{"title":"Off-label Medication Use in Pediatric Outpatients: A Retrospective Observational Study at Dr. H. Abdul Moeloek Hospital in Lampung","authors":"Cheri F. A. Dera, Suri Nurma","doi":"10.15416/ijcp.2022.11.2.116","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.2.116","url":null,"abstract":"Several medications are prescribed for infants and children, but adequate information about these drugs are unavailable. Previous studies also revealed that the use of off-label drug is prevalent among pediatric outpatients. Therefore, this study aimed to determine the prevalence of off-label drug use in pediatric outpatients at Dr. H. Abdul Moeloek Lampung Hospital from January–June 2019. This observational descriptive was conducted using simple random and retrospective sampling methods. Drugs were identified using a brochure, British National Formulary for Children (BNF), and Specialist Health Science Formulary from the Indonesian Pediatrician Association (IDAI), followed by classification with the Anatomical Therapeutical Chemical (ATC). The results showed that there were 120 samples, of which 56% are males, while 42% are within the age range of 6–12 years. The most common diagnoses were SNRS, followed by epilepsy and anemia. A total of 393 drugs were used in this study and analgesic-antipyretic was the most prescribed. The prevalence of off-label drug usage in pediatric patients was 19.6%, where the off-label age was higher (16.29%) than indication (2,81%) and doses (0,5). Furthermore, most of these medications were for the cardiovascular, respiratory, digestive, and metabolic systems. There has been a 19,6% prevalence in the use of off-label drug among pediatric outpatients, where off-label age was the highest, and most of the medication are used for the treatment of the cardiovascular system.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126277470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Viviandhari, N. Nurhasnah, R. N. Sakinah, Desi Wulandari
{"title":"A Comparison of Potentially Inappropriate Medications Identification Using Beers and STOPP Criteria in Hospitalized Geriatric Patients in Jakarta","authors":"D. Viviandhari, N. Nurhasnah, R. N. Sakinah, Desi Wulandari","doi":"10.15416/ijcp.2022.11.2.105","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.2.105","url":null,"abstract":"Adverse Drug Events (ADE) are closely related to Potentially Inappropriate Medications (PIMs) among the elderly, and can cause an increase in morbidity, mortality, and medical cost. The tools often used to assess PIMs include Beers and Screening Tool of Older Persons’ Prescriptions (STOPP) Criteria. Therefore, this study aimed to compare the PIMs identification using Beers 2019 and STOPP version 2 2016 Criteria. A descriptive-analytical method was used, and data were collected retrospectively from the medical records of 340 patients at Pondok Kopi Islamic Hospital period in 2018. The results showed that among 324 patients who met the inclusion criteria with Beers 2019, PIMs were present in 136 (41.85%), with 181 cases. Most of them were on criteria 3, namely 46 (25.41%) and 33 (18.23%) cases of furosemide and spironolactone, respectively. Meanwhile, out of 308 patients who met the inclusion criteria with STOPP, PIMs were found in 14 (4.55%) with a total of 18 cases. The use of aspirin or clopidogrel was observed in 7 people (38.89%) with uncontrolled severe hypertension, while NSAID usage was found in 3 uncontrolled severe hypertension patients (16.67%). Furthermore, there were 3 cases of aldosterone antagonist or ARB usage, which was combined with other drugs that can increase potassium without proper monitoring of the serum level (16.67%). In Pondok Kopi Islamic Hospital, Beers 2019 criteria can describe PIMs data better than the STOPP version 2 2016 due to data availability. Clinician and pharmacist collaboration is also needed in formulating the critical supporting data.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126183779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correlation between Serum Level of Vitamin D and Covid-19 Infection Severity: A Literature Review","authors":"D. Wulansari, Indi R. Tsani, R. A. Prasetya","doi":"10.15416/ijcp.2022.11.2.174","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.2.174","url":null,"abstract":"In recent years, infectious diseases caused by viruses have become one of the biggest global health problems, including coronavirus disease 2019 (Covid-19) infection. Covid-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which can induce immune responses and inflammatory reactions, thereby leading to the damage of tissues. Hyperinflammation due to cytokine storm in infected patients increases the risk of severe infection and death. Vitamin