* Corresponding Author
ANALISIS EFEKTIVITAS DAN BIAYA PENGGUNAAN SITIKOLIN DAN PIRASETAM PADA PASIEN STROKE ISKEMIK DI BANGSAL RAWAT INAP RUMAH SAKIT
https://doi.org/10.22146/jmpf.201 Nur Santi(1*), Zullies Ikawati(2), Satibi Satibi(3)
(1)
(2)
(3)
(*) Corresponding Author
Abstract
Salah satu terapi yang diberikan dalam penanganan pasien stroke iskemik adalah neuroprotektan yaitu sitikolin dan pirasetam dengan jumlah pemakaian yang sangat besar. Biaya obat - obatan tersebut paling besar diantara biaya obat lainnya dalam pengobatan stroke, sedangkan efektivitas kedua obat tersebut terhadap perbaikan kondisi neurologis pasien stroke iskemik masih kontroversial. Penelitian ini bertujuan untuk mengetahui perbandingan efektivitas antara sitikolin dan pirasetam terhadap perbaikan fungsi neurologis dan mengetahui perbandingan biaya penggunaan sitikolin dan pirasetam pada pasien stroke iskemik. Penelitian ini menggunakan metode non-eksperimental dengan rancangan kohort perspektif. Data diambil secara prospektif terhadap pasien stroke iskemik di bangsal rawat inap RSUD Undata Palu selama November 2012-Februari 2013 dengan total sampel 48 pasien yang memenuhi kriteria inklusi. Efektivitas erapi sitikolin dan pirasetam terhadap perbaikan fungsi neurologis dinilai berdasarkan skor GCS (Glasgow Coma Scale) kemudian dilakukan analisis biaya perawatan dengan menghitung biaya medis langsung (direct medical cost). Hasil penelitian menunjukan bahwa pasien stroke iskemik yang mendapat terapi sitikolin dibandingkan pirasetam tidak menunjukan adanya perbaikan fungsi neurologis dengan nilai signifikasi 0,295 (p > 0,05). Rata-rata biaya obat, rata-rata biaya non obat, dan rata-rata biaya total perawatan pasien stroke iskemik kelompok sitikolin dibandingkan pirasetam berututan adalah Rp 423.123 dan Rp 616.548, Rp 2.200.208 dan Rp 2.580.287, Rp 2.623.331 dan Rp 3.196.835.
Kata kunci: efektivitas, biaya, biaya medis langsung, sitikolin, pirasetam
Full Text:
UntitledReferences
Adams, J.R., Harold, P.,Gregory,D.Z.,Mark, J.A.,Deepak,L.B.,Lawrence.B.,et al. 2007, Gudlines for the Early Management of Adult with Ischemic Stroke, American Heart Association, 38: 1655-1711.
Adams,J.R., Larry,B.G., Mark,J.A., Lawrence,J.A., Lawrence,M.B., Cheryl,D.B.,et.al, 2006, Primary Prevention of Ischemic Stroke, American Heart Association, 37: 1583-1633.
Alan, S.G., Mozzafarian, D., Roger, L.V., Benjamin, E.J., Berry, D.J., Borden, W.B., et, al, 2013, Heart Deseases and Stroke Statistics, Circulation American Heart Association, 127 : e6-e245.
Bruhwyler, J., Dorpe, V. J., Geczy, J., 1997, Multicenter Open-Label Study of The Efficacy and Tolerability of Citicoline in The Treatment of Acute Cerebral Infraction, Current Therapeutic Research, 58 : 5.
Casado, A., Secades, J.J, Ibarz, R., Herdman, M., Brosa, M., 2008, Cost Effectiveness of Citicoline Versus Conventional Treatment in Acute Ischemic Stroke, Expert Reviews, 8 (2) : 151-157.
Davalos, A., Castillo, J., Sabin, J.A., Secadel, J.J., Mercadal, J., Lopez, S.,et al, 2002, Oral Citicolin in Acut Ischemic Stroke, American Heart Association, 33 : 2850-2857.
Dipiro, J.T., Talbret, L.R., Yee, G.C., Matzke, J.R., Wels, B.G., Posey, L.M., 2005, Pharmacotherapy A Pathophysiologic Approach, 7 th edition, Mc Graw Hill Medical, New York.
Dostovic, Z., Smajlovic, D., Dostovic, E., Ibrahimagic, O. C., 2012, Stroke and Disorder of Consciousness, Volume 2012, Cardiovasculer Pscychiatri and Neurology, Hindawy Publishing, Bosnia Herzegovina.
Ginsberg, M. D., 2008, Neuroprotection for Ischemic Stroke : Past, Present, and Future, Neuropharmacology Pubmed PMC, 55 (3) : 363-389.
Gofir, A., 2011, Manajemen Stroke, 2 th edition, Cendekia Press, Yogyakarta.
Gualtieri, F., Manetti, D., Romanelli, M. N., Ghelardini, C., 2002, Design and Study of Piracetam-like Nootropics, Controversial Members of The Problematic Class of Cognition- Enhancing Drugs, Curr Pharmaceutical Design, 8 : 125-138.
Hamidon, B., Raymond, A.A., 2003, Predictors of In- Hospital Mortality After an Acute Ischemic Stroke, Neuro Journal Southeas Asia, 8 : 5-8.
