Department of Pharmacology and Therapy, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia.
Department of Internal Medicine, Dr.Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Central Jakarta, Jakarta, Indonesia.
J Prim Care Community Health. 2021 Jan-Dec;12:2150132720984409. doi: 10.1177/2150132720984409.
Indonesia through its government National Health Insurance System has launched a non-communicable and chronic disease management program named Indonesian Chronic Disease Management Program (PROLANIS), with Type 2 Diabetes Mellitus (T2DM) and hypertension as the main focus. However, study that evaluates the clinical impact of PROLANIS in patients with T2DM is still scarce to this date. This study aims to evaluate the metabolic control and renal function of PROLANIS participants with T2DM every six month within the first 18-months of implementation.
This study was a retrospective cohort study conducted at Wates sub-district, East Java using secondary data from PROLANIS group report from April 2018 to October 2019. The study population was T2DM patients who voluntarily joined the PROLANIS group in April 2018. The six-month-evaluation included metabolic parameters [body mass index (BMI), blood pressure, hemoglobin A1C, total cholesterol, high-density lipid, low-density lipid, and triglyceride (TG)] and renal parameters [blood urea nitrogen (BUN), creatinine serum, and urinary microalbumin]. Paired -test and wilcoxon signed-rank test was used for the analysis, and the -value was adjusted using Bonferroni correction. A -value < .0015 was considered statistically significant, while a -value between .0015 and .003 was considered as marginally significant.
A total of 30 participants were included in the analysis. Following the PROLANIS implementation, the only parameter of metabolic control that showed significant improvement was TG serum level ( < .001). Despite the worsening status of other metabolic parameters, the changes were not statistically significant except for BMI that was marginally significant ( = .002). From renal function, only BUN serum level was significantly deteriorated ( < .001), while the others did not significantly change.
PROLANIS implementation in our study population seems to be ineffective. Future study with more primary healthcare centers needs to be done to scrutinize the clinical impact of this program nationwide.
印度尼西亚通过其政府国家健康保险制度推出了一项非传染性和慢性病管理计划，名为印度尼西亚慢性病管理计划（Prolanis），主要关注 2 型糖尿病（T2DM）和高血压。然而，迄今为止，评估 Prolanis 在 T2DM 患者中的临床影响的研究仍然很少。本研究旨在评估在实施后的前 18 个月内，每 6 个月对参加 Prolanis 的 T2DM 患者进行代谢控制和肾功能评估。
这是一项回顾性队列研究，在东爪哇省瓦特斯区进行，使用 2018 年 4 月至 2019 年 10 月期间 Prolanis 组报告的二级数据。研究人群为 2018 年 4 月自愿参加 Prolanis 组的 T2DM 患者。六个月的评估包括代谢参数[体重指数（BMI）、血压、糖化血红蛋白、总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯（TG）]和肾功能参数[血尿素氮（BUN）、肌酐血清和尿微量白蛋白]。采用配对 t 检验和 Wilcoxon 符号秩检验进行分析，并使用 Bonferroni 校正调整值。值<.0015 被认为具有统计学意义，而值在.0015 和.003 之间被认为具有边际意义。
共有 30 名参与者纳入分析。在实施 Prolanis 后，唯一显示代谢控制显著改善的参数是血清 TG 水平（<.001）。尽管其他代谢参数的状况恶化，但除了 BMI 具有边际显著性（=0.002）外，其他参数的变化均无统计学意义。在肾功能方面，只有血清 BUN 水平显著恶化（<.001），而其他参数没有显著变化。
在我们的研究人群中，实施 Prolanis 似乎没有效果。需要进行更多基层医疗中心的未来研究，以审查该计划在全国范围内的临床影响。
