Main Article Content
Abstract
Background: Drug related problems (DRP) can cause problems in treatments of patients with ischemic stroke.
Objective: This study was to determine the correlation between the characteristics of patients with ischemic stroke and the DRP.
Methods: A population in this study was 53 patients at dr Iskak Public Hospital in Tulungagung. Inclusion criteria were patients who were = 60 years old and were diagnosed as acute ischemic stroke patients. The DRP was classified based on Pharmaceutical Care Network Europe version 6.2, especially problem and cause domain. Correlation between age, duration of treatment, number of comorbidities and number of drugs and the DRP was analysed by Spearman Rho or by Pearson analysis. The relationship between gender, guaranteed care and the DRP was analysed by using Eta analysis.
Results: This study revealed that patients with 60-69 years were 24 patients (45.28%), men were 30 patients (57%), 1 comorbidity was 26 patients (49.06%), duration of 5 days was 14 patients (26.42%), BPJS patients were 23 patients (35.94%), using 6 types of drug was 11 patients (20.75%). Age, sex and care guarantee did not correlate with the DRP (p-values > 0.05). Duration of treatment, number of comorbidities and number of drugs correlated with the DRP (p-value <0.05) with consecutive correlation strength: weak (R = 0.32), moderate (R = 0.45), strong (R = 0.56).
Conclusion: Duration of treatment, number of comorbidities and number of drugs correlated with increasing incidences of the DRP in geriatric ischemic stroke patients.
Keywords
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References
- United States Health. Leading causes of death and numbers of deaths, by age: United States, 1980 and 2013. 2014;1–2.
- Kementrian kesehatan RI. Hasil utama riskesdas 2018. 2018;61.
- Stebbins MR, Cutler TW, Parker PL. Koda-Kimble & Youngs applied therapeutics: clinical use of drugs. 10th edito. Alldredge BK, Corelli RL, Ernst ME, Guglielmo BJ, Jacobson PA, Wayne A Kradjan, et al., editors. New York: Springer; 2016.
- Badan Pusat Statistik Indonesia. Proyeksi penduduk Indonesia: Indonesia Population Projection 2010-2035. Badan Pusat Statistik Indonesia. 2013. 978–979 p.
- Dinas Kesehatan Kabupaten Tulungagung. Profil kesehatan tahun 2013. 2013.
- Sari IN. Evaluasi drug related problems obat antidiabetes pada pasien geriatri dengan diabetes melitus tipe 2 di ruang rawat inap RSU pelabuhan periode januari-juni 2014. Universitas Islam Negeri Syarif Hidayatullah; 2015.
- Ruths S, Viktil KK, Blix HS. Classification of drug-related problems. 2003-2010 Pharmaceutical Care Network Europe Foundation. 2007;127(23):3073–6.
- Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice: The patient-centered approach to medication management services, 3rd edition. New York: McGraw-Hill; 2012.
- Chan DC, Chen JH, Kuo HK, We CJ, Lu IS, Chiu LS, et al. Drug-related problems (DRPs) identified from geriatric medication safety review clinics. Archives of Gerontology and Geriatrics. 2012;54(1):168–74.
- Ahmad A, Mast MR, Nijpels G, Elders PJ, Dekker JM, Hugtenburg JG. Identification of drug-related problems of elderly patients discharged from hospital. Patient preference and adherence. 2014;8:155–65.
- Al Hamid A, Ghaleb M, Aljadhey H, Aslanpour Z. A systematic review of hospitalization resulting from medicine-related problems in adult patients. British Journal of Clinical Pharmacology. 2014;78(2):202–17.
- Nobili A, Licata G, Salerno F, Pasina L, Tettamanti M, Franchi C, et al. Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. European Journal of Clinical Pharmacology. 2011;67(5):507–19.
- Mayasari G, Andayani TM, Rahmawati F. Faktor risiko terjadinya drug related probles pada pasien geriatrik. Jurnal Manajemen dan Pelayanan Farmasi. 2015;5(2).
- Rahmawati Y, Sunarti S. Permasalahan pemberian obat pada pasien geriatri di ruang perawatan RSUD Saiful Anwar Malang drug-related problem in Hospitalized Geriatric Patients at Saiful Anwar Hospital Malang. Jurnal Kedokteran Brawijaya. 2011;28(2):140–4.
