Peran Apoteker dalam Pengatasan Drug Related Problems Pasien Tuberkulosis Melalui Implementasi Medication Therapy Management di Rumah Sakit Daerah Istimewa Yogyakarta: Narrative Review dan Penelitian Kualitatif

PATRICIA, Dr.apt. Nanang Munif Yasin, M.Pharm.

2021 | Skripsi | S1 FARMASI

Tuberkulosis merupakan penyakit infeksi menular yang banyak menyebabkan kematian secara global. Jumlah penderita tuberkulosis semakin meningkat setiap tahun karena adanya Drug Related Problems (DRPs) yang banyak terjadi pada pasien tuberkulosis. Salah satu upaya yang dapat dilakukan untuk mengatasi DRPs tersebut adalah melalui pelayanan kefarmasian berbasis Medication Therapy Management (MTM). Penelitian ini bertujuan untuk mengetahui gambaran kasus DRPs, peran apoteker dalam pelayanan tuberkulosis, serta persepsi apoteker mengenai implementasi pelayanan MTM dalam pengatasan DRPs pasien tuberkulosis. Penelitian ini menggunakan dua metode penelitian, yaitu narrative review dan penelitian kualitatif. Narrative review dilakukan dengan pencarian literature pada enam database, yaitu Google Scholar, Pubmed, ResearchGate, E-resources perpusnas, Scopus, dan Ebsco Host. Narrative review dilakukan untuk mengetahui gambaran DRPs dan peran apoteker. Penelitian kualitatif dilakukan dengan wawancara mendalam kepada lima apoteker yang memenuhi kriteria inklusi dan eksklusi dengan teknik purposive sampling.Wawancara dilakukan untuk mengetahui gambaran DRPs, peran apoteker, dan persepsi apoteker mengenai MTM. Penelitian berlangsung sepanjang bulan Desember 2020-Februari 2021. Hasil narrative review dari 36 artikel terkait DRPs dan peran apoteker dalam pelayanan tuberkulosis menujukkan bahwa DRPs yang sering dijumpai adalah adanya ADRs, indikasi tanpa obat, dosis terlalu tinggi, dosis terlalu rendah, obat salah, obat tanpa indikasi, dan ketidakpatuhan terhadap regimen obat. Peran apoteker dalam pelayanan tuberkulosis meliputi rekonsiliasi; konseling, informasi, dan edukasi; pemantauan terapi obat, monitoring efek samping obat, pelayanan informasi obat, promosi kepatuhan, dan penelusuran riwayat medis pasien. Berdasarkan hasil wawancara, apoteker memiliki persepsi bahwa MTM dapat diterapkan dan akan sangat membantu apoteker dalam pengatasan DRPs pasien tuberkulosis di Rumah Sakit Daerah Istimewa Yogyakarta.

Tuberculosis is a contagious infectious disease that causes many deaths globally. The number of tuberculosis sufferers is increasing every year due to the existence of Drug Related Problems (DRPs) which often occur in tuberculosis patients. One of the efforts that can be made to overcome the DRPs of tuberculosis patients is the application of pharmaceutical care based on Medication Therapy Management (MTM). This study aims to determine the DRPs, pharmacists role in tuberculosis services, and pharmacists' perceptions of the implementation of MTM to overcome the DRPs in the tuberculosis patients. This study uses two research methods, namely narrative review and qualitative research. Narrative review was conducted by searching literature on six databases, namely Google Scholar, Pubmed, ResearchGate, E-resources of National Library, Scopus, and Ebsco Host. Narrative review was conducted to determine the description of DRPs and the role of pharmacists. The qualitative research was conducted with in-depth interviews with five pharmacists who met the inclusion and exclusion criteria with a purposive sampling technique. Interviews were conducted to determine the description of DRPs, the role of pharmacists, and pharmacist perceptions about MTM. The research took place from December 2020 to February 2021. The narrative review of 36 articles related to DRPs and the role of pharmacists in tuberculosis services showed that the most frequently encountered DRPs are the presence of ADRs, indication without drug, high dosage, low dosage, inappropiate drug, drug without indication, and non adherence to drug regimens. Pharmacist's role in tuberculosis services including reconciliation; counseling, information and education; monitoring drug therapy, monitoring drug side effects, drug information services, promotion of adherence, and tracking of patient's medical history. Based on the results of the interview, pharmacists have the perception that MTM can be applied and will greatly assist pharmacists in overcoming the DRPs of tuberculosis patients at the Yogyakarta Special Region Hospital.

Kata Kunci : drug related problems, tuberkulosis, rumah sakit, medication therapy management