EVALUASI RASIONALITAS PENGGUNAAN DAN PEMBERIAN OBAT PADA PASIEN HIPERTENSI GERIATRI DI PUSKESMAS TAJINAN PERIODE JANUARI – DESEMBER 2019

2020 ◽  
Vol 5 (2) ◽  
pp. 268-277
Author(s):  
Luluk Anisyah ◽  
◽  
Wibowo Wibowo
Keyword(s):  
Correlation Analysis ◽  
Medical Record ◽  
Significant Relationship ◽  
Antihypertensive Drugs ◽  
Hypertension Management ◽  
Hypertensive Patients ◽  
Primary Health ◽  
Data Collection Sheet ◽  
Dose Accuracy ◽  
Accuracy Data

Increasing the number of elderly causes an increase in health problems one of which is associated with hypertension which can cause complications and death. The purpose of this study was to determine the description and accuracy of the use of antihypertensive drugs in geriatric patients who were diagnosed with hypertension at the Tajinan Primary Health in Malang in the period January-December 2019. This study was an observational or non-experimental study conducted using retrospective medical record data. The measuring instrument used was the data collection sheet from the medical record, the Consensus for Hypertension Management 2019 to see the accuracy of indications, patient accuracy, drug accuracy, and dose accuracy. Data analysis using Correlation Test. The results of the correlation analysis showed that the resulting Standardize estimates were 0.002 (p <0.05) which showed that there was a significant relationship between sexes with the occurrence of hypertension. The results of the correlation analysis showed that the resulting Standardize estimates were 0.001 (p <0.05) which means that there was a significant relationship between the accuracy of the types of antihypertensive drugs used in hypertensive patients. The conclusion is that the rationality evaluation of the use and administration of drugs in hypertensive patients at the Tajinan Primary Health in Malang based on the 2019 Hypertension Management Consensus guidelines shows the accuracy both in terms of indication, drug, patient and dose.

scholarly journals Analisis Minimisasi Biaya Amlodipin Generik dan Bermerk pada Pengobatan Hipertensi di RS X Pekanbaru Tahun 2015

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Hanny Merliana
Keyword(s):  
Internal Medicine ◽  
Blood Pressure ◽  
Health Care ◽  
Cost Minimization ◽  
Hypertension Management ◽  
Hypertensive Patients ◽  
Cost Minimization Analysis ◽  
Primary Health ◽  
Internal Medicine Clinic ◽  
Effective Drugs

