Cindra Tri Yuniar

Background: Spontaneous Adverse Drug Reactions (ADRs) reporting is a key to improving the post-marketing safety of medicines. The important factor of under-reporting is lack of awareness for the purpose of ADRs monitoring and reporting. Spontaneous reporting is performed by the patients or consumer to the healthcare professionals and/or industry, then the healthcare facilities and industry should report the suspected ADRs to the National Agency of Drugs and Food Control (NADFC). To date, there is a lack information and study about attitudes on ADRs reporting by healthcare professionals (HCPs), especially in primary healthcare settings.Objectives: The aim of this study was to identify the attitudes towards ADRs reporting by healthcare professionals (HCP).Methods: This research was survey study with cross-sectional design, from November 2022-March 2023. The questionnaire, that have been validated and reliable, was distributed to 3 primary healthcare facilities. demographic data questions (6 items), experiences (3 items), knowledge (4 items), and motives for reporting (1 item).Results: Total 39 HCPs completed the survey, including 14 nurses, 9 midwifes, 3 general physicians, 3 pharmacists, and 10 other professions. Most of respondents were women (84.6%), and mostly the HCPs have been working for ≥5 years (74.3%). Among 39 respondents, only 1 pharmacist have a good attitude about ADRs reporting. The other HCPs had a lack of knowledge and safety awareness. The dominant motives for reporting the ADRs was serious or severe ADRs (39.4%) and the assurance of causality assessment by suspected drugs (15.4%).Conclusion: In conclusion, the HCPs in primary healthcare settings had poor attitudes towards ADRs reporting.

Penyakit hipertensi dan diabetes melitus tipe 2 merupakan penyakit kronis dengan prevalensi kematian tinggi di Indonesia. Kementerian Kesehatan Republik Indonesia telah membuat sistem layanan terintegrasi pada tingkat Puskesmas untuk memaksimalkan upaya serta sumber daya kesehatan secara efisien dan efektif, yakni melalui program pengelolaan penyakit kronis (PROLANIS). Program ini mendukung pasien penyakit kronis dalam mencapai keberhasilan terapi dan pencegahan komplikasi, namun seringkali kepatuhan yang rendah membuat tujuan tersebut tidak tercapai. Oleh karena itu, pada penelitian ini dirancang edukasi melalui pembuatan buku saku tentang penyakit dan terapinya untuk hipertensi serta diabetes melitus tipe 2 sebagai upaya meningkatkan kepatuhan pasien terhadap regimen terapi serta mengukur tingkat kepuasan pasien terhadap media edukasi. Studi ini dilakukan secara observasional potong-lintang yang dilakukan bulan Januari-Mei 2023, merekrut 88 pasien di dua Puskesmas di Bandung untuk dianalisis kepatuhannya terhadap regimen terapi menggunakan kuesioner MMAS-8 dan dibandingkan hasilnya sebelum dan sesudah pemberian buku saku. Dilakukan juga evaluasi kepuasan pasien terhadap media edukasi menggunakan kuesioner tervalidasi berbasis SERVQUAL. Hasil penelitian menunjukkan terjadi peningkatan level kepatuhan pasien terhadap regimen terapi di kedua Puskesmas yaitu 5,48 ± 1,96 (sebelum diberikan edukasi) menjadi 6,94 ± 1,70 (pasca pemberian edukasi) yang berbeda bermakna secara statistik (p<0,001). Nilai indeks kepuasan responden terhadap buku saku sebesar 88,38% yang menunjukkan bahwa responden sangat puas. Usulan perbaikan buku saku terletak pada informasi yang diuraikan sebaiknya menggunakan bahwa yang mudah dimengerti masyarakat awam serta memperbesar ukuran huruf. Penelitian ini mendukung bukti buku saku sebagai alat peningkat kepatuhan.

