Banyaknya obat yang dikonsumsi oleh pasien geriatri dengan penyakit kronis meningkatkan penurunan kepatuhan. Ada beberapa cara dalam meningkatkan kepatuhan diantaranya dengan menggunakan Pill box dan Medication reminder chart. Penelitian ini bertujuan untuk mengetahui perbandingan efektifitas penggunaan Pill box dengan Medication reminder chart dalam meningkatkan kepatuhan pasien geriatri dengan hipertensi di Kota Batam. Rancangan Penelitian ini adalah studi experimental; Randomized Controlled Trial dengan desain penelitian pre test dan post test control group. Pengambilan sampel pada penelitian ini dilakukan dengan teknik random alokasi sampling. Pasien akan dikelompokkan menjadi dua kelompok subjek yang berbeda, yaitu kelompok yang mendapat intervensi berupa Pill box dan Medication reminder chart. Data dikumpulkan secara prospektif sesuai dengan kriteria inklusi padap asien geritri rawat jalan, dengan diagnosa penyakit hipertensi di dua rumah sakit Kota Batam, penelitian dilakukan pada bulan Januari sampai April 2016. Pengukuran tingkat kepatuhan menggunakan kuesioner MMAS-8 dan pill count dan outcome klinik pasien diukur dengan melihat tekanan darah sistolik dan diastolik yang disesuaikan dengan diagnosa dokter yang tertera di rekam medik. Pengukuran dilakukan sebelum dan sesudah perlakuan. Data dianalisis secara statistik menggunakan deskripitif, uji bivariat. Hasil penelitian ini menunjukkan bahwa Pill box dapat meningkatkan kepatuhan (P=0,000) dan menurunkan tekanan darah sistolik dan diastolik secara signifikan (P=0,000 dan P=0,002), sedangkan pada Medication reminder chart hanya efektif dalam meningkatkan kepatuhan (P=0,000). Terdapat perbedaan yang signifikan antara Pill box dan Medication reminder chart dalam meningkatkan kepatuhan (P=0,008) dan pada penurunan tekanan darah sistolik dan diastolik (P=0,006 dan P= 0,016).

The use of certain drugs is known to be an extrinsic factor the risk of falling in the elderly (elderly) because it can cause postural hypotension, sedation, dizziness, weakness, drowsiness, muscle weakness, and other side effects. This study aims to determine the profile of drug use that have the potential to fall in the elderly. This study used a cross-sectional descriptive design with purposive sampling technique. The study was carried out at two regional hospitals in Madiun (RSUD Dr. Soedono Madiun and RSUD Kota Madiun). The data is sourced from the outpatient's medical record of Neurology and Internal Medicine clinics and from the medication record in the Pharmacy Installation from May to October 2018. The results showed that there were 343 patients (64.11%) out of 535 patients involved in the study using fall risk medicines (FRM). Three FRM groups that were often prescribed were antihypertensive 52.71% (282 patients), anticonvulsants 20.19% (108 patients), and benzodiazepines 10.47% (56 patients). A number of 46.54% (249 patients) used FRM included in the low-risk category (Medication Fall Risk Score 1-5), and as many as 17.57% (94 patients) were included in high risk (Medication Fall Risk Score ≥ 6). The elderly that use 1 FRM was 24.86% (133 patients), followed by 2 drugs was 19.07% (102 patients). The results of this study realized that the use of fall risk medicines in the elderly is quite high, so it is necessary to weigh the risks and benefits of its use to prevent falls in the elderly.

Objective: The management of early breast cancer (EBC) is performed with a series of treatments consisting of surgery and systemic therapy, along with long-term endocrine therapy for hormone responsive. The treatment generates a high illness effect that will affect the life quality of EBC patients. The objective of this study was to measure EBC patients’ quality of life after undergoing the treatment.Methods: A cross-sectional study was conducted by interviewing EBC patients using EQ-5D-5L instrument at private hospitals in Yogyakarta and Semarang, Indonesia. The EBC patients were women aged 18-60 y who had undergone surgery in 2010-2013 and received endocrine therapy.Results: Of the 71 patients identified, 45 patients were in disease-free survival (DFS) state, 8 patients were in locoregional recurrence (LR), and 18 patients were in metastasis (M) state. Mobility and self-care problems occurred in patients who had metastasis (4.23%). The problem of usual activities occured in patients who had recurrence (22.54%). Most of the patients (84.51%) had pain problem, and all patients had an anxiety problem. The mean utility score (SD) in DFS patients was 0.841 (0.052), in LR patients was 0.758 (0.092), and in patients who had metastasis was 0.653 (0.104). The mean scores of EQ-5D VAS (SD) for EBC patients in DFS, LR and M health state were 86.56 (6.29), 81.88 (5.30), and 69.17 (5.75), respectively.Conclusion: The health states of EBC significantly affect HRQOL of patients. Efforts should be made to improve the quality of life of EBC patients especially in terms of pain and anxiety reduction.

