BAB 6 KESIMPULAN DAN SARAN
6.2. Saran
Beberapa hal yang dapat sarankan penulis berdasarkan penelitian yang telah dilakukan, yaitu :
1. Diharapkan untuk penelitian selanjutnya dapat dilakukan dalam skala yang yang lebih luas.
2. Penelitian selanjutnya juga diharapkan dapat dilakukan dengan data primer dan sekaligus dapat dilakukan follow-up.
3. Penelitian selanjutnya juga diharapkan dapat menggunakan desain penelitian analitik, sehingga dapat menilai bagaimana outcome dari penatalaksanaan yang telah dilakukan.
4. Perlu juga dilakukan penelitian lebih lanjutterhadap sikap dokter dalam penerapan pedoman tata laksana gagal jantung.
DAFTAR PUSTAKA
Abraham, W.T. dan Hasan, A., 2007. Diagnosis and Management of Heart Failure. Dalam: R.A. Walsh, D.I. Simon, B.D. Hoit, J.C. Fang dan M. Costa, eds. 2007.Hurst’s The Heart. Edisi ke-12. USA: McGraw-Hill. Bab 26. Ajuluchukwu, J.N., Anyika, E.N. dan Raji, K.A., 2014. Physician-adherence to
pharmacotherapy guidelines for chronic heart failure in a tertiary health facility in Lagos, Nigeria. Journal of Hospital Administration 3(2): 32-41. Aleksova, A., Masson, S., Maggioni, A.P., Lucci, D., Urso, R., Staszewsky, L.,
Ciaffoni, S., Cacciatore, G., Misuraca, G., Gulizia, M., Mos, L., Proietti, G., Minneci, C., Latini, R. dan Sinagra, G., 2012. Effects of Candesartan on Left Ventricular Function, Aldosterone and BNP in Chronic Heart Failure. Cardiovascular Drugs and Therapy 26 :131–143.
Badan Penelitian dan Pengembangan Kesehatan. 2013. Riset Kesehatan Dasar. Kementerian kesehatan RI. Jakarta.
Badan Perencanaan Pembangunan Nasional. 2013. Proyeksi Penduduk Indonesia: 2010-2035. Badan Pusat Statistik. Jakarta.
Bleumink, G.S., Knetsch, A.M., Sturkenboom, M.C.J.M., Straus, S.M.J.M., Hofman, A., Deckers, J.W., Witteman, J.C.M. dan Stricker, B.H.Ch., 2004. Quantifying the Heart Failure Epidemic: Prevalence, Incidence Rate, Lifetime Risk and Prognosis of Heart Failure. European Heart Journal 25: 1614–1619.
Bower, K.M., 2003. When To Use Fisher’s Exact Test. Six Sigma Forum Magazine2(4): 35-37.
Braun, E., Landsman, K., Zuckerman, R., Berger, G., Meilik, A. dan Azzam, Z.S., 2009. Adherence to Guidelines Improves the Clinical Outcome of Patients
with Acutely Decompensated Heart Failure. Israel Medical Association Journal 11: 348-353.
Brouwers, F.P., de Boer, R.A., van der Harst, P., Voors, A.A., Gansevoort, R.T., Bakker, S.J., Hillege, H.L., van Veldhuisen, D.J. dan van Gilst, W.H., 2013. Incidence and epidemiology of new onset heart failure with preserved vs.reduced ejection fraction in a community-based cohort: 11-year follow- up of PREVEND. European Heart Journal 34: 1424–1431.
Calvert, M.J., Shankar, A., McManus, R.J., Ryan, R. dan Freemantle, N., 2009. Evaluation of the management of heart failure in primary care. Family Practice 26: 145-153.
Chatterjee, N.A. dan Fifer, M.A., 2011. Heart Failure. Dalam: L.S. Lilly, ed. 2011. Pathophysiology of Heart Disease. Edisi ke-5. Philadelphia: Lippincott Williams & Wilkins. Bab 9.
Cowie, M.R., Wood, D.A., Coats, A.J.S., Thompson, S.G., Poole-Wilson, P.A., Suresh, V. dan Sutton, G.C., 1999. Incidence and aetiology of heart failure. European Heart Journal 20: 421-428.