D can also reduce the severity of infections because it acts as an immunomodulator. Therefore, this study aimed to determine the immunomodulatory effect of vitamin D on Covid-19 infections. A total of nine articles were collected using literature searching on several databases, such as PUBMED and Science Direct with the keywords of “Covid-19”, “immunomodulator”, and “vitamin D”. Five of them were observational or retrospective studies, which determined the correlation between serum concentration of vitamin D and Covid-19 infection severity. Meanwhile, another four articles were random clinical trials testing the effect of the drugs’s supplementation on infected people. The results showed that high levels of serum vitamin D can cause low concentrations of pro-inflammatory cytokines, which reduces the incidence of acute respiratory infections and the severity of the viral infection. Furthermore, vitamin D, specifically D3, has the potential to act as an immunomodulator in Covid-19 by reducing pro-inflammatory cytokines, thereby reducing the risk of severity.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114581955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of Rational Use of Antibiotics on Clinical Improvement of Pediatric Inpatients with Pneumonia","authors":"Mega Damayanti, E. Olivianto, E. Yunita","doi":"10.15416/ijcp.2022.11.2.129","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.2.129","url":null,"abstract":"Among acute respiratory infections, pneumonia is the second leading cause of children’s death in Indonesia. The rational use of antibiotics has become a concern, because they play a significant role in managing pneumonia therapy. Therefore, this study aims to analyze the effect of rational and irrational use of antibiotics on clinical improvement in pediatric inpatients with pneumonia. This retrospective-observational analytical study was conducted using a cross-sectional method. The study instruments were the medical records of pediatric inpatients with pneumonia from January 2019 to December 2020 at Dr. Saiful Anwar General Hospital Malang. The results showed that 64 (58.18%) and 46 (41.82%) patients received antibiotics rationally and irrationally, respectively. The rational usage had a significant effect on clinical improvement on the second day, including shorter length of hospitalization, restoration of normal body temperature, respiratory rate, pulse, and leukocyte count (p=0.001; p=0.001; p=0.001; p=0.001; p=0.024). Furthermore, on the fifth day, there was restoration of normal respiratory rate and leukocyte count (p=0.009; p=0.001). Based on the result, the rational use of antibiotics can accelerate clinical condition improvement in pediatric inpatients with pneumonia.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124713520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Setiawan, Phebe Hendra, D. Virginia, L. K. Sari
{"title":"Influence of Therapy Compliance Using Medication Possession Ratio Method for Patients with Metabolic Syndrome","authors":"C. Setiawan, Phebe Hendra, D. Virginia, L. K. Sari","doi":"10.15416/ijcp.2022.11.2.145","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.2.145","url":null,"abstract":"Metabolic syndrome is still a major problem in developing countries and it has an association with high blood pressure, blood glucose, and lipid profile abnormalities, which can cause cardiovascular disease. This indicates that it is important to provide adequate treatment, but patient compliance has effects on the outcome. Improving patients’ compliance to treatment can provide a better control of the condition. Therefore, this study aimed to determine the association between medication compliance and the therapeutic outcome of metabolic syndrome. This observational analytic study was conducted using a retrospective cohort design for one year of observation, namely April 2020-March 2021. The influence of patient compliance with therapy outcomes in terms of blood pressure, blood glucose, and lipid profile was assessed using the medication possession ratio method. This study was carried out by examining patients’ medical records from the Bethesda Lempuyangwangi Hospital as parameters for compliance, while the outcome parameters were assessed by experts. The data obtained were analyzed using Anova (homogeneous data) or Kruskal-Wallis (not homogeneous data) to determine the differences in the compliance based on patients’ characteristics. The relationship of adherence to therapeutic outcomes was analyzed using logistic bivariate. From 174 patients’ data that was observed, only 151 had a blood test. The average systolic blood pressure, total cholesterol, triglyceride, and HbA1c levels were above the standard threshold. The three levels of compliance had no significant relationship with blood pressure, HbA1c, and lipid profiles (p>0.05). The adjusted data for age and gender on adherence showed patients with low compliance, and they have a 2.08 times risk of having high triglyceride levels compared to others (p<0.05). The results indicated the patients’ low compliance to therapy, hence, health professionals must strengthen education to improve this condition.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"16 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132958246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rimadani Pratiwi, I. T. Maisyarah, N. M. Saptarini