Abstrak Hipertensi merupakan tantangan besar di Indonesia, berdasarkan data Riskesdas 2013 prevalensi kejadian sebesar 25% ser­ta kondisi yang sering ditemukan pada pelayanan kesehatan primer. Disamping itu, pengontrolan hipertensi belum adekuat meskipun obat-obatan yang efektif banyak tersedia. Amlodipine adalah salah satu obat hipertensi yang paling sering direse­pkan di RS X Pekanbaru. Untuk itu,dipandang perlumelakukan analisis minimisasi biaya dari pengggunaan amlodipine generik dan bermerek sebagai bentuk kendali mutu dan kendali biaya.Penelitian ini merupakan studi retrospektif yangmenggunakan data pasien hipertensi ringan sampai sedang dan periode pengobatan selama 1 bulan dari bulan Januari sampai Desember ta­hun 2015. Analisa CMA berdasarkan perspektif provider (rumah sakit sebagai pemberi pelayanan).Hasil analisis data ditemu­kan bahwa penggunaan amlodipin generik lebih banyak dibandingkan penggunaan obat bermerk di Poli Jantung dan Penyakit Dalam RS. X.Rerata biaya pengobatan dengan amlodipin generik Rp 68.660,- per bulan sedangkan dengan amlodipin ber­merk sebesar Rp. 374.844.- atau sekitar 5,4 kali lebih tinggi dari amlodipin generik. Penggunaan amlodipin generik maupun bermerk menurukan tekanan darah secara bermakna, namun tidak terdapat perbedaan bermakna antas penurunan tekanan darah yang dicapai dengan pemberian amlodipin generik maupun amlodipin bermerk. Disimpulkan bahwa amlodipin generik merupakan pilihan yang efisien dalam menurunkan tekanan darah dan memiliki biaya yang lebih efisien dibandingkan dengan amlodipin bermerk.Abstract Hypertension in a big challenge in Indonesia, proven by its prevalence that reached 25% in 2013 and conditions that mostly found in primary health care. In addition, hypertension management is considered to be suboptimal despite the availability of effective drugs. Amlodipine is one of anti-hypertensive that is commonly prescribed by X Hospital, Pekan Baru. Therefore, it is important to do cost minimization analysis to compare both generic and branded Amlodipine as an implementation of cost and quality control. This ret­rospective study involved early and medium stage of hypertensive patients that have at least a month period of treatment from Jan­uary to December 2015 using provider’s perspectives of CMA (Cost Minimization Analysis). The result showed that generic form of Amlodipine is the most common anti-hypertensive drugs prescribed in Cardiology and Internal Medicine Clinic, X Hospital. It was suggested that average cost of generic form of Amlodipine was IDR 68.660 while branded one was IDR 374.844 or approximately 5.4 times higher. Both generic and branded Amlodipine significantly reduced blood pressure, but there was not any distinguish effect between them. It was concluded that generic form of Amlodipine was a less expensive and efficient choice in reducing blood pressure.

scholarly journals Primary health institutions preference by hypertensive patients: effect of distance, trust and quality of management in the rural Heilongjiang province of China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingjing Liu ◽  
Hui Yin ◽  
Tong Zheng ◽  
Bykov Ilia ◽  
Xing Wang ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Health Resources ◽  
Hypertension Management ◽  
Heilongjiang Province ◽  
Allocation Model ◽  
Hypertensive Patients ◽  
Primary Health ◽  
Health Institutions

Abstract Background Traditional “inverted triangle” healthcare resources allocation model in China has wasted a lot of health resources. The Chinese health reform began to strengthens the role of the primary health institutions in delivering primary health care especially in rural areas in the background of large development gap between urban-rural health and rapid growth in the incidence of chronic diseases in rural. We take hypertensive patients as an example, to verify the effect of policy implementation through distribution characteristics of rural primary health institutions preference of hypertensive patients and explore the influencing factor that promoting rationalized use of medical care for patients with chronic disease as well as rational allocation of health resources in rural areas. Methods A cross-sectional survey was conducted in Heilongjiang, a province in northeastern China by using a self-designed questionnaire. Stratified cluster sampling was used to choose 484 hypertensive patients from two villages in Heilongjiang province in 2010. Results About 88.4% of respondents reported preferred primary health institutions (83.5% preferred village clinics and 4.9% preferred township hospitals), 49.4% of respondents knew hypertension management administered by primary health institutions, 53.5% received hypertension education from primary care physicians, more than half of respondents reported that they didn’t receive telephone interviews and family visits from primary care physicians over the past 6 months. Residence closer to the primary health institutions (OR = 10.360), trust in village doctors (OR = 7.323), elders (OR = 3.001), and asked for return visits by primary health physicians (OR = 2.073) promote preferences for primary health institutions. Conclusions: Accessibility to primary healthcare and doctor-patient trust stimulate patients to choose the primary health institutions. Primary health institutions should improve general approach to hypertension management and enhance the ability of providing basic public health services.

scholarly journals EVALUASI PENGGUNAAN OBAT ANTIHIPERTENSI PADA PASIEN GERIATRI RAWAT JALAN DI RSUD DR. A. DADI TJOKRODIPO

