Survei pola penggunaan obat pada pasien geriatri di Panti Werdha Salam Sejahtera Bogor
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Abstract
Badan Pusat Statistik menyatakan populasi lansia di Indonesia terus meningkat dan diperkirakan mencapai 40 juta jiwa di tahun 2035. Geriatri cenderung menderita beberapa penyakit kronis sehingga harus mengonsumsi banyak obat yang meningkatkan risiko terjadinya polifarmasi yaitu penggunaan bersama beberapa obat pada satu pasien yang membuat semakin besar pula risiko terjadinya drug therapy problems (DTP) yang terjadi akibat potentially inappropriate medication (PIM). Kategori obat yang termasuk PIM dapat mengurangi efektifitas obat yang berinteraksi, menimbulkan toksisitas, dan adverse drug reaction (ADR). Studi ini bertujuan untuk melihat polifarmasi dan ketepatan penggunaan obat sesuai Beers Criteria 2019 pada pasien geriatri di panti werdha. Studi ini merupakan studi observasional yang dilakukan secara retrospektif dengan pendekatan cross-sectional. Sebanyak 77 subjek masuk ke dalam studi ini dengan jenis kelamin perempuan sebesar 61% dan laki-laki 39% dengan rata-rata usia 77,5 tahun. Polifarmasi ditemukan sebesar 85,7% dengan rata-rata 3 obat yang merupakan minor polypharmacy. Pada studi ditemukan 10 jenis obat (3,9%) dari seluruh obat yang tergolong potentially inappropriate medication (PIM) dari total 252 obat yang diresepkan. Interaksi obat ditemukan pada 3,8% pasien dengan penggunaan kombinasi ≥3 obat aktif yang bekerja di sistem saraf pusat. Angka kejadian polifarmasi dan potensi pemberian obat yang tidak tepat masih ditemukan pada pasien geriatri yang di rawat di panti werdha.
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References
Infodatin Kementerian Kesehatan Republik Indonesia. Lansia Berdaya, Bangsa Sejahtera. Pusat Data dan Informasi Kementerian Kesehatan RI. [Internet]. 2022. Available from: https://www.kemkes.go.id/downloads/resources/download/pusdatin/infodatin/Infodatin-Lansia-2022.pdf
Anderson G. Chronic care: making the case for ongoing care. Princeton, NJ: Robert Wood Johnson Foundation; 2010. p.7-10.
Tjakrawala L. Analisis drug therapy problems pada penderita diabetes melitus tipe 2 dengan hipertensi. Artocarpus Media Pharmacetical Indonesiana. 2012;9:12-21.
Salwe KJ, Kalyansundaram D, Bahurupi Y. A study on polypharmacy and potential drug-drug interactions among elderly patients admitted in department of medicine of a tertiary care hospital in puducherry. J Clin Diagn Res. 2016;10:6-10.
Pradhan S, Panda A, Mohanty M, Behera J, Ramani Y, Pradhan P. A study of the prevalence of potentially inappropriate medication in elderly in a tertiary care teaching hospital in the state of Odisha. Int J Med. 2015;5:344-8.
Hyttinen V, Jyrkka J, Valtonen H. A systematic review of the impact of potentially inappropriate medication on health care utilization and costs among older adults. Med Care. 2016;54:950-64.
Heider D, Matschinger H, Meid AD, Quinzler R, Adler J-B, Günster C, Haefeli WE, König H-H. Health service use, costs, and adverse events associated with potentially inappropriate medication in old age in Germany: retrospective matched cohort study. Drugs Aging. 2017;34:289-301.
Eze UI, Olowu AO. Prescribing patterns and inappropriate use of medications in elderly outpatients in a tertiary hospital in Nigeria. Trop JPharm Res. 2011;10:19-25.
Morin L, Johnell K, Laroche ML, Fastbom J, Wastesson JW. The epidemiology of polypharmacy in older adults: register-based prospective cohort study. Clin Epidemiol. 2018;10:289–98.
Kim AJ, Lee H, Shin EJ, Cho EJ, Cho YS, Lee H, et al. Pharmacist-Led collaborative medication management for the elderly with chronic kidney disease and polypharmacy. Int J Environ Res Publicx Health. 2021;18(8):4370.
