Evaluation of Drug-Related Problems in Ischemic Stroke Patients Undergoing Inpatients at the National Brain Center Hospital (RSPON) in 2018

Authors

  • Tati Suprapti Poltekkes Jakarta II
  • Gloria Murtini
  • Masfiah

DOI:

https://doi.org/10.24203/ajas.v8i5.6347

Keywords:

— Ischemic Stroke, PON Hospital, Drug- related Problems

Abstract

Stroke is a cerebrovascular disease that is increasingly found. Stroke carries a high risk of death. Victims can reverse vision and /or talk, paralysis, and confusion.1 In Indonesia, around 550,000 new stroke patients every year. This figure is considered to be very high and ranks third as the cause of death in Indonesia, after cardiovascular and cancer.2 Many factors can cause stroke, diabetes, hypertension, and high cholesterol levels, so treatment is needed for more complicated drug therapy to deal with stroke and its associated diseases.3 The more complex the drug, the more challenging the doctor to receive the right drug therapy. Therefore, in clinical practice, various drug-related problems can increase.4,5 Therefore, identifying DRP is an important priority for health professionals to improve health-related quality of life in stroke patients.6,7

OBJECTIVEEvaluating drug-related problems in ischemic stroke patients undergoing hospitalization at the National Brain Center Hospital (PON) in 2018

METHODNon-experimental research with quantitative descriptive analysis using medical records of inpatient ischemic stroke patients.

RESULTS AND CONCLUSIONS174 male ischemic stroke patients (69.32%); 77 female patients (30.68%); The age of most ischemic stroke patients was in the range of 50 -59 years 85 patients (33.86%); and the least was at the age of <40 years; 7 people (2.79%); Most types of JKN insurance financing were used by 220 people (87.64%) at least 1 patient was guaranteed by the company (0.40%); The longest stay in the hospital was 60 days for a maximum of 1 person (0.40%) and the shortest was 3-10 days for 225 people (89.64%); The most prescribed number of drug items was 70-80 items per person (0,40%) and the least was 5 to 10 drug items received by 60 patients (23,90%); Most comorbidities were hypertension + dyslipidemia 83 patients (33.03%) and the least was hypertension 5 people (1.98%); The most prescribed group of drugs was 468 prescribing (13.81%) drugs which affecting the blood clotting process, and the least prescription antibiotic medications was 122 times (3.63%); Medication errors, were the most given drugs, with a very large dose of 13 times (43.33%) and the least wrong drug; wrong dose; wrong dosage form; and the wrong frequency for each  was 1 case (3.3%); Drug interactions which had the most moderate criteria were 1313 cases.

References

REFERENCES

The Atlas of Heart Disease and Stroke. Available from: https://www.who.int/cardiovascular_diseases/resources/atlas/en/, [Accessed 17th January 2019].

Setiap Tahun Terdapat 550.000 Pasien Baru Stroke di Indonesia. Data tersedia pada situs internet: https://kebijakankesehatanindonesia.net/25-berita/berita/1428-setiap-tahun-terdapat-550000-pasien-baru-stroke-di-indonesia. [Accessed 17th January 2019].

Indonesia Stroke Society Luncurkan Kampanye Melawan Stroke, Data tersedia pada situs internet: www.tribunnews.com › Kesehatan › Health & Concerns. [Accessed 17th January 2019].

Condition That increase Risk for Stroke. Available from: https://www.cdc.gov/stroke/conditions.htm. [Accessed 17th January 2019].

Kanagala VS, Annapareddy 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 Jul-Sep; 5(3): 222–25.

Viktil KK, Blix HS. The impact of clinical pharmacits on drugrelated problems and clinical outcomes. Clin. Pharmacol. Toxicol. 2008 Mar;102(3):275-80.

Ganachari MS, Mahendra Kumar BJ, Shashikala C Wali, Fibin M. Assessment of drug therapy interventions by clinical pharmacist in a tertiary care hospital. ijopp 2010;3(3): 22-8. 6.

Khan FY, Ibrahim AS. Gender differences in risk factors, clinical presentation, and outcome of stroke: A secondary analysis of previous hospital-based study in Qatar. LJMS 2018; Volume 2 Issue 2: 51-5.

Susanto FE, Pinzon RT, Widyo K. Pengaruh infeksi saluran kemih sebagai faktor prognosis stroke iskemik akut di Rumah Sakit Bethesda Yogyakarta. JKK 2017; Volume 4, No 2: 49-55.

Nabyl RA. Deteksi dini gejala dan pengobatan stroke. Yogyakarta : Aulia Publishing; 2012.

Bushnell CD, Johnston DC, Goldstein LB. Restrospective Assessment of Initial Stroke Severity: Comparison of the NIH Stroke Scale and The CNS. Jurnal Stroke 2009; Volume 32: 656.