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Lilik Koernia Wahidah ◽  
Keyword(s):  
Blood Pressure ◽  
Heart Disease ◽  
Geriatric Patients ◽  
Sampling Methods ◽  
Antihypertensive Drugs ◽  
Retrospective Data ◽  
Hypertensive Patients ◽  
Health Quality ◽  
Dose Accuracy ◽  
Outpatient Drug

Hypertension is a condition in which systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg. Hypertension is often found in geriatrics that can affect the onslence of heart disease and blood vessels. Increased cases of hypertension, the rational use of drugs by hypertensive patients is one of the important elements in achieving health quality. The purpose of this study is to find out the harsh use of antihypertensive drugs in outpatient geriatric patients at Dr. A. Dadi Tjokrodipo Hospital bandar Lampung. This type of research is non experimental with a descriptive design using retrospective data with purposive sampling methods. The results of the study were based on the pattern of use of antihypertensive with the ATC/DDD method in hypertension patients in Dr. A. Dadi Tjokrodipo Bandar Lampung city is 5331,03 DDD/1000 KPRJ, there are nine types of antihypertensive used, namely amlodipine, lisinopril, candesartan, irbesartan, furosemide, spironolactone, ramipril, bisoprolol and captopril. Antihypertensive in the drug uses segment 90%, namely amlodipine 44.37%, lisinopril 16.88%, candesartan 15.46% and irbesartan 13.65%. The study was based on 100% patient accuracy criteria, 100% indication accuracy, 89.3% drug accuracy and 92% dose accuracy. The conclusion of this study, the pattern of use of antihypertensive widely used is amlodipine amounting to 2365.52 DDD/1000 KPRJ, antihypertensive that enters the drug uses segment 90% namely amlodipine, lisinopril, candesartan and irbesartan.Keywords: Antihypertensive, Geriatrics, Outpatient, Drug Use

scholarly journals Antihypertensive Efficacy of Fixed Combination of Amlodipine and Ramipril in Patients with Arterial Hypertension and Very High Cardiovascular Risk

2019 ◽  
Vol 14 (6) ◽  
pp. 840-845
Author(s):  
O. Yu. Korennova ◽  
S. P. Podolnaya ◽  
E. P. Prihodko ◽  
E. A. Turusheva ◽  
S. N. Starinskaya ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Antihypertensive Efficacy ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients ◽  
Coronary Artery Stenting ◽  
History Of ◽  
Very High

Aim. To evaluate the antihypertensive efficacy and tolerability of a fixed combination of amlodipine and ramipril in hypertensive patients with very high cardiovascular risk. Material and methods. A retrospective cohort study of real clinical practice of prescribing antihypertensive drugs according to 255 medical records of outpatient hypertensive patients with a history of acute coronary syndrome (ACS) and coronary artery stenting was performed in the first part. An open observational study was performed in the second part. 69 people older than 18 years with a history of ACS and coronary artery stenting, without reaching the target blood pressure (BP) level while using free combinations of antihypertensive drugs and with indications for a fixed combination of ramipril and amlodipine were included into the study. Analysis of self-monitoring of BP, office BP, daily BP monitoring (ABPM) and patients’ adherence to treatment (Morisky-Green test) initially, after 4 and after 12 weeks of taking the fixed combination of ramipril and amlodipine was performed to assess the clinical efficacy of the studied drug. Results. It was found that 42.0% of patients did not follow the recommendations for regular intake of antihypertensive drugs. So, hypertension of all patients regarded as false-refractory, which was the basis for the prescription of the fixed combination of ramipril and amlodipine in accordance with clinical guidelines for the diagnosis and treatment of hypertension. After 4 weeks of therapy, there was significant decrease in office BP with the achievement and preservation of the target level by the 12th week, normalization to the 12th week of day and night BP variability in 54.9% of patients. 78.0% of patients followed medical recommendations for regular administration of antihypertensive drugs, none of the patients had adverse events. Conclusion. The use of fixed combinations of drugs, in particular, amlodipine and ramipril as a part of multicomponent therapy in hypertensive patients with very high cardiovascular risk, led to the achievement of target BP by the 4th week of therapy and stable preservation of antihypertensive effect in 12 weeks of treatment as well as gradual normalization of day and night BP variability in more than half of patients. Fixed combination of ramipril and amlodipine allowed to improve adherence of patients to cardiovascular diseases.