Hillen, T., Dundas, R., Lawrence, E., Stewart, A. J., Rudd, G. A., Charles, D. A., et. al, 2000, Antithrombotic And Antihypertensive Management 3 Month After Ischemic Stroke, American Hearth Association, 31: 469-475.
Ikawati, Z., 2011, Farmakoterapi Penyakit Sistem Syaraf Pusat, Bursa Ilmu, Yogyakarta.
Jennet, B., 2005, Development of Glasgow Coma and Outcome Scale, Nepal Journal of Neuroscience, 2 : 24-28.
Junaidi, I., Tandung, D.,(ed). 2011, Stroke Waspadai Ancamannya, Andi Offset, Yogyakarta.
Kessler, J., Karbe, H. T., Heiss, W. D., 2000, Piracetam Improves Activated Blood Flow and Facilities Rehabilitation of Poststroke Aphasic Patiens, American Heart Association, 31 : 2112-2116.
Kim, Y. J., Cho, H. J., 2009, Efficacy and Safety of Oral Citicholine in Acute Ischemic Stroke, Pubmed PMC, 3 : 171-176.
Kornbluth, J, Bhardwajh, A., 2010, Evaluation of Coma : A Critical Appraisal of Popular Scoring System, Neurocritical Care Society, Boston.
Leng, C., Lin, M. D., Yang, J.T., Weng, H.H., Hsiao, C.T., Lai, L.S., et. al, 2011, Predictors of Early Clinical Deterioration After Acute Ischemic Stroke, The American Journal of Emegency Medicine, 29 : 557-581.
Misbach, J., Tobing, L., Ranakusuma, T. A. S., Suryamiharja, A., Harris, S., Bustami, M., 2007, Guidelines Stroke 2007, Kelompok Studi Serebrovascular Perhimpunan Dokter Spesialis Saraf Indonesia (PERDOSSI), Hal : 85-87.
Nufus, H., 2012 Peran Citicolin untuk Tatalaksana Stroke Iskemik Akut, Majalah Fokus, 38 (1) : 1 diakses pada 12 September 2012,<www.webicina.com/personalized/recent/?source =2873&cat=0&page=1.
Orion, 1997, Pharmacoeconomics Primer and Guide Introduction to Economic Evaluation, Hoesch Marrion Rousell, Virginia Qureshi, I., Endres, R.J., 2010, Citicoline : A Novel Therapeutic Agent With Neuroprotective Neuromodulatory, and Neuoregenerative Propertise, Natural Medicine Journal, 2 (6) : 1-11.
Reeder, C. E., 1995, Overview of Pharmacoeconomics and Pharmaceutical Outcomes Evaluation, American Journal of Health System Pharmacy.
Ricci, S., Celani, M. G., Cantissani, T. A., Righetti, E.,2012, Piracetam For Acute Ischemic Stroke, The Chocrane Collaboration.
Rosjidi, C., dan Nurhidayat, S., 2008, Buku Ajar Perawatan Cedera Kepala dan Stroke, Ardana Media, Yogyakarta, Hal : 143-188.
Saka, O., McGuire, A., Wolfe, C., 2009, Cost of Stroke in The United Kingdom, Age and Ageing, 38 : 27-32.
Shiddique, N. A., Nur, Z., Mahbub, S., Alam, B., 2009, Clinical Presentation And Epidemiology of Stroke – A Study of 100 Cases, Journal Medicine, 10 : 86-89.
Small, L. S., Liano, D. A., 2009, Biological Approaches To Aphasia Treatment, Curr Neuronal Neurosci, 9 (6) : 443-450.
Sternbach, G. L, 2000, The Glasgow Coma Scale, The Journal of Emergency Medicine, 19 : 67-71.
Tjiptoherijanto, P. S.B., 1994, Ekonomi Kesehatan, Rineka Cipta, Jakarta.
Ustrell, R. X., 2007, Stroke, Diagnosis and Therapeutic Management of Cerebrovascular Desease, Puesta Al Dia, Spain.
Vogenberg, F. (2001). Introduction To Applied Pharmacoeconomics. USA: McGraw- Hill Companies.
Wayne, M. C., Bejamin, J. W., Kenneth, A. S., Richard, M. Z., LuAnn, A. S., Richard, E. G., 1999, A Randomized Efficacy Trial of Citicholine in Patient with Acute Ischemic Stroke, American Heart Association, 30 : 2592- 2597.
Weir, C. J., Bradford, A. V. J., Lees, K. R., 2003, The Prognostic Value of The Components of Glasgow Coma Scale Following Acute Stroke, Q J Med, 96 : 67-74.
Wolfe, C. D. (2000). The Impact of Stroke. British Medical Journal, departement of Public Health Sciences .
Zalfonte, R., Friedewald, W. T., Lee, S. M., Levin, B., Arrazia, R. D., Ansel, B., et. al, 2009, The Citicholin Brain Injury Treatment (CORBIT) Trial : Design and Methodes, Journal of Neurotrauma, 26 : 2207-2216. DOI: https://doi.org/10.22146/jmpf.201
Article Metrics
Abstract views : 3416
| 
views : 8957
Refbacks
- There are currently no refbacks.
Copyright (c) 2013 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
