The Influence of Pharmaceutical Care Intervention on Inpatient Community Acquired Pneumonia: A Small Randomized Single Blind Study

Main Article Content

Bobby Presley
I. Setiabudi
Lestiono Lestiono
Ediyono Ediyono

Abstract

Pneumonia, one of infectious diseases, becomes a major health care problem in Indonesia. The inappropriateness use of treatment can lead to greater unexpected health outcome and prolonged length of stay. A lot of research has proved that pharmacists, as a part of health care professionals, has important role in assuring patients to get the most optimal treatment benefit. The aim of this study is to identify the influence of pharmaceutical care intervention in reducing the length of stay of inpatients community acquired pneumonia. This experimental study involved 32 subjects with community acquired pneumonia hospitalized without any other infection between 18th August and 31st December 2010. Subjects were divided into two groups, i.e. intervention and control group, by simple random sampling technique. Intervention group received pharmaceutical care services i.e. drug related problems identification and solving based on Pharmaceutical Care Network Europe Classification and therapy guideline. Both group received hospital standard care. The primary outcome of this study was length of stay. All subjects were followed until 31 December 2010. Most of drug related problems identified in this study were classified as treatment effectiveness (intervention group 76.19% and control group 81.82%) and treatment cost (intervention group 23.81% and control group 18.18%). Inappropriate use of antibiotic was the main cause for this drug related problems based on the pneumonia guideline. Ceftriaxone and ciprofloxacin (28.21%) were the most inappropriate used antibiotics found in this study. The mean of length of stay between intervention (6 days) and control group (8 days) was significantly different (P<0.05). Pharmaceutical care intervention significantly improved the length of stay of inpatients community acquired pneumonia.

Article Details

How to Cite
Presley, B., Setiabudi, I., Lestiono, L., & Ediyono, E. (2015). The Influence of Pharmaceutical Care Intervention on Inpatient Community Acquired Pneumonia: A Small Randomized Single Blind Study. Jurnal Sains Farmasi & Klinis, 2(1), 84–90. https://doi.org/10.29208/jsfk.2015.2.1.54
Section
Research Articles

References

Kenneth D, Kochanek MA, Jiaquan X, Sherry L, Murphy BS, Arialdi M, Miniño, Hsiang-Ching Kung. National Vital Statistics Reports Deaths: Preliminary Data for 2009 National Vital Statistics Reports;59(4).

Direktorat Jenderal Pemberantasan Penyakit Menular & Penyehatan Lingkungan (PPM & PL) Departemen Kesehatan RI 2004. Angka kematian bayi masih tinggi [internet]. [cited 2011 November 9]. Available from: https://www.penyakitmenular.info/pm/detil.asp?m=68s=2&i=240

Gelone SP, Donnell JO. Respiratory tract infections. In: Koda kimble, MA, Young LY, Alldredge BK, Corelli RL, Guglielmo BJ, Kradjan WA, editors. (2009). Applied therapeutics: the clinical use of the drugs. Maryland. Lippincott William & Wilkins: p.60-7.

Clover ML, Reed MD. Lower respiratory tract infections. In: Dipiro JT, Talbert RL, Yee GC, Matzke, Weels BG, Posey LM. (2008). Pharmacotherapy a pathophysiologic approach.7th ed. China: McGraw-Hill; p.1768-77.

Song, J. H., Oh, W. S., Kang, C. I., Chung, D. R., Peck, K. R., Ko, K. S., ... & Kim, Y. S. (2008). Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens. International journal of antimicrobial agents, 31(2), 107-114.

Song, J. H., Jung, S. I., Ko, K. S., Kim, N. Y., Son, J. S., Chang, H. H., ... & Lee, N. Y. (2004). High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study). Antimicrobial agents and chemotherapy, 48(6), 2101-2107.

Guglielmo BJ. Principles of infectious diseases. In: Koda kimble MA, Young LY, Alldredge BK, Corelli RL, Guglielmo BJ, Kradjan WA, editors. (2009). Applied therapeutics: the clinical use of the drugs. Maryland: Lippincott William & Wilkins: p.56.1.

INDONESIA: Antibiotic use "excessive", say specialists. IRIN [internet]. 2011 April 14 [cited 2012 April 20]; available from: https://www.irinnews.org/Report/92475/INDONESIA-Antibiotic-use-excessive-say-specialists

Ozkurt, Z., Erol, S., Kadanali, A., Ertek, M., Ozden, K., & Tasyaran, M. A. (2005). Changes in antibiotic use, cost and consumption after an antibiotic restriction policy applied by infectious disease specialists. Japanese journal of infectious diseases, 58(6), 338-343.

Tunger, O., Karakaya, Y., Cetin, C., Dinc, G., & Borand, H. (2009). Rational antibiotic use. The Journal Of Infection In Developing Countries, 3(2), 88-93. .

Tan CK, Ahaditomo, Prayitno A. Pelaksanaan pelayanan farmasi kinis. In: Aslam M, Tan CK, Prayitno A, editors. 2003. Farmasi klinis (Clinical Pharmacy) menuju pengobatan rasional dan penghargaan pilihan penderita. Jakarta: PT. Elex Media Komputindo.

Berenguer, B., La Casa, C., de La Matta, M. J., & Martin-Calero, M. J. (2004). Pharmaceutical care: past, present and future. Current pharmaceutical design, 10(31), 3931-3946.

Departemen Kesehatan. (2004). Keputusan Menteri Kesehatan Republik Indonesia Nomor 1197/Menkes/Sk/X/2004. Tentang Standar Pelayanan Farmasi Di Rumah Sakit.

Dipiro JT. Encyclopedia of clinical pharmacy. (2003). New York: Marcel Dekker.

Ahuja D, Britt BB, Bryan CS. (2010). Selection of antibiotics in critical care. In: Cunha, BA. Infectious disease in critical care medicine. 3rd ed. New York: Informa healthcare; P.487.

Mandell, L. A., Wunderink, R. G., Anzueto, A., Bartlett, J. G., Campbell, G. D., Dean, N. C., ... & Torres, A. (2007). Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clinical infectious diseases, 44(Supplement 2), S27-S72.

Vardakas, K. Z., Siempos, I. I., Grammatikos, A., Athanassa, Z., Korbila, I. P., & Falagas, M. E. (2008). Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials. Canadian Medical Association Journal, 179(12), 1269-1277.

Cabre, M., Bolivar, I., Pera, G., & Pallares, R. (2004). Factors influencing length of hospital stay in community-acquired pneumonia: a study in 27 community hospitals. Epidemiology and infection, 132(05), 821-829.

Dambrava, P. G., Torres, A., Vallès, X., Mensa, J., Marcos, M. A., Peñarroja, G., ... & Niederman, M. S. (2008). Adherence to guidelines' empirical antibiotic recommendations and community-acquired pneumonia outcome. European Respiratory Journal, 32(4), 892-901.

Friedman, H., Song, X., Crespi, S., & Navaratnam, P. (2009). Comparative Analysis of Length of Stay, Total Costs, and Treatment Success between Intravenous Moxifloxacin 400 mg and Levofloxacin 750 mg among Hospitalized Patients with Community-Acquired Pneumonia. Value in Health, 12(8), 1135-1143.

Frei, C. R., Jaso, T. C., Mortensen, E. M., Restrepo, M. I., Raut, M. K., Oramasionwu, C. U., ... & Mody, S. H. (2009). Medical resource utilization among community-acquired pneumonia patients initially treated with levofloxacin 750 mg daily versus ceftriaxone 1000 mg plus azithromycin 500 mg daily: A US-based study*. Current medical research and opinion, 25(4), 859-868.