- Dahlan MS. Statistik untuk Kedokteran dan Kesehatan. Edisi 6. Jakarta: Epidemiologi Indonesia; 2014. 110–135 p.
- Hohmann C, Neumann-Haefelin T, Klotz JM, Freidank A, Radziwill R. Drug-related problems in patients with ischemic stroke in hospital. International Journal of Clinical Pharmacy. 2012;34(6):828–31.
- Abunahlah N, Elawaisi A, Velibeyoglu FM, Sancar M. Drug related problems identified by clinical pharmacist at the Internal Medicine Ward in Turkey. International Journal of Clinical Pharmacy. 2018;40(2):360–7.
- Pasina L, Brucato AL, Falcone C, Cucchi E, Bresciani A, Sottocorno M, et al. Medication non-adherence among elderly patients newly discharged and receiving polypharmacy. Drugs and Aging. 2014;31(4):283–9.
- Semcharoen K, Supornpun S, Nathisuwan S, Kongwatcharapong J. Characteristic of drug - related problems and pharmacists ’ interventions in a stroke unit in Thailand. International Journal of Clinical Pharmacy. 2019;
- Celin AT, Seuma J, Ramesh A. Assessment of drug related problems in stroke patients admitted to a South Indian tertiary care teaching hospital. Indian Journal of Pharmacy Practice. 2012;5(4):28–33.
- Silva C, Ramalho C, Luz I, Monteiro J, Fresco P. Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention. International Journal of Clinical Pharmacy. 2015;37(2):327–34.
- Handayani D, Dominica D. Gambaran drug related problems (DRP’s) pada penatalaksanaan pasien stroke hemoragik dan stroke non hemoragik di RSUD Dr M Yunus Bengkulu. Jurnal Farmasi Dan Ilmu Kefarmasian Indonesia. 2019;5(1):36–44.
- Zazuli Z, Rohaya A, Adnyana K. Drug-related problems in Type 2 diabetic patients with hypertension in Cimahi, West Java, Indonesia: A prospective study. International Journal of Green Pharmacy. 2017;11(2):298–304.
- Iyer K, Dilipkumar N, Vasaya S, Pawar S, Diwan A. Comparison of drug related problems associated with use of narrow therapeutic index drugs and other drugs in hospitalized patients. Journal of Young Pharmacists. 2018;10(3):318–21.
- Wincent MM, Potrilingam D, V. A, Jacob SC, G. A. Assessment of drug related problems in patients with chronic diseases in the general medicine units of a tertiary care hospital. International Journal of Pharmacy and Pharmaceutical Sciences. 2017;9(12):194.
- Ali MAS, Khedr EMH, Ahmed FAH, Mohamed NNE. Clinical pharmacist interventions in managing drug-related problems in hospitalized patients with neurological diseases. International Journal of Clinical Pharmacy. 2018;40(5):1257–64.
- Lenssen R, Heidenreich A, Schulz JB, Trautwein C, Fitzner C, Jaehde U, et al. Analysis of drug-related problems in three departments of a German University hospital. International Journal of Clinical Pharmacy. 2016;38(1):119–26.
- Arini YD, Rahmawati F, Andayani TM. Faktor resiko kejadian drug related problems pada pasien penyakit kronis rawat jalan di poliklinik penyakit dalam. Jurnal Manajemen dan Pelayanan Farmasi. 2016;6(2):83–94.
- Ramanath K, Nedumballi S. Assessment of medication-related problems in geriatric patients of a rural tertiary care hospital. Journal of young pharmacists?. 2012;4(4):273–8.
- da Costa FA, Silvestre L, Periquito C, Carneiro C, Oliveira P, Fernandes AI, et al. Drug-related problems identified in a sample of Portuguese Institutionalised elderly patients and pharmacists’ interventions to improve safety and effectiveness of medicines. Drugs - Real World Outcomes. 2016;3(1):89–97.
- Lenander C, Elfsson B, Danielsson B, Midlöv P, Hasselström J. Effects of a pharmacist-led structured medication review in primary care on drug-related problems and hospital admission rates: A randomized controlled trial. Scandinavian Journal of Primary Health Care. 2014;32(4):180–6.
- Cheong VL, Sowter J, Scally A, Hamilton N, Ali A, Silcock J. Medication-related risk factors and its association with repeated hospital admissions in frail elderly: A case control study. Research in Social and Administrative Pharmacy. 2019;:0–1.