Devaranavadgi BB, Aski BS, Kashinath RT, Hundekari IA. Effect of Cigarette Smoking on Blood Lipids – A Study in Belgaum, Northern Karnataka, India. Global Journal of Medical Research. 2012; Volume 12 Issue 6:57-61

Nastiti. Gambaran Faktor risiko kejadian stroke pada pasien stroke rawat inap di rumah sakit Krakatau Medika Tahun 2011. Jakarta: Universitas Indonesia; 2012.

Junaidi I. Stroke waspadai ancamannya. Yogyakarta: PT Bhuana Ilmu Populer Kelompok Gramedia; 2011.

Boehme AK, Esenwa C, Elkin MSV. Stroke Risk Factors, Genetics, and Prevention. Circ Res.2017 Feb 3: 120(3) 472-95.

Bantah Isu yang Beredar, BPJS Kesehatan Pastikan Tetap Jamin Biaya 8 Penyakit. High cholesterol — Stroke Foundation – Australia. Available from: https://ekonomi.kompas.com/read/2017/11/27/082633626/bantah-isu-yang-beredar-bpjs-kesehatan-pastikan-tetap-jamin-biaya-8-penyakit?page=all. [Accessed 7th November 2019].

Manabe Y, Kono S, Tanaka T, Narai H, Omori N. High blood pressure in acute ischemic stroke and clinical

outcome. Neurol Int.2009; 1(1): e1.

Amiman RC, Tumboimbela MJ, Kembuan MAHN. Gambaran length of stay pada pasien stroke rawat inap di RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2015-Juni 2016. Jurnal e-Clinic (eCl); Volume 4, Nomor 2: Juli-Desember 2016

Ingeman A, Andersen G, Hundbora HH, Svendsen ML, Johnsen SP. In-hospital medical complications, length of stay, and mortality among stroke unit patients. stroke. 2011; 42:3214-8.

Chen R, Ovbiagele B, Feng Wuwei. Diabetes and stroke: Epidemiology, pathophysiology, pharmaceuticals and outcomes. Am J Med Sci. 2016 Apr; 351(4): 380–86.

High cholesterol — Stroke Foundation – Australia. Available from: https://strokefoundation.org.au › About-Stroke › Prevent-Stroke [Accessed 27th October 2019].

High blood pressure dangers: Hypertension's effects on your body. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868. [Accessed 23th October 2019].

Setiabudy RD. Hemostasis dan thrombosis. Dalam: Farmakologi dan terapi Edisi ke enam. Jakarta: FKUI; 2016

Hackam DG, Spence JD. Antiplatelet therapy in ischemic stroke and transient ischemic attack. an overview of major trials and meta-analyses. Stroke. 2019;50 No.3 :773–78

Jenis cairan infus dan kegunaannya Available from: https://www.alodokter.com/dasar-dasar-prosedur-memanfaatkan-cairan-infus. [Accessed 5th November 2019].

Saposnik G, Ray JG, Sheridan P, McQueen M, Lonn E. Homocysteine-lowering therapy and stroke risk, severity, and disability additional findings. Stroke AHA J. 2009: 40:1365-72.

Homosistein dan resiko penyakit pada pembuluh darah Available from: www.eisai.co.id › third_node › fourth › disease11-id. Accessed 10th December 2019].

Herrmann W, Obeid R. Homocysteine-lowering treatment in reduction of stroke and coronary vascular risk - Do not give up. European Cardiology. 2008; 4 (2): 20-3.

Krag M, Perner A, Wetterdlev J, Wise MP, Borthwick M, Bendel S, et al. Prevalence and outcome of gastrointestinal bleeding and use of acid suppressants in acutely ill adult intensive care patients. Intensive Care Med. 2015;41:833-45

Cook D, Guyatt G. Prophylaxis against upper gastrointestinal bleeding in hospitalized patients. N Eng J Med. 2018;378(26):2506-2516

Buendgens L, Koch A, Tacke F. Prevention of stress-related ulcer bleeding at the intensive care unit: risks and benefit of stress ulcer prophylaxis. World J Crit Care Med. 2016;5(1):57-64

Types of strokes. Available from: https://www.texasheart.org/heart-health/heart-information- center/topics/types- of-strokes/, [Accessed 3th December 2019].

Kabo P. Bagaimana menggunakan obat-obat kardiovaskular secara rasional. Jakarta: Badan Penerbit FKUI 2010: 38-41.

Metra M, Nodari S, Bordonali T, Milani P, Lombardi C, Bugatti S, Fontanella B, et al. Bisoprolol in the treatment of chronic heart failure: from pathophysiology to clinical pharmacology and trial results. Therapeutics and Clinical Risk Management 2007:3(4); 569-78.

Soegondo S. Farmakoterapi pada pengendalian glikemia diabetes melitus tipe 2. Dalam: Setiati S, Alwi I, Sudoyo AW, Simadibrata M, Setiyohadi B, Syam AF. Editor. Ilmu Penyakit Dalam. Jilid II Edisi VI. Jakarta: Internal Publishing; 2014. 2328-35.

