Identifikasi Potentially Inappropriate Medications dan Efek Samping Obat Pasien Geriatri di RSUP Dr. Sardjito Yogyakarta berdasarkan Beers Criteria 2019
Washfy Maharani Arifah, apt. Arief Rahman Hakim, M.Si.;Dr. apt. Fita Rahmawati, Sp.FRS
2023 | Skripsi | FARMASI
Perubahan
farmakokinetik dan farmakodinamik yang terjadi pada pasien geriatri mengakibatkan perubahan respon dan sensitivitas terhadap obat tertentu.
Apabila tidak diperhatikan, kondisi tersebut berisiko menyebabkan potentially
inappropriate medications (PIMs) dan
meningkatkan kejadian efek samping obat yang berkaitan
dengan tingginya angka rawat inap dan mortalitas pada lansia. Tujuan
penelitian ini adalah untuk menghitung angka kejadian potentially
inappropriate medications (PIMs) dan mengetahui
gambaran kejadian efek samping akibat penggunaan obat yang termasuk dalam kategori PIMs yang
dialami pasien geriatri di RSUP Dr. Sardjito Yogyakarta berdasarkan Beers
Criteria 2019.
Penelitian dilakukan dengan metode observasional dengan rancangan cross
sectional. Pengambilan data dilakukan dengan metode accidental sampling. Penggunaan PIMs diidentifikasi melalui wawancara dengan
pasien/keluarga pasien sebagai data primer dan catatan rekam medik sebagai data
sekunder. Efek samping obat diidentifikasi menggunakan algoritma Naranjo berdasarkan
hasil wawancara. Sejumlah 100 pasien sesuai dengan kriteria inklusi. Kriteria inklusi meliputi pasien berusia ?60 tahun yang menjalani
perawatan di RSUP Dr. Sardjito Yogyakarta pada bulan Januari – Juli 2023, mendapatkan terapi obat, memiliki catatan rekam medik lengkap, dan bersedia menjadi responden. Data yang diperoleh
dianalisis secara deskriptif meliputi
karakteristik pasien, angka kejadian PIMs, dan kejadian efek samping obat yang
dialami pasien.
Hasil penelitian menunjukkan bahwa dari 100 pasien,
terdapat 58 pasien mendapatkan peresepan obat PIMs dengan penggunaan obat PIMs
terbanyak yaitu lansoprazole (18,0%), diazepam (10,1%), dan natrium
diklofenak (10,1%). Efek samping keseluruhan terjadi pada 11 pasien (11,0%) dengan
4 orang (4,0%) mengalami kejadian efek samping akibat penggunaan obat yang termasuk
kategori PIM. Analisis kausalitas efek samping dihasilkan 11 pasien (100,0%) “possible”. Obat-obatan yang termasuk dalam kategori PIMs dan menyebabkan efek
samping obat antara lain lansoprazole (1,0%), methylprednisolone (1,0%), gabapentin (1,0%), dan acetazolamide
(1,0%).
Changes in pharmacokinetics and pharmacodynamics that
occur in geriatric patients cause changes in response and sensitivity to
certain drugs. If this condition is not considered, it can lead to the use of
potentially inappropriate drugs (PIM) and increase the incidence of drug side
effects associated with high hospitalization and mortality rates in the
elderly. The purpose of this study was to calculate the prevalence of
potentially inappropriate drugs (PIMs) and describe the incidence of side
effects due to the use of drugs included in the PIMs category experienced by
geriatric patients at RSUP Dr. Sardjito Yogyakarta based on Beers Criteria
2019.
The study was conducted by observational method with
cross sectional design. Data collection is carried out by accidental sampling
method. The use of PIMs is identified through interviews with
patients/patients' families as primary data and medical records as secondary
data. Side effects of the drug were identified using the Naranjo algorithm
based on the results of interviews. The samples needed in this study were 100
samples with inclusion criteria, including: patients aged ?60 years who
underwent treatment at RSUP Dr. Sardjito Yogyakarta during January – July 2023, received drug therapy, had a complete medical record, and were willing to
be respondents. The data obtained were analyzed descriptively including patient
characteristics, the incidence of PIMs, and the incidence of drug side effects
experienced by patients.
The results showed that out of 100 patients,
there were 58 patients who received PIMs drug prescriptions with the most PIMs
drug use, including lansoprazole (18,0%), diazepam (10,1%), and Diclofenac
Sodium (10,1%). The incidence of side effects occurred in 11 patients (11,0%)
with 4 people (4,0%) experiencing the incidence of side effects due to the use
of drugs belonging to the PIM category. Causality analysis of side effects
resulted in 11 patients (100.0%) "possible". Drugs that are PIMs and
cause drug side effects include lansoprazole (1,0%), methylprednisolone (1,0%), gabapentin (1,0%), and acetazolamide (1,0%).
Kata Kunci : Potentially Inappropriate Medications (PIMs), efek samping obat, pasien geriatri, Beers Criteria 2019