Hubungan Antara Kejadian Drug Related Problems (DRPs) Dengan Outcome Klinis Pada Pasien Stroke Iskemik

https://doi.org/10.22146/farmaseutik.v19i1.74413

Firdha Aprilia Wardhani(1), Zulies Ikawati(2*), Nanang Munif Yasin(3)

(1) Gadjah Mada University
(2) Gadjah Mada University
(3) Gadjah Mada University
(*) Corresponding Author

Abstract


Stroke iskemik merupakan salah satu penyebab kematian dan disabilitas utama di Indonesia dan di dunia yang prevalensinya terus mengalami peningkatan. Salah satu faktor peningkatan disabilitas pada pasien stroke iskemik adalah adanya poor stroke management, dan kejadian DRPs ikut berperan didalamnya. Penelitian ini dilakukan untuk mengetahui apakah terdapat hubungan signifikan antara kejadian DRPs pada pasien stroke iskemik, dengan outcome klinis pasien, yang digambarkan dengan status NIHSS pasien. Diketahui NIHSS merupakan parameter outcome dengan akurasi dan sensitivitas yang paling baik dibandingkan dengan parameter outcome lainnya. Penelitian dilakukan dengan desain cross-sectional secara retrospektif, melibatkan 111 sampel yang bersumber dari rekam medis pasien yang memenuhi kriteria inklusi pada periode April-Oktober 2021. DRPs yang dianalisis dalam studi ini adalah pemberian terapi tidak tepat, perlunya penambahan obat, dosis obat terlalu rendah, dan terjadi efek samping akibat obat. Pada studi ini DRPs terjadi pada 88,2% pasien, dengan jenis yang paling banyak ditemukan adalah perlunya penambahan obat pada pasien. Studi ini menemukan bahwa adanya DRPs pada pasien stroke iskemik, berpotensi secara signifikan dalam meningkatkan resiko pasien mengalami outcome klinis tidak membaik yang digambarkan dengan status NIHSS (OR 3,714; p-value<0,05).


Keywords


DRPs; stroke iskemik; outcome klinis; NIHSS

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References

1. Khaku AS, Tadi P. Cerebrovascular Disease. In: StatPearls. StatPearls Publishing; 2021. Accessed July 20, 2021. http://www.ncbi.nlm.nih.gov/books/NBK430927/

2. Vos T, Lim SS, Abbafati C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1204-1222.

3. Viswam S, Nair G, Thomas B, Shivashankar V. A Prospective Observational Study on Polypharmacy in Geriatrics at A Private Corporate Hospital. Journal of Applied Pharmaceutical Science. 2017;7:162-167.

4. Nahrowi NS, Ong PA, Adam A. Cognitive and Functional Outcome of Patients with Ischemic Stroke at Dr. Hasan Sadikin Hospital Bandung. Althea Medical Journal. 2018;5(2):82-86.

5. Donkor ES. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat. 2018;2018.

6. Zhang L, Li X, Wolfe CDA, O’Connell MDL, Wang Y. Diabetes As an Independent Risk Factor for Stroke Recurrence in Ischemic Stroke Patients: An Updated Meta-Analysis. Neuroepidemiology. 2021;55(6):427-435.

7. Yang Y, Shi YZ, Zhang N, et al. The Disability Rate of 5-Year Post-Stroke and Its Correlation Factors: A National Survey in China. PLOS ONE. 2016;11(11):e0165341.

8. Hsu WT, Shen LJ, Lee CM. Drug-related problems vary with medication category and treatment duration in Taiwanese heart failure outpatients receiving case management. Journal of the Formosan Medical Association. 2016;115(5):335-342.

9. Taheri PA, Butz DA, Greenfield LJ. Length of stay has minimal impact on the cost of hospital admission. J Am Coll Surg. 2000;191(2):123-130.

10. Tasaka Y, Tanaka A, Yasunaga D, Asakawa T, Araki H, Tanaka M. Potential drug-related problems detected by routine pharmaceutical interventions: safety and economic contributions made by hospital pharmacists in Japan. J Pharm Health Care Sci. 2018;4:33.

11. Niquille A, Bugnon O. Relationship between drug-related problems and health outcomes: a cross-sectional study among cardiovascular patients. Pharm World Sci. 2010;32(4):512-519.

12. DiPiro JT, Yee GC, Posey M, Haines ST, Nolin TD, Ellingrod V, eds. Stroke. In: Pharmacotherapy: A Pathophysiologic Approach, 11e. 11th ed. McGraw-Hill Education; 2020:38. Accessed March 10, 2021. https://accesspharmacy.mhmedical.com/book.aspx?bookID=2577

13. Kose E, Maruyama R, Okazoe S, Hayashi H. Impact of Polypharmacy on the Rehabilitation Outcome of Japanese Stroke Patients in the Convalescent Rehabilitation Ward. Journal of Aging Research. 2016;2016:1-8.

