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