Efektivitas Pengobatan pada Pasien Penyakit Paru Obstruksi Kronis (PPOK) di Rumah Sakit Wilayah Yogyakarta

https://doi.org/10.22146/jmpf.56418

Chynthia Pradiftha Sari(1*), Suci Hanifah(2), Rosdiana Rosdiana(3), Yuni Anisa(4)

(1) Department of Pharmacy, Universitas Islam Indonesia
(2) Department of Pharmacy, Universitas Islam Indonesia
(3) Department of Pharmacy, Universitas Islam Indonesia
(4) Department of Pharmacy, Universitas Islam Indonesia
(*) Corresponding Author

Abstract


Chronic Obstructive Pulmonary Disease (COPD) is a complex respiratory disorder that requires multiple approaches to assess treatment response, no specific therapy can stop the progression of disease cure. This study aimed to measure the response of COPD treatment in outpatients at Hospitals in Yogyakarta. The study was designed descriptive observational cross-sectional involved  COPD outpatients in July 2018 - June 2019 (N = 156). Inclusion criteria the subjects: age> 40 years, without other respiratory diseases (asthma, lung cancer), took theophylline for at least the last one month, complete the CAT questionnaire, and sign an informed consent. Data collected were characteristics of respondents, treatment profile (exacerbation, maintenance), and response therapy data. Evaluation of treatment response was measured using the COPD Assessment Test (CAT) questionnaire and classified the response into effective, quite effective, and not effective. These data were then presented in form of percentage distribution. The results showed that an exacerbation study with single bronchodilator 39.10%, and a combination of bronchodilator with other bronchodilators 60.90%, most LABA-ICS / LAMA rescue therapies (48.72%). Results of evaluation the use of LABA-ICS / LAMA / Methylxanthine (18.59%), LABA-ICS / LAMA / Methylxanthine/ Mucolytic (11.54%), LABA-ICS / LAMA / SABA / Methylxanthine / Mucolytic (9.62%) )) gave a fairly effective treatment response (CAT score ≥10-19) 50.64%, effective (CAT score <10) 47.43%, ineffective (CAT score ≥20) 1.93%.


Keywords


Teofilin; Penyakit Paru Obstruksi Kronik (PPOK); COPD Assessment Test (CAT); Efektivitas