- Kojima G, Bell C, Tamura B, Inaba M, Lubimir K, Blanchette PL, et al. Reducing cost by reducing polypharmacy: the polypharmacy outcomes project. Journal of the American Medical Directors Association. 2012;13(9):818.e11-818.e15.
- Ayalew M, Megersa T, Mengistu Y. Drug-related problems in medical wards of Tikur Anbessa specialized hospital, Ethiopia. Journal of Research in Pharmacy Practice. 2015;4(4):216.
- Ma shu ning, Huri hasniza Z, Yahya F. Drug-related problems in patients with rheumatoid arthritis. Therapeutics and Clinical Risk Management. 2019;15:505–24.
- Baek YH, Shin JY. Trends in polypharmacy over 12 years and changes in its social gradients in South Korea. PLoS ONE. 2018;13(9):1–17.
References
United States Health. Leading causes of death and numbers of deaths, by age: United States, 1980 and 2013. 2014;1–2.
Kementrian kesehatan RI. Hasil utama riskesdas 2018. 2018;61.
Stebbins MR, Cutler TW, Parker PL. Koda-Kimble & Youngs applied therapeutics: clinical use of drugs. 10th edito. Alldredge BK, Corelli RL, Ernst ME, Guglielmo BJ, Jacobson PA, Wayne A Kradjan, et al., editors. New York: Springer; 2016.
Badan Pusat Statistik Indonesia. Proyeksi penduduk Indonesia: Indonesia Population Projection 2010-2035. Badan Pusat Statistik Indonesia. 2013. 978–979 p.
Dinas Kesehatan Kabupaten Tulungagung. Profil kesehatan tahun 2013. 2013.
Sari IN. Evaluasi drug related problems obat antidiabetes pada pasien geriatri dengan diabetes melitus tipe 2 di ruang rawat inap RSU pelabuhan periode januari-juni 2014. Universitas Islam Negeri Syarif Hidayatullah; 2015.
Ruths S, Viktil KK, Blix HS. Classification of drug-related problems. 2003-2010 Pharmaceutical Care Network Europe Foundation. 2007;127(23):3073–6.
Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice: The patient-centered approach to medication management services, 3rd edition. New York: McGraw-Hill; 2012.
Chan DC, Chen JH, Kuo HK, We CJ, Lu IS, Chiu LS, et al. Drug-related problems (DRPs) identified from geriatric medication safety review clinics. Archives of Gerontology and Geriatrics. 2012;54(1):168–74.
Ahmad A, Mast MR, Nijpels G, Elders PJ, Dekker JM, Hugtenburg JG. Identification of drug-related problems of elderly patients discharged from hospital. Patient preference and adherence. 2014;8:155–65.
Al Hamid A, Ghaleb M, Aljadhey H, Aslanpour Z. A systematic review of hospitalization resulting from medicine-related problems in adult patients. British Journal of Clinical Pharmacology. 2014;78(2):202–17.
Nobili A, Licata G, Salerno F, Pasina L, Tettamanti M, Franchi C, et al. Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. European Journal of Clinical Pharmacology. 2011;67(5):507–19.
Mayasari G, Andayani TM, Rahmawati F. Faktor risiko terjadinya drug related probles pada pasien geriatrik. Jurnal Manajemen dan Pelayanan Farmasi. 2015;5(2).
Rahmawati Y, Sunarti S. Permasalahan pemberian obat pada pasien geriatri di ruang perawatan RSUD Saiful Anwar Malang drug-related problem in Hospitalized Geriatric Patients at Saiful Anwar Hospital Malang. Jurnal Kedokteran Brawijaya. 2011;28(2):140–4.
Dahlan MS. Statistik untuk Kedokteran dan Kesehatan. Edisi 6. Jakarta: Epidemiologi Indonesia; 2014. 110–135 p.
Hohmann C, Neumann-Haefelin T, Klotz JM, Freidank A, Radziwill R. Drug-related problems in patients with ischemic stroke in hospital. International Journal of Clinical Pharmacy. 2012;34(6):828–31.
Abunahlah N, Elawaisi A, Velibeyoglu FM, Sancar M. Drug related problems identified by clinical pharmacist at the Internal Medicine Ward in Turkey. International Journal of Clinical Pharmacy. 2018;40(2):360–7.
Pasina L, Brucato AL, Falcone C, Cucchi E, Bresciani A, Sottocorno M, et al. Medication non-adherence among elderly patients newly discharged and receiving polypharmacy. Drugs and Aging. 2014;31(4):283–9.
