Profil Kerapuhan dan Masalah terkait Obat pada Kelompok Lanjut Usia di Panti Jompo Kota Surabaya

https://doi.org/10.22146/jmpf.38869

Verlita Evelyn Susanto(1), Adji Prayitno Setiadi(2), Bobby Presley(3), Steven Victoria Halim(4), Eko Setiawan(5*)

(1) Departemen Farmasi Klinis dan Komunitas, Fakultas Farmasi, Universitas Surabaya, Jalan Raya Kali Rungkut, Surabaya
(2) 1) Departemen Farmasi Klinis dan Komunitas, Fakultas Farmasi, Universitas Surabaya, Jalan Raya Kali Rungkut, Surabaya 2) Pusat Informasi Obat dan Layanan Kefarmasian (PIOLK), Fakultas Farmasi, Universitas Surabaya, Gedung FF Lantai 5 Jalan Raya Kali Rungkut, Surabaya
(3) 1) Departemen Farmasi Klinis dan Komunitas, Fakultas Farmasi, Universitas Surabaya, Jalan Raya Kali Rungkut, Surabaya 2) Pusat Informasi Obat dan Layanan Kefarmasian (PIOLK), Fakultas Farmasi, Universitas Surabaya, Gedung FF Lantai 5 Jalan Raya Kali Rungkut, Surabaya
(4) 1) Departemen Farmasi Klinis dan Komunitas, Fakultas Farmasi, Universitas Surabaya, Jalan Raya Kali Rungkut, Surabaya 2) Pusat Informasi Obat dan Layanan Kefarmasian (PIOLK), Fakultas Farmasi, Universitas Surabaya, Gedung FF Lantai 5 Jalan Raya Kali Rungkut, Surabaya
(5) 1) Departemen Farmasi Klinis dan Komunitas, Fakultas Farmasi, Universitas Surabaya, Jalan Raya Kali Rungkut, Surabaya 2) Pusat Informasi Obat dan Layanan Kefarmasian (PIOLK), Fakultas Farmasi, Universitas Surabaya, Gedung FF Lantai 5 Jalan Raya Kali Rungkut, Surabaya
(*) Corresponding Author

Abstract


Frailty and drug related problems (DRPs) are common among elderly who lives in the nursing home. There is currently limited information available regarding the profile of frailty and DRPs among elderly living in the nursing homes in Indonesia. This project aims to describe the profile of frailty and DRPs among nursing home residents in Surabaya. This cross-sectional study was conducted in three nursing homes in Surabaya. Integrated Systematic Care for older People (ISCOPE) questionnaire was used to identify the frailty profile among participants. Beers Criteria, screening tool of older person’s prescriptions (STOPP), geriatric dosage handbook and drug interactions analysis and management were used as tools to identify and analyse drug related problems in this study. Several DRPs were identified in this study including inappropriate drug choices, drugs interaction, and inappropriate dose of drugs. In total, 68 elderly were recruited in this study and 41.18% of them were classified as frail older people. There was no drugs interaction with “clinical significance” being identified, however, inappropriate dose of drugs and potentially inappropriate drug choices were found in 58.82% and 19.12% of nursing home residents, respectively. Findings regarding the profile of frailty and DRPs among elderly may indicate the needs to implement an appropriate intervention strategic in order to optimize the use of medications among nursing homes-dwelling elderly people.

Keywords


elderly; frailty; drug related problem

Full Text:

