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EFEKTIVITAS PENERAPAN AUTOMATED DOSE DISPENSING DI BANGSAL RAWAT INAP RUMAH SAKIT UMUM KABUPATEN TANGERANG Pradata, Abiyoga; Andrajati, Retnosari; Jufri, Mahdi; Milladi, Ayup
Indonesian Journal of Clinical Pharmacy Vol 8, No 4 (2019)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2019.8.4.264

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Penerapan dan penelitian terkait efektivitas automated dose dispensing (ADD) di Indonesia masih sangat terbatas. Oleh karena itu, penelitian ini bertujuan untuk melihat efektivitas ADD di salah satu rumah sakit di Indonesia yang telah menerapkannya, yaitu Rumah Sakit Umum Kabupaten Tangerang. Metode penelitian yang digunakan adalah cross-sectional study dengan membandingkan jumlah dispensing error dan dispensing time dari populasi resep yang menggunakan ADD dan manual dispensing (MD). Sampel didapat dari resep unit dose dispensing (UDD) bangsal rawat inap RSU Kabupaten Tangerang periode Mei?Juli 2019. Hasil penelitian dari 1086 resep untuk masing-masing populasi menunjukkan terdapat perbedaan rata-rata geometrik dispensing time yang signifikan (p<0,001) antara ADD yaitu 53,70 (52,48?54,95) detik dengan MD yaitu 144,54 (141,25?147,91) detik. Hasil penelitian ini juga memaparkan terdapat perbedaan jumlah resep dengan dispensing error yang signifikan (p<0,002) antara ADD yaitu 44 errors dan MD yaitu 77 errors dengan nilai odds ratio sebesar 1,83. Hal ini menunjukkan bahwa di RSU Kabupaten Tangerang, ADD lebih efektif dibandingkan dengan MD dilihat dari rata-rata geometrik dispensing time dan jumlah resep dengan dispensing error. Meskipun ADD dapat mempercepat dispensing time dan menurunkan jumlah dispensing error, penting dilakukan telaah sebelum menerapkan mesin ini dengan mempertimbangkan faktor biaya, sistem informasi rumah sakit, resep elektronik, dan keterampilan sumber daya manusia.Kata kunci: Automated dose dispensing, dispensing time, dispensing error, dose dispensing Effectiveness of Automated Dose Dispensing Implementation in Inpatient Ward of Tangerang District General Hospital AbstractThe application and research related to the effectiveness of automated dose dispensing (ADD) in Indonesia is still very limited. Therefore, this study aimed to investigate the effectiveness of ADD in a hospital in Indonesia that have implemented this method, that is Tangerang District General Hospital. This research was cross sectional study by comparing the number of recipes with dispensing error and dispensing time of the recipe population using ADD and manual dispensing (MD). Samples were obtained from the prescription unit dose dispensing (UDD) inpatient ward of Tangerang District Hospital in the period of May?July 2019. The result of 1086 prescriptions for each population showed a significant difference (p<0.001) in the geometric mean of dispensing time between ADD 53.70 (52.48?54.95) seconds and MD 144.54 (141.25?147.91) seconds. There were differences in the number of recipes with a significant dispensing error (p<0.002) between ADD 44 errors and MD 77 errors with an odds ratio of 1.83. This shows that in Tangerang District General Hospital, ADD was more effective compared to MD in terms of the geometric mean of dispensing time and the number of prescriptions with dispensing error. Although ADD can speed up dispensing time and reduce the number of dispensing errors, it is important to conduct a study before implementing this machine by considering cost factors, hospital information systems, electronic prescriptions, and human resource skills.Keywords: Automated dose dispensing, dispensing time, dispensing error, unit dose dispensing
Assessment of antibiotics use after introducing a hospital formulary by ATC/DDD methodology Andrajati, Retnosari; Vlček, Jiři; Wahyudin, Iwan
Medical Journal of Indonesia Vol 13, No 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (206.574 KB) | DOI: 10.13181/mji.v13i3.149

