Perspectives of Pharmacists, Doctors, and Nurses on Collaborative Management of Hypertension in Primary Health Centers
Downloads
Background: Puskesmas is a primary healthcare facility that conducts chronic disease management, such as hypertension. The role of pharmacists in team collaboration includes that of managerial and clinical pharmacies. However, doctors and nurses still need to be fully aware of the role of pharmacists, particularly in clinical pharmacies. Objective: This study aimed to determine the perspectives of pharmacists, doctors, and nurses on the collaborative management of hypertension in health centres across the Central Lombok Regency. Methods: observational qualitative method with a maximum variation sampling technique was used. Data saturation was achieved after interviewing 27 participants between April and June 2023. Participants were pharmacists, doctors, and nurses responsible for managing hypertension in the selected primary healthcare centers. Results: Five main themes were identified. The first was a perspective on pharmacists' managerial and clinical pharmacy roles. Almost all participants agreed that pharmacists played more roles in ensuring the availability of hypertension drugs than clinical pharmacies. Four themes were derived from a conceptual framework related to team readiness to collaborate: cognitive, affective/relational, behavioral, and leadership aspects. In general, doctors and nurses need to be made aware of pharmacists' role in the area of clinical pharmacy; meanwhile, pharmacists need to improve their clinical pharmacy knowledge. Meanwhile, team collaboration has not run optimally because each team member works individually rather than as a team member. Conclusion: Pharmacists need to improve their clinical pharmacy role, be more involved in team collaborations, and be more engaged in team collaborations; efforts are required to prepare for team collaboration.
Abdulkadir, W.S. (2017). Collaboration of Physician, Pharmacist and Director Model toward the Improvement of Teamwork Effectiveness in Hospital. Indonesian Journal of Clinical Pharmacy; 6(3); pp. 210–219. doi: 10.15416/ijcp.2017.6.3.210.
Albassam, A. et al. (2020). Perspectives of primary care physicians and pharmacists on interprofessional collaboration in Kuwait : A quantitative study. PLoS ONE; 15(7); pp. 1–17. doi: 10.1371/journal.pone. 0236114.
Ayu, G.A. and Syaripuddin, M. (2019). Peranan Apoteker dalam Pelayanan Kefarmasian pada Penderita Hipertensi. Jurnal Kedokteran dan Kesehatan; 15(1); p. 10. doi:10.24853/jkk.15.1.10-21.
Badan Penyelenggara Jaminan Sosial (BPJS). (2014). Faskes tingkat pertama tangani 144 penyakit: Info BPJS Media Internal resmi BPJS Kesehatan.
Badan Penyelenggara Jaminan Sosial (BPJS). (2014). Panduan praktis prolanis (Program Pengelolaan Penyakit Kronis) BPJS Kesehatan.
Barreto, E.F. et al. (2022). Development and Feasibility of a Multidisciplinary Approach to AKI Survivorship in Care Transitions: Research Letter. Canadian Journal of Kidney Health and Disease; 9; pp. 1–5. doi: 10.1177/20543581221081258.
Bui-Duy, M.K. et al. (2019). Development of a multistep hypertension quality improvement program in an academic general medicine practice. Journal for Healthcare Quality; 41(3); pp. 172–179. doi: 10.1097/ JHQ.000000000 0000158.
Carter, B.L. et al. (2015). Cluster-randomized trial of a physician/pharmacist collaborative model to improve blood pressure control. Circulation: Cardiovascular Quality and Outcomes; 8(3); pp. 235–243. doi: 10.1161/CIRCOUTCOMES.114.001283.
Chung, T.H. et al. (2020). The evaluation of comprehensive medication management for chronic diseases in primary care clinics, a Texas delivery system reform incentive payment program. BMC Health Services Research; 20(1); pp. 1–8. doi; 10.1186/s12913-020-05537-3.
Dikes Lombok Tengah. (2021). Data Jumlah Capaian SPM Pelayanan Penderita Hipertensi Berdasarkan Kinerja Puskesmas. Dinas Kesehatan Kabupaten Lombok Tengah.
Diskominfotik NTB. (2021). Status Gizi Balita Berdasarkan Indeks Bb/U, Tb/U, Dan Bb/Tb Menurut Kecamatan Dan Puskesmas Provinsi Nusa Tenggara Barat tahun 2020. https://data.ntbprov.go.id/dataset/status-gizi-balita-berdasarkan- indeks-bbu-tbu-dan-bbtb-di-provinsi-ntb-stunting-wasting-dan. Accessed: 30 June 2023.
