Potensi Interaksi Obat pada Pasien Skizofrenia di Salah Satu Rumah Sakit Jiwa di Provinsi Jawa Barat
Abstract
Antipsikotik merupakan terapi utama pada penyakit skizofrenia. Banyak di antara pasien skizofrenia menerima terapi kombinasi antipsikotik. Hal ini dapat menyebabkan kemungkinan timbulnya potensi interaksi obat. Studi ini bertujuan untuk mengevaluasi potensi interaksi obat dan mengidentifikasi faktor-faktor yang berpengaruh terhadap potensi interaksi obat. Studi potong lintang dan retrospektif dilakukan pada pasien skizofrenia periode tahun 2015–2016 di salah satu Rumah Sakit Jiwa di Provinsi Jawa Barat. Penelitian ini dilakukan dengan mengumpulkan data rekam medik pasien pada saat pasien menjalani rawat inap. Sebanyak 92,54% pasien teridentifikasi memiliki potensi interaksi obat dengan kategori significant (78,24%), serious (9,64%) dan minor (12,11%). Potensi interaksi farmakodinamik (85%) lebih mendominasi dibandingkan farmakokinetik (15%). Hasil studi ini juga menyatakan sebanyak 35,16% pasien tidak patuh dalam menjalani terapi dan 67,03% memiliki komorbiditas berupa efek samping gejala ekstrapiramidal akibat antipsikotik. Analisis bivariat menunjukkan bahwa jumlah obat yang diresepkan, kepatuhan terapi dan komorbid (gejala ekstrapiramidal) berkaitan dengan potensi interaksi (p<0,05). Hasil ini diperkuat oleh hasil analisis regresi logistik biner yang menunjukkan bahwa jumlah obat yang diresepkan (OR=14,139; (5,887–33,957); p=0,000) dan kepatuhan (OR=2,424; (1,277–4,601); p=0,007) berhubungan signifikan terhadap potensi interaksi obat. Potensi kejadian interaksi obat pada pasien skizofrenia adalah sebesar 92,54% yang berkaitan dengan jumlah obat yang diberikan kepada pasien, dalam bentuk kombinasi terapi dan ketidakpatuhan pasien.
Kata kunci: Faktor potensi interaksi obat, interaksi obat potensial, skizofrenia
Potential Drug Interactions on Schizophrenic Patients at a Mental Hospitals in West Java, Indonesia
Abstract
Antipsychotic is a primary therapy in schizophrenia. Many shizophrenic patients receive combination antipsychotic therapy which might lead to potential drug interactions. The aim of this study was to evaluate and identify factors associated with potential drug interactions. A cross-sectional and retrospective study was conducted on schizophrenic patients in the period of 2015–2016 at one of mental hospitals in the Province of West Java, Indonesia. This study used patients’ medical record data when the patients were hospitalized. A total of 92,54% patients were identified as having potential drug interactions which categorized as significant (78.24%), serious (9.64%) and minor (12.11%). Potential pharmacodynamic interaction (85%) was more dominating than pharmacokinetic (15%). It was also found that 35.16% of patients had poor therapeutic adherence and 67.03% had comorbidities in the form of extrapyramidal symptoms due to antipsychotics. Bivariate analysis showed that the adherence medication, comorbid (syndrome extrapyramidal), and the number of prescribed were related to the number of potential drugs interaction (p-value<0.05). This result was strengthened by the result of logistic binary regression analysis which showed that the number of prescribed drugs (OR=14.139; (5.887–33.957); p=0.000) and therapy adherence (OR=2.424; (1.277–4.601); p=0.007) were significantly associated with potential drug interactions. The potential drug interaction in schizophrenic patient was 92.54% which related to a number of drugs taken by the patients in the form of combination therapy and patients’ inadherence.
Keywords: Potential drug interaction, potential factors of drug interaction, schizophrenia
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DOI: https://doi.org/10.15416/ijcp.2018.7.4.280
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