Abstract

The objective of this study is to compare the use of antibiotics at the Metropolitan Medical Center Hospital in Jakarta, Indonesia (MMCH), before and after the implementation of a hospital formulary. All antibiotic data under J01 Anatomical Therapeutic Chemical (ATC) classification were collected from pharmacy inpatient and outpatient records. Quantitative antibiotic use was expressed in Defined Daily Doses/100 bed-days (DDDs/hbd) for inpatients and DDDs/1000 patients/day (DDDs/tpd) for outpatients. The general quality of drug use was assessed in number of drugs that account for 90% of the use (DU90%) and the adherence to hospital formulary by substance and brand name within the DU90% segment. Quantitative and qualitative antibiotic use were compared before and after implementation of the formulary (1999 to 2000). The Wilcoxon rank sign test was used to compare overall antibiotic use. Inpatient antibiotic usage decreased significantly by 23.1%, 124.96 DDDs/hbd in 1999 to 96.13 DDDs/hbd during 2000 (p= 0.03) and outpatient antibiotic usage decreased insignificantly by 4.9%, 3.49 DDDs/tpd during 1999 to 3.32 DDDs/tpd during 2000 (p=0.58).The most commonly antibiotic use was ciprofloxacin in inpatient setting during the study and in out-patient setting was amoxicillin in 1999 and ciprofloxacin in 2000. The adherence to the formulary by substance and by brand name in inpatient department was 100% and 90.5% and in outpatient department was 100% and 94.3% during the study. DU 90% by substance name and by brand name was considerably not improved in both settings. The conclusion is that the effectiveness of one year formulary implementation at MMCH was only revealed in inpatient setting. (Med J Indones 2004; 13: 173-9) Keywords: antibiotic use, hospital formulary
Toksisitas Hematologi Regimen TAC (Docetaxel-Doksorubisin-Siklofosfamid) dan FAC (Fluorourasil-Doksorubisin-Siklofosfamid) pada Pasien Kanker Payudara di Rumah Sakit Kanker “Dharmais” Jakarta: Analisis Data Rekam Medik 2007-2008 Regimen, Toksisitas Hematologi; ANDRAJATI, RETNOSARI; ANDALUSIA, RIZKA
Indonesian Journal of Cancer Vol 4, No 1 (2010): Jan - Mar 2010
Publisher : "Dharmais" Cancer Center Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Breast cancer in Indonesia the second most common cancer in women after cervical cancer in 2008. FAC and TAC are chemotherapy regiments for breast cancer that give good therapy response but affect patient haematology. Study about hematologic toxicity of TAC and FAC in breast cancer patient has not been conducted in “Dharmais” Cancer Hospital. The purpose of this study was to determine hematologic toxicity of 6 cycles TAC (docetaxel 75 mg/m2, doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2, day 1, 21) and FAC (fluorouracil 500 mg/m2, doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2, day 1, 21) in breast cancer patients in “Dharmais” Cancer Hospital. This study used cross sectional design in 11 and 179 patient medical records that were indentified treated with TAC and FAC. Patients received first cycles both regiments in 2007-2008. All stages of breast cancer were included in this study. Differences between TAC and FAC in proportion of haematology count after chemotherapy and average decrease of hematology count were analyzed by chi square and t test statistic methods. From 66 hematology data in patients treated with 6 cycles TAC grade 1-4 of hematologic toxicity occurred 84,8% in haemoglobin with average decrease 0,71 g/dl; 97% in leucocyte with average decrease 7,51 x 103 cell/?l; 22,7% in trombocyte with average decrease 147,77 x 103 cell/mm3. From 1079 hematology data in patients treated with 6 cycles FAC grade 1-4 of hematologic toxicity occurred 72,6% in haemoglobin with average decrease 0,66 g/dl; 85% in leucocyte with average decrease 2,73 x 103 cell/?l; and 10,9% in thrombocyte with average decrease 104,25 x 103 cell/mm3.
ANALISIS PEMBERIAN ANTIBIOTIK BERDASARKAN HASIL UJI SENSITIVITAS TERHADAP PENCAPAIAN CLINICAL OUTCOME PASIEN INFEKSI ULKUS DIABETIK DI RSUD DR. H. ABDUL MOELOEK LAMPUNG Kahuripan, Ardiansyah; Andrajati, Retnosari; Syafridani, Tetty
Pharmaceutical Sciences and Research (PSR) Vol 6, No 2 (2009)
Publisher : Directorate of Research and Community Engagement, Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (53.94 KB) | DOI: 10.7454/psr.v6i2.3437

