Prevalensi Penggunaan Fall Risk Medicine pada Pasien Lanjut Usia di Instalasi Rawat Jalan Rumah Sakit Madiun

https://doi.org/10.22146/jmpf.45206

Fita Rahmawati(1*), Nasikhatul Mustafidah(2), Lily Annisa(3)

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

Abstract


The use of certain drugs is known to be an extrinsic factor the risk of falling in the elderly (elderly) because it can cause postural hypotension, sedation, dizziness, weakness, drowsiness, muscle weakness, and other side effects. This study aims to determine the profile of drug use that have the potential to fall in the elderly. This study used a cross-sectional descriptive design with purposive sampling technique. The study was carried out at two regional hospitals in Madiun (RSUD Dr. Soedono Madiun and RSUD Kota Madiun). The data is sourced from the outpatient's medical record of Neurology and Internal Medicine clinics and from the medication record in the Pharmacy Installation from May to October 2018. The results showed that there were 343 patients (64.11%) out of 535 patients involved in the study using fall risk medicines (FRM). Three FRM groups that were often prescribed were antihypertensive 52.71% (282 patients), anticonvulsants 20.19% (108 patients), and benzodiazepines 10.47% (56 patients). A number of 46.54% (249 patients) used FRM included in the low-risk category (Medication Fall Risk Score 1-5), and as many as 17.57% (94 patients) were included in high risk (Medication Fall Risk Score ≥ 6). The elderly that use 1 FRM was 24.86% (133 patients), followed by 2 drugs was 19.07% (102 patients). The results of this study realized that the use of fall risk medicines in the elderly is quite high, so it is necessary to weigh the risks and benefits of its use to prevent falls in the elderly.


