MODEL TEMAN APOTEKER: ALTERNATIF MODEL INTERVENSI APOTEKER BAGI PASIEN TUBERKULOSIS

https://doi.org/10.22146/jmpf.350

Nanang Munif Yasin(1*), Djoko Wahyono(2), Bambang Sigit Riyanto(3), Ika Puspitasari(4)

(1) Fakultas Farmasi, Universitas Gadjah Mada, Yogyakarta
(2) Fakultas Farmasi, Universitas Gadjah Mada, Yogyakarta
(3) RSUP Dr. Sardjito, Yogyakarta
(4) Fakultas Farmasi, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Tingginya prevalensi tuberkulosis (TB) di Indonesia memerlukan keterlibatan apoteker dalam pelayanan pasien TB. Penelitian ini bertujuan untuk mengidentifikasi jenis pelayanan TB, mengembangkan model intervensi, dan mengembangkan tools dan rencana intervensi apoteker bagi pasien TB.   Penelitian ini merupakan jenis penelitian observasional yang terdiri dari tiga tahapan  yaitu focus grup discussion (FGD), pengembangan model intervensi, dan pengembangan tools dan rencana model intervensi apoteker. Instrumen yang digunakan adalah panduan FGD dan kuesioner pelayanan TB. FGD membahas pelayanan pada pasien TB dan dihadiri oleh apoteker dan programmer TB di puskesmas dan Rumah Sakit Khusus Paru Respira di Yogyakarta. Data FGD didukung oleh hasil kuesioner yang diisi sebelum FGD. Pengembangan  model intervensi terdiri dari tahap identifikasi kebutuhan pharmaceutical care, penentuan outcome, dan kompilasi akhir model intervensi apoteker. Pengembangan tools model intervensi apoteker berbasis berbagai literatur dan hasilnya dievaluasi oleh pakar.  Data penelitian dianalis secara deskriptif dan analisis kualitatif. Hasil FGD dan kuesioner menunjukkan bahwa keterlibatan apoteker masih terbatas dan hanya  4 (21%) yang pernah mendapatkan pelatihan TB. Semua petugas TB sudah melakukan edukasi namun materi yang diberikan sangat beragam dan belum terstruktur. Sebanyak 15 (78,9%) apoteker melakukan monitoring efek samping, 10 (52,6%) monitoring interaksi obat,  10 (52,6%) monitoring respon klinik,   16 (84,2 %)  monitoring kepatuhan pasien, 2 (10,5%) melakukan home care dan 18 (94,7%) telah berbagi peran dengan perawat. Melalui formulasi hasil studi pustaka, studi pendahuluan, dan FGD diperoleh rekomendasi bahwa peran apoteker dalam pelayanan TB dapat ditingkatkan melalui model intervensi yang mencakup 5 aspek penting yaitu training, education, monitoring, adherence, dan networking yang disingkat TEMAN Apoteker. Selanjutnya Model TEMAN Apoteker diterjemahkan dan dijabarkan dalam 6 bentuk tools yaitu modul, booklet, leaflet, poster, buku panduan pelaksanaan dan lembar dokumentasi pharmaceutical care. Model TEMAN Apoteker yang komprehensif dapat menjadi alternatif model intervensi dalam meningkatkan peran apoteker pada pelayanan pasien TB.

Keywords


tuberkulosis; TEMAN Apoteker; intervensi; apoteker; tuberculosis; TEMAN Apoteker; pharmaceutical care; intervention; pharmacists



References

Bhardawaj, A., Kumar, R., Dabas, V., and Alam, N. 2012, Assessment and Enhancing Adherence to Treatment Regimen in Tuberculosis Out Patient, Int J Pharm Pharm Sci, 4(3):517-522.

Bosch-Capblanch, X., Abba, K., Prictor, and M., Garner, P. 2007. Contracts between patients and healthcare practitioners for improving patients’ adherence to
treatment, prevention and health promotion activities. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD004808. DOI: 10.1002/14651858.CD004808.pub3.