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The administration of antibiotic at RSUD dr. H. Abdul Moeloek Lampung is based on sensitivity test result and empirical therapy on diabetic ulcer. Therefore, the objective of the research is to analyze the effectivity of various antibiotics adminis-tration based on the sensitivity test result on clinical outcome reached by consider-ing influenced factors. On the other hand, total evaluation of the resistances ofempirical antibiotic used by considering germ and sensitivity test feature was done.The research was conducted at dr. H. Abdul Moeloek Regional Hospital from April - July 2008 by applying cross sectional design retrospectively. Data was taken by the diabetic ulcer patients medical record which were treated from January 1st 2005 to Mei 30, 2009. Requirement of patient inclution are patient with diabetic ulcer infection, receiving antibiotic recipe, antibiotic given is based on sensitivity test result, patient was cured until getting the doctor approval to go home. The research which involved 98 patient inclution showed that clinical outcome of diabetic ulcer patient who was administered antibiotic based on sensitivity test result was influ-enced by chronic level of patient and age.Key words : Diabetic ulcer, antibiotic, sensitivity test.
KEJADIAN REAKSI OBAT YANG TIDAK DIKEHENDAKI YANG MENYEBABKAN PASIEN USIA LANJUT DIRAWAT DI RUANG PERAWATAN PENYAKIT DALAM INSTALASI RAWAT INAP B RUMAH SAKIT DR. CIPTO MANGUNKUSUMO Christianie, Merry; Setiati, Siti; Trisna, Yulia; Andrajati, Retnosari
Pharmaceutical Sciences and Research (PSR) Vol 5, No 3 (2008)
Publisher : Directorate of Research and Community Engagement, Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (40.425 KB) | DOI: 10.7454/psr.v5i3.3428

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Objectives. To determine the prevalence of adverse drug reaction related hospital ad-missions in geriatric patients, to describe the most frequent clinical manifestationsand the drugs responsible to adverse drug reaction related hospital admissions.Design. Observational cross-sectional study.Methods. Naranjo algorithm used to assess the adverse drug reaction causality.Subjects and setting. Geriatric patients admitted to geriatric inpatient installation of Cipto Mangunkusumo general hospital over one month period and assessed for cause of admissions.Results. 14,7% of 102 admissions were identified to be adverse drug reaction related hospital admissions. One adverse drug reaction was categorized as definite and 14 were probable causality. Gastrointestinal bleeding and hypoglicemia were the most common clinical manifestation found. The drugs most frequent responsible for these adverse drug reactions were nonsteroidal antiinflamatory drugs and oral antidiabeticdrugs.Conclusion. Adverse drug reactions are an important cause of hospital admission in geriatric patients.Keywords: adverse drug reaction, geriatric, Naranjo algorithm.
Uji Efek Analgesik Ekstrak Etanol Mencit Jantan dengan Metode Tail-Flick Widiarti, .; Andrajati, Retnosari; Amin, Juheini
Pharmaceutical Sciences and Research (PSR) Vol 9, No 2 (2012)
Publisher : Directorate of Research and Community Engagement, Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (437.313 KB) | DOI: 10.7454/psr.v9i2.3355

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In the previous study the analgesic effect of Cinnamommum zeylanicum Breyn had been investigating. The aim of this study was to investigate analgesic effect of the 70% ethanol extract of cinnamon bark (Cinnamommum zeylanicum Breyn.). This study used Tail- Flick method at 25 male mice which have passed sensitivity test, divided into five groupes. Group I as negative control was administered 0,5% CMC, group Il as positive control was administered tramadol HCI, group Ill, IV and V was administered extract of cinnamon bark at 8; 16 and 32 mg/20 g BW. Drugs were orally administered to mice. The reaction of time exhibited by each animal was counted for two hour with interval thirty minutes. The Result revealed that the prepared extract in at the all dose, had analgesic effect significantly in all groups which have been studied (p&lt; 0,05) in comparison to the negative control, to the highest analgesic effect by dose (32 mg/ 20 g BW). Our results showed that the analgesic effect of extract (32 mg/20 g BW) the same with tramadol hidroclorida. Keywords: Analgesic; Cinnamommum zeylanicum Breyn.; Kayu manis; Tail- Flick method
PERBANDINGAN EFIKASI BEBERAPA KOMBINASI ANTIRETROVIRAL PADA PASIEN HIV/AIDS DITINJAU DARI KENAIKAN JUMLAH CD4 RATA-RATA (ANALISIS DATA REKAM MEDIS DI RSK DHARMAIS JAKARTA TAHUN 2005 – 2006) Rahmadini, Yulian; Andrajati, Retnosari; Andalusia, Rizka
Pharmaceutical Sciences and Research (PSR) Vol 5, No 2 (2008)
Publisher : Directorate of Research and Community Engagement, Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.785 KB) | DOI: 10.7454/psr.v5i2.3420

Abstract

Dharmais Cancer Hospital is one of 237 hospital appointed by the government of Indonesia to give treatment, support and ARV therapy for HIV/AIDS patients. Ev-ery year, there is a significant increasing number of HIV/AIDS patients in DharmaisCancer Hospital, therefore successfully of therapy is needed to be carried out regularly for the optimum result to the patients. One of methods to evaluating therapy is by reviewing efficacy of ARV combinations toward escalation of immunity respond (es-calation of CD4). The ARV combinations give a good efficacy if increasing CD4 &gt; 50 cell/mm3. The objective of this study was to know the efficacy of four ARV combina-tion (each type consists of two Nucleosides Reverse Transcriptase Inhibitor and one Non-Nucleosides Reverse Transcriptase Inhibitor) base on increasing CD4 mean HIV/AIDS patients after 6 &ndash; 12 months treatment in Dharmais Cancer Hospital from 2005 &ndash; 2006, and to compare the efficacy of four ARV combinations. The four ARVcombinations are combination I (Lamivudin + Zidovudin + Efavirenz), combina-tions II (Lamivudin + Zidovudin + Nevirapin), combination III (Lamivudin + Stavudin + Efavirenz), and combination IV (Lamivudin + Stavudin + Nevirapin).This study was analytical, cross-sectional design. Samples for this study were taken by total sampling using all data of HIV/AIDS patients in Dharmais Cancer Hospital from the year 2005 &ndash; 2006. The inclusion criteria were patients of fifteen years of age or more, baseline count CD4&nbsp; &lt; 200 cell/mm3, received ARV treatment for 6 &ndash; 12 months, received treatment of either one of the four ARV combination, and had dataof CD4 from laboratory result before and after the treatment. Data were taken from patients&rsquo; medical record and analyzed with ANOVA-test. The result of this study from 151 patients showed that all the four combinations gave good efficacy based on the increasing CD4 mean. There was a significant difference increasing CD4 mean to HIV/AIDS patients between those received ARV combination II and those received ARV combination III (p value = 0,032). And there was not a significant difference for the other combinations. This study was from the four ARV combinations gave two the best efficacy are combination II and combination III.Key words : Dharmais Cancer Hospital, HIV/AIDS patients, ARV combinations, efficacy ARV combination, increasing CD4.
UJI HAMBATAN TUMORIGENESIS SARI BUAH MERAH (PANDANUS CONOIDEUS LAM.) TERHADAP TIKUS PUTIH BETINA YANG DIINDUKSI 7,12 DIMETILBENZ(a)ANTRASEN (DMBA) Munim, Abdul; Andrajati, Retnosari; Susilowati, Heni
Pharmaceutical Sciences and Research (PSR) Vol 3, No 3 (2006)
Publisher : Directorate of Research and Community Engagement, Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (68.036 KB) | DOI: 10.7454/psr.v3i3.3407

