EVALUASI DRUG RELATED PROBLEMS PADA PASIEN RAWAT INAP DISLIPIDEMIA DENGAN TERAPI STATIN DI RUMAH SAKIT SURAKARTA
DOI:
https://doi.org/10.23917/ujp.v5i2.975Keywords:
Dislipidemia, Drug Related Problems, Indikasi Tanpa Obat, Interaksi Obat, StatinAbstract
Dislipidemia merupakan gangguan metabolisme lipid yang ditandai dengan peningkatan kolesterol total, kolesterol LDL (Low-Density Lipoprotein), trigliserida (TG), dan penurunan kolesterol HDL (High-Density Lipoprotein). Drugs Related Problems (DRPs) pada pasien dislipidemia dapat menyebabkan target penurunan lipid tidak tercapai sehingga kadar kolesterol total, kolesterol LDL, dan trigliserida tetap tinggi. Penelitian ini bertujuan untuk mengevaluasi DRPs kategori indikasi tanpa obat, obat tanpa indikasi, dosis obat terlalu tinggi, dosis obat terlalu rendah, dan interaksi obat pada pasien rawat inap dislipidemia dengan terapi statin di RS Surakarta tahun 2024. Penelitian ini menggunakan desain observasional dengan pengumpulan data secara retrospektif dan dianalisis secara deskriptif. Subjek penelitian dipilih menggunakan metode purposive sampling. Analisis dilakukan dengan mengevaluasi DRPs berdasarkan PCNE Vol.9.1 kategori indikasi tanpa obat, obat tanpa indikasi, dosis obat terlalu tinggi, dosis obat terlalu rendah, dan interaksi obat pada seluruh obat yang diterima pasien. Kriteria inklusi mencakup pasien rawat inap terdiagnosis dislipidemia yang mendapatkan terapi statin dengan usia >18 tahun dengan atau tanpa penyakit penyerta. Hasil penelitian dari 77 pasien, peresepan obat terbanyak yaitu 94,8% menggunakan atorvastatin. Sebanyak 731 peresepan obat yang dianalisis, ditemukan 43 (5,88%) kasus DRPs yang terdiri dari 6 (0,82%) kasus indikasi tanpa obat, 4 (0,55%) kasus dosis obat terlalu tinggi, 16 (2,19%) kasus dosis obat terlalu rendah, 17 (2,33%) kasus interaksi obat, dan tidak ada kasus obat tanpa indikasi. Berdasarkan penelitian yang telah dilakukan, masih terdapat kejadian DRPs pada pasien dislipidemia dengan terapi statin di instalasi rawat inap RS Surakarta tahun 2024. Dengan demikian, diperlukan peningkatan peran apoteker untuk melakukan monitoring serta evaluasi terapi seperti memastikan ketepatan indikasi, pemilihan obat, evaluasi dosis, serta pemantauan parameter klinis.
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References
Ah, Y. M., Jeong, M., & Choi, H. D. (2022). Comparative safety and efficacy of low-or moderate-intensity statin plus ezetimibe combination therapy and high-intensity statin monotherapy: A meta-analysis of randomized controlled studies. Plos one, 17(3), e0264437. https://doi.org/10.1371/journal.pone.0264437.
Allo, D. T. (2024). Evaluasi penggunaan obat golongan statin di instalasi farmasi rawat inap pada salah satu Rumah Sakit x di Bandung. Jurnal Skolastik Keperawatan, 10(2), 386-393. https://doi.org/10.35974/jsk.v10i2.3996.
American Pharmacist Association. (2009). Drug information handbook: a comprehensive resource for all clinicians and healthcare professionals, 17th edition. Lexicomp, USA.
Annisa R. & Hidayatti N. (2025). Dampak insomnia pada penurunan fungsi kognitif dan neurodegeneration. Journal Medic nutricia, 10 (3), 1-6. https://garuda.kemdiktisaintek.go.id/documents/detail/4679838.
