ANALISIS BIAYA DAN OUTCOME TERAPI OBAT ANTIPSIKOTIK ATIPIKAL RISPERIDON DIBANDINGKAN KOMBINASI RISPERIDON-CLOZAPIN PADA PENDERITA SKIZOFRENIA DI RSJ PROF.DR.SOEROJO MAGELANG DAN RSJD DR.AMINO GONDOHUTOMO PROVINSI JAWA TENGAH PERIODE JANUARI-JUNI 2015

SIKNI RETNO K, Prof.Dr.Zullies Ikawati, Apt.; dr.Cecep Sugeng K., Sp.KJ(K)

2016 | Tesis | S2 Ilmu Farmasi

INTISARI Skizofrenia merupakan sindrom heterogen kronis yang ditandai dengan pola pikir yang tidak teratur, delusi, halusinasi, perubahan perilaku yang tidak tepat serta adanya gangguan fungsi psikososial. Skizofrenia dikarakteristik oleh waham, halusinasi, pemikiran dan bicara tidak terorganisasi, ketidaknormalan tingkah laku motorik dan simptom negatif. Tujuan penelitian ini untuk mengetahui outcome terapi, rata-rata biaya total rawat inap, perbedaan rata-rata komponen biaya terapi antipsikotik atipikal risperidon dibandingkan kombinasi risperidon-clozapinpada penderita skizofrenia di instalasi rawat inap. Penelitian ini mengikuti rancangan penelitian deskritif analitiknon eksperimental. Efektivitas terapi antipsikotik atipikal risperidon dibandingkan kombinasi risperidon-clozapindilihat berdasarkan outcome klinik yaitu lama rawat inap (Length of Stay/LOS) dan persentase kesembuhan. Analisis biaya terapi dilakukan dengan cara menghitung perbedaan rata-rata komponen biaya obat dan non-obat. Hasil penelitian menunjukkan outcome terapi antipsikotik atipikal pada penderita skizofrenia dilihat dari lama rawat inap (length of stay) nilainya lebih kecil pada kelompok risperidon (26,48±14,93 hari) dibandingkan kelompok kombinasi risperidon-clozapin(30,26±17,79 hari), sedangkan dari persentase kesembuhannya kelompok kombinasi risperidon-clozapinlebih tinggi (100%) dibandingkan kelompok risperidon. Secara statistik tidak terdapat perbedaan rata-rata lama rawat antara kelompok risperidon dan kombinasi risperidon-clozapindengan nilai p > 0,05 yaitu 0,597. Rata-rata biaya total terapi antipsikotik atipikal risperidon (Rp.3.390.587,22±1.514.410,77) lebih kecil dibandingkan kombinasi risperidon-clozapin(Rp.3.624.905,79±1.362.209,56) pada penderita skizofrenia di instalasi rawat inap. Rata-rata biaya total pengobatan risperidon dan kombinasi risperidon-clozapinsecara statistik berbeda tidak signifikan dengan nilai p > 0,05 yaitu 0,526. Perbedaan rata-rata komponen biaya terapi antipsikotik atipikal kombinasi risperidon-clozapinlebih hemat pada komponen biaya akomodasi, visite dokter, asuhan keperawatan, IGD dan laboratorium dibandingkan kelompok risperidon. Kata kunci: skizofrenia, clozapin, risperidon,outcome terapi, analisis biaya

ABSTRACT Schizophrenia is a chronic heterogeneous syndrome characterized by irregular patterns of thinking, delusions, hallucinations, changes in behavior that is not appropriate and the disruption of psychosocial functioning. Schizophrenia is characterized by delusions, hallucinations, disorganized thinking and speech, abnormal motor behavior and negative symptoms. The purpose of this study to know the outcome of therapy, the average total cost of hospitalization, the average difference of the avarage cost components of atypical antipsychotic risperidone therapy compared with the combination of risperidone-clozapine on hospitalized schizophrenic patients. This research used the analytic descriptive non-experimental research design. The effectiveness of atypical antipsychotic risperidone therapy compared with the combination of risperidone-clozapine visits based on clinical outcomes, namely the length of stay (Length of Stay / LOS) and the percentage of recovery. Analysis of the cost of treatment is done by calculating the average difference of drug cost components andnon-medicinal drugs. The results of this research showed that the outcome of atypical antipsychotic treatment in patients with schizophrenia seen from the length of stay of hospitalization, the value of risperidone group was smaller (26.48 ± 14.93 days) than the value of clozapine-risperidone combination group (30.26 ± 17.79 day), while the percentage recovery of the combination of risperidone-clozapine group was higher (100%) than the risperidone group. Statistically, there was no difference in the average length of stay between the risperidone group and the clozapine-risperidone group with p value >0.05 was 0.597. Then, the average totalcost of atypical antipsychotic risperidone therapy (Rp.3,390,587.22±1,514,410.77) was smaller than the average totalcost of combination of risperidone-clozapine (Rp.3,624,905.79±1,362,209.56) in hospitalized schizophrenic patients. The average total cost of treatment of risperidone and clozapine-risperidone combination was statistically different or it was not significantlydifferent with p values> 0.05 was 0.526. The average difference of cost component of the cost of atypical antipsychotic clozapine-risperidone combinationteraphywas more efficient than the cost componentof accommodation, doctor visit, nursing care,emergency departmentandlaboratoryofrisperidonegroup. Keywords: schizophrenia, clozapine, risperidone, theraphy outcomes, cost analysis

Kata Kunci : schizophrenia, clozapine, risperidone, theraphy outcomes, cost analysis