Davies, M.K., Hobbs, F.D.R., Davis, R.C., Kenkre, J.E., Roalfe, A.K., Hare, R., Wosornu, D. dan Lancashire, R.J., 2001. Prevalence of left-ventricular systolic dysfunction and heart failure in the Echocardiographic Heart of England Screening study: a population based study. The Lancet 358: 439- 444.
Engelhardt, S., 2005. β-Adrenergic Signaling in Heart Failure. Dalam: G.W. Dec, T. DiSalvo, R.J. Hajjar dan M.J. Semigran, eds. 2005. HEART FAILURE: A Comprehensive Guide to Diagnosis and Treatment. New York: Marcel Dekker. Bab 5.
Erhardt, L., Komajda, M., Hobbs, F.D.R. dan Soler-Soler, J., 2008. Cardiologists' awareness and perceptions of guidelines for chronic heart failure: The
ADDress your Heart survey. European Journal of Heart Failure 10: 1020– 1025.
Frankenstein, L., Remppis, A., Fluegel, A., Doesch, A., Katus, H.A., Senges, J. dan Zugck, C., 2010. The association between long-term longitudinal trends in guideline adherence and mortality in relation to age and sex. European Journal of Heart Failure 12: 574-580.
Go, A.S., Mozaffarian, D., Roger, V.L., Benjamin, E.J., Berry, J.D., Borden, W.B., Bravata, D.M., Dai, S., Ford, E.S., Fox, C.S., Franco, S., Fullerton, H.J., Gillespie, C., Hailpern, S.M., Heit, J.A., Howard, V.J., Huffman, M.D., Kissela, B.M., Kittner, S.J., Lackland, D.T., Lichtman, J.H., Lisabeth, L.D., Magid, D., Marcus, G.M., Marelli, A., Matchar, D.B., McGuire, D.K., Mohler, E.R., Moy, C.S., Mussolino, M.E., Nichol, G., Paynter, N.P., Schreiner, P.J., Sorlie, P.D., Stein, J., Turan, T.N., Virani, S.S., Wong, N.D., Woo, D. danTurner, M.B., 2013. Heart Disease and Stroke Statistics - 2013 Update: A Report From the American Heart Association. Circulation 127: e6-e245.
Ives, H.E., 2007. Obat Diuretik. Dalam: B.G. Katzung, ed. 2007. Farmakologi Dasar & Klinik. Edisi ke-10. Diterjemahkan oleh A.W. Nugroho, L. Rendy dan L. Dwijayanthi. Jakarta: Penerbit Buku Kedokteran EGC. Bab 15. Kelder, J.C., Cramer, M.J., Wijngaarden, J., Tooren, R., Mosterd, A., Moons,
K.G.M., Lammers, J.W., Cowie, M.R., Grobbee, D.E. dan Hoes, A.W., 2011. The Diagnostic Value of Physical Examination and Additional Testing in Primary Care Patients With Suspected Heart Failure. Circulation 124: 2865-2873.
Komajda, M.,Follath, F., Swedberg, K., Cleland, J., Aguilar, J.C., Cohen-Solal, A., Dietz, R., Gavazzi, A., Van Gilst, W.H., Hobbs, R., Korewicki, J., Madeira, H.C., Moiseyev, V.S., Preda, I., Widimsky, J., Freemantle, N., Eastaugh, J. dan Mason, J., 2003. The EuroHeart Failure Survey
programme—a survey on the quality of care among patients with heart failure in Europe: Part 2:treatment. European Heart Journal 24: 464-474. Komajda, M., Lapuerta, P., Hermans, N., Gonzalez-Juanatey, J.R., van
Veldhuisen, D.J., Erdmann, E.,Tavazzi, L., Poole-Wilson, P. dan Le Pen, C., 2005. Adherence to guidelines is a predictor of outcome in chronic heart failure: the MAHLER survey. European Heart Journal 26: 1653-1659. Lόpez-Sendόn, J., Swedberg, K., McMurray, J., Tamargo, J., Maggioni A.P.,
Dargie, H., Tendera, M., Waagstein F., Kjekshus, J., Lechat, P., Torp- Pedersen, C., Priori, S.G., García, M.A.A., Blanc, J-J., Budaj, A., Cowie, M., Dean, V., Deckers, J., Burgos, E.F., Lekakis, J., Lindahl, B., Mazzotta, G., McGregor, K., Morais, J., Oto, A., Smiseth, O.A., Ardissino, D., Avendano, C., Blomström-Lundqvist, C., Clément, D., Drexler, H., Ferrari, R., Fox, K.A., Julian, D., Kearney,P., Klein, W., Köber, L., Mancia, G., Nieminen, M., Ruzyllo, W., Simoons, M., Thygesen, K., Tognoni, G., Tritto, I., Wallentin, L., 2004. Expert consensus document on β-adrenergic receptor blockers: The Task Force on Beta-Blockers of the European Society of Cardiology. European Heart Journal 25: 1341-1362.
