Profil Penggunaan Antikoagulan pada Pasien Covid-19 di Instalasi Rawat Inap Rumah Sakit Akademik UGM

PRISCILIA HADINOTO, Dr. apt. Fita Rahmawati, Sp.FRS.

2022 | Skripsi | S1 FARMASI

Covid-19 seringkali menyebabkan gangguan koagulasi pada pasien di rumah sakit yang ditandai peningkatan konsentrasi D-dimer yang signifikan. Salah satu terapi pasien Covid-19 di rumah sakit adalah terapi antikoagulan. Tujuan penelitian ini adalah untuk mengetahui profil penggunaan, luaran terapi, serta keamanan terapi antikoagulan pada pasien Covid-19 rawat inap di RS Akademik UGM. Penelitian observasional ini menggunakan metode cross sectional. Data diambil secara retrospektif melalui rekam medik pasien dengan teknik purposive sampling. Subjek penelitian adalah pasien Covid-19 dewasa yang mendapatkan terapi antikoagulan dan dirawat inap di RS Akademik UGM periode Juli-September 2021 dengan sejumlah 110 data pasien digunakan. Data dianalisis secara deskriptif untuk menggambarkan profil penggunaan antikoagulan, luaran terapi terhadap kadar D-Dimer, serta keamanan terapi berdasarkan kejadian perdarahan dan potensi interaksi obat. Hasil penelitian menunjukkan bahwa jenis antikoagulan yang banyak diberikan adalah heparin sebanyak 80 (72,7%) pasien dengan dosis harian yang sering diresepkan adalah 5000 unit 2 kali sehari. Antikoagulan paling sering diberikan dengan durasi 7 hingga 14 hari. Luaran terapi menunjukkan 102 dari 110 pasien (92,7%) mengalami penurunan kadar D-dimer dimana 44 pasien (43,1%) mencapai target kadar D-dimer yaitu <500 µg/L. Kejadian perdarahan terjadi pada 6 (5,46%) pasien dimana 5 pasien menerima heparin dan 1 pasien menerima enoxaparin. Sebanyak 47 dari 110 pasien (42,7%) berpotensi mengalami interaksi obat. Dari hasil penelitian ini, diharapkan apoteker di RS Akademik UGM dapat meningkatkan pelayanan kefarmasian untuk mengoptimalkan terapi antikoagulan.

Covid-19 often causes coagulation disorders in hospitalized patient that characterized by elevated level of D – dimer significantly. Anticoagulant therapy is one of the therapies in hospitalized patients with Covid-19. The aims of this study are to know anticoagulant’s utilization profile, therapeutic outcomes, and safety of anticoagulant therapy in hospitalized Covid-19 patients at UGM Academic hospital. This study was observational design with cross-sectional method. The data were taken retrospectively using purposive sampling method from patient’s medical record. The subjects of this study were adult Covid-19 patients of UGM Academic hospital who received anticoagulant therapy in July-September 2021 with total of 110 patient data used. Data were analyzed descriptively to describe anticoagulant’s utilization profile (anticoagulant type, anticoagulant daily dose, duration of anticoagulant administration, and baseline coagulation parameters), therapeutic outcomes based on D-dimer levels, and safety of anticoagulant therapy based on bleeding events and potential drug interactions. The results showed that heparin was the most widely-given anticoagulant, as 72.7% of patients, with the most frequently dose was 2 x 5000 unit per day. Anticoagulants were commonly given with duration of 7 to 14 days. The therapy outcomes showed that D-dimer levels of 102 (92.7%) patients had decreased which 44 patients (43.1%) reached the target of D-dimer <500 µg/L. Bleeding events occurred in 6 (5.46%) patients which 5 patients received heparin and 1 patient received enoxaparin. There were 47 of 110 patients (42.7%) who had potential drugs interaction. Based on the results of study, it is hoped Academic UGM hospital pharmacists can improve pharmaceutical care to optimize anticoagulant therapy.

Kata Kunci : profil, penggunaan antikoagulan, Covid-19, Rumah Sakit Akademik UGM