Assessing Potentially Inappropriate Medications in Hospitalized Geriatric Patients in 2 Hospital in Jakarta using STOPP START Criteria

https://doi.org/10.22146/jmpf.48944

Daniek Viviandhari(1*), Nora Wulandari(2), Numlil Khaira Rusdi(3), Nur Rahmi(4), Nurul Hildayana(5), Noni Sri Susi Faniroh(6)

(1) Faculty of Pharmacy and Science, Universitas Muhammadiyah Prof. Dr. HAMKA, South Jakarta
(2) Faculty of Pharmacy and Science, Universitas Muhammadiyah Prof. Dr. HAMKA, South Jakarta
(3) Faculty of Pharmacy and Science, Universitas Muhammadiyah Prof. Dr. HAMKA, South Jakarta
(4) Faculty of Pharmacy and Science, Universitas Muhammadiyah Prof. Dr. HAMKA, South Jakarta
(5) Faculty of Pharmacy and Science, Universitas Muhammadiyah Prof. Dr. HAMKA, South Jakarta
(6) Faculty of Pharmacy and Science, Universitas Muhammadiyah Prof. Dr. HAMKA, South Jakarta
(*) Corresponding Author

Abstract


Geriatric patients have more comorbidities and often receive polypharmacy prescriptions. The prevalence of inappropriate drug use in geriatric patients is in the range of 11.5% - 62.5%. The consequence of polypharmacy is Adverse Drug Reactions (ADR). An effort to reduce the occurrence of medication errors in geriatric patients is the STOPP and START criteria. This study aimed to identify PIMs (Potentially Inappropriate Medications) and PPO (Potentially Prescribing Omission) in geriatric patients according to STOPP / START criteria at Gatot Soebroto Army Hospital and the Jakarta Cempaka Putih Islamic Hospital. This study used a descriptive-analytical method with a cross-sectional design and a prospective data collection method based on analysis of medical records, inpatient installation, and pharmacy installation at Gatot Soebroto Army Hospital in Jakarta on October 2017 and Jakarta Cempaka Putih Islamic Hospital in January 2019. The tool used to collect data in this research was the STOPP START toolkit supporting medication review version 1 2016. The results show that of 85 hospitalized geriatric patients at Gatot Soebroto Army Hospital with the use of 579 drugs, PIMs were present in 8.24% of patients and the prevalence of PPO was 5.88%. Meanwhile, out of 124 hospitalized geriatric patients in Jakarta Cempaka Putih Islamic Hospital with the use of 945 drugs, PIMs were present in 35.48% of patients and the prevalence of PPO was 6.45%. Polypharmacy found to be an independent predictor for PIMs incident.


Keywords


geriatrics; PIMs; PPO; STOPP/START criteria

Full Text:

PDF


References

  1. Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach.; 2017.
  2. World Health Organization. Ageing and Health. 2018;(February 2018):1-4.
  3. Ministry of Health Republic of Indonesia. Peraturan Menteri Kesehatan RI No. 79 Tahun 2014 tentang Penyelenggaraan Pelayanan Geriatri di Rumah Sakit. Indonesia. 2014:1-36. doi:10.1177/1076029609348647
  4. Ministry of Health Republic of Indonesia. Situasi Lansia di Indonesia Tahun 2017. 2017.
  5. Momin TG, Pandya RN, Rana DA, Patel VJ. Use of potentially inappropriate medications in hospitalized elderly at a teaching hospital: A comparison between Beers 2003 and 2012 criteria. Indian J Pharmacol. 2013;45(6):603. doi:10.4103/0253-7613.121372
  6. O’Mahony D, Gallagher P, Ryan C, et al. STOPP & START criteria: A new approach to detecting potentially inappropriate prescribing in old age. Eur Geriatr Med. 2010;1(1):45-51. doi:10.1016/j.eurger.2010.01.007
  7. Rosa ASKC da, Costa BP, Kapper CP, et al. Identification of inappropiate prescribing in a Geriatric outpatient clinic using the Criteria Stopp Start. Rev Bras Geriatr e Gerontol. 2016;19(5):871-879. doi:10.1590/1809-98232016019.150220
  8. Pyszka LL, Seys Ranola TM, Milhans SM. Identification of inappropriate prescribing in geriatrics at a veterans affairs hospital using STOPP/START screening tools. Consult Pharm. 2010;25(6):365-373. doi:10.4140/TCP.n.2010.365
  9. Muhte G, Yayla E, Bilge UL, Binen E, Keskin A. The Use of START / STOPP Criteria for Elderly Patients in Primary Care. Sci World J. 2013;2013.
  10. Mulyani E, Darmawan E, Mustofa M. Hubungan Jumlah Obat Yang Diresepkan Dengan Potensial Penggunaan Obat Yang Tidak Tepat Pada Pasien Ckd Di Rs Pku Muhammadiyah Yogyakarta. Pharmaciana. 2015;5(2):153. doi:10.12928/pharmaciana.v5i2.2063
  11. Syuaib ANM, Dermawan E, Mustofa. Penggunaan Potentially Inappropriate Medications ( PIMs ) pada Pasien Geriatri Rawat Inap Osteoarthritis di RS PKU Muhammadiyah Yogyakarta. Pharmaciana. 2015;5:77-84. doi:10.12928/pharmaciana.v5i1.2289
  12. United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2017 - Highlights (ST/ESA/SER.A/397).; 2017. http://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2017_Highlights.pdf.
  13. Davies EA, O’Mahony MS. Adverse drug reactions in special populations - The elderly. Br J Clin Pharmacol. 2015;80(4):796-807. doi:10.1111/bcp.12596
  14. Neto PRO, Nobili A, de Lyra DP, et al. Incidence and predictors of adverse drug reactions caused by drug-drug interactions in elderly outpatients: A prospective cohort study. J Pharm Pharm Sci. 2012;15(2):332-343.
  15. Shah BM, Hajjar ER. Polypharmacy, Adverse Drug Reactions, and Geriatric Syndromes. Clin Geriatr Med. 2012;28(2):173-186. doi:10.1016/j.cger.2012.01.002
  16. Doan J, Zakrzewski-Jakubiak H, Roy J, Turgeon J, Tannenbaum C. Prevalence and Risk of Potential Cytochrome P450–Mediated Drug-Drug Interactions in Older Hospitalized Patients with Polypharmacy. Ann Pharmacother. 2013;47(3):324-332. doi:10.1345/aph.1r621
  17. Marcum ZA, Amuan ME, Hanlon JT, et al. Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans. J Am Geriatr Soc. 2012;60(1):34-41. doi:10.1111/j.1532-5415.2011.03772.x
  18. Bourgeois FT, Shannon MW, Valim C, Mandl KD. Adverse Drug Events in the Outpatient Setting : an 11-year national analysis. Pharmacoepidemiol Drug Saf. 2010;19(July):901-910. doi:10.1002/pds
  19. Blanco-Reina E, Garcı´a-Merino MR, Ocaña-Riola R, et al. Assessing Potentially Inappropriate Prescribing in Community-Dwelling Older Patients Using the Updated Version of STOPPSTART Criteria: A Comparison of Profiles and Prevalences with Respect to the Original Version. PLoS One. 2016;11(12):e01:1-10. doi:10.1371/journal.pone.0167586
  20. Chandrasekhar D, Samjas M. Evaluation of potentially inappropriate medications among hospitalized geriatric patients in tertiary care referral hospital using STOPP / START criteria. Clin Epidemiol Glob Heal. 2018;(January):0-1. doi:10.1016/j.cegh.2018.10.008
  21. American Heart Association. What Is Hyperkalemia ( High Potassium )? 2017.
  22. Fox C, Richardson K, Maidment ID, et al. Anticholinergic medication use and cognitive impairment in the older population: The medical research council cognitive function and ageing study. J Am Geriatr Soc. 2011;59(8):1477-1483. doi:10.1111/j.1532-5415.2011.03491.x
  23. Kersten H, Wyller TB. Anticholinergic Drug Burden in Older People’s Brain - How well is it Measured? Basic Clin Pharmacol Toxicol. 2014;114(2):151-159. doi:10.1111/bcpt.12140
  24. Markov YI. Anticholinergic syndrome (lecture). Emerg Med. 2017;0(1.80):17-20. doi:10.22141/2224-0586.1.80.2017.94447
  25. Campbell N, Boustani M, Limbil T, et al. The cognitive impact of anticholinergics: a clinical review. Clin Interv Aging. 2009;4:225-233.
  26. Melani AS. Management of asthma in the elderly patient. Clin Interv Aging. 2013;8:913-922. doi:10.2147/CIA.S33609
  27. Abdulah R, Insani WN, Destiani DP, Rohmaniasari N, Mohenathas ND, Barliana MI. Polypharmacy leads to increased prevalence of potentially inappropriate medication in the indonesian geriatric population visiting primary care facilities. Ther Clin Risk Manag. 2018;14:1591-1597. doi:10.2147/TCRM.S170475



DOI: https://doi.org/10.22146/jmpf.48944

Article Metrics

Abstract views : 2408 | views : 2310

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 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