Pramita Z, Aditama L. Efektivitas edukasi terapi insulin terhadap pengetahuan dan perbaikan glikemik pasien diabetes melitus. Jurnal Farmasi Klinik Indonesia 2013; 2: 137.

Insulin glulisin, Available from: https://www.drugs.com/mtm/insulin-glulisine.html [Accessed 12th October 2019].

Soelistijo SA, Novida H, Rudijanto A, Soewondo P, Suastika K, Manaf A, Sanusi H, et al. Konsensus pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia 2015. Jakarta: PB Perkeni; 1-87.

Wrotek SE, Wieslaw E. Kozak WE, Hess DC, Fagan SC. Treatment of fever after stroke: conflicting evidence. Pharmacotherapy. 2011; 31(11): 1085–1091.

Keeratikunakorn T, Watcharasaksilp K, Chaiwarith R. Incidence of Fever in Patients Diagnosed with Cerebrovascular Diseases in a Tertiary Care Hospital in Northern Thailand. J Neurol Neurosurg.2016; 3(2) 129:

Georgilis K, Plomaritoglou A, Dafni U, Bassiakos Y, Vemmos K. Aetiology of fever in patients with acute stroke. J Intern Med. J. Intern.1999;246(2):203-9.

Setiani S, GavindaA. Imobilisasi pada usia lanjut. Dalam: Setiani S, Alwi I, Sudoyo AW, Simadibrata M, Setyohadi B, Syam AF. Editor. Ilmu penyakit dalam. Jilid III Edisi VI. Jakarta: InternaPublishing; 2014. 3758-70.

Lizarrondo SM, Gakuba C, Herbiq BA, Repesse Y,Ali C, Denis CV, Lenting PJ, et al. Potent Thrombolytic effect of N-Acetylcysteine on Arterial Thrombi.Circulation. 2017;136:646–60.

Gunawan SG, Setiabudy R, Nafrialdi, Asma bronkial, Dalam: Setiawati A, Gan S, Editor, Farmakologi dan terapi, Edisi 6, Jakarta: Badan Penerbit FKUI; 2016. 63-82.

Harris S, Al Rasyid. Urinary tract infection (UTI) Dalam: Al Rasyid, Misbach Y, Harris S. Stroke, Kompilasi medis dan tatalaksana. Jakarta: Badan Penerbit FKUI; 2015. 77-81.

Amin Z. Stroke dan pneumonia. Dalam: Al Rasyid, Misbach Y, Harris S. Stroke, Kompilasi medis dan tatalaksana. Jakarta: Badan Penerbit FKUI; 2015. 19-33.

Yogiantoro M. Pendekatan klinis hipertensi. Dalam: Setiani S, Alwi I, Sudoyo AW, Simadibrata M, Setyohadi B, Syam AF. Editor. Ilmu penyakit dalam. Jilid III. Edisi VI. Jakarta: InternaPublishing; 2014. 2259-83.

Adam JMF. Dislipidemia. Dalam: Setiani S, Alwi I, Sudoyo AW, Simadibrata M, Setyohadi B, Syam AF. Editor. Ilmu penyakit dalam. Jilid III. Edisi VI. Jakarta: InternaPublishing; 2014. 2549-58.

Soegondo S. Farmakoterapi pada pengendalian glikemia diabetes melitus tipe 2 Dalam: Setiani S, Alwi I, Sudoyo AW, Simadibrata M, Setyohadi B, Syam AF. Editor. Ilmu penyakit dalam. Jilid III. Edisi VI. Jakarta: InternaPublishing; 2315-35.

Soelistijo SA, Novida H, Rudijanto A, Soewondo P, Suastika K, Manaf A, Sanusi H, dkk. Konsensus pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia 2015. Jakarta: Perkeni; 1-82.

Yen-Fu C, Neil KE, Avery AJ, Dewey ME, Johnson C. Prescribing errors and other problems reported by community pharmacists. Therapeutics and Clinical Risk Management 2005:1(4) 333–42

Abhimanyu P, Vijit A. Medication errors and role of clinical pharmacist in identification, assessment and prevention: Need of the time. Asian Journal of Pharmacy and Life Science.2016; 6 (4): 1-13.

Giwati R. Interaksi obat dan beberapa implikasinya. Media Litbang Kesehatan.2008; Vol XVIII (4): 175-84.

Drug.com. Available from: https://www.drugs.com/comments/drug interaction/ [Accessed 22th June 2019].

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Published

2020-10-30

How to Cite

Suprapti, T., Gloria Murtini, & Masfiah. (2020). Evaluation of Drug-Related Problems in Ischemic Stroke Patients Undergoing Inpatients at the National Brain Center Hospital (RSPON) in 2018. Asian Journal of Applied Sciences, 8(5). https://doi.org/10.24203/ajas.v8i5.6347