Gums, T. et al. (2015). Pharmacist Intervention for Blood Pressure Control: Medication Intensification and Adherence. J Am Soc Hypertens; 9(7); pp. 569–578. doi: 10.1016/j.jash.2015.05.005.
Hirsch, J.D. et al. (2015). Primary care-based, pharmacist-physician collaborative medication-therapy management of hypertension: a randomized, pragmatic trial. Clin Ther; 36(9); pp. 1244–1254. doi: 10.1016/j.clinthera.2014.06.030.
Huda, B., Kumala, S. and Hasan, D. (2020). Analisis Ketersediaan Obat Antihipertensi dan Pengaruhnya Terhadap Pengobatan Pasien Hipertensi Di Puskesmas Kota Bandar Lampung. Jurnal Ilmiah Indonesia; 5(1); pp. 1–49.
Kementerian Kesehatan Republik Indonesia. (2013). Panduan pelaksanaan Puskesmas Keliling (Pusling). Jakarta: Kementerian Kesehatan Republik Indonesia; 1–36.
Kementerian Kesehatan Republik Indonesia. (2019). Peraturan Menteri Kesehatan
Republik Indonesia Nomor 43 Tahun 2019 Tentang Puskesmas. Jakarta: Kementerian Kesehatan Republik Indonesia.
Kulchaitanaroaj, P. et al. (2017). Cost-utility analysis of physician-pharmacist collaborative intervention for treating hypertension compared with usual care. Journal of Hypertension; 35(1); pp. 178–187. doi: 10.1097/HJH.0000000000001126.
Litke, J. et al. (2018). Impact of the clinical pharmacy specialist in telehealth primary care. American Journal of Health-System Pharmacy; 75(13); pp. 982–986. doi: 10.2146/ajhp170633.
Margolis, K.L. et al. (2020). Design of a pragmatic cluster-randomized trial comparing telehealth care and best practice clinic-based care for uncontrolled high blood pressure. Contemporary Clinical Trials; 92(January); p. 105939. doi: 10.1016/ j.cct.2020.105939.
Markossian, T.W. et al. (2021). A Mobile App to Support Self-management of Chronic Kidney Disease: Development Study. JMIR Human Factors; 8(4); pp. 1–11. doi: 10.2196/29197.
Mulrooney, M. et al. (2022). Practical implementation insights from 2 population health pharmacist project approaches to improve blood pressure control. Journal of the American Pharmacists Association; 62(1); pp. 270–280. doi: 10.1016/j.japh.2021.07.012.
Njonkou, G. et al. (2021). Assessment of the Impact of Pharmacist-led Transitions of Care Services in a Primary Health Center. Hospital Pharmacy; 56(3); pp. 187–190. doi: 10.1177/ 0018578719883805.
Nursyamsi, I. (2012). Pengaruh kepemimpinan, pemberdayaan dan stres kerja terhadap komitmen organisasional serta dampaknya terhadap kinerja dosen. In Conference In Business, Accounting, And Management. pp.405–23.
Oktiano, D., Sarnianto, P. and Ramadaniati, H.U. (2022). Pengaruh Ketersediaan Obat Hipertensi terhadap Rujukan Pasien Hipertensi Ringan dan Sedang di Puskesmas. Journals of Ners Community; 13(6); pp. 682–687.
Prabowo, P., Satibi and Gunawan Pamudji. (2016). Analisis Faktor-faktor yang mempengaruhi ketersediaan obat di era JKN pada rumah sakit umum daerah dr. Soedono Madiun. Jurnal Manajemen dan Pelayanan Farmasi; 6(3); pp. 213–218. doi: 10.22146/jmpf.348.
Pratiwi, A.I., Fudholi, A. and Satibi. (2021). Analisis Faktor yang Mempengaruhi Implementasi Pelayanan Kefarmasian Puskesmas di Kota Semarang. Majalah Farmaseutik; 17(1); p. 1. doi: 10.22146/farmaseutik.v17i1.46980.
Presiden Republik Indonesia. (1960). Undang-undang Republik Indonesia Nomor 9 tahun 1960 tentang pokok-pokok kesehatan. Jakarta
Rachmawati, S. (2021). Analisis pelaksanaan program pengelolaan penyakit kronis (PROLANIS) pada pasien hipertensi di Kabupaten Sampang. Tesis; Fakultas Farmasi Universitas Airlangga, Surabaya.
Rachmawati, E. (2018). Evaluasi peranan tenaga kefarmasian dalam pelayanan dan pengelolaan obat, BMHP, dan alkes program poned di Puskesmas Kota Semarang. Tesis; Fakultas Farmasi Universitas Gadjah Mada, Yogyakarta.
