Hubungan antara Drug-Related Problems dan Lama Rawat Inap pada Pasien dengan Diabetes Tipe 2

Surya Yuli Astuti(1), Mawardi Ihsan(2*), Fita Rahmawati(3)

(1) Graduate Program of Pharmacy, Universitas Gadjah Mada, Yogyakarta
(2) Department of Pharmacology and Clinical Pharmacy, Universitas Gadjah Mada, Yogyakarta
(3) Department of Pharmacology and Clinical Pharmacy, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author


Drug-Related Problems have been associated to blood glucose control along with the morbidity and mortality of type 2 diabetes patients through previous studies. However, studies that associate Length of Stay (LOS) with DRPs in type 2 diabetes patients have not been done. The study that had been done was to associate between LOS and Medication Errors (ME). Medication errors include DRPs because other researchers state that errors are also kind of problem. This study was aimed to identify Drug-Related Problems (DRPs) and to associate between DRPs and LOS in type 2 diabetes patients who were hospitalized. This study was a prospective observation study with a cross-sectional design. Sample collection was carried out by consecutive sampling method in type 2 diabetic patients hospitalized in internal medicine ward in one academic hospital in Yogyakarta. Data analysis was done descriptively to see DRPs description and the association between DRPs and LOS was analyzed using Chi-square or Fisher's exact test whenever Chi-square test conditions were not met. Data collection was carried out in January till April 2018. The results showed that the DRPs in hospitalized type 2 diabetic patients were 80.56% with unnecessary drug therapy occurring at 34.72%; dosage too low of 25%; needs additional drug therapy 13.38%; dosage too high 12.5%; ineffective drug 11.11%; and there was no association seen between DRPs and LOS.


Association; Drug-Related Problems (DRPs); Length of Stay (LOS); type 2 diabetes

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1. World Health Organization. Global Report on Diabetes.; 2016.

2. International Diabetes Foundation. IDF DIABETES ATLAS Eighth Edition.; 2017.

3. Badan Penelitian dan Pengembangan Kesehatan. Riset Kesehatan Dasar 2013.; 2013.

4. Muka T, Imo D, Jaspers L, et al. The global impact of non-communicable diseases on healthcare spending and national income: a systematic review. Eur J Epidemiol. 2015;30(4):251-277.

5. Seuring T, Archangelidi O, Suhrcke M. The Economic Costs of Type 2 Diabetes: A Global Systematic Review. Pharmacoeconomics. 2015;33(8):811-831.

6. Ogbonna BO, Ezenduka CC, Opara CA, Ahara LG. Drug therapy problems in patients with type 2 diabetes. Int J Innov Res Dev. 2014;3(1):494-502.

7. van Roozendaal BW, Krass I. Development of an evidence-based checklist for the detection of drug related problems in type 2 diabetes. Pharm World Sci. 2009;31(5):580-595.

8. Inamdar SZ, Kulkarni RV. Drug related problems in elderly patients with type 2 diabetes mellitus. J Diabetol. 2018;1(1):1-12.

9. Cramer JA, Benedict A, Muszbek N, Keskinaslan A, Khan ZM. The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a review. Int J Clin Pract. 2008;62(1):76-87.

10. Ernst FR, Grizzle AJA. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc. 2001;41(2):192-199.

11. Pfister B, Jonsson J, Gustafsson M. Drug-related problems and medication reviews among old people with dementia. BMC Pharmacol Toxicol. 2017;18:52.

12. Chiampas TD, Kim H, Badowski M. Evaluation of the occurrence and type of antiretroviral and opportunistic infection medication errors within the inpatient setting. Pharm Pract (Granada). 2015;13(1):512.

13. Martinez-Ramirez D, Giugni JC, Little CS, et al. Missing Dosages and Neuroleptic Usage May Prolong Length of Stay in Hospitalized Parkinson ’ s Disease Patients. PLoS One. 2015;10(4):e0124356.

14. Dedefo MG, Mitike AH, Angamo MT. Incidence and determinants of medication errors and adverse drug events among hospitalized children in West Ethiopia. BMC Pediatr. 2016;16:81.

15. Lemeshow S, Hosmer Jr. DW, Klar J, Lwanga SK. Adequacy of Sample Size in Health Studies. Chichester: John Wiley & Sons; 1990.

16. Cipolle R, Strand LM, Morley P. Pharmaceutical Care Practice. New York: McGraw-Hill; 1998.

17. Zazuli Z, Rohaya A, Adnyana IK. Drug‑related problems in Type 2 diabetic patients with hypertension in Cimahi, West Java, Indonesia: A prospective study. Int J Green Pharm. 2017;11(2):S298-S304.

