<0.05).Conclusion: Blood magnesium levels of patients using PPIs were significantly lower than those who did not use PPIs. Decreased levels of magnesiumin patients using PPI are affected by PPI type and the duration of PPI use - >1 year. Thus, the long-term use of PPIs may lead to decreased levels ofmagnesium. Therefore, monitoring the levels of magnesium is important in patients using PPIs for a long term to avoid the risk of hypomagnesemia

Pengaruh Konseling dan Leaflet terhadap Efikasi Diri, Kepatuhan Minum Obat, dan Tekanan Darah Pasien Hipertensi di Dua Puskesmas Kota Depok

Self-efficacy and low adherence was significant problem on using antihypertension drugs. The study purpose was to evaluate the effectiveness of counseling and provision of leaflets againts self-efficacy and adherence as well as the blood pressure of hypertensive patients at two community health centers in Depok City. The study desain is a quasi-experimental with 37 patients in counseling group and 36 patients in the leaflets group during March to June 2013. The instrument determine self-efficacy is MUSE scale, MMAS-8 scale for adherence and the tensimeter for blood pressure. Data were analyzed uses the Wilcoxon and Kolmogorov-Smirnov test. The results showed that the largest percentage of hypertension patients in community health centers have mild hypertension, has been suffering from hypertension between 1-5 years, received a single drug, mostly captopril, and did not feel any side effects. The counseling and provision of leaflets can increase self-efficacy and medication adherence, and lower systolic blood pressure significantly. Provision of leaflets to patients can increase self-efficacy and adherence, and lowering the systolic and diastolic pressure significantly. There is no significant difference between the effects of counseling and the provision of leaflets to increase self-efficacy and adherence, as well as a decrease in blood pressure in hypertensive patients in community health centers in Depok Cit