Skripsi

Evaluasi Penggunaan Potentially Inappropriate Medication (PIM) berdasarkan Kriteria Beers pada Pasien Geriatri Rawat Inap di RSCM Jakarta = Evaluation of Potentially Inappropriate Medication (PIM) based on Beers Criteria in hospitalized geriatric patients in Cipto Mangunkusumo Hospital Jakarta.

Penggunaan Potentially Inappropriate Medication (PIM) dapat mengganggu hasil luaran kesehatan yang diinginkan. Penggunaan PIM pun berperan penting dalam terjadinya morbiditas dan mortalitas sehingga dapat menurunkan kualitas hidup pasien geriatri. Di RSCM Jakarta, belum ada data mengenai proporsi penggunaan PIM pada pasien geriatri rawat inap. Tujuan penelitian ini adalah mengevaluasi penggunaan PIM berdasarkan kriteria Beers 2012 pada pasien geriatri rawat inap di RSCM Jakarta. Penelitian ini menggunakan desain potong lintang (cross-sectional) retrospektif. Data diperoleh dari rekam medis pasien geriatri rawat inap yang terdaftar di Bagian Rekam Medis RSCM Jakarta periode Januari-Juni 2015. Data mengenai riwayat penggunaan obat dan diagnosis tiap pasien diolah dan dianalisis berdasarkan kriteria Beers 2012. Dari 63 pasien yang memenuhi kriteria inklusi, didapatkan 16 (25,4%) pasien geriatri rawat inap telah menerima PIM. Obat-obatan yang termasuk PIM berdasarkan kriteria Beers yang paling banyak diresepkan antara lain digoxin >0,125 mg per hari, haloperidol dan klonidin. Dibandingkan dengan penggunaan PIM di Rumah Sakit Pendidikan Layanan Tersier di India, Daerah Malabar di Kerala, Rumah Sakit Pendidikan India, Minnesota dan Rumah Sakit Tersier Pedalaman Nigeria, penggunaan PIM di RSCM Jakarta lebih rendah, namun, lebih tinggi dibandingkan di Rumah Sakit Italia, Brazil, RSUP Dr. M. Djamil Padang dan Metropolitan Hyderabad India. Perbedaan proporsi penggunaan PIM di RSCM Jakarta dibandingkan dengan RS lain dapat dipengaruhi oleh perbedaan profil pasien dalam hal penyakit komorbid yang multipel, polifarmasi, ketersediaan obat dan pengetahuan dokter mengenai obat-obat yang masuk didalam kriteria Beers.
Kata kunci: kriteria beers 2012, pasien geriatri rawat inap, penggunaan Potentially Inappropriate Medications/PIM



The use of Potentially Inappropriate Medication (PIM) can affect the outcome of treatment. The use of PIM contributes to the morbidity and mortality event and it can reduce the quality of life of geriatric patients. In Cipto Mangunkusumo (CM) Jakarta Hospital, there was no data about the proportion of the use of PIM in hospitalized geriatric patients. The aim of this study is to evaluate the use of PIM based on the Beers criteria 2012 in hospitalized geriatric patients in CM Hospital Jakarta. The design of this study is a retrospective, cross sectional study. Data was obtained from the medical records of geriatric patients hospitalized in the internal medicine ward CM Hospital during the period of January to June 2015. Data about the history of drug use and the diagnosis of patients were processed and analyzed based on the Beers criteria 2012. Of the 63 geriatric patients evaluated, 16 (25.4%) have received PIM. The most frequent prescribed drugs categorized as PIM based on Beers criteria are digoxin > 0,125 mg per day, haloperidol and clonidine. Compared with the PIM use in The Tertiary Care Teaching Hospital in India, Indian Teaching Hospital, Minnesota and Nigerian Rural Tertiary Hospital, the PIM use in CM Hospital is lower. However, it is higher when compared to those in the Italian Hospital, Brazil Hospital, RSUP Dr. M. Djamil Padang and Metropolitan Hyderabad India. The differences in the proportion of use of PIM in CM Jakarta Hospital compared to other hospitals can be influenced by the differences of patients profile in terms of the multiple comorbid diseases, polypharmacy, availability of drugs and knowledge of physicians about drugs listed in the Beers criteria.
Keyword: beers criteria 2012, hospitalized geriatric patient, Potentially Inappropriate Medications/PIM use