Azqinar, T. C., Anggraini, D. I., & Kania, S. (2022). Penatalaksanaan holistik pada wanita usia 60 tahun dengan dislipidemia melalui pendekatan kedokteran keluarga. Jurnal Penelitian Perawat Profesional, 4(4), 1093-1100. https://doi.org/10.37287/jppp.v4i4.1105.
Baker, C., Retzik-Stahr, C., Singh, V., Plomondon, R., Anderson, V., & Rasouli, N. (2021). Should metformin remain the first-line therapy for treatment of type 2 diabetes?. Therapeutic advances in endocrinology and metabolism, 12. 2042018820980225.
Bakhtiar, M. I., Yudhistirawati, N., & Hamzah, H. (2023). Analisis drps statin dan estimasi risiko atherosclerotic cardiovascular disease (ascvd) pasien diabetes melitus tipe 2 rawat jalan di RS “x” samarinda. JIFI (Jurnal Ilmiah Farmasi Imelda), 6(2), 85-91. https://doi.org/10.52943/jifarmasi.v6i2.1268.
Banach, M., Shekoohi, N., Mikhailidis, D. P., Lip, G. Y., Hernandez, A. V., & Mazidi, M. (2022). Relationship between low-density lipoprotein cholesterol, lipid-lowering agents and risk of stroke: a meta-analysis of observational studies (n= 355,591) and randomized controlled trials (n= 165,988). Archives of medical science: AMS, 18(4), 912. 10.5114/aoms/145970.
Baxter K., Davis M., Driver S., Lee R., Marshall A., McLarney R., Sharp J.M. & Shute B.E. (2008). Stockley’s drug interactions, 8th edition. Pharmaceutical Press, London.
Berberich, A. J., & Hegele, R. A. (2022). A modern approach to dyslipidemia. Endocrine reviews, 43(4), 611-653.
BNF. (2021). British national formulary (bnf) 82. BMJ Group, London.
Chang, T. I., Park, H., Kim, D. W., Jeon, E. K., Rhee, C. M., Kalantar-Zadeh, K., & Han, S. H. (2020). Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study. Scientific reports, 10(1), 18964. https://doi.org/10.1038/s41598-020-75888-8.
Derosa, G., Mugellini, A., Pesce, R. M., D’Angelo, A., & Maffioli, P. (2015). A study about the relevance of adding acetylsalicylic acid in primary prevention in subjects with type 2 diabetes mellitus: effects on some new emerging biomarkers of cardiovascular risk. Cardiovascular Diabetology, 14(1), 95. https://doi.org/10.1186/s12933-015-0254-8.
Dipiro J.T., Tee G.C., Haines S.T., Nolin T.D., Ellingrod V. & Posey L.M. (2023). Pharmacotherapy: a pathophysiologic approach, 12th edition. McGraw-Hill Education.
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., & Yeboah, J. (2019). Aha/acc/aacvpr/aapa/abc/acpm/ada/ags/apha/aspc/nla/pcna guideline on the management of blood cholesterol: a report of the american college of cardiology/american heart association task force on clinical practice guidelines. Journal of the American College of Cardiology, 73(24), e285-e350. https://www.jacc.org/doi/10.1016/j.jacc.2018.11.003.
Hirano, T. (2018). Pathophysiology of diabetic dyslipidemia. Journal of atherosclerosis and thrombosis, 25(9), 771-782. https://doi.org/10.5551/jat.RV17023.
Jacobson, T. A., Ito, M. K., Maki, K. C., Orringer, C. E., Bays, H. E., Jones, P. H., & Brown, W. V. (2015). National lipid association recommendations for patient-centered management of dyslipidemia: part 1—full report. Journal of clinical lipidology, 9(2), 129-169. https://doi.org/10.1016/j.jacl.2015.02.003.
Kemenkes. (2018). Laporan nasional riset kesehatan dasar. Badan Penelitian dan Pengembangan Kesehatan.