Latar belakang: Pemeriksaan antropometri merupakan pemeriksaan non-invasif kuantitatif yang menyediakan pengkajian mengenai status gizi pada anak-anak dan orang dewasa. Pemeriksaan antropometeri yang tidak tepat dan teliti, dapat menghasilkan data yang tidak valid untuk dijadikan dasar penegakan interpretasi status gizi. Kesalahan interpretasi status gizi, akan berdampak pada tidak tepatnya terapi gizi yang diberikan pada sasaran terkait. Salah satu status gizi yang dinilai berdasarkan penilaian antropometri adalah kondisi stunting. Stunting merupakan kondisi gagal tumbuh yang terjadi dikarenakan kekurangan gizi berkepanjangan, terutama pada 1000 Hari Pertama Kehidupan. Salah satu upaya yang dilakukan untuk mengejar ketertinggalan pertumbuhan, antara lain adalah dengan memberikan Pemberian Makanan Tambahan (PMT) yang disesuaikan dengan usia sasaran. Pulau Kangean, sebagai salah satu pulau terluar di Madura, memerlukan pemberdayaan kader sebagai pihak yang menyampaikan informasi esensial berkaitan dengan kesehatan dan gizi pada sasaran. Pulau Kangean memiliki bahan makanan lokal berupa anggur laut yang dapat dimanfaatkan sebagai bahan dasar dari pembuatan PMT. Pemberian materi mengenai pengukuran antropometri dan PMT dalam bentuk presentasi oral, merupakan salah satu metode yang dapat digunakan untuk meningkatkan pengetahuan audiens melalui pemaparan materi satu arah yang dilanjutkan dengan diskusi dan tanya jawab. Tujuan: Meningkatkan kapasitas kader dalam melakukan pengukuran antropometri, terutama pengukuran tinggi badan dan panjang badan sebagai upaya skrining stunting dengan validitas yang baik. Memberikan pandangan mengenai jenis makanan tambahan yang bisa dijadikan alternatif menu makanan tumbuh kejar yang bersumber dari bahan makanan lokal yang terjangkau. Peningkatan pengetahuan kader diharapkan terjadi dengan indikasi peningkatan skor prettest dan posttest sebelum dan sesudah intervensi presentasi oral dilakukan. Metode: Intervensi diberikan secara oral dengan menggunakan Power Point dengan durasi pemberian materi selama 45 menit secara sinkronus dan 15 menit secara asinkronus. Pengukuran tingkat pengetahuan pada kader diukur dengan menggunakan pretest dan posttest yang berjumlah 15 pertanyaan, dengan 10 pertanyaan mengenai skrining antropometri tinggi badan dan panjang badan serta 5 pertanyaan mengenai PMT. Hasil: Terjadi peningkatan pengetahuan kader ditandai dengan skor posttest dan pretest yang mengalami peningkatan sebesar 11 dari 100 poin yang diberikan. Sebanyak 70% kader mengalami peningkatan pengetahuan dan 30% dari kader tidak mengalami peningkatan pengetahuan. Seluruh kader yang terlibat dalam penelitian ini tidak berhasil melampaui batas nilai minimal untuk dikatakan lulus, yaitu sebesat 70 poin dari total 100 poin yang setara dengan 6-7 soal yang terjawab benar. Rata-rata soal yang berhasil terjawab benar pada pretest adalah 3-4 soal benar. Terjadi peningkatan jumlah soal benar, yaitu sebesar 5-6 soal pada posttest yang menjadi indikasi peningkatan pengetahuan mengenai skrining antropometri dan pemberian makanan tambahan pada kader. Kesimpulan: Presentasi oral yang dilakukan dengan memaparkan materi berkaitan dengan skrining stunting dan PMT tidak dapat meningkatkan pengetahuan kader secara signifikan. Salah satu penyebab inoptimalisasi paparan presentasi yang diberikan adalah durasi paparan materi yang terlalu lama dan diskusi interaktif yang tidak berjalan dengan baik. Diperlukan pengembangan metode edukasi gizi yang lebih aplikatif dan interaktif dengan melibatkan audiens, salah satunya adalah dengan menggunakan metode emo demo dan demo secara langsung yang melibatkan partisipasi aktif dari sasaran.