{"title":"Precautionary Measures, Attitude, and Productive Activities of Students in West Java Province, Indonesia, during Covid-19 Pandemic","authors":"Rimadani Pratiwi, I. T. Maisyarah, N. M. Saptarini","doi":"10.15416/ijcp.2022.11.2.155","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.2.155","url":null,"abstract":"The Covid-19 pandemic has been ongoing for approximately one year, hence, several activities must be carried out remotely from home. Studying from home for every level of education has its challenges, specifically for university students in terms of maintaining productive activity. Therefore, this study aimed to determine the impact of a one-year pandemic on the precautionary measures, attitudes, and productive activities of students in Indonesia. A descriptive cross-sectional approach was used, and an online questionnaire was distributed between 11–15 January 2021 to 628 undergraduates in West Java Province. The result showed that students still adhere to health protocols by wearing a face mask (93.8%), washing hands (74.7%), and social distancing (64.5%), but they were feeling bored (60.2%) with the online activities carried out at home. A total of 81.4% hope the activity and online class can change to face-to-face to keep social interaction with other people. In productivity, more than 40% can find new hobbies and carry out positive activities while staying at home. They were also feeling more grateful during the pandemic. Based on the results, students are still aware of health protocols and regulations of the government as precautionary measures for the spread of Covid-19. Despite the boredom, they can still stay productive by engaging in positive activities at home.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133545589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Gene Polymorphism in Drug-metabolizing Enzyme on Concentration of Rivaroxaban: A Narrative Review","authors":"S. P. Atmaja, Ani Kristiyani, E. Rawar","doi":"10.15416/ijcp.2022.11.2.164","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.2.164","url":null,"abstract":"Rivaroxaban is an anticoagulant agent that often experience biotransformation in the liver through CYP3A4/5 (18%); CYP2J2 (14%) and CYP independent hydrolytic cleavage (14%). Several studies revealed that Polymorphism in drug-metabolizing enzyme genes can affect the rivaroxaban levels in the body. Therefore, this study aims to review the effect of gene variations of metabolizing enzymes on rivaroxaban concentration in patient’s body. A search using keyword rivaroxaban, polymorphism, CYP3A4, CYP3A5 and CYP2J2 was carried out in Google Scholar. Several studies showed that polymorphisms of metabolizing genes do not have a significant effect on rivaroxaban concentration. There is also a need for comprehensive studies involving all single nucleotide polymorphisms (SNPs) that play a role in the drug’s pharmacokinetics. This is because rivaroxaban is metabolized by several CYP isoenzymes and excreted by different transporters. This still opens the opportunity for further studies on its pharmacogenomic.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127988289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of Prescriptions Pattern in Geriatric Patients at Dr. Soedarso Regional Public Hospital Pontianak Based on Beers Criteria","authors":"Sarah M. Sasfi, E. K. Untari, Shoma Rizkifani","doi":"10.15416/ijcp.2022.11.2.95","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.2.95","url":null,"abstract":"Geriatric patients are suffering from multiple diseases and disorders due to decreased physiological function. The prescription of polypharmacy in this condition can increase the risk of adverse events. Beers Criteria is often used as a reference to identify the risk in geriatric medications. Therefore, this study aimed to obtain an overview of prescriptions with the percentage of usage based on Beers Criteria 2012. A descriptive and observational design was used with a cross-sectional approach. A total of 150 medical records and prescriptions of geriatric outpatients were obtained using a simple random sampling