Hubungan antara pola peresepan polifarmasi dengan kejadian efek samping obat pada responden geriatri rawat inap
DOI: https://doi.org/10.33024/hjk.v20i6.3623
Adverse Drug Reactions Geriatrics Naranjo Algorithm Pharmacovigilance Polypharmacy
Abstract
Background: The growing geriatric population has led to an increased prevalence of chronic diseases and multimorbidity, necessitating the simultaneous use of multiple medications, or polypharmacy. This condition potentially increases the incidence of drug-related problems (DRPs)—particularly adverse drug reactions (ADRs) and drug interactions—as geriatric patients undergo pharmacokinetic and pharmacodynamic changes due to aging. Such vulnerability is often heightened in hospitalized patients, who typically face more complex therapeutic regimens.
Purpose: To analyze the relationship between polypharmacy prescribing patterns and the incidence of adverse drug reactions among hospitalized geriatric patients, using secondary data from medical records.
Method: An observational analytic study with a retrospective cross-sectional design was conducted using medical records of hospitalized geriatric patients. Data meeting the inclusion and exclusion criteria were selected via simple random sampling. Assessments of adverse drug reactions were performed using the Naranjo Algorithm to determine the probability of a causal relationship between medication use and the observed reactions. Data analysis included univariate analysis, bivariate analysis (using the Spearman correlation test), and multivariate analysis (using ordinal logistic regression) to evaluate the relationship between the number of medications in polypharmacy regimens and the incidence of adverse drug reactions, while controlling for confounding variables.
Results: The study found that 220 patients experienced polypharmacy; the majority (159 patients or 72.3%) fell into the excessive polypharmacy category (≥10 medications), while 61 patients (27.7%) fell into the moderate polypharmacy category (5–9 medications). Based on the Naranjo Algorithm assessment, the majority of patients (199 or 90.5%) fell into the "doubtful" category, followed by the "possible" category (17 patients or 7.7%) and the "probable" category (4 patients or 1.8%). Bivariate analysis revealed a significant relationship between polypharmacy prescribing patterns and the incidence of adverse drug reactions among hospitalized geriatric patients (r=0.307; p<0.001). Multivariate analysis using ordinal logistic regression demonstrated that polypharmacy prescribing patterns remained significantly associated with the occurrence of adverse drug reactions after adjusting for age, gender, and the number of comorbidities (OR=1.207; 95% CI: 1.097−1.326; p<0.001).
Conclusion: There is a significant association between polypharmacy prescribing patterns and the occurrence of adverse drug reactions among hospitalized geriatric patients.
Suggestion: Enhance the evaluation of medication use in geriatric patients through medication reviews, therapy monitoring, early detection of adverse drug reactions (ADRs), and the strengthening of pharmacovigilance systems.
Keywords: Adverse Drug Reactions; Geriatrics; Naranjo Algorithm; Pharmacovigilance; Polypharmacy.
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