scholarly journals Kesesuaian Obat Hipoglikemik Oral pada Pasien Diabetes Mellitus Tipe 2 di Fasilitas Kesehatan Tingkat Pertama X di Surakarta

Author(s):  
Khotimatul Khusna ◽  
Rita Septiana

ABSTRAKDiabetes mellitus (DM) didefinisikan sebagai penyakit kronis yang disebabkan karena keturunan atau kurangnya produksi insulin oleh pankreas, atau tidak efektifnya insulin yang dihasilkan. Pelayanan obat untuk peserta Jaminan Kesehatan Nasional pada fasilitas kesehatan mengacu pada daftar obat yang tercantum dalam Formularium Nasional (Fornas). Selain itu, pelayanan kesehatan juga harus sesuai dengan algoritma terapi. Pemilihan obat hipoglikemik oral (OHO) yang tepat sangat menentukan keberhasilan terapi DM. Penelitian ini bertujuan untuk mengetahui gambaran kesesuaian penggunaan OHO berdasarkan Fornas dan algoritma terapi DM tipe 2 di Faskes Tingkat Pertama X di Surakarta. Penelitian ini termasuk jenis penelitian deskriptif. Pengambilan data dilakukan secara retrospektif dari catatan rekam medik pasien. Sampel dalam penelitian ini adalah OHO di Faskes Tingkat Pertama X di Surakarta pada periode Januari sampai Mei 2019. Hasil penelitian menunjukkan bahwa pasien yang mendapatkan OHO sesuai rekomendasi Fornas sebanyak 105 dan pasien yang mendapatkan OHO sesuai rekomendasi Algoritma Terapi DM sebanyak 75. Kesimpulan penelitian ini adalah 100% penggunaan OHO sesuai rekomendasi Fornas dan 71,43 % penggunaan OHO sesuai rekomendasi Algoritma Terapi DM.Kata kunci : Kesesuaian, Diabetes, Fornas, Algoritma terapiDiabetes mellitus (DM) is a chronic disease caused by heredity or when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Medication services for National Health Insurance participants in health facilities refer to the list of drugs listed in the National Formulary. In addition, health services must also be in accordance with the therapy algorithm. The selection of the right oral hypoglycemic (OH) drug greatly determines the success of DM therapy. This study aimed to know the description of conformity of OH drug use based on the national formulary and type 2 diabetes mellitus therapy algorithm at primary health facility X in Surakarta. This research was a descriptive research with data collection in Retrospective from medical record patient. Sample in this research was OH drug in Primary Health Facilities X at Surakarta period January to May 2019. The results showed that patients who received OH drug according to Fornas recommendations were 105. Patients who received OH drug according to the recommendations of the DM Therapy Algorithm were 75. The conclusion of this study is 100% OH drug according to National recommendations and 71,43% OH drug according to DM Therapy Algorithm recommendations Keywords: Conformity, Diabetes, National Formulary, Therapy Algorithm

2021 ◽  
Vol 3 (2) ◽  
pp. 74-80
Author(s):  
Loraetta Brety Sebayang ◽  
Romauli Anna Teresia Marbun ◽  
Dewi Kartika

Background: Diabetes Mellitus is a chronic condition, which occurs because the body cannot produce insulin, normally or insulin cannot work effectively. Objective: To determine the effectiveness of the rational administration of antidiabetic, oral treatment of diabetes mellitus patients at the age of 30-50 years type 2 in Deli Serdang Hospital, lubuk pakam in 2020. Method: This study is a non-experimental type of research using descriptive methods. Results: Shows that from 72 samples of Type II Diabetes Mellitus patients at Deli Serdang General Hospital, April-July Period 2020. With the number (52.8%) of male sex patients and the number (47.2%) of type patients  female genitalia and antidiabetic drugs most widely used by patients, in the period of April-July 2020, namely (20.8%) glycionion + metformin and (20.8%) insulin drugs.  the use of DM drugs with the right rational indication (65.3%), Rational with the right medicine (100%), rational with the right dosage (100%), the right rational patient (100%) and the rational way of administration (100:%). Conclusion: Evaluation of drug use is a structured quality assurance process that is carried out continuously to ensure that the drugs used are appropriate, safe, and efficient.


Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 290
Author(s):  
Khabo Mahlangu ◽  
Perpetua Modjadji ◽  
Sphiwe Madiba

The study determined the nutritional status of adult antiretroviral therapy (ART) recipients, and investigated the association between the duration on ART and the nutritional status. This study was based in primary health facilities in Gauteng, South Africa. The data collected included sociodemographic variables; the duration of the treatment; and the body mass index (BMI), classified as undernutrition (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or overweight/obesity (≥25 kg/m2). ART recipients (n = 480) had a mean age of 35 (± 8.4SD) years. All had taken ART for six months or more (range 6–48 months). The data were analyzed using STATA 13.0. The overall prevalence of overweight/obesity was 39%, it was higher in females (46%) than in males (30%), 26% were overweight, and 13% were obese. Underweight was 13%, and was higher in males (18%) than females (9%). Being overweight was more likely in those aged ≥35 years and those in smaller households. Being obese was less likely in males, in the employed, and in those with a higher income, but was more likely in those with a longer duration on ART. Abdominal obesity was high, but less likely in males. Interventions to prevent overweight/obesity should be integrated into routine HIV care, while at the same time addressing the burden of undernutrition among ART recipients.


2021 ◽  
Vol 24 (1) ◽  
pp. 11-19
Author(s):  
Eka Fitria Sari ◽  
Faihatul Mukhbitin ◽  
Ernawaty Ernawaty

Head of Surabaya City Health Department Decree No.440/19547/436.3/2016 is based on Indonesian Minister of Health Decree No.HK.02.02/MENKES/514/2015. The regulation explains the need for the management of 195 clinical diagnoses in primary health facilities because it is related to the primary health facilities' capability to handle 195 clinical diagnoses. The RRNS achievement table in January-May 2017 shows that primary care clinics were primary health facilities that occupy the unsafe zone (RRNS>5%) namely 16.68% in Surabaya City. The research objective is to analyze the primary care clinics' capability in Surabaya City to handle the 195 clinical diagnoses. This research used a descriptive cross-sectional design in four primary care clinics with 20 people sampled. The results showed that all clinics had not been able to provide complete services. Clinical doctors had good capabilities in accordance with the Head of Surabaya City Health Department Decree No.440/19547/436.3/2016 but were not supported by the completeness of supply following the Indonesia Minister of Health Decree No.HK.02.02/MENKES/514/2015. In conclusion, only 65 (≤33%) clinical diagnoses can be handled properly with the imbalance between the doctors' capabilities and completeness of supply. This research suggests the regulation makers must also review the primary care clinics' capability to provide supplies and clinics can determine the right cost-containment strategy to handle 195 clinical diagnoses. Abstrak SK Kadinkes Kota Surabaya No.440/19547/436.3/2016 didasari oleh Kepmenkes RI No.HK.02.02/MENKES/514/2015. Peraturan yang menjelaskan tentang kebutuhan penatalaksanaan penanganan 195 diagnosis klinis di FKTP karena berkaitan dengan kemampuan FKTP melakukan penanganan. Tabel pencapaian RRNS bulan Januari-Mei 2017 menunjukkan klinik pratama merupakan jenis FKTP yang paling banyak menempati zona tidak aman (RRNS>5%) yakni 16,68% di Surabaya. Penelitian bertujuan menganalisis kemampuan klinik pratama di Kota Surabaya dalam menangani 195 diagnosis klinis. Penelitian menggunakan desain crosssectional deskriptif di empat klinik pratama dengan sampel 20 orang. Hasil menunjukkan semua klinik yang diteliti belum mampu menyediakan pelayanan secara lengkap. Dokter klinik memiliki kemampuan yang baik sesuai SK Kadinkes Kota Surabaya No.440/19547/436.3/2016 tetapi tidak didukung dengan kelengkapan supply yang dibutuhkan sesuai Kepmenkes RI No.HK.02.02/MENKES/514/2015. Kesimpulannya, diagnosis klinis yang dapat ditangani dengan baik hanya sebanyak 65 (≤33%) dengan hambatan ketidakseimbangan antara kemampuan dokter dan kelengkapan supply. Penelitian ini menyarankan pembuat kebijakan juga meninjau kemampuan klinik dalam menyediakan supply dan klinik dapat menentukan strategi cost containment yang tepat untuk menangani 195 diagnosis klinis.


