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"Tesis ini bertujuan untuk mengetahui nilai titik potong tes SPPB sebagai tes performa fisik dalam mendiagnosa sarkopenia pada pasien lanjut usia di rawat jalan. Selain itu juga untuk mengetahui nilai sensitivitas dan spesifisitas tes SPPB berdasarkan kecepatan jalan 6 meter untuk estimasi performa fisik sebagai komponen sarkopenia. Penelitian ini merupakan studi potong lintang pada pasien lanjut usia rawat jalan di RSUPN Ciptomangunkusumo. Pada penelitian ini didapatkan 100 subjek yang diminta melakukan uji SPPB, uji kecepatan jalan 6 meter, uji penilaian massa otot dengan BIA (Bio Impedance Analysis), dan penilaian kekuatan otot dengan menggunakan handgrip dynamometer. Dari hasil penilaian didapatkan nilai titik potong 7 untuk populasi total dan populasi perempuan. Sedangkan untuk populasi laki laki didapatakan nilai 8. Setelah didapatkan titik potong baru, dilakukan uji diagnostik antara nilai SPPB titik potong baru dengan status performa fisik menurun berdasarkan kecepatan jalan 6 meter. Dari penilaian didapatkan sensitivitas 81.5% dan spesifisitas 73.7% untuk populasi total. Pada populasi perempuan didapatkan sensitivitas 81.4% dan spesifisitas 66.7%. Sedangkan untuk populasi laki laki menggunakan titik potong 8 didapatkan sensitivitas 81.8% dan spesifisitas 71.4%. Kesimpulan penelitian ini adalah SPPB dengan nilai titik potong 7 untuk populasi perempuan dan 8 untuk populasi laki laki baik dipakai sebagai alat uji untuk screening dan diagnostik performa fisik sebagai komponen sarkopenia rawat jalan.

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This thesis aims to determine the cut-off point of the SPPB test as a physical performance test in diagnosing sarcopenia in elderly patients on an outpatient basis. In addition, to determine the sensitivity and specificity of the SPPB test based on a walking speed of 6 meters to estimate physical performance as a component of sarcopenia. This study is a cross-sectional study of elderly outpatients at Ciptomangunkusumo General Hospital. In this study, 100 subjects were asked to perform the SPPB test, 6 meter walking speed test, muscle mass assessment test using BIA (Bio Impedance Analysis), and muscle strength assessment using a handgrip dynamometer. From the results of the assessment, it was found that the cut-off point was 7 for the total population and the female population. As for the male population, a score of cut oof point is 8. After obtaining a new cut-off point, a diagnostic test was conducted between the SPPB value of the new cut-off point and the decreased physical performance status based on a 6-metre walking speed. From the assessment, sensitivity was 81.5% and specificity was 73.7% for the total population. In the female population, sensitivity was 81.4% and specificity was 66.7%. Meanwhile, for the male population using the 8 cut-off point, the sensitivity was 81.8% and the specificity was 71.4%.The conclusion of this study is that the SPPB with a cutoff value of 7 for the female population and 8 for the male population can be used as a test tool for screening and diagnostic of physical performance as a component of outpatient sarcopenia."

"Latar Belakang. Polifarmasi, pengobatan berpotensi tidak tepat (PIM),ketidakpatuhan terhadap pengobatan, dan interaksi obat merupakan permasalahanterkait obat pada usia lanjut dan berhubungan dengan sindrom geriatri danberbagai luaran klinis negatif.Tujuan. Mengetahui karakteristik pasien dan pengobatan yang didapatkannya,mengetahui proporsi polifarmasi, PIM, ketidakpatuhan terhadap pengobatan, daninteraksi obat pada pasien di Poliklinik Geriatri.Metode. Penelitian deskriptif ini dilakukan secara potong-lintang di Rumah SakitUmum Pusat Nasional Dr. Cipto Mangunkusumo. Sampel diambil secarakonsekutif. Melalui wawancara dan telaah rekam medik, data pasien yangdikumpulkan berupa usia, jenis kelamin, tingkat pendidikan, status sosial danekonomi, komorbiditas, pengkajian geriatri komprehensif, obat-obatan yangdikonsumsi pasien, PIM berdasarkan kriteria STOPP versi 2 dan Beers 2019,ketidakpatuhan pengobatan berdasarkan MAQ, dan interaksi obat berdasarkanLexi-Interact Online dari Lexicomp®.Hasil. Dari 101 subjek, didapatkan karakteristik berupa sebagian besar subjekberusia 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%). Sebagianbesar 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%). Obatantihipertensi merupakan obat yang paling banyak diresepkan (88,12%), terdapat11,88% subjek mengkonsumsi obat tradisional. Seluruh subjek (100%) memilikimultimorbiditas, komorbid terbanyak adalah hipertensi (85,15%). Polifarmasiterjadi pada 86,14% subjek, PIM berdasarkan kriteria STOPP versi 2 terjadi pada30,69% subjek, sedangkan berdasarkan kriteria Beers 2019 terjadi pada 36,63%subjek. Ketidakpatuhan terhadap pengobatan terjadi pada 60,4% subjek, daninteraksi 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 obatobatanyang mengandung potensi interaksi obat.

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Background. Polypharmacy, potentially inappropriate medicine (PIM), nonadherence

to treatment, and drug interactions are drug-related problems that often

occur in the elderly and are associated with geriatric syndrome and various

clinical outcomes so that it needs attention in administering drugs for elderly

patients. .

Aim. Knowing character of the patients and the treatment they received, looking

at polypharmacy, PIM, non-adherence to treatment, and drug interactions in

patients at the Geriatric Polyclinic.

Method. It is a cross-sectional study done in March - April 2020 at Dr. Cipto

Mangunkusumo. The subject selecting based on consecutive sampling. Subjects

are interviewed with questionnaires and review the patient's medical records to

obtain 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 treatment

with 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 the

National Health Insurance (97.03%). Most of them are not malnourished

(78.22%), have normal cognitive function (87.13%), do not suffer from

depression (90.1%), independent functional status (64.36%), pre-frail (70.3 %),

and have moderate Charlson's comorbidity index (50.5%). Anti-hypertensive

drugs were the most prescribed drug (88.12%), 11.88% of patients consumed

traditional medicine. All subjects (100%) had multimorbidity, the most common

comorbid was hypertension (85.15%). Polypharmacy occurred in 86.14% of

subjects, PIM based on the STOPP version 2 criteria occurred in 30.69% of

subjects, and based on Beers 2019 criteria occurred in 36.63% of subjects. Nonadherence

to treatment did occur in 60.4% of subjects, and drug interactions

occurred in 82.18% of subjects.

Conclusion. Most elderly patients in the Geriatric Polyclinic experience

polypharmacy, but only a small proportion of them contain PIM. Most of the

patients do not adhere to treatment, and take drugs that involve drug interactions.

Keywords. polypharmacy, PIM, medication non-compliance, drug interactions,

elderly, outpatient."