Madiyono, B. et al., 2011. Perkiraan besar sampel. Dalam: S. Sastroasmoro dan I. Sofyan, eds. 2011. Dasar-dasar Metodologi Penelitian Klinis. Edisi ke-4. Jakarta: Sagung Seto. Bab 17.
Maggioni, A.P., Anker, S.D., Dahlström, U., Filippatos, G., Ponikowski, P., Zannad, F., Amir, O., Chioncel, O., Leiro, M.C., Drozdz, J., Erglis, A., Fazlibegovic, E., Fonseca, C., Fruhwald, F., Gatzov, P., Goncalvesova, E., Hassanein, M., Hradec, J., Kavoliuniene, A., Lainscak, M., Logeart, D., Merkely, B., Metra, M., Persson, H., Seferovic, P., Temizhan, A., Tousoulis, D. dan Tavazzi, L., 2013. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines?Evidence from 12.440 patients of the ESC Heart Failure Long- Term Registry. European Journal of Heart Failure 15: 1173-1184.
Maggioni, A.P., Dahlström, U., Filippatos, G., Chioncel, O., Leiro, M.C., Drozdz, J., Fruhwald, F., Gullestad, L., Logeart, D., Metra, M., Parissis, J., Persson, H.,Ponikowski, P., Rauchhaus, M., Voors, A., Nielsen, O.W., Zannad, F. dan Tavazzi, L., 2010. EURObservational Research Programme: The Heart Failure Pilot Survey (ESC-HF Pilot).European Journal of Heart Failure 12: 1076-1084.
Maggioni, A.P., Dahlström, U., Filippatos, G., Chioncel, O., Leiro, M.C., Drozdz, J., Fruhwald, F., Gullestad, L., Logeart, D., Fabbri, G., Urso, R., Metra, M., Parissis, J., Persson, H., Ponikowski, P., Rauchhaus, M., Voors, A.A., Nielsen, O.W., Zannad, F. dan Tavazzi, L., 2013. EURObservational Research Programme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). European Journal of Heart Failure 15: 808-817.
Mancia, G., Fagard, R., Narkiewicz, K., Redόn, J., Zanchetti, A., Bö hm, M., Christiaens, T., Cifkova, R., Backer, G.D., Dominiczak, A., Galderisi, M., Grobbee, D.E., Jaarsma, T., Kirchhof, P., Kjeldsen, S.E., Laurent, S., Manolis, A.J., Nilsson, P.M., Ruilope, L.M., Schmieder, R.E., Sirnes, P.A., Sleight, P., Viigimaa, M., Waeber, B. dan Zannad, F., 2013. 2013 ESH/ESC Guidelines for themanagement of arterial hypertension: TheTask Force for the management ofarterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of Hypertension 31(7):1281-1357.
Manikandan, S., 2011. Measures of central tendency: Median and mode. Journal of Pharmacology and Pharmacotherapeutics 2(3): 214-215.
Mann, D.L., 2012. Pathophysiology of Heart Failure. Dalam: R.O. Bonow, D.L. Mann, D.P. Zipes dan P. Libby, eds. 2012. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Edisi ke-9. Philadelphia: Saunders. Bab 25.
Mann, D.L., 2012. Management of Heart Failure Patients with Reduced Ejection Fraction. Dalam: R.O. Bonow, D.L. Mann, D.P. Zipes dan P. Libby, eds. 2012. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Edisi ke-9. Philadelphia: Saunders. Bab 28.
Mant, J., Doust, J., Roalfe, A., Barton, P., Cowie, M.R., Glasziou, P., Mant, D., McManus, R.J., Holder, R., Deeks, J., Fletcher, K., Qume, M., Sohanpal, S., Sanders, S. dan Hobbs, F.D.R., 2009. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care. Health Technology Assessment 13(32): 1-207.
