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

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.

A Comparison of Potentially Inappropriate Medications Identification Using Beers and STOPP Criteria in Hospitalized Geriatric Patients in Jakarta

“…23 A previous study in 2 hospitals in Jakarta, Indonesia, found that polypharmacy is an independent risk factor for PIMs incidence. 24 From those previous research, it may be declared there is a correlation between number of medications used and PIMs. [20][21][22][23][24] As seen in Table 1, cardiovascular and endocrine disorders rank second and third in samples, which can be seen as a factor leading to polypharmacy on this research.…”

“…24 From those previous research, it may be declared there is a correlation between number of medications used and PIMs. [20][21][22][23][24] As seen in Table 1, cardiovascular and endocrine disorders rank second and third in samples, which can be seen as a factor leading to polypharmacy on this research. This result is similar to two previous studies, namely studies in Malaysia and Finland, which showed that the occurence of polypharmacy among geriatrics was related to the high prevalence of cardiovascular diseases and diabetes mellitus.…”

Identifikasi Potensi Peresepan Obat Tidak Tepat pada Pasien Geriatri dengan Penyakit Kardiovaskular Berdasarkan Kriteria STOPP START di Salah Satu Rumah Sakit Balikpapan

“…al. [6] yang menyatakan kejadian PIM sebedar 35,48% dan kejadian PPO sebesar 6,45% [6]. Angka kejadian PIM dan PPO dalam penelitian lebih tinggi dibandingkan hasil penelitian Rusdi, et al [14] yang mengungkapkan kejadi PIM sebesar 1,9% dan kejadian PPO sebesar 3,8%.…”

“…Perubahan fisiologis menyebabkan perubahan farmakokinetik dan farmakodinamik obat pada pasien geriatri. Pasien geriatri cendrung memiliki banyak komorbiditas yang menyebabkan pemberian resep polifarmasi [6]. Polifarmasi adalah penggunaan bersamaan 5 atau lebih obat.…”

“…[9]. Studi yang dilakukan di salah satu rumah sakit Yogyakarta pada tahun 2019 mengungkapkan angka kejadian PIM sebesar 35,48% dan PPO sebesar 6,45% [6].…”