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References

  1. GOLD. Global Initiative for Obstructive Lung Disease. http://www.goldcopd.com. Published 2019.
  2. Mannino D, Buist A. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007;370(9589):765-773.
  3. Kemenkes (Kementrian Kesehatan Republik Indonesia). Riset Kesehatan Dasar.; 2013.
  4. Antus B. Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review. ISRN Pulmonol. 2013;2013:1-11. doi:10.1155/2013/582807
  5. Cazzola M, Calzetta L, Barnes PJ, et al. Efficacy and safety profile of xanthines in COPD: A network meta-analysis. Eur Respir Rev. 2018;27(148):1-12. doi:10.1183/16000617.0010-2018
  6. Houben-Wilke S, Janssen DJA, Franssen FME, Vanfleteren LEGW, Wouters EFM, Spruit MA. Contribution of individual COPD assessment test (CAT) items to CAT total score and effects of pulmonary rehabilitation on CAT scores. Health Qual Life Outcomes. 2018;16(1):1-8. doi:10.1186/s12955-018-1034-4
  7. Tu YH, Zhang Y, Fei GH. Utility of the CAT in the therapy assessment of COPD exacerbations in China. BMC Pulm Med. 2014;14(1):1-8. doi:10.1186/1471-2466-14-42
  8. Sugiharta S, Syamsudin A, Rianti A. Evaluation of Treatment Bronchodilators and Corticosteroids in COPD Patients in RSUP Fatmawati Inpatient Jakarta Period. Soc Clin Pharm Indones J. 2016;1(1):76-88.
  9. Sholihah M, Suradi, Aphridasari J. Pengaruh Pemberian Quercetin Terhadap Kadar Interleukin 8 (IL- 8) Dan Nilai COPD Assessment Test (CAT) Pasien Penyakit Paru Obstruktif Kronik (PPOK) Stabil. J RESPIROLOGI Indones. 2019;39(2).
  10. Allopurinol P, Kadar T, Sulfhydryl G, Minute S, Test W. Kadar Kotinin Urin dan CO Ekspirasi pada Perempuan Dewasa yang 1. Allopurinol P, Kadar T, Sulfhydryl G, Minute S, Test W. Kadar Kotinin Urin dan CO Ekspirasi pada Perempuan Dewasa yang Terpajan Asap Rokok di Lingkungan Rumah Hubungan Lesi Tuberkulosis Par. 2019;39(3).
  11. Jones PW, Brusselle G, Dal Negro RW, et al. Properties of the COPD assessment test in a cross-sectional European study. Eur Respir J. 2011;38(1):29-35. doi:10.1183/09031936.00177210
  12. Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34(3):648-654. doi:10.1183/09031936.00102509
  13. Kwon N, Amin M, Hui DS, et al. Validity of the COPD assessment test translated into local languages for asian patients. Chest. 2013;143(3):703-710. doi:10.1378/chest.12-0535
  14. Mokoagow MI, Uyainah A, Subardi S, Rumende CM, Amin Z. Peran Skor COPD Aseessment Test (CAT) sebagai Prediktor Kejadian Eksaserbasi Akut Penyakit Paru Obstruktif Kronik pada Jemaah Haji Provinsi DKI Jakarta Tahun 2012. 2014;1(2).
  15. Decker R, Hadfield R, Hess M. Global Strategy for Prevention, Diagnosis and Management of COPD. In: Disclosure Forms for GOLD Committees Are Posted on the GOLD Website, Www.Goldcopd.Org. ; 2019.
  16. Leem AY, Park B, Kim YS, Jung JY, Won S. Incidence and risk of chronic obstructive pulmonary disease in a Korean community-based cohort. Int J COPD. 2018;13:509-517. doi:10.2147/COPD.S148618
  17. Aryal S, Diaz-Guzman E, Mannino DM. Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes. Int J COPD. 2014;9:1145-1154. doi:10.2147/COPD.S54476
  18. Henoch I, Strang S, Löfdahl CG, Ekberg-Jansson A. Management of COPD, equal treatment across age, gender, and social situation? A register study. Int J Chron Obstruct Pulmon Dis. 2016;11:2681-2690. doi:10.2147/copd.s115238
  19. Blánquez Moreno C, Colungo Francia C, Alvira Balada MC, Kostov B, González-de Paz L, Sisó-Almirall A. Effectiveness of an educational program for respiratory rehabilitation of Chronic Obstructive Pulmonary Disease patients in Primary Care in improving the quality of life, symptoms, and clinical risk. Aten Primaria. 2018;50(9):539-546. doi:10.1016/j.aprim.2017.03.019
  20. Yazar E, Sahin F, Aynaci E, Yildiz P, Ozgul A, Yilmaz V. s there any relationship between the duration to diagnosis of COPD and severity of the disease? Eur Respir J. 2012:739.
  21. Badaran E, Ortega E, Bujalance C, Puerto L Del, Torres M, Riesco JA. Smoking and COPD exacerbations. Eur Respir J. 2012:1055.
  22. Barnes PJ. Chronic obstructive pulmonary disease: Effects beyond the lungs. PLoS Med. 2010;7(3):1-4. doi:10.1371/journal.pmed.1000220
  23. Irianti EC, A. A. A, Tahir Abdullah M. Quality of life in patients with chronic obstructive pulmonary disease at Pulmonary Community Health Centre Makassar. Int J Community Med Public Heal. 2018;5(9):3753. doi:10.18203/2394-6040.ijcmph20183456
  24. Barnes PJ. Theophylline. Am J Respir Crit Care Med. 2013;188(8):1-19. https://www.atsjournals.org/doi/full/10.1164/rccm.201302-0388PP?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&.
  25. Currie GP, Lipworth BJ. Inhaled treatment for chronic obstructive pulmonary disease: What’s new and how does it fit? Qjm. 2016;109(8):505-512. doi:10.1093/qjmed/hcv212
