RCE Yogyakarta - 2023

Education Model of SANTUN: Pharmacist Home Care Innovation through Supervision of Adherence, New Techniques Utilization, and Networking Elderly Medication with Chronic Disease Therapy
Basic Information
Title of project : 
Education Model of SANTUN: Pharmacist Home Care Innovation through Supervision of Adherence, New Techniques Utilization, and Networking Elderly Medication with Chronic Disease Therapy
Submitting RCE: 
RCE Yogyakarta
Contributing organization(s) : 
1. Faculty of Pharmacy, Universitas Gadjah Mada (UGM) Yogyakarta
2. Universitas Al-Irsyad Cilacap (UNAIC)
3. Indonesian Pharmacist Association (Ikatan Apoteker Indonesia/IAI)
4. Educational Fund Management Institution (Lembaga Pengelola Dana Pendidikan/LPDP - Ministry of Finance Republic of Indonesia)
5. National Population and Family Planning Board (Badan Kependudukan dan Keluarga Berencana Nasional/BKKBN)
Focal point(s) and affiliation(s)
Name: 
Yuhansyah Nurfauzi
Organizational Affiliation: 
Faculty of Pharmacy Universitas Gadjah Mada (UGM) and Universitas Al-Irsyad Cilacap (UNAIC)
E-mail: 
yuhansyah.nurfauzi@mail.ugm.ac.id
Format of project: 
Manuscript
Language of project: 
English
Date of submission:
Saturday, August 26, 2023
Web link: 
https://golantang.bkkbn.go.id/home-care-apoteker-peduli-obat-lansia
Additional resources: 
The first link:
https://drive.google.com/file/d/1qLPV6PsOV8J9drmHOsrSIRM4_K822Vnz/view?usp=sharing

The second link:
https://golantang.bkkbn.go.id/upload/artikel/pdf/1207-home-care-apoteker-peduli-obat-lansia.pdf

The third link:
https://ijrps.com/home/article/view/684

The fourth link:
https://www.tjpr.org/home/abstract.php?id=2935&aTitle=Innovative%20education%20approaches%20by%20geriatric%20pharmacists%20and%20their%20training%20needs:%20A%20systematic%20review