technique at Dr. Soedarso Regional Public Hospital Pontianak, from December 2018 to July 2019. Demographic-characteristic data of patients and class of therapy were identified from medical records and prescriptions. The data were analyzed with a quantitative approach to determine the percentage of patients receiving medications and the percentage of medications based on Beers Criteria 2012. The percentage of polypharmacy based on prescriptions was 21.33%, while 36% received the treatments, which met the criteria. Among the 150 prescriptions that met Beers Criteria, 15 were Spironolactone, which the most frequent therapy. Based on the results, geriatric patients still received medications that met Beers Criteria. It is also very important to carry out safety monitoring when drugs are used by infected people.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133677471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Mariati, Y. Wibowo, K. K. Widjaja, A. P. Setiadi
{"title":"Effects of Labelling Quality on Hypertensive Patients’ Knowledge and Adherence in Mataram","authors":"I. Mariati, Y. Wibowo, K. K. Widjaja, A. P. Setiadi","doi":"10.15416/ijcp.2022.11.1.11","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.1.11","url":null,"abstract":"Hypertension is a chronic condition that requires long-term treatment, hence, adherence has been a major issue. The dispensed medication label has been commonly used to provide written information to optimize drug use in achieving treatment goals. Therefore, this study aimed to determine the effect of improved labeling quality on knowledge and adherence of hypertensive patients in Mataram. This is a pre-/post-intervention study with improved labeling quality (according to Good Dispensing Practice (GDP) standard–9 attributes) as the intervention. The differences in knowledge, adherence, and blood pressure pre-/post-intervention were statistically tested. A total of 132 patients from 11 Public Health Center in Mataram participated in this study from August to October 2017. The results showed a baseline labeling score of 3.6, and after the intervention (improved labeling), a maximum score of 9 was achieved. Knowledge was significantly increased through improved labeling (median score from 2.0 to 5.0; p=0.001). In addition, the intervention enhanced adherence (median score from 1.0 to 2.0; p=0.001). Significant changes were reported in systolic and diastolic blood pressure pre-/post-intervention (p=0.001 and 0.026, respectively). Therefore, preliminary data were provided on the potential of high-quality labeling to improve knowledge and adherence among hypertensive patients in Mataram.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122840285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rehmadanta Sitepu, Fira Dwijayanti, C. D. Yoedistira
{"title":"The Emerge of Mycobacterium tuberculosis Gene from Blood Sample of Tuberculosis Conversion Phase Treatment Patient Using PCR which Staining Evaluation has Not Detected in Janti Public Health Center","authors":"Rehmadanta Sitepu, Fira Dwijayanti, C. D. Yoedistira","doi":"10.15416/ijcp.2022.11.1.22","DOIUrl":"https://doi.org/10.15416/ijcp.2022.11.1.22","url":null,"abstract":"The conversion phase in tuberculosis treatment examines patients to ensure the possibility of further advancement. Despite its low specificity, microscopic evaluation is a standard method at public health centers. Moreover, the biased results from this method form a new problem related to multidrug-resistant tuberculosis (MDR-TB). Molecular approaches are known for their high specificity and accuracy in microbial identification. Therefore, this study aimed to compare the specificity and sensitivity of molecular and microscopic methods. The sample used was 17 blood of tuberculosis patients in the conversion phase accompanied by one positive and negative control collected from October to November 2020. The DNA sequence was 16s RNA with forwarding ACT GAG ATA CGG CCC AGA CT and reverse primer TCA CGA ACA ACG CGA CAA AC. Furthermore, the research was conducted by optimizing variations in the number of cycles, temperature melting (Tm), and template DNA concentration. The results showed 279 bp length of PCR product, under the optimum conditions under 35 cycles, Tm of 60˚C, and template DNA concentration of 5 µmol. The PCR result identified that 2 of 17 samples contain positive Mycobacterium tuberculosis. Meanwhile, none was positive on microscopic evaluation. Therefore, there are different results between microscopic and molecular methods.","PeriodicalId":351729,"journal":{"name":"Indonesian Journal of Clinical Pharmacy","volume":"17 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123726983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}