McMullen, J.R. dan Jennings, G.L., 2007. Differences Between Pathological and Physiological Cardiac Hypertrophy: Novel Therapeutic Strategies to Treat Heart Failure. Clinical and Experimental Pharmacology and Physiology 34: 255–262.
McMurray, J.J.V., Adamopoulos, S., Anker, S.D., Auricchio, A., Böhm, M., Dickstein, K., Falk, V., Filippatos, G., Fonseca, C., Gomez-Sanchez, M.A.,Jaarsma, T., Køber, L., Lip, G.Y.H., Maggioni, A.P., Parkhomenko, A., Pieske, B.M., Popescu, B.A., Rønnevik, P.K., Rutten, F.H., Schwitter, J., Seferovic, P., Stepinska, J., Trindade, P.T., Voors, A.A., Zannad, F., Zeiher, A., Bax, J.J., Baumgartner, H., Ceconi, C., Dean, V., Deaton, C., Fagard, R., Funck-Brentano, C., Hasdai, D., Hoes, A., Kirchhof, P., Knuuti, J., Kolh, P., McDonagh, T., Moulin, C., Reiner, Ž., Sechtem, U., Sirnes, P.A., Tendera, M., Torbicki, A., Vahanian, A., Windecker, S., Bonet, L.A., Avraamides, P., Ben Lamin, H.A., Brignole, M., Coca, A., Cowburn, P., Dargie, H., Elliott, P., Flachskampf, F.A., Guida, G.F., Hardman, S., Iung, B., Merkely, B., Mueller, C., Nanas, J.N., Nielsen, O.W., Ørn, S., Parissis, J.T. dan Ponikowski, P., 2012. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society
of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European Heart Journal 33: 1787-1847. Mosterd, A., Hoes, A.W., de Bruyne, M.C., Deckers, J.W., Linker, D.T., Hofman,
A. dan Grobbee, D.E., 1999. Prevalence of heart failure and left ventricular dysfunction in the general population. European Heart Journal 20: 447-455. Mosterd, A. dan Hoes, A.W., 2007. Clinical Epidemiology of Heart Failure. Heart
93:1137–1146.
Nafrialdi, 2009. Antihipertensi. Dalam: S.G. Gunawan, R.S. Nafrialdi dan Elysabeth, eds. 2009. Farmakologi dan Terapi. Edisi ke-5. Jakarta: Balai Penerbit FKUI. Halaman: 341-360.
Notoatmodjo, S., 2012. Metodologi penelitian kesehatan. Edisi revisi.Jakarta: Rineka Cipta.
Oudejans, I., 2012. Heart failure in geriatric outpatients: diagnosis, prognosis and treatment. Disertasi. Universitas Utrecht.
Oudejans, I., Mosterd, A., Bloemen, J.A., Valk, M.J., Velzen, E., Wielders, J.P., Zuithoff, N.P., Rutten, F.H. dan Hoes, A.W., 2011. Clinical evaluation of geriatric outpatients with suspected heart failure: value of symptoms, signs, and additional tests. European Journal of Heart Failure 13: 518-527.
Peters-Klimm, F., Müller-Tasch, T., Schellberg, D., Remppis, A., Barth, A., Holzapfel, N., Jünger, J., Herzog, W. dan Szecsenyi, J., 2008. Guideline adherence for pharmacotherapy of chronic systolic heart failure in general practice: a closer look on evidence-based therapy. Clinical Research in Cardiology 97: 244-252.
Reibis, R., Dovifat, C., Dissmann, R., Ehrlich, B., Schulz, S., Stolze, K., Wegscheider, K. dan Völler, H., 2006. Implementation of evidence-
basedtherapy in patients with systolic heart failure from 1998–2000. Clinical Research in Cardiology 95: 154-161.
Richardson, D.M., Bain, K.T., Diamond, J.J., Novielli, K.D., Lee, S.P. dan Goldfarb, N.I., 2010. Effectiveness of Guideline-Recommended Cardiac Drugs for Reducing Mortality in the Elderly Medicare Heart Failure Population: A Retrospective, Survey-Weighted, Cohort Analysis. Drugs Aging 27(10): 845-854.
Sastroasmoro, S., 2011. Pemilihan subyek penelitian. Dalam: S. Sastroasmoro dan I. Sofyan, eds. 2011. Dasar-dasar Metodologi Penelitian Klinis. Edisi ke-4. Jakarta: Sagung Seto. Bab 5.
