Permasalahan Pemberian Obat pada Pasien Geriatri di Ruang Perawatan RSUD Saiful Anwar Malang
DOI:
https://doi.org/10.21776/ub.jkb.2014.028.02.15Abstract
Permasalahan terkait pemberian obat sering terjadi pada pasien yang menjalani perawatan di rumah sakit, dengan faktor risiko yang tersering  adalah polifarmasi dan peningkatan usia. Penelitian ditujukan untuk mengetahui deskripsi usia, jenis kelamin, jumlah obat dan  prevalensi adanya Permasalahan terkait pemberian obat (Drug Related Problem=DRP) pada pasien geriatri yang menjalani perawatan di Rumah Sakit. Penelitian kohort retrospektif  dengan pengambilan data sekunder pada  pasien geriatri (≥60 thn) di Ruang Perawatan RSUD Saiful Anwar Malang selama Periode Januari- Desember 2011. Penelitian ini  menunjukkan dari 150 subjek  55,3% adalah pria, rentang usia 60-65 tahun (28%),  66-70 tahun (36%), 71- 75 tahun (19,3%), >75 tahun (16,7%). Polifarmasi terjadi pada  72% pasien geriatri dengan prevalensi kejadian  DRP sebesar 72%. Penggunaan obat tersering yaitu antibiotik (73,3%), H2 antagonis (60,7%),  antihipertensi (46 %),  antiemetik (37,3%), NSAID ( 32%). Kejadian DRP tersering yaitu potensi interaksi obat (66%), dosis yang tidak tepat (17,3%) , pemakaian obat yang tidak perlu (16%), efek samping obat (14%), pemilihan jenis obat yang tidak tepat (8,7%). Potensi interaksi obat terbanyak yaitu pada obat ACE-inhibitor, diuretik dan antiplatelet. Duplikasi obat terjadi pada pemberian PPI dan H2 antagonis.  Terdapat hubungan yang signifikan antara peningkatan jumlah obat yang diberikan dengan prevalensi terjadinya DRP (p=0,000). Tidak terdapat hubungan yang signifikan antara peningkatan usia subjek dengan prevalensi DRP (p=0,366). Risiko relatif pasien geriatri dengan polifarmasi mengalami DRP  sebesar  1,822 (CI 95%: 1,291-2,569).
Kata Kunci: Geriatri, permasalahan terkait pemberian obat, polifarmasi
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References
Stewart RB and Cooper JW. Polypharmacy in the Aged: Practical Solutions. Drugs Aging. 1994; 4(6): 449-461.
Montamat SC and Cusack B. Overcoming Problems with Polypharmacy and Drug Misuse in the Elderly. Clinics in Geriatric Medicine. 1992; 8(1): 143-158.
Cipolle RJ, Strand L, and Morley P. Pharmaceutical Care Practice: The Patient-centered Approach to Medication Management. Third Edition. New York: Mc Graw-Hill Companies, Inc: 2012.
Koh Y, Kutty FBM, and Li SC. Drug-Related Problems in Hospitalized Patients on Polypharmacy: The Influence of Age and Gender. Therapeutics and Clinical Risk Management. 2005; 1(1): 39-48.
Hanlon J, Schmader K, Koronkowski M, et al. Adverse Drug Events in High Risk Older Outpatients. Journal of the American Geriatrics Society. 1997; 45(8): 945-948.
Rusdi I. Kebijakan Khusus Lansia. (Online) 2010. http://ocw.usu.ac.id/course/download/1280000150-keperawatan-komunitas/pks_123_slide_kebijakan_ khusus_lansia.pdf.
World Health Organization. International Drug Monitoring: The Role of National Centres. Geneva: World Health Organization; 1950.
Supartondo dan Roosheroe AG. Pedoman Memberi Obat pada Pasien Geriatric serta Mengatasi Masalah Polifarmasi. Di dalam: Sudoyo WA, Setiyohadi B, Alwi I, Simadibrata M, dan Setiati S (Eds). Buku Ajar Geriatric Ilmu Penyakit Dalam. Jilid III. Jakarta: Geriatri; 2006; hal. 1437-1438.
Joint Formulary Committee. British National Formulary London: British Medical Association and Royal Pharmaceutical Society of Great Britain March 2010. London; British National Formulary: 2010.
The American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society. 2012; 60(4): 616-631.
Burgess CL, Holman CDAJ, and Satti AG. Adverse Drug Reactions in Older Australians, 1981–2002. The Medical Journal of Australia. 2005; 182(6): 267-270.
Elliott RA. Problems with Medication Use in the Elderly: An Australian Perspectiv. Journal of Pharmacy Practice and Research. 2006; 36(1): 58-66.
Hallas J, Gram L, Grodum E, et al. Drug Related Admissions to Medical Wards: A Population Based Survey. British Journal of Clinical Pharmacology. 1992; 33(1): p. 61 -88.
Veehof LJ, Stewart RE, Meyboom-de Jong B, and Haaijer-Ruskamp FM. Adverse Drug Reactions And Polypharmacy in the Elderly in General Practice. European Journal of Clinical Pharmacology. 1999; 55(7): 533-536.
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