Background: In Indonesia, compliance to the rational use of medicines (RUM) was 47.08% in community healthcare centers, and so might the university students. Objectives: The study aims to evaluate students' knowledge and attitude toward the RUM and identify the correlation between these parameters and drug safety awareness. Method: A cross-sectional study used the online questionnaire among university students in Greater Bandung Area from March-April 2022. Spearman’s rank was carried out in correlation analysis between the parameters. Result: In 342 subjects, 54.1% of students have moderate knowledge of RUM and drug safety awareness (56.7%). However, 80.1% of students have a high attitude towards RUM. Attitude toward RUM formed a significant, weak, and unidirectional correlation with knowledge (r = 0.292) and so did with safety awareness (r = 0.345). Conclusion: Students have a positive attitude towards RUM while having moderate knowledge of RUM and drug safety awareness.

Background: Deprescribing of preventive medication is recommended in older patients with polypharmacy, including people with type 2 diabetes (T2D). It seems that many patients in low-middle-income countries are not willing to have their medicines deprescribed. This study aims to assess attitudes of Indonesian patients with T2D towards deprescribing in general and regarding specific cardiometabolic medicines, and factors influencing their willingness to stop medicines. Methods: Primary care patients with T2D of ≥60 years in Indonesia completed the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire. Attitudes in general and for cardiometabolic medicines were reported descriptively. Proportions of patients willing to stop one or more medicines when recommended by different healthcare professionals were compared with Chi-square test. Multiple regression analysis was used to analyse the influence between patient-related factors and the willingness to stop medicines. Results: The survey was completed by 196 participants (median age 69 years, 73% female). The percentages willing to stop medicines were 69, 67, and 41%, when the general practitioner (GP), the specialist, or the pharmacist initiates the process (p-value < 0.001). Higher perceived burden of medicines (p-value = 0.03) and less concerns about stopping (p-value < 0.001) were associated with a higher willingness to stop medicines if proposed by the GP. Patients using multiple glucose-regulating medicines were less willing to stop (p-value = 0.02). Using complementary or alternative medicines was not associated with the willingness to stop. If proposed by their pharmacist, patients without substantial education were more willing to stop than educated patients. Conclusions: Only two-thirds of older people with T2D in Indonesia were willing to stop one or more of their medicines if the GP or specialist recommended this, and even less when the pharmacist proposed this. Attention should be given to concerns about stopping specific medicines, especially among patients using multiple glucose-lowering medicines, who may be more eligible but were less willing to accept deprescribing.

BACKGROUND Methylphenidate is an effective first-line treatment for attention-deficit/hyperactivity disorder (ADHD). However, many adverse effects of methylphenidate have been recorded from randomized clinical trials and patient-reported outcomes, but it is difficult to determine abuse from them. In the context of COVID-19, it is important to determine how drug use evaluation, as well as misuse of drugs, have been affected by the pandemic. As people share their reasons for using medication, patient sentiments, and the effects of medicine on social networking services (SNSs), the application of machine learning and SNS data can be a method to overcome the limitations. Proper machine learning models could be evaluated to validate the effects of the COVID-19 pandemic on drug use. OBJECTIVE To analyze the effect of the COVID-19 pandemic on the use of methylphenidate, this study analyzed the adverse effects and nonmedical use of methylphenidate and evaluated the change in frequency of nonmedical use based on SNS data before and after the outbreak of COVID-19. Moreover, the performance of 4 machine learning models for classifying methylphenidate use based on SNS data was compared. METHODS In this cross-sectional study, SNS data on methylphenidate from Twitter, Facebook, and Instagram from January 2019 to December 2020 were collected. The frequency of adverse effects, nonmedical use, and drug use before and after the COVID-19 pandemic were compared and analyzed. Interrupted time series analysis about the frequency and trends of nonmedical use of methylphenidate was conducted for 24 months from January 2019 to December 2020. Using the labeled training data set and features, the following 4 machine learning models were built using the data, and their performance was evaluated using F-1 scores: naïve Bayes classifier, random forest, support vector machine, and long short-term memory. RESULTS This study collected 146,352 data points and detected that 4.3% (6340/146,352) were firsthand experience data. Psychiatric problems (521/1683, 31%) had the highest frequency among the adverse effects. The highest frequency of nonmedical use was for studies or work (741/2016, 36.8%). While the frequency of nonmedical use before and after the outbreak of COVID-19 has been similar (odds ratio [OR] 1.02 95% CI 0.91-1.15), its trend has changed significantly due to the pandemic (95% CI 2.36-22.20). Among the machine learning models, RF had the highest performance of 0.75. CONCLUSIONS The trend of nonmedical use of methylphenidate has changed significantly due to the COVID-19 pandemic. Among the machine learning models using SNS data to analyze the adverse effects and nonmedical use of methylphenidate, the random forest model had the highest performance.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).