Drug Related Problems (DRPs) merupakan masalah yang berhubungan dengan obat yang banyak terjadi di pelayanan kesehatan. Tujuan penelitian ini untuk mengetahui profil kejadian DRPs, profil antibiotik yang mengalami DRPs, dan hubungan antara Drug Related Problems penggunaan antibiotik dengan luaran terapi. Penelitian ini merupakan penelitian observasional analitik dengan rancangan retrospective cohort study. Subyek penelitian yang memenuhi kriteria inklusi sebanyak 128 pasien, dimana terdapat 78 kejadian drug related problems pada 64 pasien dengan rincian sebagai berikut; indikasi tanpa obat 0 kejadian, obat tanpa indikasi yang sesuai 5 kejadian (6,41%), pemberian obat tidak tepat 1 kejadian (1,28%), dosis kurang 17 kejadian (21,79%), dosis lebih 7 kejadian (8,97%), adverse drug reaction 14 kejadian (17,95%), interaksi obat 33 kejadian (42,32%), dan kegagalan menerima obat 1 kejadian (1,28%). Terdapat dua antibiotik yang paling banyak mengalami DRPs, yaitu ceftriaxon dan cefotaxim. Pada uji Chi square didapatkan tidak ada hubungan antara jumlah kejadian DRPs terhadap luaran terapi dan lama waktu rawat inap (p>0,05).

ABSTRAKTerapi adjuvan pada pasien early breast cancer (EBC) bertujuan untuk meningkatkan disease free survival, menurunkan risiko relaps dan menurunkan angka kematian. Tetapi pada kenyataannya masih sering dijumpai, pasien EBC yang telah mendapat terapi adjuvan mengalami relaps. Kejadian relaps sering dihubungkan dengan meningkatnya risiko kematian tanpa memperhatikan jenis pengobatan. Tujuan penelitian ini adalah mengetahui angka kejadian relaps pada pasien premenopausal EBC yang telah mendapatkan terapi adjuvan di RSUP dr. Sardjito Yogyakarta. Penelitian ini merupakan penelitian deskriptif observasional dengan desain cross sectional study menggunakan data retrospektif yang diperoleh dari data rekam medik pasien premenopausal EBC di Poliklinik Kanker Terpadu "Tulip" RSUP dr. Sardjito Yogyakarta yang telah mengalami tindakan pembedahan pada tahun 2010-2013, bersifat hormon responsif dan HER-2 negatif, mendapatkan terapi adjuvan, perempuan dengan umur 18-60 tahun dan riwayat pemeriksaan sampai bulan Desember 2016. Pasien akan di eksklusi bila mempunyai penyakit penyerta. Dari 30 pasien diketahui sebanyak 46,67% berumur 41-50 tahun, sebanyak 63,33% menunjukkan ekspresi ER-PR positif, sebanyak 93,34% merupakan invasive ductal carcinoma (IDC). Semua pasien mendapatkan terapi adjuvan kemoterapi menggunakan regimen kombinasi dan semua pasien mendapatkan terapi endokrin berupa tamoksifen. Relaps terjadi pada 11 pasien (36,67%) dan kejadian relaps paling banyak adalah metastasis tulang yaitu pada 8 pasien (26,67%). Kata kunci : premenopausal, EBC, adjuvan, relaps ABSTRACTAdjuvant therapy in patients with early breast cancer (EBC) aims to improve disease free survival, decrease the risk of relapse and reduce mortality. But in reality they often encountered, EBC patients who had received adjuvant therapy relapse. The incidence of relapse is often associated with increased risk of death regardless of the type of treatment. The purpose of this study was to determine the incidence of relapse in patients premenopausal EBC who have received adjuvant therapy in RSUP dr. Sardjito Yogyakarta. This study is a descriptive observational with cross sectional design using retrospective data obtained from medical records premenopausal EBC patients at Integrated Cancer Clinic "Tulip" RSUP dr. Sardjito Yogyakarta who have undergone surgery in 2010-2013, are hormone responsive and HER-2 negative, have received adjuvant therapy, women aged 18-60 years and a history of the last inspection in December 2016. Patients were excluded if would have comorbidities. From 30 patients known to as much as 46.67% aged 41-50 years, as many as 63.33% showed positive expression of ER-PR, as much as 93.34% is the IDC. All patients received adjuvant therapy of chemotherapy using a combination regimen and all patients received endocrine therapy such as tamoxifen. Relapses occurred in 11 patients (36.67%) and the most incidence of relapse is bone metastasis in 8 patients (26.67%).