Semcharoen K, Supornpun S, Nathisuwan S, Kongwatcharapong J. Characteristic of drug - related problems and pharmacists ’ interventions in a stroke unit in Thailand. International Journal of Clinical Pharmacy. 2019;
Celin AT, Seuma J, Ramesh A. Assessment of drug related problems in stroke patients admitted to a South Indian tertiary care teaching hospital. Indian Journal of Pharmacy Practice. 2012;5(4):28–33.
Silva C, Ramalho C, Luz I, Monteiro J, Fresco P. Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention. International Journal of Clinical Pharmacy. 2015;37(2):327–34.
Handayani D, Dominica D. Gambaran drug related problems (DRP’s) pada penatalaksanaan pasien stroke hemoragik dan stroke non hemoragik di RSUD Dr M Yunus Bengkulu. Jurnal Farmasi Dan Ilmu Kefarmasian Indonesia. 2019;5(1):36–44.
Zazuli Z, Rohaya A, Adnyana K. Drug-related problems in Type 2 diabetic patients with hypertension in Cimahi, West Java, Indonesia: A prospective study. International Journal of Green Pharmacy. 2017;11(2):298–304.
Iyer K, Dilipkumar N, Vasaya S, Pawar S, Diwan A. Comparison of drug related problems associated with use of narrow therapeutic index drugs and other drugs in hospitalized patients. Journal of Young Pharmacists. 2018;10(3):318–21.
Wincent MM, Potrilingam D, V. A, Jacob SC, G. A. Assessment of drug related problems in patients with chronic diseases in the general medicine units of a tertiary care hospital. International Journal of Pharmacy and Pharmaceutical Sciences. 2017;9(12):194.
Ali MAS, Khedr EMH, Ahmed FAH, Mohamed NNE. Clinical pharmacist interventions in managing drug-related problems in hospitalized patients with neurological diseases. International Journal of Clinical Pharmacy. 2018;40(5):1257–64.
Lenssen R, Heidenreich A, Schulz JB, Trautwein C, Fitzner C, Jaehde U, et al. Analysis of drug-related problems in three departments of a German University hospital. International Journal of Clinical Pharmacy. 2016;38(1):119–26.
Arini YD, Rahmawati F, Andayani TM. Faktor resiko kejadian drug related problems pada pasien penyakit kronis rawat jalan di poliklinik penyakit dalam. Jurnal Manajemen dan Pelayanan Farmasi. 2016;6(2):83–94.
Ramanath K, Nedumballi S. Assessment of medication-related problems in geriatric patients of a rural tertiary care hospital. Journal of young pharmacists?. 2012;4(4):273–8.
da Costa FA, Silvestre L, Periquito C, Carneiro C, Oliveira P, Fernandes AI, et al. Drug-related problems identified in a sample of Portuguese Institutionalised elderly patients and pharmacists’ interventions to improve safety and effectiveness of medicines. Drugs - Real World Outcomes. 2016;3(1):89–97.
Lenander C, Elfsson B, Danielsson B, Midlöv P, Hasselström J. Effects of a pharmacist-led structured medication review in primary care on drug-related problems and hospital admission rates: A randomized controlled trial. Scandinavian Journal of Primary Health Care. 2014;32(4):180–6.
Cheong VL, Sowter J, Scally A, Hamilton N, Ali A, Silcock J. Medication-related risk factors and its association with repeated hospital admissions in frail elderly: A case control study. Research in Social and Administrative Pharmacy. 2019;:0–1.
Kojima G, Bell C, Tamura B, Inaba M, Lubimir K, Blanchette PL, et al. Reducing cost by reducing polypharmacy: the polypharmacy outcomes project. Journal of the American Medical Directors Association. 2012;13(9):818.e11-818.e15.
Ayalew M, Megersa T, Mengistu Y. Drug-related problems in medical wards of Tikur Anbessa specialized hospital, Ethiopia. Journal of Research in Pharmacy Practice. 2015;4(4):216.
Ma shu ning, Huri hasniza Z, Yahya F. Drug-related problems in patients with rheumatoid arthritis. Therapeutics and Clinical Risk Management. 2019;15:505–24.
Baek YH, Shin JY. Trends in polypharmacy over 12 years and changes in its social gradients in South Korea. PLoS ONE. 2018;13(9):1–17.