18. Mogre V, Salifu ZS, Abedandi R. Prevalence, components and associated demographic and lifestyle factors of the metabolic syndrome in type 2 diabetes mellitus. J Diabetes Metab Disord. 2014;13(1):1-7.

19. Iglay K, Hannachi H, Howie PJ, et al. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Curr Med Res Opin. 2016;32(7):1243-1252.

20. MacKay D. Treatment of acute bronchitis in adults without underlying lung disease. J Gen Intern Med. 1996;11(9):557-562.

21. O’Brien KL, Dowell SF, Schwartz B, Marcy M, Phillips WR, Gerber MA. Cough Illness/Bronchitis-Principles of Judicious Use of Antimicrobial Agents. Pediatrics. 1998;101(Supplement 1):178-181.

22. Direktorat Bina Farmasi Komunitas dan Klinik. Pharmaceutical Care Untuk Penyakit Infeksi Saluran Pernapasan.; 2005.

23. Blackford MG, Glover ML, Reed MD. Lower Respiratory Tract Infections. In: Pharmacotherapy: A Pathophysiologic Approach, 8th Edition. ; 2011:1845-1865.

24. DiPiro JT. Antimicrobial Regimen Selection. In: Pharmacotherapy Handbook Ninth Edition. ; 2015:313-322.

25. Snape WJ, Battle WM, Schwartz SS, Braunstein SN, Goldstein HA, Alavi A. Metoclopramide to Treat Gastroparesis due to Diabetes Mellitus: A Double-Blind, Controlled Trial. Ann Intern Med. 1982;96(4):444-446.

26. Emerson A, Martin RM, Tomlin M, Mann RD. Prospective cohort study of adverse events monitored by hospital pharmacists. Pharmacoepidemiol Drug Saf. 2001;10:95-103.

27. DeWitt DE, Hirsch IB. Outpatient Insulin Therapy in Type 1 and Type 2 Diabetes Mellitus. J Am Med Assoc. 2003;289(17):2254-2264.

28. Schwinghammer TL. Dyslipidemia. In: Pharmacotherapy Handbook Ninth Edition. ; 2015:65-74.

29. American Diabetes Association. Diabetes Care in the Hospital. Diabetes Care. 2017;40(Suppl.):120-127.

30. Lee A, Kuo B. Metoclopramide in the treatment of diabetic gastroparesis. Expert Rev Endocrinol Metab. 2011;5(5):653-662.

31. Bogun M, Inzucchi SE. Inpatient Management of Diabetes and Hyperglycemia. Clin Ther. 2013;35(5):724-733.

32. Pedersen-Bjergaard U, Kristensen PL, Beck-Nielsen H, et al. Effect of insulin analogues on risk of severe hypoglycaemia in patients with type 1 diabetes prone to recurrent severe hypoglycaemia (HypoAna trial): a prospective, randomised, open-label, blinded-endpoint crossover trial. Lancet Diabetes Endocrinol. 2014;2(7):553-561.

33. Fink S, Lange R, McCallum R. Effect of metoclopramide on normal and delayed gastric emptying in gastroesophageal reflux patients. Dig Dis Sci. 1983;28(12):1057-1061.

34. World Health Organization. Global Guidelines on the Prevention of Surgical Site Infection.; 2016.

35. Rubin DJ. Hospital Readmission of Patients with Diabetes. Curr Diab Rep. 2015;15(17):1-9.

36. Enomoto LM, Shrestha DP, Rosenthal MB, Hollenbeak CS, Gabbay RA. Risk factors associated with 30-day readmission and length of stay in patients with type 2 diabetes. J Diabetes Complications. 2017;31(1):122-127.

37. Chen JY, Ma Q, Chen H, Yermilov I. New Bundled World: Quality of Care and Readmission in Diabetes Patients. J Diabetes Sci Technol. 2012;6(3):563-571.

38. Raval AD, Zhou S, Wei W, Bhattacharjee S, Miao R, Sambamoorthi U. 30-Day Readmission Among Elderly Medicare Beneficiaries with Type 2 Diabetes. Popul Health Manag. 2015;18(4):256-264.

39. Dungan KM. The Effect of Diabetes on Hospital Readmissions. J Diabetes Sci Technol. 2012;6(5):1045-1052.

40. Dryden M, Baguneid M, Eckmann C, et al. Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections. Clin Microbiol Infect. 2015;21(S2):27-32.

41. Huang D, Xie L, Qiu Y. Analysis of Factors Affecting the Length of Hospital Stay for Patients with Diabetes. Exp Clin Endocrinol Diabetes. 2016;124(1):5-10.


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