Although low birth weight (LBW) is still a major health problem in Indonesia, studies about determinants of LBW with large sample sizes are still limited. This study aimed to examine the association between LBW and maternal characteristics, as well as socio-economic backgrounds in Indonesia. A secondary analysis of 2017 Indonesian Demographic and Health Survey (IDHS) was conducted, specifically using the questionnaires for women of childbearing age. A bivariate chi-square analysis and a multivariate logistic regression analysis were performed. As many as 6.7% of infants were born with LBW. In terms of maternal characteristics, women who gave birth to twins were 20.30 times more likely to have infants with LBW (p < 0.001). Women with birth intervals of p < 0.05). Complications during pregnancy were also associated with LBW (1.99 times higher than women with no complications) (p < 0.001). In terms of socio-economic factors, women with higher education and higher wealth index were less likely to give birth to infants with LBW. Additionally, marital status and type of residence were also significantly associated with a higher risk of LBW. In conclusion, LBW was associated with maternal characteristics and socio-economic backgrounds among women of childbearing age in Indonesia, including twin births, birth interval, and pregnancy complications as well as educational attainment, wealth index, marital status, and type of residence.

Over the past two years, the world has faced the pandemic, COVID-19, and various changes. Several regulations and recommendations from the Ministry of Health of Indonesia have contributed to behavioral changes among Indonesian residents, especially in food consumption patterns. The change in food consumption patterns can be a positive change that formed due to the COVID-19 pandemic. This study aimed to examine whether the application of a Health Belief Model (HBM)-based nutrition education programme can be effectively used in changing the beliefs of adults with or without a COVID-19 history in supplement and nutrient intake. This study was a cross-sectional study involving 140 adults. This study placed 70 adults with/without a COVID-19 history into the intervention group. The intervention group participated in a nutrition education programme. The respondents were asked to fill out the questionnaire. The data were analyzed by independent and paired t-tests and Chi-square test. The result of this study showed no association between perceived susceptibility, severity, benefit, barrier, and self-efficacy, of nutrient and supplement intake with the history of COVID-19 among the respondents. However, most of the respondents in this study were low in their scores of perceivedness. Thus, it is still important for the government to increase nutrient and supplement intake education, especially in young adults aged below 25 years old.

Objectives: This study aimed to examine the association between maternal health behaviors and neonatal outcomes among the Indonesian population. Methods: Articles were collected from PubMed, EBSCO, ProQuest, DOAJ, and GARUDA. Funnel plots and Egger’s tests analyzed indications of publication bias. A Mantel–Haenszel random-effects model was used to see the overall effect size of exposures on outcomes. Heterogeneity was seen based on I². Data collected from articles included the author, year of publication, location of the study, study design, number of samples, risk factors, and effect sizes. Results: We identified 24 relevant studies, including eight from the primary databases and 16 from an additional database. A total of 12 studies were included in the meta-analysis, examining the association between maternal health behaviors and neonatal outcomes. The pooled odds ratio (OR) for passive smoking and low-birth-weight (LBW) was 3.41 (95% CI: 1.75–6.63, I² = 40%, four studies). The pooled OR for incomplete antenatal care (ANC) and LBW was 6.29 (95% CI: 2.11–18.82, I² = 70%, four studies). The pooled OR for incomplete ANC and neonatal mortality was 2.59 (95% CI: 1.01–6.66, I² = 93%, four studies). Conclusions: The results indicated that pregnant women with incomplete ANC had a higher risk of LBW and neonatal mortality, and those who were passively exposed to smoking had a higher risk of LBW. Further investigations are needed, considering the high heterogeneity found, and additional meta-analyses should be based on the variations of socio-demographic conditions.