Penggunaan Potentially Inappropriate Medications Pada Pasien Geriatri Rawat Inap Dengan Gagal Jantung Di RS Panti Nugroho Yogyakarta
KRISTINA DIANSIANA, Prof. Dr. Lukman Hakim, M.Sc., Apt; dr. Probosuseno, Sp. PD, K-Ger
2016 | Tesis | S2 Ilmu FarmasiINTISARI Pasien geriatri dengan gagal jantung pada umumnya disertai dengan komorbiditas kompleks dan sangat berisiko mengalami masalah pemilihan obat yang tepat, polifarmasi dan lama perawatan di rumah sakit. Penelitian ini dilakukan untuk mengetahui prevalensi potentially inappropriate medications, serta mengetahui hubungan antara jumlah obat yang diresepkan dan durasi rawat inap pasien geriatri dengan penggunaan potentially inappropriate medications. Penelitian ini merupakan penelitian observasional cross sectional dan pengumpulan data dilakukan secara retrospektif berdasarkan data rekam medis pasien geriatri dengan gagal jantung yang dirawat inap di RS Panti Nugroho Yogyakarta periode Januari 2013 - Desember 2015 dan mendapatkan terapi obat. Pasien yang meninggal, pulang paksa, dan dirujuk ke tempat lain tidak disertakan. Pengambilan sampel dilakukan secara purposive sampling. Data dianalisis dengan uji statistik Chi-square dan jika syarat uji Chi-square tidak terpenuhi, maka sebagai alternatifnya digunakan uji Fisher. Jumlah pasien pada penelitian ini sebanyak 127 pasien. Hasil penelitian menunjukkan penggunaan potentially inappropriate medications sebesar 45,67% (58 pasien). Sedangkan sisanya sebanyak 69 pasien (54,33%) tidak menggunakan potentially inappropriate medications. Penggunaan potentially inappropriate medications paling banyak berhubungan dengan obat golongan benzodiazepin yaitu diazepam (34,62%) dan alprazolam (20,51%). Uji Chi-square menunjukkan bahwa umur, jenis kelamin dan penyakit penyerta tidak berpengaruh terhadap penggunaan potentially inappropriate medications. Uji Fisher menunjukkan jumlah obat berhubungan signifikan dengan penggunaan potentially inappropriate medications (p 0,021; OR 0,12; 95% CI 0,01-0,95), sedangkan durasi rawat inap tidak berhubungan dengan penggunaan potentially inappropriate medications (p>0,05).
ABSTRACT Geriatric patients with heart failure is generally accompanied by comorbidities complex and very risky having trouble selecting the right medication, polypharmacy and a long hospital stay. This study aims to determine the prevalence of Potentially Inappropriate Medications, as well as determine the relationship between the amount of drug prescribed and duration of inpatient geriatric patients with the use of Potentially Inappropriate Medications. This study is an observational cross-sectional and retrospective data collection based on medical records geriatric patients with heart failure who are hospitalized in Panti Nugroho Hospital Yogyakarta period of January 2013 to December 2015 and get drug treatment. Patients who died, the forced return, and referred to elsewhere are not included. Sampling was taken using purposive sampling method. Data were analyzed by Chi-square statistic and if the Chi-square test requirements are not met, then alternatively used Fisher's exact test. The number of patients in this study were 127 patients. The results showed potentially inappropriate medications use by 45.67% (58 patients). While the remaining 69 patients (54.33%) not using potentially inappropriate medications. Potentially Inappropriate Medications use most widely associated with drugs known as benzodiazepines are diazepam (34.62%) and alprazolam (20.51%). Chi-square test showed that age, gender and comorbidities no effect on the use of potentially inappropriate medications. Fisher's exact test showed a significant number of drugs are associated with the use of Potentially Inappropriate Medications (p 0.021; OR 0.12; 95% CI 0.01-0.95), while the duration of hospitalization is not associated with the use of Potentially Inappropriate Medications (p>0.05).
Kata Kunci : geriatri, potentially inappropriate medications, Beers Criteria 2012, lama rawat, polifarmasi.