The fifth link:
http://ejurnal.setiabudi.ac.id/ojs/index.php/farmasi-indonesia/article/view/768
Does this project link to any education and/or sustainable development policy or policies?: 
Yes
Dimensions of Aging in the BKKBN (GoLantang-Go Lansia Tangguh) Elderly Program
At what level is the policy operating?: 
National
Geographical & Education Information
Region: 
Asia-Pacific
Country: 
Indonesia
Location(s): 
Cilacap
Address of focal point institution for project: 
Jl. Cerme No. 24, Kelurahan Sidanegara, Kecamatan Cilacap Tengah, Kabupaten Cilacap, Propinsi Jawa Tengah.
Ecosystem(s):
Coastal
Target Audience:
Community, Higher
Socioeconomic and environmental characteristics of the area : 
Cilacap Regency is one of the districts that supports the economy in Central Java Province. This position makes its existence strategic to grow rapidly. The main support for the economy of Cilacap Regency is the processing industry which contributes 58.35%, while from the expenditure side it is dominated by household consumption expenditure which reaches 42.10%. In 2021, the population of Cilacap Regency based on the projected population will reach 1.96 million people. The elderly population reaches 12.71% and the increase in the elderly population has many consequences for various aspects of life in society, including problems related to medication.
Description of sustainable development challenge(s) in the area the project addresses: 
The use of medicines at home for chronic diseases is often a problem in elderly patients, requiring attention from pharmacists in order to optimize the outcome of therapy. However, current guidelines for home pharmacy care in Indonesia do not detail the educational skills needed by pharmacists to provide services to elderly patients with chronic illnesses. This program develops a pharmacist intervention model of Supervision-Adherence-New Techniques Utilization-Networking (SANTUN) in home care for type 2 DM accompanied by treatment of hypertension in the elderly. The intended outcomes are HbA1c control, blood pressure, adherence, increased knowledge and quality of life.
Contents
Status: 
Completed
Period: 
January, 2022
Rationale: 
The program that has been carried out is an application from a geriatric pharmacy. The development of pharmaceutical science in Indonesia needs to prepare pharmacists to provide education on pharmaceutical services to the elderly. Services for the elderly can use the context of home pharmacy care as mandated by pharmaceutical service standards in Indonesia.
The educational model developed in this program also refers to comprehensive health services in communities based on home care from WHO. Pharmacy services are accompanied by intervention models of various activities that are proven to produce good outcomes for chronic diseases in the elderly so that they are expected to be able to provide solutions to problems that will be faced in Indonesia related to drug use in the elderly.
Pharmacists in the community (clinics, pharmacies and health centers) need to implement education to carry out pharmaceutical services for elderly patients from their practice to the patient's home to optimize therapy results. Education as an important component in this program will enrich the skills of pharmacists as educators for the elderly. Educational activities by pharmacists together with the patient's family will support the achievement of therapeutic goals, increase patient knowledge, and patient quality of life.
Objectives: 
Along with the increase in the elderly population in Indonesia, they use regular medicines at home to treat their health problems. This program has 4 objectives:
1. To find out the potential and reality of home pharmacy care (HPC) for the elderly and the obstacles experienced by pharmacists in their implementation.
2. Educating pharmacists to be able to provide HPC to elderly patients.
3. Assess needs and develop intervention models needed so that pharmacists can provide education in HPC to the elderly.
4. Applying HPC to improve clinical response, HbA1c, quality of life, and level of knowledge in elderly patients.
Activities and/or practices employed: 
The program consists of 3 main activities and uses a combination of surveys, modeling, training and a patient-focused approach. Phase I is the development of new techniques in home care, Focus Group Discussion (FGD) and the development of the SANTUN model. Phase II is education and training for pharmacists. Stage III is the application of the model in the form of patient education and measurement of HbA1c outcomes, quality of life, and level of knowledge. Education is given to pharmacists and elderly patients in Cilacap. Application of the model in the form of HPC as many as 3 home visits by pharmacists to each patient. Training is provided for pharmacists after the FGD and education by pharmacists who have been trained is carried out at the patient's home. The educational instruments used are the SANTUN model guide for pharmacists as well as educational materials for patients and their families.
Size of academic audience: 
12 pharmacists and 72 patients
Results: 
Various monitoring activities have been developed and carried out by pharmacists to optimize HPC. A total of 72 patients were included in this program and divided into 2 groups. Of the total elderly patients, 21 (29.2%) patients were male and 51 (70.8%) patients were female. Furthermore, 36 patients became the group that was given HPC services, while the other 36 patients became the usual care group. With usual care, the clinical parameters of elderly patients have not been controlled. Through a preliminary survey and needs analysis as well as FGD recommendations were obtained that pharmacists can provide pharmaceutical services in the context of HPC by using the SANTUN model. The SANTUN training effectively increased the knowledge and skills of 12 pharmacists. The application of the SANTUN model to HPC in type 2 DM has been shown to reduce HbA1c, improve quality of life, and increase knowledge in the elderly.
Lessons learned: 
Pharmacists who provide medication for the elderly have a great opportunity to avoid drug side effects such as hypoglycemia through adequate education. In drug service practice, pharmacists have challenges to ensure the safety and effectiveness of a drug. If drugs are given to the elderly, there are several obstacles to conveying drug information at the practice site, such as time constraints and the level of knowledge of the elderly who receive the information. Innovative efforts by pharmacists to provide education at the patient's home is a determining factor for the success of this program.
Key messages: 
Education in the practice of HPC supports the implementation of services that are oriented towards improving the quality of life of patients. The collaboration between pharmacists and families of elderly patients is also getting better. The patient's quality of life increases along with stable blood sugar levels and increased knowledge.
Funding: 
The author would like to thank the Universitas Gadjah Mada and the Educational Fund Management Institution for funding this program.

Pictures:

File Name Caption for picture Photo Credit
Image icon Focus Group Discussion of Pharmacists.JPG (6.02 MB) Focus Group Discussion (FGD) of Pharmacists Y. Nurfauzi
Image icon Training of SANTUN Model for pharmacists.JPG (5.6 MB) Training of SANTUN Model for Pharmacists Y. Nurfauzi
Image icon Home care and education for patient.png (329.34 KB) Home care and education for patient Y. Nurfauzi
References and reference materials: 
PDF icon Article and journal publications of SANTUN Model.pdf
UN Sustainable Development Goals (SDGs)
(https://sustainabledevelopment.un.org/sdgs) and other themes of Education for Sustainable Development (ESD)
SDG 1 - End poverty in all its forms everywhere 
Indirect
SDG 2 - End hunger, achieve food security and improved nutrition, and promote sustainable agriculture 
Indirect
SDG 3 - Ensure healthy lives and promote wellbeing for all at all ages 
Direct
SDG 4 - Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all 
Direct
SDG 5 - Achieve gender equality and empower all women and girls 
Indirect
SDG 6 - Ensure availability and sustainable management of water and sanitation for all 
Indirect
SDG 8 - Promote sustained, inclusive and sustainable economic growth, full and productive employment, and decent work for all 
Indirect
SDG 17 - Strengthen the means of implementation and revitalise the global partnership for sustainable development 
Direct
Theme
Traditional Knowledge  
Indirect
Curriculum Development 
Direct
ESD for 2030-Priority Action Areas
Priority Action Area 1 - Advancing policy 
state: 
Direct
Priority Action Area 2 - Transforming learning and training environments 
state: 
Indirect
Priority Action Area 3 - Developing capacities of educators and trainers 
state: 
Direct
Priority Action Area 5 - Accelerating sustainable solutions at local level 
state: 
Direct
Update: 
No
I acknowledge the above: 
Yes