Robins, L.S. et al. (2014). Barriers and Facilitators to Evidence-based Blood Pressure Control in Community Practice. J Am Board Farm Med; 26(5); pp. 1–19. doi: 10.3122/jabfm.2013.05. 130060.
Rosdiana, A. et al. (2017). Implementasi Program Pengelolaan Penyakit Kronis (Prolanis). Higeia Journal of Public Health Research and Development; 1(3)(3); pp. 140–150.
Santschi, V. et al. (2021). Team-Based Care for Improving Hypertension Management: A Pragmatic Randomized Controlled Trial. Frontiers in Cardiovascular Medicine; 8(October); pp. 1–10. doi: 10.3389/fcvm.2021.760662.
Schrager. (2020). Focus on Team-Based Care. Wisconsin Medical Journal. doi: 10.1056/NEJMp2006740.3.
Shoemaker, S.J. et al. (2016). A review of instruments to measure interprofessional team-based primary care. Journal of Interprofessional Care; 30(4); pp. 423–432. doi: 10.3109/13561820.2016.1154023.
Sitohang. (2017). Implementasi Peraturan Pemerintah Nomor 65 Tahun 2010 Tentang Sistem Informasi Keuangan Daerah Pada Pemerintah Kabupaten Dairi Rayambong. Journal of Chemical Information and Modeling; 53(9); pp. 1689–1699.
Smith, S.M. et al. (2016). Physician-Pharmacist Collaboration versus Usual Care for Treatment-Resistant Hypertension. J Am Soc Hypertens; 10(4); pp. 307–317. doi: 10.1016/j.jash.2016.01.010.
Sulistiyono, H., Sarnianto, P. and Anggiani, Y. (2020). Dampak Kebijakan Pengadaan Obat Pada Puskesmas di Jakarta Era Jaminan Kesehatan Nasional. Jurnal Kesehatan Window oh Health; 3(4); pp. 295–307.
Taylor, A.M. et al. (2018). Integrating innovative telehealth solutions into an interprofessional team-delivered chronic care management pilot program. Journal of Managed Care and Specialty Pharmacy; 24(8); pp. 813–818. doi: 10.18553/jmcp.2018.24.8.813.
Tetuan, C. et al. (2019). Assessing the effect of a telepharmacist's recommendations during an integrated, interprofessional telehealth appointment and their alignment with quality measures. Journal of Managed Care and Specialty Pharmacy; 25(12); pp. 1334-1339. doi: 10.18553/jmcp.2019.25.12.1334.
Utaminingrum, W., Pranitasari, R. and Kusuma, A.M. (2017). Effect of Pharmacist Home Care on Adherence of Hypertensive Patients. Indonesian Journal of Clinical Pharmacy; 6(4); pp. 240–246. doi:10.15416/ ijcp.2017.6.4.240.
Viani, Ella, Yulia, R., and Herawati, F. (2021). Persepsi tenaga kesehatan terhadap praktik kolaborasi interprofesional dalam terapi antibiotik pada bedah ortopedi. Jurnal Sains Farmasi & Klinis; 8(3); pp.296–302.
Wibowo, M.I.N.A. et al. (2020). Pengaruh Konseling dan Alat Bantu Pengingat Pengobatan terhadap Kepatuhan Minum Obat dan Outcome Klinik Pasien Diabetes Melitus dan Hipertensi. Jurnal Ilmu Kefarmasian Indonesia; 18(2); pp. 169–176.
Yusransyah et al. (2022). Pengaruh Pelatihan Farmasi Klinik Terhadap Peningkatan Kompetensi Apoteker Di Puskesmas Provinsi Banten Di Era Pandemi Covid-19. Jurnal Ilmiah Manuntung; 8(1); pp. 89–99. doi: 10.51352/jim.v8i1.497.
ZieliÅ„ska-Tomczak, Å. et al. (2021). Pharmacists perspectives on interprofessional collaboration with physicians in poland: A quantitative study. International Journal of Environmental Research and Public Health; 18(18). doi :10.3390/ijerph18189686
Copyright (c) 2023 JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
1. The copyright of this journal belongs to the Editorial Board and Journal Manager with the author's knowledge, while the moral right of the publication belong to the author.
2. The formal legal aspect of journal publication accessibility refers to the Creative Commons Attribution-Non-Commercial-Share Alike (CC BY-NC-SA), which implies that the publication can be used for non-commercial purposes in its original form.
3. Every publication (print/electronic) is open access for educational, research, and library purposes. In addition to the objectives mentioned above, the editorial board is not responsible for copyright infringement
.jpg)