PDF


References

  1. United Nations. World population ageing. 2017 [cited 2018 Agustus 1]. Available from: http://www.un.org/en/development/desa/population/publication s/pdf/ageing/ WPA2017_Highlights.pdf.
  2. The International Longevity Center Global Alliance. Global aging report: threats to longevity a call to action. 2009 [cited 2018 Agustus 1]. Available from:http://www.ilcalliance.org/images/uploads/publicationpdfs/0902_PUBLICATIONS _Global_Aging_Report.pdf.
  3. Kementerian Kesehatan Republik Indonesia. Analisis lansia di Indonesia. 2017. [cited 2018 Agustus 1]. Available from: http://www.pusdatin.kemkes. go.id/article/view/18012600001/analisis-lansia-di-indonesia-2017.html.    
  4. Badan Pusat Statistik Provinsi Jawa Timur. Persentase penduduk lansia hasil proyeksi penduduk menurut kabupaten/kota di Jawa Timur, 2010-2020. 2018 [cited 2018 Agustus 1]. Available from: https://jatim.bps.go.id/dynamictable /2018/02/06/328/persentase-penduduk-lansia-hasil-proyeksi-penduduk-menurut-kabupaten-kota-di-jawa-timur-2010-2020.html.
  5. Badan Pusat Statistik. Statistik penduduk lanjut usia. 2014 [cited 2018 Agustus 1]. Available from: https://www.bappenas.go.id/files/data/Sumber_Daya_ Manusia_dan_Kebudayaan/Statistik%20Penduduk%20Lanjut%20Usia%20Indonesia%202014.pdf.  
  6. Badan Pusat Statistik Provinsi Jawa Timur. Penghuni Pantai Sosial Tresna Werdha (Lanjut Usia) menurut jenis kelamin, 2004-2016. 2017 [cited 2018 Agustus 1]. Available from: https://jatim.bps.go.id/statictable/ 2017/10/10/649 /penghuni-panti-sosial-tresna-werdha-lanjut-usia-menurut-jenis-kelamin-20042016.html.
  7. Golchin N, Frank SH, Vince A, Isham L, Meropol SB. Polypharmacy in the elderly. J Res Pharm Pract. 2015 Apr-Jun; 4(2): 85–88.
  8. Nursing home-Silva C, Ramalho C, Luz I, Monteiro J, Fresco P. Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention. Int J Clin Pharm. 2015;37:327-334.
  9. Nursing home-Brulhart MI, Wermeille JP. Multidisciplinary medication review: evaluation of a pharmaceutical care model for nursing homes. Int J Clin Pharm. 2011;33(3):549-57.
  10. Nursing home- Chen LL, Tangiisuran B, Shafie AA, Hassali MA. Evaluation of potentially inappropriate medications among older residents of Malaysian nursing homes. Int J Clin Pharm. 2012;34(4):596-603.
  11. Nursing home-Fog AF, Kvalvaag G, Engedal K, Straand J. Drug-related problems and changes in drug utilization after medication reviews in nursing homes in Oslo, Norway. Scand J Prim Health Care. 2017;35(4):329-335.
  12. Nyborg G, Straand J, Brekke M. Inappropriate prescribing for the elderly-a modern epidemic?. Eur J Clin Pharmacol. 2012;68(7):1085-94.
  13. Tommelein E, Mehuys E, Petrovic M, Somers A, Colin P, Boussery K. Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. Eur J Clin Pharmacol. 2015;71(12):1415-27.
  14. Wallace E, McDowell R, Bennett K, Fahey T, Smith SM. Impact of potentially inappropriate prescribing on adverse drug events, health related quality of life and emergency hospital attendance in older people attending general practice: a prospective cohort study. J Gerontol A Biol Sci Med Sci. 2017;72(2):271-277.
  15. Cahir C, Bennett K, Teljeur C, Fahey T. Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients. Br J Clin Pharmacol. 2014;77(1):201-10.
  16. O'Mahony D, O'Sullivan D, Byrne S, O'Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213–218.
  17. American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60:616–31
  18. Cahir C, Moriarty F, Teljeur C, Fahey T, Bennett K. Potentially inappropriate prescribing and vulnerability and hospitalization in older community-dwelling patients. Ann Pharmacother. 2014;48(12):1546-54.
  19. Cullinan S, O'Mahony D, O'Sullivan D, Byrne S. Use of a frailty index to identify potentially inappropriate prescribing and adverse drug reaction risks in older patients. Age Ageing. 2016;45(1):115-20.
  20. Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging. 2014;9:433–441.
  21. Gilardi F, Capanna A, Ferraro M, Scarcella P, Marazzi MC, Palombi L, et al. Frailty screening and assessment tools: a review of characteristics and use in Public Health. Ann Ig. 2018;30(2):128-139.