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Red fruit (Pandanus conoideous Lam.) has been known by public as a medicine for any kind of diseases, among of them is for cancer. To determine the carcinogenesis inhibition effect of red fruit extract , we have examined the effect on 7,12- dimethylbenz[a]anthrasene (DMBA)-induced rat lungs cancer model in female Sprague-Dawley rats. The extract was tested at 0.21 ml/200 g bw; 0.43 ml/200 g bw and 0.88 ml/ 200 g bw. The experiment was terminated at day 120. Lung histology was used to evaluate carcinogenesis inhibition. The result showed that the extract at 0.21 ml/200g bw improved lung carcinogenesis inhibition than other dose. Key words : red fruit extract, DMBA, lung cancer, Pandanus conoideus
Perbandingan Kejadian Reaksi Obat yang Tidak Dikehendaki Antara Kontrasepsi Suntik Tunggal dan Kombinasi di Kota Bengkulu Putri, Yona Harianti; Andrajati, Retnosari; Yanuar, Arry
JSFK (Jurnal Sains Farmasi & Klinis) Vol 5, No 3 (2018): J Sains Farm Klin 5(3), Desember 2018
Publisher : Fakultas Farmasi Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jsfk.5.3.154-159.2018

Abstract

Reaksi obat yang tidak dikehendaki (ROTD) adalah salah satu penyebab akseptor menghentikan penggunaan kontrasepsi. Penghentian kontrasepsi dapat meningkatkan kejadian kehamilan yang tidak dikehendaki. Penelitian ini bertujuan untuk mengetahui perbandingan kejadian ROTD dari penggunaan kontrasepsi suntik tunggal (Depo Medroksi Progesteron Asetat) dan kontrasepsi suntik kombinasi (MPA/Estradiol Sipionat). Desain penelitian adalah cross sectional uji dua populasi. Jumlah sampel sebanyak 65 akseptor kontrasepsi suntik tunggal dan 62 akseptor kontrasepsi suntik kombinasi. Kejadian ROTD dianalisis menggunakan Chi-Square dan uji regresi logistik multivariat. Hasil penelitian menunjukkan kejadian ROTD gangguan menstruasi lebih banyak terjadi pada akseptor kontrasepsi suntik tunggal (89.2%) dibanding akseptor kontrasepsi suntik kombinasi (38.7%) dengan P-value <0.001. Kejadian ROTD mudah marah lebih banyak terjadi pada akseptor kontrasepsi suntik tunggal (67.7%) dibanding akseptor kontrasepsi suntik kombinasi (46.8%) dengan P-value 0.017. Kejadian ROTD kurang gairah seksual lebih banyak terjadi pada akseptor kontrasepsi suntik tunggal (56.9%) dibanding akseptor kontrasepsi suntik kombinasi (37.1%) dengan P-value 0.025. Kejadian ROTD sakit kepala lebih banyak terjadi pada akseptor kontrasepsi suntik tunggal (56.9%) dibanding akseptor kontrasepsi suntik kombinasi (50.0%), akan tetapi perbandingannya tidak signifikan (P-value 0.434). Kejadian ROTD gangguan menstruasi 13 kali lebih banyak terjadi pada akseptor kontrasepsi suntik tunggal dibanding kombinasi.
Efektivitas Leaflet dan Konseling terhadap Kepatuhan Minum Tablet Besi dan Kadar Hemoglobin Ibu Hamil dengan Anemia di Puskesmas di Kabupaten Bogor Vernissa, Venni; Andrajati, Retnosari; Supardi, Sudibyo
Media Penelitian dan Pengembangan Kesehatan Vol 27, No 4 (2017)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/mpk.v27i4.6628.229-236

