ANALISIS EFEKTIVITAS DAN BIAYA r-HuEPO DAN TRANSFUSI PRC PADA TERAPI ANEMIA PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISIS
| Main Authors: | , MURWININGSIH, , Dr. Satibi, M.Si., Apt. |
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| Format: | Thesis NonPeerReviewed |
| Terbitan: |
[Yogyakarta] : Universitas Gadjah Mada
, 2013
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| Subjects: | |
| Online Access: |
https://repository.ugm.ac.id/120782/ http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=60820 |
Daftar Isi:
- Patients of Chronic Renal Failure (CRF) undergoing hemodialysis generally have anemia. Anemia in CRF patients occurred primarily because of lack erytropoietin. Anemia in CRF can be treated with Recombinant Human Erythropoietin (r- HuEPO) or Packed Red Cell (PRC) transfusion. PRC transfusion can transmit diseases, such as hepatitis B, hepatitis C, HIV and complications of hemosiderosis. Although it has been demonstrated that administration of r-HuEPO in CRF significantly improve patient quality of life, considering the price is expensive and not all patients are able to get it. The purpose of this study to determine differences in effectiveness therapy r-HuEPO therapy and transfusion PRC in the treatment of anemia CRF patients undergoing hemodialysis and reveal the cost of treatment. This research was conducted on 62 patients with anemia who are active CRF undergoing hemodialysis and get r-HuEPO or without the combination of PRC transfusion in 3 hospitals in Cilacap and Banyumas. Hb samples were taken at the beginning of month 1 and the end of the 6th month and the direct medical costs for 6 months, then analyzed overview of patient characteristics and the use of antianemia with Chi Square. Efficacy parameters such as hemoglobin levels during 1 month post later / month 6, effectiveness monitoring is done by looking at the percentage of patients achieving a therapeutic target Hb post in accordance with the standards of nursing then analyzed Crosstabs. Determine the effect of the difference between the pre Hb levels Hb post on both group analyzed with Anacova (á = 0.05). Analysis of costs calculated on the average total cost of treatment, the average cost of drug and non-drug in both groups. The results r-HuEPO therapy effectiveness where higher than the PRC transfusion Hb target therapy of anemia of chronic renal failure patients undergoing hemodialysis, the condition of the sample size of 31 patients per group with 36.15% power research. Achievement of the target Hb r-HuEPO therapy post 70.97% and 54.84% PRC transfusion. The average post-treatment Hb in the r- HuEPO group 7.10 ± 1.24 g/dL and 6.0 ± 1.38 g/dL in the PRC transfusion group. Result Anacova test obtained p = 0.016 <á = 0.05, after pre-treatment covariates controlled hemoglobin value Hb post differences were significant between the treatment and get r-HuEPO who get PRC transfusions. The average total cost of anemia treatment in CRF patients undergoing hemodialysis for 6 months for r- HuEPO group Rp.42.338.504 ± 10,560,303 and Rp. 32,532,704 ± 7.01494 million for PRC transfusion group. The largest cost component in the 2nd group is non drug costs. Although the average cost of total treatment of anemia with r-HuEPO higher than PRC transfusion, but need to be considered in the patient's condition based on symptoms and the benefits of r-HuEPO therapy in the long run, especially the effects on the cardiovascular system and prevent the transmission of disease.