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Abstract
Abstract
Background: Hypertension is one of the main causes of mortality and morbidity in Indonesia. Drug usage, utilization patterns, and cost estimates are important elements in calculating drug needs in the forecasting of drug needs plans for pharmacies.
Objective: to determine the pattern of drug use with the Anatomical Therapeuetik Chemical (ATC)/Defined Daily Dose (DDD) and Drug Use 90% (DU90%) methods and the estimated cost of antihypertensives with the use of antihypertensive drugs based on the national formulary.
Methods: This research uses observational methods using a cross-sectional design. Retrospective data collection includes prescription from BPJS Kesehatan back-referral program (PRB) which goes into pharmacy A, B, and C for the period 2020.
Results: The most widely used drugs at pharmacy A, B and C based on ATC/DDD classification were amlodipine, candesartan, ramipril, hydrochlorothiazide, and lisinopril. Amlodipine was the most frequent drug in the DU segment 90%. The highest cost of using the drug was candesartan 16 mg (Rp 4,381,531). The percentages of adherence to the use of antihypertensive drugs with the national formulary in pharmacy A, B, and C were 73.91%, 80%, and 68.42%, respectively.
Conclusion: In general, the highest consumption of antihypertensive drugs in Back-Referral Program (PRB) pharmacies in the area of Kudus Regency, which is included in the DU segment 90%, was amlodipine, and the suitability of drugs with the National Formulary has not reached 100%. Referring to the results of the pattern of use of PRB drugs in this study, it is hoped that there will be better coordination between BPJS Kesehatan and pharmacies regarding the distribution and availability of PRB drugs.
Keywords: ATC/DDD, DU 90%, hypertension, national formulary, PRB
Intisari
Latar belakang: Hipertensi merupakan salah satu penyebab utama mortalitas dan morbiditas di Indonesia. Pola pemakaian obat dan perkiraan biaya merupakan elemen penting dalam menghitung rencana kebutuhan obat di apotek.
Tujuan: Penelitian ini bertujuan untuk mengetahui pola penggunaan obat dengan metode Anatomical Therapeuetik Chemical (ATC)/ Defined Daily Dose (DDD), DU 90%, perkiraan biaya antihipertensi dan kesesuaian penggunaan obat antihipertensi dengan Formularium Nasional (Fornas).
Metode: Penelitian menggunakan metode observasional dengan desain cross sectional. Pengumpulan data dilakukan secara retrospektif meliputi resep Program Rujuk Balik (PRB) yang masuk ke apotek A, B dan C pada periode 2020.
Hasil: Penggunaan obat di apotek A, B dan C berdasarkan ATC/DDD yang banyak digunakan yaitu amlodipin, candesartan, ramipril, hidroklorotiazid dan lisinopril. Segmen DU 90% penggunaan obat tertinggi adalah amlodipin dan biaya penggunaan obat tertinggi yaitu candesartan 16mg sebesar Rp4.381.531,00. Persentase kesesuaian penggunaan obat antihipertensi dengan Fornas pada apotek A, B, dan C yaitu 73,91%, 80%, dan 68,42%.
Kesimpulan: Secara umum konsumsi obat antihipertensi terbanyak di apotek PRB Kabupaten Kudus yang masuk dalam segmen DU 90% adalah amlodipin serta kesesuaian obat dengan Fornas belum mencapai 100%. Merujuk pada hasil pola penggunaan obat PRB pada penelitian ini, diharapkan adanya koordinasi yang lebih baik antara BPJS Kesehatan dengan pihak apotek mengenai distribusi dan ketersediaan obat PRB.
Kata kunci: ATC/DDD, DU 90%, hipertensi, formularium nasional, PRB
Keywords
Article Details
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References
- Adolof, L. N. D., Winda, L. N., & Melia, T. R. M. (2019). Evaluasi Penggunaan Obat Antihipertinesi pada Pasien Rawat Inap di RSUD Lerik Kupang Tahun 2018 dengan Metode ATC/ DDD dan DU 90%. CHMK: Pharmaceutical Scientific Journal, 2(2).
- Ardhany, S. D., Pandaran, W., & Pratama, M. R. F. (2018). Profil Penggunaan Obat Antihipertensi Di Rsud Mas Amsyar Kasongan Kabupaten Katingan (A Profile of Antihypertensive Medicines in Mas Amsyar Hospital Kasongan Katingan Regency). Borneo Journal of Pharmacy, 1(1), 47-50.
- BPJS Kesehatan. (2014). Panduan Praktis Program Rujuk Balik Bagi Peserta Jaminan Kesehatan Nasional. Badan Penyelenggara Jaminan Sosial Kesehatan.
- Dinas Kesehatan. (2019). Profil Kesehatan Provinsi Jawa Tengah Tahun 2019. Dinas Kesehatan Provinsi Jawa Tengah.