Case Management Society of America. 2006, Case Management Adherence Guidelines version 2.0; viewed 1 May 2014 <http://www.cmsa.org.prtals/o/pdf/CM AG2.pdf>.

Castro, A.T., Mendes, M., Freitasa, S. and Roxo, P.C. 2015, Incidence and risk factors of major toxicity associated to first-line antituberculosis drugs for latent and active tuberculosis during a period of 10 years, Rev Port Pneumol, 21(3):144---150

Centers for Disease Control and Prevention. 2008, Self-Study Modules on Tuberculosis: Module 1-9, Division of Tuberculosis Elimination CDC, Atlanta, Georgia.

Clark, P.M., Karagoz, T., Apikoglu-Rabus, S.,and Izzettin, F.V. 2007, Effect of pharmacistled patient education on adherence to tuberculosis treatment, Am J Health-Syst Pharm, 64:497-506

Departemen Kesehatan Republik Indonesia. 2005, Pharmaceutical Care Untuk Penyakit Tuberkulosis, Jakarta, Departemen Kesehatan Republik Indonesia.

Departemen Kesehatan Republik Indonesia. 2008, Pedoman pelayanan kefarmasian di rumah (home pharmacy care), Jakarta, Departemen Kesehatan Republik Indonesia.

Departemen Kesehatan Republik Indonesia. 2009, Buku Saku Kader Program Penanggulangan TB), Jakarta, Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Departemen Kesehatan RI

Departemen Kesehatan Republik Indonesia. 2011, Pedoman Nasional Pengendalian Tuberkulosis, Jakarta, Departemen Kesehatan Republik Indonesia.

Esmael, A., Ali, I., Agonafir, M., Desale, A., Yaregal, Z. and Desta, K. 2013, Assessment of Patients’ Knowledge, Attitude, and Practice Regarding Pulmonary Tuberculosis in Eastern Amhara Regional State, Ethiopia: CrossSectional Study; Am. J. Trop. Med. Hyg, 88(4):785–788

Francis, M.T., and Chandrasekaran, K. 2012, Effectiveness of Knowledge Based Approach for the Provement of Patient Adherence and Reducing the Severity of Adverse Drug Reaction in Anti Tubercular Therapy, IJPTP, 3(3):313-317

Government of India and Indian Pharmaceutical Association. 2013, Revised National Tuberculosis Control Programme, Training Module for Community Pharmacist, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, India

Gulbay, B.E, Gurkan, O.U., Yıldız, O.A., Onen, Z.P., Erkekol, F.O., Baccıoglu, A, et al. 2006, Side effects due to primary antituberculosis drugs during the initial phase of therapy in 1149 hospitalized patients for tuberculosis, Respiratory Medicine, 100:1834-1842.

Harries A., 2004, What are the most common adverse drug events to first-line tuberculosis drugs, and what is the procedure for reintroduction of drugs? in WHO, 2004, Toman’s Tuberculosis Case detection, treatment, and monitoring –questions and answers, WHO, Geneva, pp 152-158

Kanjee, Z., Catterick, K., Moll, A.P., Amico, K.R., and Friedland, G.H. 2011, Tuberculosis infection control in rural South Africa: survey of knowledge, attitude and practice in hospital staff, Journal of Hospital Infection, 79:333-338.

Liam, C.K., Lim, K.H., Wong, C.M.M., Tang, B.G. 1999, Attitudes and knowledge of newly diagnosed tuberculosis patients regarding the disease, and factors affecting treatment compliance, Int J Tuberc Lung Dis, 3(4):300–309

Liu, Q., Abba, K., Alejandria, M.M., Balanag, V.M., Berba, R.P., and Lansang, M.A.D. 2008. 2008, Reminder systems and late patient tracers in the diagnosis and management of tuberculosis, Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD006594. DOI: 10.1002/14651858.CD006594.pub2.

Lutge, E.E., Wiysonge, C.S., Knight, S.E., and Volmink, J. 2012. Material incentives and enablers in the management of tuberculosis, Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD007952. DOI: 10.1002/14651858.CD007952.pub2.

