Indonesian Journal of Pharmacy
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New, Valid, and Reliable Indonesian Version of the Quality of Life Assessment Instrument Based On the Health Condition: Health-Related Quality of Life With Six Dimensions
Get PDFHealth-related quality of life is very important to be measured as the parts of Patient-Reported Outcome (PRO). PRO can show the disease proression and also may influence the clinical decision making. There are many QoL instruments available in Indonesia as generic and specific instruments, however, there is no QoL instrument which measured the respondents’ functions based on the health status. This study is aimed to translate, adapt and validate the new QoL instrument based on the health condition, namely HRQ-6D (Health Related Quality of Life, 6 Dimensions). We conducted forward and backward translations. The subjects were people who lived in Yogyakarta city with aged more than 18 years old, and agreed to participate in this study. While the exclusion criteria were patients whose questionnaire data were incomplete. We shared the questionnaire to the area of Yogyakarta from September to October 2023. We used Pearson correlation, Cronbach alpha reliability test and Student T-test for the validity and reliability assessment. We recruited 69 respondents with mostly female (60.9%) and the age is more than 60 yo (80.9%). Based on the health condition, more than fifty percent of the subjects (59.4%) were in Category 1, which considered as healthy, and only one subject were having more than one disease and have been hospitalized more than three times due to the disease or the complications (Category 4). The reliability test showed the Cronbach alpha value between 0.60-0.75. And all of the items in the questionnaire met the convergent and discriminant validity. TheHRQ-6D can be implemented as the new Bahasa Version of QoL instrument, supported with the validity and reliability assessment
The Inhibitory Effect of Several Compounds of Citrus Sp. on Dipeptidyl Peptidase-4 (DPP-4) Enzymes: In Vitro and In Silico Studies
No full textDiabetes mellitus is a chronic disease that has an increasing prevalence over the years. One of the treatment approaches for diabetes mellitus is to inhibit the DPP-4 enzyme, which plays an important role in glucose metabolism. The use of citrus peel as a rich source of flavonoids can be an antioxidant that has a relation with inhibitory activity on the DPP-4 enzyme. This study aims to determine the potential of citrus peel based on its phytochemical content from three locations on DPP-4 enzyme inhibitory activity associated with antioxidant activity in vitro and in silico. Since this activity is closely related to antioxidant activity, a DPPH assay was measured and the IC50 (ppm) was evaluated. DPP-4 inhibition was evaluated by the percent of relative inhibition values of flavonoids, scopoletin, vildagliptin, and sitagliptin. The highest IC50 value of antioxidant in the citrus peel extract was found in Yogyakarta at 3271.7 ppm, and quercitrin as a flavonoid standard at 5.2 ppm. The highest DPP-4 enzyme inhibitory activities were found in the Yogyakarta extract and scopoletin standard by 75.3% and 94.9%, respectively. The DPP-4 enzyme inhibitory activity of flavonoids in citrus peel can be described in silico and indicates promising potential as DPP-4 inhibitors. Several flavonoids reported to be contained in citrus peel have antioxidant activity that can be directly correlated with DPP-4 inhibitor activity in vitro and in silico
Preparation and Evaluation of Orodispersible Films Containing Spray-Dried Rifampicin Nanosuspension
No full textBackground: Tuberculosis remains a major global health challenge, with high mortality rates. Conventional anti-TB dosage forms like tablets are often unsuitable for patients who struggle with swallowing, leading to poor compliance. To overcome these limitations, this research aimed to develop an orodispersible film (ODF) containing rifampicin, a widely used anti-tuberculosis drug. However, rifampicin’s low aqueous solubility poses challenges for its incorporation into ODFs and affects its therapeutic effectiveness. To address these issues, rifampicin was first prepared as a nanosuspension and subsequently dried before being formulated into the ODF.Methods: Nanosuspensions were stabilized using polyvinyl alcohol (PVA), poloxamer 188 (POX), and their combination at various concentrations. The nanosuspensions were prepared using solvent-antisolvent precipitation followed by sonication and spray-drying. The resulting spray-dried nanosuspension was characterized, and the optimal formula was used in ODF formulation through the solvent-casting method.Results: Formulations PV2 (PVA 0.4%) and POX1 (POX 0.2%) demonstrated the smallest particle sizes at 306±14.01 nm and 291±7.55 nm, respectively. After reconstitution, PV2 maintained the particle size comparably to POX1. The spray-dried PV2 nanosuspension exhibited a 21.48-fold increase in saturated solubility compared to the pure rifampicin and superior drug release (79% vs 58%) compared to the standard rifampicin suspension. ODF containing PV2 showed improved organoleptic properties and enhanced drug dissolution (82% vs 56%) compared to original rifampicin ODF.Conclusion: Formulating rifampicin into a nanosuspension stabilized by PVA and POX, followed by spray-drying, significantly improves its solubility and drug release profile. This approach also enhances the organoleptic properties and dissolution of rifampicin in ODF, offering a promising strategy to boost rifampicin’s therapeutic efficacy in tuberculosis treatment, particularly for pediatric patients.