Abstract

According to National Basic Health Research (Riskesdas) 2013, the prevalence of anemia in pregnant women in urban area is 36.4%. The treatment of anemia in pregnant women is conducted by administering 90 iron tablets during pregnancy. The majority of anemia in pregnant women is mostly caused by lacking of iron (Fe) due to lack of adherence in taking iron tablets. The objective of this research was to assess the effectiveness of leaflet compared to counseling to improve adherence and increasing hemoglobin status of pregnant women with anemia in primary health care in Bogor District. The research design was quasi-experimental by giving counseling as an intervention conducted by pharmacists to 79 pregnant women with anemia in Cibungbulan primary health care and delivering leaflet to 79 pregnant women with anemia in Ciluengsi primary health care Bogor District in 2013. The evaluation was conducted by using MMAS-8 (Morisky Medication Adherence Scale) questionnaires and Hb rate with STAT-Site MHgb equipment a month after the intervention. Data analysis was carried out with Chi-Square test, Wilcoxon test, Mann-Whitney test and multivariate logistic regression analysis. This research suggests that either counseling by pharmacist or leaflet increases adherence to take iron tablets (P &lt; 0.05). The effectiveness of leaflets and counseling to increase adherence to pregnant women with anemia were not statistically different. Pregnant women with anemia who adhere to take iron tablet have their Hb rate improved 3.24 times compared to those who do not adhere to take iron tablet. Pregnant women with anemia who eat food source of heme every day have their Hb rate improved 2.31 times compared to those who do not eat food source of heme every day.   Abstrak Menurut Riset Kesehatan Dasar (Riskesdas) 2013, prevalensi anemia pada ibu hamil di perkotaan sebesar 36,4%. Penanggulangan anemia pada ibu hamil dilakukan dengan pemberian minimal 90 tablet besi selama kehamilannya. Sebagian besar anemia pada ibu hamil di Indonesia disebabkan karena kekurangan zat besi (Fe) akibat ketidakpatuhannya meminum tablet besi. Tujuan penelitian ini adalah menilai efektivitas leaflet dibandingkan konseling terhadap peningkatan kepatuhan minum tablet besi dan kadar hemoglobin (Hb) ibu hamil dengan anemia di dua puskesmas di Kabupaten Bogor. Rancangan penelitian yang digunakan adalah kuasi eksperimen, dengan intervensi berupa konseling oleh apoteker pada 79 ibu hamil dengan anemia di Puskesmas Cibungbulan dan pemberian leaflet pada 79 ibu hamil dengan anemia di Puskesmas Cileungsi Kabupaten Bogor pada tahun 2013. Sebulan setelah intervensi, dilakukan evaluasi untuk menilai peningkatan kepatuhan minum tablet besi dan kadar Hb menggunakan kuesioner MMAS-8 dan pengukuran kadar Hb. Analisis data dilakukan dengan uji Chi-square, uji Wilcoxon, uji Mann Whitney dan uji regresi logistik multivariat. Kesimpulan bahwa konseling oleh apoteker atau pemberian leaflet pada ibu hamil dengan anemia meningkatkan kepatuhan minum tablet besi (P &lt; 0,05) secara bermakna. Efektivitas leaflet dan konseling terhadap peningkatan kepatuhan minum tablet besi pada ibu hamil dengan anemia secara statistik tidak berbeda. Peningkatan kepatuhan minum obat dan makan makanan yang mengandung protein setiap hari dapat meningkatkan kadar Hb secara bermakna (P &lt; 0,05). Ibu hamil dengan anemia yang patuh minum tablet besi, kadar Hb-nya meningkat 3,24 kali dibandingkan yang tidak. Ibu hamil dengan anemia yang makan makanan yang mengandung protein setiap hari, kadar Hb-nya meningkat 2,31 kali dibandingkan ibu yang tidak makan makanan yang mengandung protein.