  22. Pialoux T, Goyard J, Lesourd B. Screening tools for frailty in primary health care: a systematic review. Geriatr Gerontol Int. 2012;12(2):189-97.
  23. van Houwelingen AH, den Elzen WP, le Cessie S, Blom JW, Gussekloo J. Consequences of interaction of functional, somatic, mental and social problems in community-dwelling older people. PLoS One. 2015;10(4):e0121013.
  24. Verdoorn S, Verbeij A, Kwint HF, Blom J, Gussekloo J, Bouvy M. Which patients will have the highest risk for drug-related problems? A comparison between older patients with and without complex problems.
  25. Hansten PD, Horn JR. Drug Interaction Analysis and Management. Misouri:Wolters Kluwer Health; 2013.
  26. Semla TP, Beizer JL, Higbee MD. Geriatric Dosage Handbook. 20th ed. Ohio: Lexicomp; 2015.
  27. Siriwardhana DD, Hardoon S, Rait G, Weerasinghe MC, Walters KR. Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Open. 2018 Mar 1;8(3):e018195
  28. Kaufmann CP, Stämpfli D, Hersberger KE, Lampert ML. Determination of risk factors for drug-related problems: a multidisciplinary triangulation process. BMJ Open. 2015;5:e006376.
  29. Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;00:1-98.
  30. American Diabetes Association. Older adults: standards of medical care in diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S119-S125.
  31. Finucane C, Kenny RA. Falls risk, orthostatic hypotension, and optimum blood pressure management: is it all in our heads?. Am J Hypertens. 2017;30(2):115-117.
  32. Shaw BH, Claydon VE. The relationship between orthostatic hypotension and falling in older adults. Clin Auton Res. 2014;24:3–13.
  33. Kachroo S, Kawabata H, Colilla S, Shi L, Zhao Y, Mukherjee J, et al. Association between hypoglycemia and fall-related events in type 2 diabetes mellitus: analysis of a U.S. commercial database. J Manag Care Spec Pharm. 2015;21(3):243-53.
  34. Zhao Y, Kachroo S, Kawabata H, Colilla S, Mukherjee J, Fonseca V, et al. Association between hypoglycemia and fall-related fractures and health care utilization in older veterans with type 2 diabetes. Endocr Pract. 2016;22(2):196-204.
  35. Alekna V, Stukas R, Tamulaitytė-Morozovienėa I, Šurkienėa G, Tamulaitienėab M. Self-reported consequences and healthcare costs of falls among elderly women. Medicina. 2015;51:57-62.
  36. Burns ER, Stevens JA, Lee R. The direct costs of fatal and non-fatal falls among older adults — United States. J Safety Res. 2016;58:99-103.
  37. McCreight LJ, Bailey CJ, Pearson ER. Metformin and the gastrointestinal tract. Diabetologia. 2016;59:426–435
  38. van der Stelt CA, Vermeulen Windsant-van den Tweel AM, Egberts AC, van den Bemt PM, Leendertse AJ, Hermens WA, et al. The association between potentially inappropriate prescribing and medication-related hospital admissions in older patients: a nested case control study. Drug Saf. 2016;39(1):79-87.
  39. Kim GJ, Lee KH, Kim JH. South Korean geriatrics on Beers Criteria medications at risk of adverse drug events. PLoS One. 2018 Mar 15;13(3):e0191376.
  40. Riddle MC. More reasons to say goodbye to glyburide. J Clin Endocrinol Metab. 2010;95(11):4867-4870.
  41. Nicolucci A, Pintaudi B, Rossi MC, Messina R, Dotta F, Frontoni S, et al. The social burden of hypoglycemia in the elderly. Acta Diabetol. 2015;52(4):677-85.
  42. Sircar M, Bhatia A, Munshi M. Review of hypoglycemia in the older adult: clinical implications and management. Can J Diabetes. 2016;40(1):66-72.
  43. Clemens KK, McArthur E, Dixon SN, Fleet JL, Hramiak I, Garg AX. The hypoglycemic risk of glyburide (glibenclamide) compared with modified-release gliclazide. Can J Diabetes. 2015;39(4):308-16.
  44. Yakaryılmaz FD, Öztürk ZA. Treatment of type 2 diabetes mellitus in the elderly. World J Diabetes. 2017;8(6):278-285.
  45. Zhu QO, Tan CS, Tan HL, Wong RG, Joshi CS, Cuttilan RA, et al. Orthostatic hypotension: prevalence and associated risk factors among the ambulatory elderly in an Asian population. Singapore Med J. 2016;57(8):444-51.



DOI: https://doi.org/10.22146/jmpf.38869

Article Metrics

Abstract views : 410 | views : 552

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats