Latar Belakang. Polifarmasi, pengobatan berpotensi tidak tepat (PIM),
ketidakpatuhan terhadap pengobatan, dan interaksi obat merupakan permasalahan
terkait obat pada usia lanjut dan berhubungan dengan sindrom geriatri dan
berbagai luaran klinis negatif.
Tujuan. Mengetahui karakteristik pasien dan pengobatan yang didapatkannya,
mengetahui proporsi polifarmasi, PIM, ketidakpatuhan terhadap pengobatan, dan
interaksi obat pada pasien di Poliklinik Geriatri.
Metode. Penelitian deskriptif ini dilakukan secara potong-lintang di Rumah Sakit
Umum Pusat Nasional Dr. Cipto Mangunkusumo. Sampel diambil secara
konsekutif. Melalui wawancara dan telaah rekam medik, data pasien yang
dikumpulkan berupa usia, jenis kelamin, tingkat pendidikan, status sosial dan
ekonomi, komorbiditas, pengkajian geriatri komprehensif, obat-obatan yang
dikonsumsi pasien, PIM berdasarkan kriteria STOPP versi 2 dan Beers 2019,
ketidakpatuhan pengobatan berdasarkan MAQ, dan interaksi obat berdasarkan
Lexi-Interact Online dari Lexicomp®.
Hasil. Dari 101 subjek, didapatkan karakteristik berupa sebagian besar subjek
berusia 70 – 79 tahun (57,43%), berpendidikan tinggi (41,58%), menikah
(62,38%), tinggal dengan keluarga (87,13%), berpenghasilan di bawah UMR
(56,44%), dan berobat dengan Jaminan Kesehatan Nasional (97,03%). Sebagian
besar tidak mengalami malnutrisi (78,22%), memiliki fungsi kognitif normal
(87,13%), tidak menderita depresi (90,1%), status fungsional mandiri (64,36%),
pre-frail (70,3%), dan indeks komorbiditas Charlson sedang (50,5%). Obat
antihipertensi merupakan obat yang paling banyak diresepkan (88,12%), terdapat
11,88% subjek mengkonsumsi obat tradisional. Seluruh subjek (100%) memiliki
multimorbiditas, komorbid terbanyak adalah hipertensi (85,15%). Polifarmasi
terjadi pada 86,14% subjek, PIM berdasarkan kriteria STOPP versi 2 terjadi pada
30,69% subjek, sedangkan berdasarkan kriteria Beers 2019 terjadi pada 36,63%
subjek. Ketidakpatuhan terhadap pengobatan terjadi pada 60,4% subjek, dan
interaksi antar-obat terjadi pada 82,18% subjek.
Kesimpulan. Sebagian besar pasien di Poliklinik Geriatri mengalami polifarmasi,
namun hanya sebagian kecil yang mengandung obat berpotensi tidak tepat.
Sebagian besar pasien tidak patuh terhadap pengobatan dan mengkonsumsi obatobatan
yang mengandung potensi interaksi obat.
Background. Polypharmacy, potentially inappropriate medicine (PIM), nonadherenceto treatment, and drug interactions are drug-related problems that oftenoccur in the elderly and are associated with geriatric syndrome and variousclinical outcomes so that it needs attention in administering drugs for elderlypatients. .Aim. Knowing character of the patients and the treatment they received, lookingat polypharmacy, PIM, non-adherence to treatment, and drug interactions inpatients at the Geriatric Polyclinic.Method. It is a cross-sectional study done in March - April 2020 at Dr. CiptoMangunkusumo. The subject selecting based on consecutive sampling. Subjectsare interviewed with questionnaires and review the patient's medical records toobtain data on age, gender, education level, social and economic status,comorbidities, comprehensive geriatric assessments, drugs consumed by patients,PIM based on STOPP version 2 and Beers 2019 criteria, adherence of treatmentwith MAQ, and drug interactions based on Lexi-Interact Online from Lexicomp®.Result. Of the 101 subjects, most of the subjects were 70-79 years old (57.43%),female (54.46%), highly educated (41.58%), married (62.38%), living with family(87.13%), earning below the UMR (56.44%), and seeking treatment with theNational Health Insurance (97.03%). Most of them are not malnourished(78.22%), have normal cognitive function (87.13%), do not suffer fromdepression (90.1%), independent functional status (64.36%), pre-frail (70.3 %),and have moderate Charlson's comorbidity index (50.5%). Anti-hypertensivedrugs were the most prescribed drug (88.12%), 11.88% of patients consumedtraditional medicine. All subjects (100%) had multimorbidity, the most commoncomorbid was hypertension (85.15%). Polypharmacy occurred in 86.14% ofsubjects, PIM based on the STOPP version 2 criteria occurred in 30.69% ofsubjects, and based on Beers 2019 criteria occurred in 36.63% of subjects. Nonadherenceto treatment did occur in 60.4% of subjects, and drug interactionsoccurred in 82.18% of subjects.Conclusion. Most elderly patients in the Geriatric Polyclinic experiencepolypharmacy, but only a small proportion of them contain PIM. Most of thepatients do not adhere to treatment, and take drugs that involve drug interactions.Keywords. polypharmacy, PIM, medication non-compliance, drug interactions,elderly, outpatient.