2020 ◽  
Vol 11 (1) ◽  
pp. 7-10
Author(s):  
Khadiza Begum ◽  
Fahmida Islam ◽  
Farjana Aktar ◽  
Murshida Aziz ◽  
Tohfa E Ayub Tahiya

Background: In recent times much is talked about of serum ferritin, an acute phase reactant a marker of iron stores in the body and its association with diabetes mellitus. Studies implicate that increased body iron stores and subclinical hemochromatosis has been associated with the development of glucose intolerance, type 2 diabetes and its micro as well as macrovascular complications. Material & Methods: This study was carried out to examine and to observe for any relationship between serum ferritin with Type 2 diabetes mellitus. Our study populations were included 163. Among them 81 type 2 diabetes patients as a case (M=49,F=32, mean 44.68 age in years)and 82 normal healthy individual as a control ( M=35, F=47 , mean 34.71 in years). Results: Majority were healthy outpatients who had come for regular checkup and were matched with controls. Serum ferritin and FBS were estimated and other investigations. Results showed that although Serum ferritin was in the normal range value it was increased in type 2 diabetes patients than in controls and was statistically significant, we did get a positive correlation with duration of diabetes. It can be concluded that there were positive associations between serum ferritin and FBG, age, sex among study groups. Conclusion: In conclusion our study shows that there is significant correlation between increased serum ferritin in diabetes compared to individuals with normal blood sugars in this part and hyper ferritinemia may be one of the causes for development of insulin resistance before overt diabetes. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 7-10


2018 ◽  
Vol 31 (3) ◽  
pp. 190-202 ◽  
Author(s):  
Jennie Jaribu ◽  
Suzanne Penfold ◽  
Cathy Green ◽  
Fatuma Manzi ◽  
Joanna Schellenberg

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.


2021 ◽  
Vol 13 (3) ◽  
pp. 1343
Author(s):  
José Carmelo Adsuar ◽  
Jose Parraca ◽  
Armando Raimundo ◽  
Miguel Angel Garcia-Gordillo ◽  
Patricia Polero ◽  
...  

Background: Reliability studies are used to verify the evaluation accuracy of a given device. Strength is an important factor for the development of daily activities and its correct management is fundamental. The objective of this study was to examine the reliability of a concentric strength test in people with type 2 diabetes mellitus (T2DM). Methods: Twenty-seven individuals with T2DM performed three repetitions of extension-flexion in concentric-concentric action at 60°/s, for both legs, using an isokinetic dynamometer. For the reliability analysis, we performed an intra-session test retest. Results: The total sample and men sub-group intra-class correlation coefficient (ICC) values were excellent for peak torque and work. In the women sub-group, ICC values were excellent for extensors in both peak torque and work; however, concerning flexor, the ICC values were good for peak torque while, for work, they were good for the right leg and moderate for the left leg. Standard error of measurement (SEM) percentage oscillated from 3.85% to 6.80%, with the smallest real difference (SRD) percentage being from 10.66% to 18.86% for peak torque. Furthermore, the SEM (%) was around 5.5% and SRD (%) was around 15% for work. Conclusions: The isokinetic dynamometry had “good” to “excellent” relative reliability for peak torque (0.862–0.983) and work (0.744–0.982) of extension-flexion in concentric-concentric action at 60°/s. In addition, our study showed that, in general, an SRD < 20% could indicate a true change in strength regarding this protocol in T2DM.


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