scholarly journals Obstructive sleep apnea syndrome and sleep quality in hypertensive patients

2017 ◽  
Vol 63 (12) ◽  
pp. 1055-1060 ◽  
Author(s):  
Marcelo Rodrigues Bacci ◽  
Jonathan Naim Mora Emboz ◽  
Beatriz da Costa Aguiar Alves ◽  
Glaucia Luciano da Veiga ◽  
Neif Murad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
High Blood Pressure ◽  
Antihypertensive Drugs ◽  
Poor Sleep ◽  
Hypertensive Patients ◽  
Group I ◽  
Obstructive Sleep

Summary Introduction: Obstructive sleep apnea and hypopnea syndrome (OSAHS) is one of the developmental factors of high blood pressure (HBP), a relevant global public health problem. OSAHS is characterized by the reduction or complete cessation of respiratory airflow due to intermittent airway collapse. Additionally, significant changes in sleep rhythm and pattern are observed in these patients. Objective: To evaluate the association between OSAHS and sleep quality in essential and resistant hypertensives. Method: A cross-sectional, observational study evaluated 43 hypertensive patients treated at the outpatient clinics of the Faculdade de Medicina do ABC (FMABC) who were medicated with two or more antihypertensive drugs and divided into nonresistant or resistant to treatment. Results: Group I (using up to two antihypertensive agents – 60.47% of the sample) presented mean systolic blood pressure (SBP) of 127.5±6.4 mmHg, mean diastolic blood pressure (DBP) of 79.6±5.2 mmHg, mean body mass index (BMI) of 27.2±5.3 kg/m2 and mean age of 51.2±15.1 years. Group II (using more than two antihypertensive drugs – 37.2% of the sample) presented mean SBP of 132.1±9.3 mmHg, mean DBP of 84.5±5.8 mmHg, mean BMI of 27.2±7.2 kg/m2 and mean age of 55.5±13.4 years. The patients presented low quality of sleep/sleep disorder evaluated by the Pittsburgh Sleep Quality Index (PSQI), which represents a preponderant factor for OSAHS. Conclusion: Patients at high risk for OSAHS had poor sleep quality and high levels of DBP, suggesting a causal relation between these parameters. However, they did not present a higher prevalence of resistant high blood pressure (RHBP).

Abstract 438: Association between Insomnia and Use of BP-lowering Drugs in hypertensive Patients: a Cross-sectional Cohort Study

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Rosa Maria Bruno ◽  
Laura Palagini ◽  
Veronica Mancuso ◽  
Martina Cargiolli ◽  
Angelo Gemignani ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Trait Anxiety ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Multiple Logistic Regression Analysis ◽  
Female Gender ◽  
Short Sleep Duration ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Drug Classes