Graphical Abstract
Understanding Drug-taking Behavior and Factors influencing in People with Schizophrenia: A Qualitative Study
No full textSchizophrenia is a chronic mental disorder that significantly impacts patients, families, and healthcare systems. Medication non-adherence poses a major challenge, leading to relapse and increased healthcare costs. The Si-Care (Schizophrenia Care) program, a pharmacist-led home care intervention, was developed to improve medication adherence and therapy outcomes. This study aimed to refine the Si-Care program and its educational booklet using focus group discussions (FGDs) with healthcare professionals. FGDs were conducted with 13 healthcare professionals, including pharmacists, psychiatrists, nurses, and general practitioners, in Banjarmasin, Indonesia. Participants were recruited purposively for their experience in schizophrenia care. Discussions explored the feasibility and components of the Si-Care program and gathered recommendations for optimizing the educational booklet. Data were analyzed thematically to identify key themes and patterns. Four themes emerged from FGDs, including the importance of interdisciplinary collaboration, the perceived benefits of the program, the expanded role of pharmacists, and the need for management and regulatory support. Participants emphasized the program’s potential to enhance medication adherence through comprehensive counseling, education, and monitoring. For the booklet, recommendations included using plain language, incorporating visual aids, and addressing emergency signs for schizophrenia. Practicality and cost-effectiveness were highlighted as essential considerations. The Si-Care program presents a promising pharmacist-led intervention for improving schizophrenia care. Multidisciplinary input refined the program and its educational materials, enhancing their feasibility and relevance. Future research should focus on pilot testing to evaluate the program’s scalability and impact on patient outcomes, incorporating feedback from patients and families
The Usability Assessment of PRiSMA and My.Pharma-C Web Application System
Get PDFThe Pharmaceutical Services Program (PSP) has not yet evaluated the usability of the web application system. The System Usability Scale (SUS) and Net Promoter Score (NPS) assessment tools give you a quick overview of your system's usability and help you improve it further. The goal of this study was to assess the usability of the PRiSMA and My.Pharma-C systems using SUS and NPS. From April 2019 to July 2020, a survey was conducted using a validated self-administered questionnaire that was prompted after each successful log-out from the PRiSMA and My.Pharma-C systems. The questionnaire was divided into three sections: demographic, device type, and SUS and NPS questionnaire. The mean SUS and NPS scores were computed. The survey was completed by 3,959 PRiSMA users and 811 My.Pharma-C users. The SUS score was interpreted as a grade, adjective, and range of acceptability. The PRiSMA mean SUS score was 70.2 (SD 15.44), indicating a 'Grade C' and 'Good' system. The mean SUS score for My.Pharma-C was 58.2 (SD 15.13), indicating a 'Grade D' and 'OK' system. Users accepted both systems on the basis of their usability. Calculated NPS value for PRiSMA was p=42%, n=49% and d=9%, NPS value=+33, whereas My.Pharma-C p=18%, n=46% and d=36%, NPS value=-18. A positive NPS value for PRiSMA represents the user's readiness to recommend the system to others compared to My.Pharma-C. The findings also established that SUS alone is insufficient and needs to be complemented by another method, such as qualitative instruments. It could help to drill down in depth to understand how to address potentially problematic areas for web application systems and assist in the improvement phases. However, both of the tools are applicable to be used to evaluate the usability of the web application systems that managed by the Pharmaceutical Services Program
Metformin HCl Controlled-Release Microparticles: DoE-Based Formulation Development and In-Vivo Proof of Concept Study