- Gudmundsdottir, H., Høieggen, A., Stenehjem, A., Waldum, B., & Os, I. (2012). Hypertension in Women: Latest Findings and Clinical Implications. Therapeutic Advances in Chronic Disease, 3(3), 137-146. doi:https://doi.org/10.1177/2040622312438935
- Gunawan, S. G., Setiabudy, R., & Nafrialdi, E. (2008). Farmakologi dan Terapi edisi 5. Jakarta: Departemen Farmakologi dan Terapeutik FKUI.
- Hapsari, W. S., & Agusta, H. F. (2017). Pola Penggunaan Obat Antihipertensi Pada Pasien Hipertensi Rawat Jalan Bpjs Di Rsud Krt Setjonegoro Wonosobo. Jurnal Farmasi Sains dan Praktis, 3(2), 24-28. doi:https://doi.org/10.31603/pharmacy.v3i2.1728
- Hasan, A. (2018). Korelasi umur dan jenis kelamin dengan penyakit hipertensi di emergency center unit rumah sakit islam siti khadijah palembang 2017. Indonesia Jurnal Perawat, 3(1), 9-16.
- Kemenkes RI. (2017). Standar Tarif Pelayanan Kesehatan dalam Penyelenggaraan Program Jaminan Kesehatan, Kementerian Kesehatan Republik Indonesia. Retrieved from https://peraturan,bpk,go,id/Home/Details/114070/permenkesno-52-tahun-2016
- Kusumawardhani, O. B., & Ripha, R. W. (2020). Systematic Review: Kendali Mutu Dan Biaya Program Rujuk Balik (PRB) BPJS Kesehatan. Paper presented at the Prosiding University Research Colloquium.
- Lewandowski, C., Co-investigator, N., & Lewandowski, C. (2015). World Health Organization. Guidelines for ATC Classification and DDD Assignment 2016. The Effects of Briefmind Fulness Intervention Onacutepain Experience: An Examination of Individual Difference. doi:https://doi.org/10.1017/CBO9781107415324.004
- Nasyanka, A. L., Maesaroh, D., & Arizka, H. E. (2020). Profil Kesesuaian Penulisan Resep Pada Pasien Umum Eawat Inap Dengan Formularium Di Rumah Sakit Bedah Mitra Sehat Lamongan. Journal of Herbal, Clinical Pharmaceutical Science, 1(02), 24-28. doi:http://dx.doi.org/10.30587/herclips.v1i02.1414
- Prihayati, A., & Pujiyanto, P. (2019). Drug Utilization Pattern and Cost Estimates of Anti-Hypertensive Drugs in Pharmacies under the National Health Insurance Program. Paper presented at the 6th International Conference on Public Health 2019, Surakarta.
- Putri, A. N. N. (2022). Kesesuaian Peresepan Obat Antihipertensi Dengan Fornas Periode Juni 2021–November 2021 Di Poli Penyakit Jantung Rumah Sakit Islam Jemursari Surabaya. Diploma thesis, Akademi Farmasi Surabaya: Surabaya.
- Ratnasari, D., Mediastini, F. E., & Diah, K. I. (2017). Pola Peresepan Obat Antihipertensi Pasien BPJS yang Diresepkan Dokter Keluarga di Apotek Kabupaten Kendal Periode Januari-Desember 2016. Cendekia Journal of Pharmacy, 1(1), 49-58. doi:https://doi.org/10.31596/cjp.v1i1.7
- Sembada, S. D., Kuswinarti, K., & Arisanti, N. (2016). Jumlah Pemenuhan dan Pola Penggunaan Obat Program Rujuk Balik di Apotek Wilayah Gedebage Kota Bandung. Jurnal Sistem Kesehatan, 2(1). doi:https://doi.org/10.24198/jsk.v2i1.10410
- Syamsudin, S. (2011). Farmakoterapi Kardiovaskuler dan Renal. Jakarta: Salemba Medika.
- Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., & Tomaszewski, M. (2020). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75(6), 1334-1357. doi:https://doi.org/10.1161/HYPERTENSIONAHA.120.15026
- WHO. (2021). Guidelines For ATC Classification And DDD Assignment. In Norwegian Institute of Public Health.
- Yusransyah, H., Halimah, E., & Suwantika, A. A. (2019). Utilization and Cost Minimization Study of Antihypertensive Drugs in Primary Healthcare Center. Journal of Advanced Pharmacy Education and Research, 9(4), 83-88.
References
Adolof, L. N. D., Winda, L. N., & Melia, T. R. M. (2019). Evaluasi Penggunaan Obat Antihipertinesi pada Pasien Rawat Inap di RSUD Lerik Kupang Tahun 2018 dengan Metode ATC/ DDD dan DU 90%. CHMK: Pharmaceutical Scientific Journal, 2(2).
Ardhany, S. D., Pandaran, W., & Pratama, M. R. F. (2018). Profil Penggunaan Obat Antihipertensi Di Rsud Mas Amsyar Kasongan Kabupaten Katingan (A Profile of Antihypertensive Medicines in Mas Amsyar Hospital Kasongan Katingan Regency). Borneo Journal of Pharmacy, 1(1), 47-50.