Kusuma, N. D., & Ariwibowo, D. D. (2024). Gambaran komplikasi hipertensi di RSUD Cengkareng tahun 2021-2022. JURNAL SEHAT INDONESIA (JUSINDO): Publikasi Indonesia, 7(01), 370-381. https://doi.org/10.59141/jsi.v7i01.267.
Larasati, S., & Alvina, A. (2018). Rasio lingkar pinggang panggul berhubungan dengan kadar kolesterol total pada dewasa. Jurnal Biomedika dan Kesehatan, 1(2), 126-132. https://doi.org/10.18051/JBiomedKes.2018.v1.126-132.
Latif, W. D. (2022). Perbandingan efektivitas klinik simvastatin dan atorvastatin terhadap profil lipid darah: studi kasus di Rumah Sakit Universitas Hasanuddin study on the clinical effectivenees of simvastatin and atorvastatin on the blood lipid profiles: a case study at hassanuddin university hospital. Jurnal sains dan farmas klinik, 1 (2), 34–41. https://doi.org/10.25077/jsfk.9.1.34-41.2022.
Lexicomp. (2009). Drug information handbook. Lexicomp.
Liang, J., Jiang, Y., Huang, Y., Song, W., Li, X., Huang, Y., & Gu, J. (2020). The comparison of dyslipidemia and serum uric acid in patients with gout and asymptomatic hyperuricemia: a cross-sectional study. Lipids health and disease, 19(1),31.doi: 10.1186/s12944-020-1197-y
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., & Wiklund, O. (2020). 2019 esc/eas guidelines for themanagement of dyslipidaemias: lipid modification to reduce cardiovascular risk. Russian journal of cardiology, 25(5), 3826. https://doi.org/10.15829/1560-4071-2020-3826.
Nuraliyah, N. M., & Sinuraya, R. K. (2017). Efek neuroprotektif dan gangguan kognitif statin: sebuah literature review. Farmaka, 15(2), 111-118. https://doi.org/10.24198/jf.v15i2.13176.
Perdossi. (2011). Pedoman tatalaksana penyakit saraf. Perhimpunan Dokter Spesialis Indonesia.
Parfenov, V. A., Golyk, V. A., Matsnev, E. I., Morozova, S. V., Melnikov, O. A., Antonenko, L. M., & Zamergrad, M. V. (2017). Effectiveness of betahistine (48 mg/day) in patients with vestibular vertigo during routine practice: the virtuoso study. PLOS one, 12(3), e0174114. https://doi.org/10.1371/journal.pone.0174114.
Patel, D., Steinberg, J., & Patel, P. (2018). Insomnia in the elderly: a review. Journal of Clinical Sleep Medicine, 14(6), 1017-1024. https://doi.org/10.5664/jcsm.7172.
Patrono, C., Morais, J., Baigent, C., Collet, J. P., Fitzgerald, D., Halvorsen, S., & Vilahur, G. (2017). Antiplatelet agents for the treatment and prevention of coronary atherothrombosis. Journal of the American College of Cardiology, 70(14), 1760-1776. https://www.jacc.org/doi/10.1016/j.jacc.2017.08.037.
PCNE. (2020). PCNE classification for drug-related problems v9.1. PCNE Association, 1 (2), 22–28.
Perhi. (2021). Konsensus penatalaksanaan hipertensi 2021. I-Hefcard.com, 118.
Perhimpunan Reumatologi Indonesia. (2018). Pedoman diagnosis dan pengelolaan gout 2018. Perhimpunan Reumatologi Indonesia.
Perki. (2021). Panduan tatalaksana dislipidemia 2021. Perhimpunan Dokter Spesialis Kardiovaskular Indonesia.
Perkeni. (2021). Pengelolaan dislipidemia di indonesia 2021. PB Perkeni, 1–2.
Rahayu, S .N.N ., & Simanjuntak N. (2023). Identifikasi permasalahan terkait pengobatan pada pasien dislipidemia komorbid diabetes melitus dengan terapi statin. Jurnal Sains dan Ilmu Farmasi, 9 (2), 97–113. https://doi.org/10.36805/jpx.v9i2.8037.