Get PDFConventional drug delivery systems deal with side effects caused by fluctuating plasma levels. However, controlled drug delivery systems face another challenge since big dosing results in voluminous dosage forms. The drug delivery system is only suitable for some patients. A sustained-release drug delivery system in microparticles is proposed to conquer the problems. This research proposed to develop and optimize sustained-release microparticles consisting of metformin HCl as a drug model and a mixture of Eudragit RS and Kollidon SR as a polymeric matrix using a Box-Behnken design. The evaluation was conducted regarding drug loading, entrapment efficiency, and particle size to determine the optimal formulation. Metformin HCl concentration and drug-polymer ratio were dominant increased particle size, drug loading, entrapment efficiency, and particle size distribution. Particle size testing showed that the optimized formulation had a microparticle size of 1.363 ± 0.03 µm with a particle size distribution of 1.131 ± 0.028. In vitro evaluation showed that the release of metformin HCl microparticles followed Weibull kinetics within 24 hours. In contrast, in vivo evaluation confirmed the ability of microparticles to control blood glucose levels in mice for up to 24 hours with a 59% reduction. The microparticle effectively controlled drug release and reduced blood glucose levels in the rats
Survey of Bachelor of Pharmacy Students Thesis Trends Before, During, and After the Covid-19 Pandemic
Get PDFThe COVID-19 pandemic spread to Indonesia in March 2020 and subsided in mid-2022. The pandemic has had a major impact on the health of people around the world and has affected other aspects of life, especially education. The pandemic had an impact on academic activities in higher education. This study aims to describe the research patterns of bachelor pharmacy student's thesis before, during, and after the COVID-19 pandemic. We also investigated the reasons for students in determining thesis research topics and the percentage of theses published in journals or proceedings. The study was designed observationally with a questionnaire to collect the data. The respondents included pharmacy undergraduate students at Universitas Gadjah Mada who are completing or have completed the thesis during the period before, during, or after the COVID-19 pandemic. The data obtained were analyzed descriptively according to the same variables such as trends in thesis research topics, students' reasons for determining topics, and number of journal publications from thesis research. The total number of respondents who completed the questionnaire was 258, with 53, 100, and 95 students conducting the research before, during, and after the pandemic, respectively. Before the pandemic, among all respondents, most of them conducted research on the topics of pharmaceutical technology (22.73%), pharmacology & toxicology (15.91%), pharmacotherapy & clinical pharmacy (15.91%), and pharmacy management and community pharmacy (15.91%). In terms of research methods, most of them conducted laboratory-based research (76.06%). During the pandemic, the topics of research were dominated by pharmacotherapy & clinical pharmacy (34.88%), and pharmacy management and community pharmacy (32.56%), and the most common type of final project study was literature review (47.57%). After the pandemic subsided in mid-2022, pharmacy management and community pharmacy (41.94%) was the most dominant one. In the study, we observed that scientific interest and supervisor competence were two main reasons for students in determining the topic of research topics. Among respondents, up to 25% of all bachelor student thesis was published in the form of national and international journal articles, and presentations at national and international conferences. Based on the study, we conclude that the COVID-19 pandemic influenced the trends of bachelor pharmacy student thesis
Characterization of Curcumin from Curcuma purpurascens Blume and Its Activity Test as Antioxidant and Antilipase
No full textCurcuma purpurascens Blume is a plant in the Zingiberaceae family and known as temu blenyeh. This plant has been used as a medicinal plant but there is still little research and not much has been reported about its chemical components. The research aimed to isolate and characterize the chemical components of the rhizomes of C. purpurascens and test its activity as an antioxidant and antilipase. The ethanol extract of temu blenyeh (Curcuma purpurascens Blume) underwent antioxidant activity-guided purification using vacuum liquid chromatography to obtain pure compounds. The antioxidant activity test used the DPPH (2,2-diphenyl-1picrylhydrazyl) method, while the antilipase activity test