M’Imunya, J.M., Kredo, T., and Volmink, J. 2012, Patient education and counselling for promoting adherence to treatment for tuberculosis (Review), Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD006591. DOI: 10.1002/14651858.CD006591.pub2.

Marra, F., Marra, C.A., Bruchet, N., Richardson, K., Moadebi, S., Elwood, R.K., et al. 2007, Adverse drug reactions associated with first-line anti-tuberculosis drug regimens, Int J Tuberc Lung Dis, 11: 868– 875.

McDonnell, M., Turner, J., and Weaver, M.T. 2001, Antecedents of adherence to antituberculosis therapy, Publib Health Nursing, 18(6):392-400

Medecins Sans Frontieres. 2013, Checklists for Patient education/counselling sessions for those with active TB disease, Including drug-resistant TB, MSF OCB, Georgia.

Minnery, M., Contreras, C., Perez, R., Solorzano, N.,Tintaya, K., Jimenez, J. et al. 2013, A Cross Sectional Study of Knowledge and Attitutes Towards Tuberculosis amongst Front-Line Tuberculosis Personnel in High Burden Areas of Lima, Peru. PloS ONE 8(9):e75698. Doi:10.1371/journal.pone.0075698.

Mitrzyk, B.M. 2008, Treatment of extensively drug-resistant tuberculosis and role of the pharmacist, Pharmacotherapy, 28(10): 1243-1254

Navio, J.L.P., Yuste, M.R. and Pasicatan, M.A. 2002, Socio-economic determinants of knowledge and attitudes about tuberculosis among the general population of Metro Manila, Philippines, Int J Tuberc Lung Dis, 6(4):301–306

Putera, I., Pakasi, A.T., and Karyadi, E. 2015, Knowledge and perception of tuberculosis and the risk to become treatment default among newly diagnosed pulmonary tuberculosis patients treated in primary health care, East Nusa Tenggara: a retrospective study, BMC Res Notes, 8:238 

Schaberg, T., Rebhan, K. and Lode, H. 1996, Risk factors for side-effects of isoniazid, Damrifampin and pyrazinamide in patients hospitalized for pulmonary tuberculosis, Eur Respir J, 9: 2026–2030.

United States Agency for International Development. 2005, A Trainers Guide for A Workshop On Tuberculosis For Pharmacy Staff in Cambodia, 2005-2011, USAID, Cambodia.

United States Agency for International Development. 2012, Multidrug-resistant tuberculosis: What every patient should know Flipchart Generic, TB CARE II, USAID, US.

Volmink, J. and Garner, P. 2009, Directly observed therapy for treating tuberculosis, The Cochrane Collaboration, 4:1-32

Westerlund, E.E., Tovar, M.A., Lo¨nnermark, E., Montoya, R. And Evans, C.A. 2015, Tuberculosis-related knowledge is associated with patient outcomes in shantytown residents; results from a cohort study, Peru, Journal of Infection, 71: 347-357

World Health Organization (WHO). Adherence to Long-Term Therapies: Evidence for action, Geneva, WHO, 2003

World Health Organization. 2015, Global Tuberkulosis Report 2015, Geneva, WHO.

Wu, P.S., Chou, P., Chang N.T., Sun, W.J., and Kuo, H.S. 2009, Assessment of Changes in Knowledge and Stigmatization Following Tuberculosis Training Workshops in Taiwan, J Formos Med Assoc, 108(5):377-385.

Yasin NM, Wahyono D, Riyanto BS, Sari IP. 2016, Tuberculosis-Related to Knowledge, Adverse Drug Reactions, Clinical Outcome, Adherence in Tuberculosis Patients and Pharmacist Role, A Preliminary Survey for Pharmacist Intervention Model Development. IJPCR, 8(5)Suppl: 517-522

Yee, D., Valiquette, C., Pelletier, M., Parisien, I., Rocher, I. and Menzies, D. 2003, Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis, Am J Respir Crit Care Med, 167: 1472– 1477. 

Yew, W.W. 2002, Clinically Significant Interactions with Drugs Used in the Treatment of Tuberculosis, Drug Safety, 25(2):111-133



DOI: https://doi.org/10.22146/jmpf.350

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