Rosada, A., Kassner, U., Weidemann, F., König, M., Buchmann, N., Steinhagen-Thiessen, E., & Spira, D. (2020). Hyperlipidemias in elderly patients: results from the berlin aging study ii (baseii), a cross-sectional study. Lipids in health and disease, 19(1), 92. https://doi.org/10.1186/s12944-020-01277-9.
Saldanha, V., Araújo, I. B. D., Lima, S. I. V. C., Martins, R. R., & Oliveira, A. G. (2020). Risk factors for drug-related problems in a general hospital: A large prospective cohort. PLoS One, 15(5), e0230215. https://doi.org/10.1371/journal.pone.0230215.
Setiawati, M. C. N., Mutiarawati, C., Chasanah, U., & Fauziyyah, L. F. (2021). Statins drug use and drug-drug interactions. Jurnal Ilmu Farmasi dan Farmasi Klinik, 17(2), 51-59. https://doi.org/10.31942/jiffk.v17i2.4068.
Shang, Y. S., Zhong, P. Y., Ma, Y., Bai, N., Niu, Y., & Wang, Z. L. (2022). Efficacy and safety of proton pump inhibitors in patients with coronary artery diseases receiving oral antiplatelet agents and/or anticoagulants: a systematic review and meta-analysis. Journal of Cardiovascular Pharmacology, 80(1), 1-12. 10.1097/FJC.0000000000001284.
Srinutta, T., Chewcharat, A., Takkavatakarn, K., Praditpornsilpa, K., Eiam-Ong, S., Jaber, B. L., & Susantitaphong, P. (2019). Proton pump inhibitors and hypomagnesemia: a meta-analysis of observational studies. Medicine, 98(44), e17788. 10.1097/MD.0000000000017788.
Stroes, E. S., Thompson, P. D., Corsini, A., Vladutiu, G. D., Raal, F. J., Ray, K. K., & Wiklund, O. (2015). Statin-associated muscle symptoms: impact on statin therapy—european atherosclerosis society consensus panel statement on assessment, aetiology and management. European heart journal, 36(17), 1012-1022. https://doi.org/10.1093/eurheartj/ehv043.
Walsh, C. P., Prior, J. A., Chandratre, P., Belcher, J., Mallen, C. D., & Roddy, E. (2016). Illness perceptions of gout patients and the use of allopurinol in primary care: baseline findings from a prospective cohort study. BMC Musculoskeletal Disorders, 17(1), 394. https://doi.org/10.1186/s12891-016-1252-z.
Wang, J. G., Palmer, B. F., Vogel Anderson, K., & Sever, P. (2023). Amlodipine in the current management of hypertension. The Journal of Clinical Hypertension, 25(9), 801-807. https://doi.org/10.1111/jch.14709.
Xue, R., Jia, K., Wang, J., Yang, L., Wang, Y., Gao, L., & Hao, J. (2018). A rising star in pancreatic diseases: pancreatic stellate cells. Frontiers in physiology, 9, 754. https://doi.org/10.3389/fphys.2018.00754.
Zaman Huri, H., & Chai Ling, L. (2013). Drug-related problems in type 2 diabetes mellitus patients with dyslipidemia. BMC public health, 13(1), 1192. https://doi.org/10.1186/1471-2458-13-1192.
Zhang, Y., He, D., Zhang, W., Xing, Y., Guo, Y., Wang, F., & Lin, S. (2020). Ace inhibitor benefit to kidney and cardiovascular outcomes for patients with non-dialysis chronic kidney disease stages 3–5: a network meta-analysis of randomised clinical trials. Springer Nature, 80(8), 797-811. https://doi.org/10.1007/s40265-020-01290-3.
Zhao, M., Liu, C. F., Feng, Y. F., & Chen, H. (2022). Potential drug-drug interactions in drug therapy for older adults with chronic coronary syndrome at hospital discharge: a real-world study. Frontiers in Pharmacology, 13, 946415. https://doi.org/10.3389/fphar.2022.946415.
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