Analisis obat yang berpotensi tidak tepat terhadap reaksi obat yang tidak diinginkan (ROTD) pada pasien lansia
DOI: https://doi.org/10.33024/hjk.v19i7.1103
Lansia Obat yang Berpotensi Tidak Tepat Reaksi Obat yang tidak Diinginkan (ROTD)
Abstract
Background: The elderly population is a vulnerable group due to physiological changes, including decreased organ function. In Depok City, the number of elderly people is expected to increase to 202,194 by 2023. Potentially inappropriate medication use (PDR) in the elderly is associated with an increased risk of adverse drug reactions (ADRs). STOPP_INA is a tool for identifying PDRs and can help reduce the incidence of PDRs.
Purpose: To analyze potentially inappropriate medication use associated with adverse drug reactions (ADRs) in elderly patients.
Method: This was a descriptive observational study with a cross-sectional design. Data were collected retrospectively from electronic prescriptions and electronic medical records of elderly inpatients at RSUI. The minimum sample size was 52.
Results: Of 528 medications prescribed to 52 patients, 90 PDRs (17.04%) were identified. The most common medications included in the STOPP_INA criteria were aspirin, ramipril, clopidogrel, spironolactone, clonidine, and amlodipine. Twenty-two patients (42.3%) experienced ADRs, with the most common adverse effects being hypotension (12 cases), followed by cognitive impairment, gastric ulcer recurrence, bleeding, and decreased renal function (3 cases each).
Conclusion: There was a very strong correlation between the number of PIMs and ADRs (r = 0.758; p < 0.01) in patients with polypharmacy.
Keywords: Adverse Drug Reactions (ADRs); Elderly; Potentially Inappropriate Medications.
Pendahuluan: Populasi lanjut usia merupakan kelompok rentan karena mengalami perubahan fisiologis, termasuk penurunan fungsi organ. Di Kota Depok, jumlah lansia meningkat mencapai 202,194 jiwa pada tahun 2023. Penggunaan obat yang berpotensi tidak tepat atau potentially inappropriate medications (PIMs) pada lansia dikaitkan dengan peningkatan risiko reaksi obat yang tidak diinginkan (ROTD). STOPP_INA merupakan salah satu instrumen untuk mengidentifikasi PIMs dan dapat membantu mengurangi kejadian ROTD.
Tujuan: Untuk menganalisis obat yang berpotensi tidak tepat terhadap reaksi obat yang tidak diinginkan (ROTD) pada pasien lansia.
Metode: Studi observasional deskriptif dengan desain cross-sectional. Data dikumpulkan secara retrospektif dari resep elektronik dan catatan rekam medis elektronik pasien lansia rawat inap di RSUI. Jumlah sampel minimal berdasarkan perhitungan adalah 52 sampel.
Hasil: Dari total 528 obat yang diresepkan kepada 52 pasien, ditemukan 90 PIMs (17.04%). Obat yang paling sering termasuk dalam kriteria STOPP_INA adalah aspirin, ramipril, klopidogrel, spironolakton, klonidin, dan amlodipin. Sebanyak 22 pasien (42.3%) mengalami kejadian ROTD, dengan efek samping terbanyak berupa hipotensi (12 kasus), diikuti gangguan kognitif, kekambuhan tukak peptik, perdarahan, dan penurunan fungsi ginjal (masing-masing 3 kasus).
Simpulan: Terdapat korelasi yang sangat kuat antara jumlah PIMs dan ROTD (r = 0.758; p < 0.01) pada pasien dengan polifarmasi.
Kata Kunci: Lansia; Obat yang Berpotensi Tidak Tepat; Reaksi Obat yang tidak Diinginkan (ROTD).
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