performed inhibition of pancreatic lipase enzyme activity. The results showed that the ethanol extract had antioxidant activity with an IC50 value of 55.501±0.361µg/mL with the positive control Vitamin C having an IC50 of 5.843±0.181µg/mL. The antilipase activity of the ethanol extract had an IC50 value of 117.863 ± µg/mL. The antilipase activity of orlistat as a positive control had an IC50 value of 12.265 ± µg/mL. The ethylacetate fraction activated the lipase enzyme with the highest inhibition of 70.33%. Curcumin was isolated from the ethyl acetate fraction of C. purpurascens rhizomes in the form of a yellow-orange powder with antioxidant activity of IC50 71.305±0.215µg/mL and was found to be an active lipase inhibitor with an IC50 of 54.786±5.588µg/mL. The structure was identified using UV-Vis, IR, UPLC-MSMS, 1D-NMR, and 2D-NMR analysis
Nanoparticles Formulation of Begonia medicinalis Extract Using PLGA-Alginate-PVA Polymers for Immunomodulation and SARS-CoV-2 Protease Inhibition
Get PDFThe study explores the formulation of nanoparticles containing Begonia medicinalis extract using a blend of PLGA (Poly-Lactic-co-Glycolic Acid), sodium alginate, and polyvinyl alcohol. This formulation aimed to investigate its physicochemical properties and potential immunomodulatory and anti-SARS-CoV-2 activities. Immunomodulation was evaluated through phagocytosis activity measurement, TNF-α, and IFN-γ levels, while anti-SARS-CoV-2 activity was assessed through in vitro testing on the SARS-CoV-2 protease enzyme. Nanoparticles were prepared via the solvent evaporation method with various PLGA:alginate:PVA ratios (1:3:3, 1:3:6, 1:6:3, and 1:6:6). Characterization included organoleptic examination, particle size measurement (179.3-250.7 nm), thermal degradation at 190°C, and analysis of phytochemical content (phenolic, flavonoid, and saponin total) ranging from 18.66-21.028 mg GAE/g, 1.862-2.492 mg QE/g, and 191.975-307.897 mg EE/g, respectively. The formulations exhibited notable immune-stimulating effects by increasing phagocytotic percentage and TNF-α/IFN-γ levels and demonstrated inhibitory activity against SARS-CoV-2 3Cl protease enzyme. The encapsulation efficiency (EE) for phenolic, flavonoid, and saponin fell within the ranges of 17-19%, 16-22%, and 60-96%, respectively. Among the formulations, nanoparticle 3 (1:6:3) emerged as the optimal choice due to its superior physicochemical attributes. This particular nanoparticle exhibited immune-stimulating properties and inhibited the SARS-CoV-2 virus, suggesting its potential application in SARS-CoV-2 treatment. In conclusion, nanoparticle formulation 3 (1:6:3) displayed promising characteristics, showcasing immunomodulatory effects and anti-SARS-CoV-2 activity. This research paves the way for potential therapeutic interventions against SARS-CoV-2 using nanoparticle-based B. medicinalis extract formulations
Systematic Review : Cost-Effectiveness Analysis of Artificial Intelligence in Cancer Treatment
No full textCancer is one of the leading causes of death and is estimated to cause huge global economic losses. Artificial intelligence (AI) has massively assisted in the diagnosis, prognosis, and determination of the most effective therapy for cancer patients. The utilization of AI is estimated to reduce healthcare expenditures. This study aimed to systematically review the implementation of AI and its cost-effectiveness in cancer treatment. The study followed PRISMA guidelines and utilized the PubMed database. The search strategy was conducted up to 2 September 2023 using three main keywords; “Cost-effectiveness analysis”, “Cancer”, and “Artificial intelligence”. From 1746 retrieved articles, a total of 11 articles were included in the analysis. Studies found two types of AI interventions in cancer; screening type intervention(n = 6; 55%) and surgery type (n = 5; 45%). Prostate cancer was the most frequently studied (n = 3; 27%). The cost-effectiveness analysis showed that the implementation of AI was cost-effective (n=5, 46%), particularly in cancer screening intervention. The review highlights two main groups of AI interventions in cancer care: screening and cancer surgery. From a cost-effectiveness point of view, AI intervention in screening was the most cost-effective strategy in cancer. On the other hand, the AI implementation in surgery showed inconsistent findings, with many studies not fully addressing the full economic evaluation