Hazra NC, Dregan A, Jackson S, Gulliford MC. Drug utilization and inappropriate prescribing in Centenarians. J Am Geriatr Soc. 2016;64:1079–84.
American Geriatrics Society. American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67:674-94.
American Geriatrics Society. American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67:674-94.
Marcum ZA, Perera S, Thorpe JM, et al. Anticholinergic use and recurrent falls in community-dwelling older adults: findings from the Health ABC Study. Ann Pharmacother. 2015;49:1214–21.
Hanlon JT, Boudreau RM, Roumani YF, et al. Number and dosage of central nervous system medications on recurrent falls in community elders: the health, aging and body composition study. J Gerontol Med Sci. 2009;64A:492–8.
King MB, Halter J, Ouslander J, Tinetti M, Studenski S, High K, Asthana S, editors. Hazzard’s Geriatric Medicine and Gerontology. 6th ed. New York, NY: McGraw-Hill; 2009. p.659-70.
Tinetti ME. Clinical practice: preventing falls in elderly persons. N Engl J Med. 2003;348:42–9.
Shin JY, Choi NK, Lee J, et al. Risk of ischemic stroke associated with the use of antipsychotic drugs in elderly patients: a retrospective cohort study in Korea. PLoS One. 2015;10:e0119931.
Dennis M, Shine L, John A, et al. Risk of adverse outcomes for older people with dementia prescribed antipsychotic medication: a population based e-cohort study. Neurol Ther. 2017; 6: 57–77.
Lader M. Benzodiazepine harm: how can it be reduced?. Br J Clin Pharmacol. 2014;77:295–301.
Holstein A, Hammer C, Hahn M, Kulamadayil NS, Kovacs P. Severe sulfonylurea-induced hypoglycemia: a problem of uncritical prescription and deficiencies of diabetes care in geriatric patients. Expert Opin Drug Saf. 2010;9:675-81.
Masclee GM, Valkhoff VE, Coloma PM, et al. Risk of upper gastrointestinal bleeding from different drug combinations. Gastroenterology. 2014;147:784-92.e9;quiz e13-4.
Tannenbaum C, Paquette A, Hilmer S, Holroyd-Leduc J, Carnahan R. A systematic review of amnestic and non-amnestic mild cognitive impairment induced by anticholinergic, antihistamine, GABAergic and opioid drugs. Drugs Aging. 2012;29:639-58.
Billioti de Gage S, Begaud B, Bazin F, Verdoux H, Dartigues JF, Peres K, Kurth T, Pariente A. Benzodiazepine use and risk of dementia: prospective population based study. BMJ. 2012;345:e6231.
Roe CM, Anderson MJ, Spivack B. Use of anticholinergic medications by older adults with dementia. J Am Geriatr Soc. 2002 May;50:836-42.
Huang AR, Mallet L, Rochefort CM, et al. Medication-related falls in the elderly. Drugs Aging. 2012; 29:359–76.
Park H, Satoh H, Miki A, et al. Medications associated with falls in older people: systematic review of publications from a recent 5-year period. Eur J Clin Pharmacol. 2015;71:1429–40.
Bowie MW, Slattum PW. Pharmacodynamics in older adults: a review. Am J Geriatr Pharmacother. 2007;5:263–303.
Szczerbińska K, Topór-Mądry R. Association between central nervous system drugs and recurrent falling based on prospective falls registration in nursing homes. Eur Geri Med. 2012;3:82–6.
Filippatos TD, Makri A, Elisaf MS, Liamis G. Hyponatremia in the elderly: challenges and solutions. Clin Interv Aging. 2017;12:1957–65.
Rothberg MB, Herzig SJ, Pekow PS, et al. Association between sedating medications and delirium in older inpatients. J Am Geriatr Soc. 2013;61:923–30.
Naja M, Zmudka J, Hannat S, et al. In geriatric patients, delirium symptoms are related to the anticholinergic burden. Geriatr Gerontol Int. 2016;16:424–31.
Olsen C, Pedersen I, Bergland A, et al. Differences in quality of life in home-dwelling persons and nursing home residents with dementia - a cross-sectional study. BMC Geriatr. 2016;16:137.
Bogaisky M, Dezieck L. Early hospital readmission of nursing home residents and community-dwelling elderly adults discharged from the geriatrics service of an urban teaching hospital: patterns and risk factors. J Am Geriatr Soc. 2015;63:548–52.