BPJS Kesehatan. (2014). Panduan Praktis Program Rujuk Balik Bagi Peserta Jaminan Kesehatan Nasional. Badan Penyelenggara Jaminan Sosial Kesehatan.
Dinas Kesehatan. (2019). Profil Kesehatan Provinsi Jawa Tengah Tahun 2019. Dinas Kesehatan Provinsi Jawa Tengah.
Gudmundsdottir, H., Høieggen, A., Stenehjem, A., Waldum, B., & Os, I. (2012). Hypertension in Women: Latest Findings and Clinical Implications. Therapeutic Advances in Chronic Disease, 3(3), 137-146. doi:https://doi.org/10.1177/2040622312438935
Gunawan, S. G., Setiabudy, R., & Nafrialdi, E. (2008). Farmakologi dan Terapi edisi 5. Jakarta: Departemen Farmakologi dan Terapeutik FKUI.
Hapsari, W. S., & Agusta, H. F. (2017). Pola Penggunaan Obat Antihipertensi Pada Pasien Hipertensi Rawat Jalan Bpjs Di Rsud Krt Setjonegoro Wonosobo. Jurnal Farmasi Sains dan Praktis, 3(2), 24-28. doi:https://doi.org/10.31603/pharmacy.v3i2.1728
Hasan, A. (2018). Korelasi umur dan jenis kelamin dengan penyakit hipertensi di emergency center unit rumah sakit islam siti khadijah palembang 2017. Indonesia Jurnal Perawat, 3(1), 9-16.
Kemenkes RI. (2017). Standar Tarif Pelayanan Kesehatan dalam Penyelenggaraan Program Jaminan Kesehatan, Kementerian Kesehatan Republik Indonesia. Retrieved from https://peraturan,bpk,go,id/Home/Details/114070/permenkesno-52-tahun-2016
Kusumawardhani, O. B., & Ripha, R. W. (2020). Systematic Review: Kendali Mutu Dan Biaya Program Rujuk Balik (PRB) BPJS Kesehatan. Paper presented at the Prosiding University Research Colloquium.
Lewandowski, C., Co-investigator, N., & Lewandowski, C. (2015). World Health Organization. Guidelines for ATC Classification and DDD Assignment 2016. The Effects of Briefmind Fulness Intervention Onacutepain Experience: An Examination of Individual Difference. doi:https://doi.org/10.1017/CBO9781107415324.004
Nasyanka, A. L., Maesaroh, D., & Arizka, H. E. (2020). Profil Kesesuaian Penulisan Resep Pada Pasien Umum Eawat Inap Dengan Formularium Di Rumah Sakit Bedah Mitra Sehat Lamongan. Journal of Herbal, Clinical Pharmaceutical Science, 1(02), 24-28. doi:http://dx.doi.org/10.30587/herclips.v1i02.1414
Prihayati, A., & Pujiyanto, P. (2019). Drug Utilization Pattern and Cost Estimates of Anti-Hypertensive Drugs in Pharmacies under the National Health Insurance Program. Paper presented at the 6th International Conference on Public Health 2019, Surakarta.
Putri, A. N. N. (2022). Kesesuaian Peresepan Obat Antihipertensi Dengan Fornas Periode Juni 2021–November 2021 Di Poli Penyakit Jantung Rumah Sakit Islam Jemursari Surabaya. Diploma thesis, Akademi Farmasi Surabaya: Surabaya.
Ratnasari, D., Mediastini, F. E., & Diah, K. I. (2017). Pola Peresepan Obat Antihipertensi Pasien BPJS yang Diresepkan Dokter Keluarga di Apotek Kabupaten Kendal Periode Januari-Desember 2016. Cendekia Journal of Pharmacy, 1(1), 49-58. doi:https://doi.org/10.31596/cjp.v1i1.7
Sembada, S. D., Kuswinarti, K., & Arisanti, N. (2016). Jumlah Pemenuhan dan Pola Penggunaan Obat Program Rujuk Balik di Apotek Wilayah Gedebage Kota Bandung. Jurnal Sistem Kesehatan, 2(1). doi:https://doi.org/10.24198/jsk.v2i1.10410
Syamsudin, S. (2011). Farmakoterapi Kardiovaskuler dan Renal. Jakarta: Salemba Medika.
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., & Tomaszewski, M. (2020). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75(6), 1334-1357. doi:https://doi.org/10.1161/HYPERTENSIONAHA.120.15026
WHO. (2021). Guidelines For ATC Classification And DDD Assignment. In Norwegian Institute of Public Health.
Yusransyah, H., Halimah, E., & Suwantika, A. A. (2019). Utilization and Cost Minimization Study of Antihypertensive Drugs in Primary Healthcare Center. Journal of Advanced Pharmacy Education and Research, 9(4), 83-88.