Setiawati, A. dan Nafrialdi, 2009. Obat Gagal Jantung. Dalam: S.G. Gunawan, R.S. Nafrialdi dan Elysabeth, eds. 2009. Farmakologi dan Terapi. Edisi ke-5. Jakarta: Balai Penerbit FKUI. Halaman: 299-313.
Shoukat, S., Gowani, S.A., Taqui, A.M., Hassan R.U., Bhutta, Z.A., Malik, A.L., Sherjeel, S.A., Sheheryar, Q. dan Dhakam, S.H., 2011. Adherence to the European Society of Cardiology (ESC) guidelines for chronic heart failure - A national survey of the cardiologists in Pakistan. BMC Cardiovascular Disorders 11(68): 1-8.
Stewart, S., MacIntyre, K., Hole, D.J., Capewell, S. dan McMurray, J.J.V., 2001. More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure. European Journal of Heart Failure 3: 315-322. Störk, S., Hense, H.W., Zentgraf, C., Uebelacker, I., Jahns, R., Ertl, G. dan
Angermann, C.E., 2008. Pharmacotherapy according to treatment guidelines is associated with lower mortality in a community-based sample of patients with chronic heart failure: A prospective cohort study. European Journal of Heart Failure 10: 1236-1245.
Sumartono, W., Sirait, A.M., Holy, M. dan Thabrany, H., 2011. Smoking and Socio-Demographic Determinant of Cardiovascular Diseases among Males 45+ Years in Indonesia. International Journal of Environmental Research and Public Health 8: 528-539.
Triposkiadis, F., Karayannis, G., Giamouzis, G., Skoularigis, J., Louridas, G. dan Butler, J., 2009. The Sympathetic Nervous System in Heart Failure: Physiology, Pathophysiology, and Clinical Implications. Journal of the American College of Cardiology 54(19): 1747–1762.
van Berlo, J.H., Maillet, M. dan Molkentin, J.D., 2013. Signaling effectors underlying pathologic growth and remodeling of the heart. Journal of Clinical Investigation 123(1): 37-45.
Wahyuni, A.S., 2007. Statistika Kedokteran. Edisi ke-1. Jakarta Timur: Bamboedoea Communication.
Yamin, C.K., Miller, C.A., Antman, E.M., Strichartz, G.R. dan Lilly, L.S., 2011. Cardiovascular Drugs. Dalam: L.S. Lilly, ed. 2011. Pathophysiology of Heart Disease. Edisi ke-5. Philadelphia: Lippincott Williams & Wilkins. Bab 17.
Yancy, C.W., Jessup, M., Bozkurt, B., Butler, J., Casey, Jr, D.E., Drazner, M.H., Fonarow, G.C., Geraci, S.A., Horwich, T., Januzzi, J.L., Johnson, M.R., Kasper, E.K., Levy, W.C., Masoudi, F.A., McBride, P.E., McMurray, J.J.V., Mitchell, J.E., Peterson, P.N., Riegel, B., Sam, F., Stevenson, L.W., Tang, W.H.W., Tsai, E.J. dan Wilkoff, B.L., 2013. 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 128: e240-e327.
Yoo, B-S., Oh, J., Hong, B-K., Shin, D-H., Bae, J-H., Yang, D.H., Shim, W-J., Kim, H-S., Kim, S-H., Choi, J-O., Chun, W-J., Go, C-W., Kang, H-J., Baek,
S.H., Cho, J-H., Hong, S-K., Shin, J-H., Oh, S-K., Pyun, W-B., Kwan, J., Hong, Y-J., Jeong, J-O., Kang, S-M. dan Choi, D-J., 2014. SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): A Multi-Center, Retrospective, Observational Study. PLoS ON 9(1): e86596.
Zugck, C., Franke, J., Gelbrich, G., Frankenstein, L., Scheffold, T., Pankuweit, S., Duengen, H.D., Regitz-Zagrosek, V., Pieske, B., Neumann, T., Rauchhaus, M., Angermann, C.E., Katus, H.A., Ertl, G.E. dan Störk, S., 2012. Implementation of pharmacotherapy guidelines in heart failure: experience from the German Competence Network Heart Failure. Clinical Research in Cardiology 101: 263-272.