Purpose: Insomnia and short sleep duration have been associated with increased prevalence, incidence and severity of hypertension. However, the relationship between insomnia and use of different antihypertensive drug classes has not been ascertained yet. Methods: 371 hypertensive patients at their first visit in a tertiary Hypertension Outpatient Unit were enrolled. Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAY-Y2) were administered. Insomnia was defined as ISI>8, depressive symptoms as BDI>10, trait anxiety as STAI -Y2>40. Patients with self-reported sleep apneas or snoring (n=29) or with incomplete data (n=12) were excluded. Results: Data from 330 patients were analyzed (males 51%, mean age 57±13 years, antihypertensive treatment 84%, previous CV events 9%, diabetes 7%, obesity 24%, smoking 13%, hypercholesterolemia 67%). Insomniacs (n=70, 21%) were older than non-insomniacs (60±11 vs 56±13 years, p=0.02); female gender (62 vs 46%, p=0.01), anxiety (68 vs 34%, p<0.0001) and depressive symptoms (30 vs 6%, p<0.0001) were more prevalent in insomniacs. Insomniacs were treated with higher number of antihypertensive drugs (1.8±1.0 vs 1.5±1.0, p=0.04) and more frequently with angiotensin-receptor-blockers (ARBs, 49 vs 31%, p=0.009) and diuretics (50 vs 28%, p=0.0007), whereas the use of other drug classes was similar. In a multiple logistic regression analysis, adjusted for cardiovascular and psychiatric variables, ARBs use (OR 2.4, CL95% 1.1-5.2), depressive symptoms (OR 3.2, CL95%1.2-8.7) and anxiety (OR 2.9, CL95%1.4-6.1) were associated with a higher probability of insomnia. Conclusions: This cross-sectional analysis suggests that ARBs use may be associated with insomnia in a cohort of hypertensive patients

The Case of Shisong Hospital: Is Promotion the Reason for Employee Satisfaction, Commitment or Intention to Quit?

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Benard Berinyuy ◽  
Lema Catherine Forje
Keyword(s):  
Correlation Analysis ◽  
Significant Relationship ◽  
Employee Satisfaction ◽  
Employee Commitment ◽  
Strong Relationship ◽  
Health District ◽  
Intention To Quit ◽  
Significant Relationships ◽  
Northwest Region ◽  
Labour Turnover

The movement of professionals from one organisation to another in quest for satisfaction has been a matter of serious concern to health organisations especially Shisong hospital in Kumbo east health district, Bui Division of the Northwest Region of Cameroon. This hospital sought to reduce this labour turnover and increase employee satisfaction through promotion, which is one of its internal recruitment sources. The question has been whether the use of promotion will lead to employee satisfaction and commitment and reduce the urge to leave this organisation. An investigation has been done using a close ended questionnaire with 166 employees of this hospital to prove if significant relationships exist between promotion and employee satisfaction; employee satisfaction and employee commitment; and promotion and employee intention to quit the organisation. Correlation analysis concluded that there is a significantly strong relationship between promotion and employee satisfaction, a significantly very strong relationship between employee satisfaction and employee commitment and a negatively weak significant relationship between promotion and employee intention to quit this Hospital. Specially, it has been realised that even employees who have not experienced promotion in Shisong hospital are not willing to quit their job as a result of promotion. There will therefore be need to investigate the reason for this special result. Based on promotion alone, much is left to be desired from Shisong hospital.

CLINICAL, ECHOGRAPHIC, MORPHOLOGICAL AND IMMUNOLOGICAL CRITERIA FOR EVALUATING A WELL-FOUNDED SCAR ON THE UTERUS AFTER CESAREAN SECTION

2021 ◽  
Vol Special issue (1) ◽  
pp. 57-61
Author(s):  
Venera Kurbaniyazova ◽  
Keyword(s):  
Correlation Analysis ◽  
Cesarean Section ◽  
Correlation Coefficient ◽  
Significant Relationship ◽  
Strong Correlation ◽  
Type I Collagen ◽  
Morphological Features ◽  
Average Degree ◽  
Type I ◽  
Uterine Scar

The results of the conducted studies 102 of the manufacturer testify to the presence of essential clinical and echographic, immunological and morphological features of the "wealthy" or "insolvent" scar on the uterus after the cesarean section. The correlation analysis with the calculation of the Correlation coefficient of Gamma (G) indicates a statistically significant relationship between the average degree between the way of the delivery and the scar thickness (G = 0.55, p = 0.001), strong correlation between the ultrasound data (G = 0.74 , p = 0.002) and antibodies to type I collagen (G = 0.93, p = 0.003). Determining the level of antibodies to the type I collagen is the mostimportant criterion confirming the usefulness of the scar on the uterus.Keywords: cesarean section, uterine scar, pregnancy

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