14. Kanagala VS, Anusha A, Rao BS, Challa SR, Nalla KS, Gadde RS. A study of medication-related problems in stroke patients: A need for pharmaceutical care. J Res Pharm Pract. 2016;5(3):222-225.

15. Hohmann C, Neumann-Haefelin T, Klotz JM, Freidank A, Radziwill R. Drug-related problems in patients with ischemic stroke in hospital. Int J Clin Pharm. 2012;34(6):828-831.

16. Nurhaini R, Jatiningrum A, Akrom. GAMBARAN DRUG RELATED PROBLEMS (DRPs) PADA PASIEN STROKE RAWAT INAP RUMAH SAKIT X DI YOGYAKARTA. Universitas Ahmad Dahlan Press. Published online 2017:9.

17. Kasner SE. Clinical interpretation and use of stroke scales. The Lancet Neurology. 2006;5(7):603-612.

18. Chalos V, van der Ende NAM, Lingsma HF, et al. National Institutes of Health Stroke Scale. Stroke. 2020;51(1):282-290. doi:10.1161/STROKEAHA.119.026791

19. Young FB, Weir CJ, Lees KR. Comparison of the National Institutes of Health Stroke Scale With Disability Outcome Measures in Acute Stroke Trials. Stroke. 2005;36(10):2187-2192.

20. Siegler JE, Boehme AK, Kumar AD, Gillette MA, Albright KC, Martin-Schild S. What Change in the National Institutes of Health Stroke Scale Should Define Neurologic Deterioration in Acute Ischemic Stroke? J Stroke Cerebrovasc Dis. 2013;22(5):675-682.

21. Siegler JE. The Utility of Quantifiable Neurologic Assessments After Stroke. Neurohospitalist. 2016;6(3):95-96.

22. Lemeshow S, World Health Organization, eds. Adequacy of Sample Size in Health Studies. Published on behalf of the World Health Organization by Wiley ; Distributed in the U.S.A., Canada, and Japan by Liss; 1990.

23. PERDOSSI. Guideline Stroke. Perhimpunan Dokter Spesialis Saraf Indonesia; 2011.

24. Kemenkes. PEDOMAN NASIONAL PELAYANAN KEDOKTERAN TATA LAKSANA STROKE. Vol 342.; 2019:1-82.

25. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019;50(12).

26. Berge E, Whiteley W, Audebert H, et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. European Stroke Journal. 2021;6(1):I-LXII.

27. Fonseca AC, Merwick Á, Dennis M, et al. European Stroke Organisation (ESO) guidelines on management of transient ischaemic attack. European Stroke Journal. Published online March 16, 2021:239698732199290.

28. Dawson J, Merwick Á, Webb A, et al. European Stroke Organisation expedited recommendation for the use of short-term dual antiplatelet therapy early after minor stroke and high-risk TIA. European Stroke Journal. Published online March 11, 2021:239698732110008.

29. Sandset EC, Anderson CS, Bath PM, et al. European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage. European Stroke Journal. Published online May 11, 2021:239698732110121.

30. Lexicomp. Lexicomp’s DrugID and Drug Interaction Checker. Wolters Kluwer; 2022.

31. Ekker MS, de Leeuw FE. Higher Incidence of Ischemic Stroke in Young Women Than in Young Men. Stroke. 2020;51(11):3195-3196.

32. Sudha S, A B, M KH, et al. The lifetime risk of stroke: estimates from the Framingham Study. Stroke. 2006;37(2).

33. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation. 2022;145(8):e153-e639.

34. Setyopranoto I, Bayuangga HF, Panggabean AS, et al. Prevalence of Stroke and Associated Risk Factors in Sleman District of Yogyakarta Special Region, Indonesia. Stroke Res Treat. 2019;2019:2642458.

35. Zheng S, Yao B. Impact of risk factors for recurrence after the first ischemic stroke in adults: A systematic review and meta-analysis. J Clin Neurosci. 2019;60:24-30.

36. Yimama M, Jarso H, Desse TA. Determinants of drug-related problems among ambulatory type 2 diabetes patients with hypertension comorbidity in Southwest Ethiopia: a prospective cross sectional study. BMC Res Notes. 2018;11.

37. Wajngarten M, Silva GS. Hypertension and Stroke: Update on Treatment. Eur Cardiol. 2019;14(2):111-115.

38. Ishitsuka K, Kamouchi M, Hata J, et al. High Blood Pressure After Acute Ischemic Stroke Is Associated With Poor Clinical Outcomes. Hypertension. 2014;63(1):54-60.

39. Al-Weshahy A, El-Sherif R, Selim KAAW, Heikal A. Short term outcome of patients with hyperglycemia and acute stroke. The Egyptian Journal of Critical Care Medicine. 2017;5(3):93-98.

40. Nascimento Y, Carvalho W, Acurcio F. Drug-related problems observed in a pharmaceutical care service, Belo Horizonte, Brazil. Brazilian Journal of Pharmaceutical Sciences - BRAZ J PHARM SCI. 2009;45.



DOI: https://doi.org/10.22146/farmaseutik.v19i1.74413

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