Keywords


prevalence; fall risk medicines; the elderly

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References

  1. Badan Pusat Statistik. Statistik Penduduk Lanjut Usia 2017. Jakarta: Badan Pusat Statistik; 2018.
  2. Yoshida S. A Global Report on Falls Prevention- Epidemiology of Falls. Ageing Life Course, Fam Community Heal WHO. 2007:1-40. doi:10.1007/BF02365631
  3. Paolo C, Loredana G, Gianfranco S, et al. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients). Curr Gerontol Geriatr Res. 2013;2013:1-6. doi:10.1155/2013/928603
  4. Ganz DA, Huang C, Saliba D, Berlowitz D, Lukas CV. Preventing Falls in Hospitals A Toolkit for Improving Quality of Care. Agency Healthc Res Qual. 2013;13-0015-EF.
  5. Musich S, Wang SS, Ruiz J, et al. Falls-Related Drug Use and Risk of Falls Among Older Adults : A Study in a US Medicare Population. Drugs Aging. 2017;34(7):555-565. doi:10.1007/s40266-017-0470-x
  6. Badan Pusat Statistik Jawa Timur. Profil Penduduk Lanjut Usia Provinsi Jawa Timur 2017. (BPS Provinsi Jawa Timur, ed.). Surabaya: PT Sinar Multi Indoprinting; 2018.
  7. Carral JMC, Ayán C, Sturzinger L, Gonzalez G. Relationship Between Body Mass Index and Static and Dynamic Balance in Active and Inactive Older Adults. J Geriatr Phys Ther. 2018:1-6. doi:10.1519/JPT.0000000000000195
  8. Mitchell RJ, Lord SR, Harvey LA, Close JCT. Associations between obesity and overweight and fall risk, health status and quality of life in older people. Aust N Z J Public Health. 2014;(July 2013):13-18. doi:10.1111/1753-6405.12152
  9. Alshammari SA, Alhassan AM, Aldawsari MA, Bazuhair FO, Alotaibi FK. Falls among elderly and its relation with their health problems and surrounding environmental factors in Riyadh. J Family Community Med. 2018;25(1):29-34. doi:10.4103/jfcm.JFCM
  10. Bao W, Hu D, Shi X, et al. Comorbidity increased the risk of falls in Chinese older adults : a cross-sectional study. 2017;10(7):10753-10763.
  11. Kementerian Kesehatan Republik Indonesia. Hasil Utama RISKESDAS 2018.; 2018.
  12. Kementerian Kesehatan Republik Indonesia. Infodatin Hipertensi.; 2017.
  13. Kusumawaty J, Hidayat N, Ginanjar E. Hubungan Jenis Kelamin dengan Intensitas Hipertensi pada Lansia di Wilayah Factors Related Events Sex with Hypertension in Elderly Work Area Health District Lakbok Ciamis. Mutiara Med. 2016;16(2):46-51.
  14. Leipzig RM, Cumming RG. Drugs and Falls in Older People: A Systematic Review and Meta-analysis: I. Psychotropic Drugs. J Am Geriatr Soc. 1999;47:30-39.
  15. Bloch F, Thibaud M, Dugué B, Brèque C, Kemoun G. Psychotropic Drugs and Falls in the Elderly People: Updated Literature Review and Meta-Analysis. J Aging Health. 2011;23(2):329-346. doi:10.1177/0898264310381277
  16. J.C. W, K.J. R, M.O. W, et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169(21):1952-1960. http://archinte.ama-assn.org/cgi/reprint/169/21/1952%5Cnhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed9&NEWS=N&AN=2010011449.
  17. Pratt NL, Ramsay EN. Association Between Use of Multiple Psychoactive Medicines and Hospitalization for Falls : Retrospective Analysis of a Large Healthcare Claim Database. Drug Saf. 2014;37:529-535. doi:10.1007/s40264-014-0179-2
  18. Vries M de, Seppala LJ, Daams JG, Glind EMM van de, Masud T, Velde N van der. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis:I. Cardiovascular Drugs. JAMDA. 2018:1-9. doi:10.1016/j.jamda.2017.12.013
  19. Masud TM, Frost M, Ryg J, et al. Central nervous system medications and falls risk in men aged 60 – 75 years : the Study on Male Osteoporosis and Aging ( SOMA ). Age Ageing. 2013;42(August 2012):121-124. doi:10.1093/ageing/afs118
  20. Wolter Kluwer. Lexicomp Drug Information Handbook. 26th ed. American Pharmacist Association; 2018.
  21. Mustafidah N. Hubungan Penggunaan Obat Psikoaktif Dengan Risiko Jatuh Pada Pasien Geriatri Rawat Jalan Di Klinik Saraf Rumah Sakit Madiun. 2019.
  22. Annisa L. Hubungan Penggunaan Obat Psikoaktif dengan Risiko Jatuh pada Pasien Lanjut Usia di Klinik Penyakit Dalam Rumah Sakit Madiun. 2019.
  23. Lee JK, Mendoza DM, Mohler MJ, Lee EM. Geriatrics. In: Chisholm-Burns MA, Schwinghammer TL, Wells BG, Malone PM, Kolesar JM, DiPiro JT, eds. Pharmacotherapy Principle and Practice. 4th ed. United State: McGraw-Hill Education; 2016:7-18.
  24. WHO. Guideline for ATC Classification and DDD Assignment 2018.; 2018. ttps://www.whocc.no/atc_ddd_index/.
  25. Gee NS, Brown JP, Dissanayake VUK, Offord J, Thurlow R, Woodruff GN. The Novel Anticonvulsant Drug , Gabapentin ( Neurontin ), Binds to the alfa2gama Subunit of a Calcium Channel. J Biol Chem. 1996;271(10):5768-5776. ttps://www.whocc.no/atc_ddd_index/.
  26. Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P. A Comparison of the Pharmacokinetics and Pharmacodynamics of Pregabalin and Gabapentin. Clin Pharmacokinet. 2010;49(10):661-669.
  27. Cai K, Nanga RPR, Lamprou L, et al. The Impact of Gabapentin Administration on Brain GABA and Glutamate Concentrations : A 7T 1 H-MRS Study. Neuropsychopharmacology. 2012;37(13):2764-2771. doi:10.1038/npp.2012.142
  28. Wiffen PJ, Derry S, Bell RF, et al. Gabapentin for chronic neuropathic pain in adults ( Review ). Cochrane Database Syst Rev. 2017;(6):10-13. doi:10.1002/14651858.CD007938.pub4.Copyright
  29. Fife TD, Sirven J. Antiepileptic drugs and their impact on balance. Aging health. 2005;1(1):147-155. www.futuremedicine.com.
  30. Ra M, Derry S, Aldington D, et al. Amitriptyline for neuropathic pain in adults ( Review ) Amitriptyline for neuropathic pain in adults. Cochrane Database Syst Rev. 2017;(7):2015-2017. doi:10.1002/14651858.CD008242.pub3.Copyright
  31. Kamerman PR, Finnerup NB, Lima L De, et al. Gabapentin for neuropathic pain: An application to the 21st meeting of the WHO Expert Committee on Selection and Use of Essential Medicines for the inclusion of gabapentin on the WHO Model List of Essential Medicines. In: An Application to the 21st Meet- Ing of TheWHO Expert Committee on Selection and Use of Essential Medicines for the Inclusion of Gabapentin on TheWHO Model List of Essential Medicines. ; 2016:1-50. doi:10.6084/m9.figshare.3814206.v2, 2016
  32. Lawson K. A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia. Biomedicines. 2017;5(24):1-12. doi:10.3390/biomedicines5020024



DOI: https://doi.org/10.22146/jmpf.45206

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