  26. Cazzola M, Rogliani P, Calzetta L, Hanania NA, Matera MG. Impact of Mucolytic Agents on COPD Exacerbations: A Pair-wise and Network Meta-analysis. COPD J Chronic Obstr Pulm Dis. 2017;14(5):552-563. doi:10.1080/15412555.2017.1347918
  27. Poole P, Sathananthan K, Fortescue R. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease (Review). Cochrane Database Syst Rev. 2020:1-3. doi:10.1017/CBO9780511543555.027
  28. Woods JA, Wheeler JS, Finch CK, Pinner NA. Corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease. Int J COPD. 2014;9:421-430. doi:10.2147/COPD.S51012
  29. Llor C, Moragas A, Hernández S, Bayona C, Miravitlles M. Efficacy of antibiotic therapy for acute exacerbations of mild to moderate chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186(8):716-723. doi:10.1164/rccm.201206-0996OC
  30. Cazzola M, Matera MG. Triple combinations in chronic obstructive pulmonary disease - Is three better than two? Expert Opin Pharmacother. 2014;15(17):2475-2478. doi:10.1517/14656566.2014.972367
  31. Tricco AC, Strifler L, Veroniki AA, et al. Comparative safety and effectiveness of long-acting inhaled agents for treating chronic obstructive pulmonary disease: A systematic review and network meta-analysis. BMJ Open. 2015;5(10). doi:10.1136/bmjopen-2015-009183
  32. David A Lipson, Barnhart F, Boucot I, et al. Comparison of LAMA/LABA vs ICS/LABA in high risk COPD patients: Pre-specified analysis on lung function and health status from the IMPACT trial. Eur Respir J. 2018;52(DOI: 10.1183/13993003.congress-2018.PA4385).
  33. Kopsaftis ZA, Sulaiman NS, Mountain OD, Carson-Chahhoud K V., Phillips PA, Smith BJ. Short-acting bronchodilators for the management of acute exacerbations of chronic obstructive pulmonary disease in the hospital setting: Systematic review. Syst Rev. 2018;7(1). doi:10.1186/s13643-018-0860-0
  34. Kiri VA, Bettoncelli G, Testi R, Viegi G. Inhaled corticosteroids are more effective in COPD patients when used with LABA than with SABA. Respir Med. 2005;99(9):1115-1124. doi:10.1016/j.rmed.2005.02.018
  35. Kozma CM, Paris AL, Plauschinat CA, Slaton T, Mackowiak JI. Comparison of resource use by COPD patients on inhaled therapies with long-acting bronchodilators: A database study. BMC Pulm Med. 2011;11(1):61. doi:10.1186/1471-2466-11-61
  36. Barrecheguren M, Monteagudo M, Miravitlles M. Population-based study of LAMA monotherapy effectiveness compared with LABA/LAMA as initial treatment for COPD in primary care. npj Prim Care Respir Med. 2018;28(1). doi:10.1038/s41533-018-0102-x
  37. Vanfleteren L, Fabbri LM, Papi A, Petruzzelli S, Celli B. Triple therapy (ICS/LABA/LAMA) in COPD: Time for a reappraisal. Int J COPD. 2018;13:3971-3981. doi:10.2147/COPD.S185975
  38. Lee JK, Rhee CK, Kim K, et al. Prescription status and clinical outcomes of methylxanthines and leukotriene receptor antagonists in mild-to-moderate chronic obstructive pulmonary disease. Int J COPD. 2019;14:2639-2647. doi:10.2147/COPD.S216326
  39. Devereux G, Cotton S, Fielding S, et al. Low-dose oral theophylline combined with inhaled corticosteroids for people with chronic obstructive pulmonary disease and high risk of exacerbations: a RCT. Health Technol Assess (Rockv). 2019;23(37). https://www.journalslibrary.nihr.ac.uk/hta/hta23370#/abstract.
  40. McIvor R a, Tunks M, Todd DC. Respiratory disorders (COPD). BMJ Clin Evid. 2011;(April 2010):1502.
  41. Ejiofor S, Turner AM. Pharmacotherapies for COPD. Clin Med Insights Circ Respir Pulm Med. 2013;7(1):17-34. doi:10.4137/CCRPM.S7211
  42. Appleton S, Jones T, Poole P, et al. Ipratropium bromide vs. LABA for COPD. 2008;(3). doi:10.1002/14651858.CD006101.www.cochranelibrary.com
  43. Decramer M, Rutten-van Mölken M, Dekhuijzen PNR, et al. Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial. Lancet (London, England). 2005;365(9470):1552-1560. doi:10.1016/S0140-6736(05)66456-2
  44. Horita N, Miyazawa N, Kojima R, Inoue M, Ishigatsubo Y, Kaneko T. Chronic Use of Theophylline and Mortality in Chronic Obstructive Pulmonary Disease: A Meta-analysis. Arch Bronconeumol. 2016;52(5):233-238. doi:10.1016/j.arbr.2015.06.014
  45. Okutan O, Tas D, Demirer E, Kartaloglu Z. Evaluation of quality of life with the chronic obstructive pulmonary disease assessment test in chronic obstructive pulmonary disease and the effect of dyspnea on disease-specific quality of life in these patients. Yonsei Med J. 2013;54(5):1214-1219. doi:10.3349/ymj.2013.54.5.1214
  46. Chetta A, Olivieri D. The COPD Assessment Test in the evaluation of chronic obstructive pulmonary disease exacerbations. Expert Rev Respir Med. 2012;6(4):373-375. doi:10.1586/ers.12.37
  47. Zhou A, Zhou Z, Peng Y, Zhao Y, Duan J, Chen P. The role of CAT in evaluating the response to treatment of patients with AECOPD. Int J COPD. 2018;13:2849-2858. doi:10.2147/COPD.S175085



DOI: https://doi.org/10.22146/jmpf.56418

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