Penilaian Risiko Interaksi Obat pada Pasien dengan Diabetes Melitus Tipe 2

Indriastuti Cahyaningsih, Winda A. Wicaksono

Abstract


Diabetes melitus tipe 2 merupakan sebuah penyakit yang memiliki risiko menimbulkan komplikasi baik makrovaskular maupun mikrovaskular. Komplikasi yang terjadi menimbulkan jumlah obat yang diresepkan menjadi semakin banyak. Bertambahnya jumlah obat yang diresepkan dapat meningkatkan risiko interaksi obat. Tujuan penelitian ini adalah untuk mengetahui gambaran dan seberapa besar risiko kejadian interaksi obat yang terjadi pada pasien rawat jalan dengan diabetes melitus (DM) tipe 2. Penelitian ini bersifat noneksperimental, melalui pengamatan secara retrospektif dengan pendekatan cross-sectional. Subjek penelitian adalah pasien DM tipe 2 rawat jalan di RSUD Panembahan Senopati Bantul pada tahun 2015 dan telah memenuhi kriteria inklusi dengan total 260 lembar resep. Kejadian interaksi obat diidentifikasi berdasarkan literatur Drug Interaction Facts oleh Tatro dan Stockley’s Drug Interaction oleh Stockley. Pengujian hipotesis dilakukan dengan menggunakan uji Chi-Square dan perhitungan risiko kejadian interaksi obat ditampilkan dengan nilai odds ratio. Hasil penelitian menunjukkan bahwa dari 260 lembar resep yang dianalisis terdapat potensi kejadian interaksi obat yang teridentifikasi sebanyak 121 dengan persentase terbesar adalah interaksi antara insulin dan aspirin (14,29%). Pengujian hipotesis dengan menggunakan uji Chi-Square menunjukkan adanya hubungan yang bermakna (p=0,000) antara jumlah peresepan obat dengan potensi kejadian interaksi obat dengan nilai p<0,05. Hasil odds ratio menunjukkan bahwa pasien yang menerima obat ≥5 berisiko 3,657 kali lebih tinggi berpotensi terjadi interaksi obat (95% CI 2,173–6,157).

Kata kunci: Diabetes melitus tipe 2, interaksi obat, odds ratio


Risk Assessment of Drug Interaction in Patients with Type 2 Diabetes Mellitus

Abstract
Type 2 diabetes mellitus (DM) is a disease that has the risk of causing both macrovascular and microvascular complications, which results in numerous number of drugs prescribed. Increased number of drugs prescribed can elevate the risk of drug interactions. The purpose of this study was to determine the description and potency of the incidence of drug interactions that occurred in outpatients with type 2 diabetes mellitus. This research was non-experimental that observed retrospectively with a cross-sectional approach. Subjects were outpatient type 2 DM patients at Panembahan Senopati Hospital Bantul in 2015 who had fulfilled the inclusion criteria, with a total of 260 prescription sheets. Drug interaction events were identified based on the Drug Interaction Facts literature by Tatro and Stockley’s Drug Interaction. Hypothesis testing was carried out using the Chi-Square test and the calculation of risk of incidence of drug interactions was displayed by odds ratio. The results showed that of the 260 prescription sheets analyzed, there were 121 identified potential drug interactions with the largest percentage is the interaction between insulin and aspirin (14.29%). Hypothesis testing using Chi-Square test showed a significant relationship (p=0.000) between the amount of drug prescribing and the potential occurrence of drug interactions (p<0.05). Result of odds ratio showed that patients receiving drugs ≥5 had 3.657 times higher risk of potential drug interaction (95% CI 2.173–6.157).

Keywords: Diabetes mellitus type 2, drug interaction, odds ratio


Keywords


Diabetes melitus tipe 2, interaksi obat, odds ratio

References


American Diabetes Association. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2018. Diabetes Care. 2018;41(1):S13–27. doi: 10.2337/dc18-S002

Sonu GKS, Harikumar SL, Navis S. A review on drug-drug and drug-food interaction in patients during the treatment of diabetes mellitus. Int J Pharmacol Clin Sci. 2015;4(4):98–105. doi: 10.5530/ijpcs.4.4.6

Nidhi S. Concept of drug interaction. Int Res J Pharm. 2012;3(7):120–2.

Amin M, Suksomboon N. Pharmacotherapy of type 2 diabetes mellitus: An update on drug-drug interactions. Drug Saf. 2014;37(11):903–19. doi: 10.1007/s40264-014-0223-2

May M, Schindler C. Clinically and pharmacologically relevant interactions of diabetic drugs. Ther Adv Endocrinol Metab. 2016;7(2):69–83. doi: 10.1177/2042018816638050

Harreiter J, Willer AK. Sex and gender differences in prevention of type 2 diabetes. Front Endocrinol. 2018;9:220. doi: 10.3389/fendo.2018.00220

Wu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci. 2014;11(11):1185–200. doi: 10.7150/ijms.10001

Stage TB, Brosen K, Christensen MH. A comprehensive review of drug-drug interactions with metformin. Clin Pharmacokinet. 2015;54(8):811–24. doi: 10.1007/s40262-015-0270-6

Natsir RM, Wahyudin E, Umar H. Pengaruh terapi kombinasi insulin-metformin terhadap kualitas hidup pasien diabetes melitus tipe 2 (diunduh 12 Februari 2018). Tersedia dari: http://pasca.unhas.ac.id/jurnal/files/709c77bec5060b0 de735ff66e0ddde12.pdf

Hemmingsen B, Christensen LL, Watterslev J, Vaag A, Gluud C, Lund SS, et al. Comparison of metformin and insulin versus insulin alone for type 2 diabetes: Systematic review of randomised clinical trial sequential analyses. BMJ. 2012;344:1–19. doi: 10.1136/bmj.e1771

Lastra G, Syed S, Kurukulasuriya LR, Manrique C, Sowers JR. Type 2 diabetes mellitus and hypertension. Endocrinol Metab Clin North Am. 2014;43(1):103–22. doi: 10.1016/j.ecl.2013.09.005

Bhole V, Choi JW, Kim SW, de Vera M, Choi H. Serum uric acid levels and the risk of type 2 diabetes: A prospective study. Am J Med. 2010;123(10):957–61. doi: 10.1016/j.amjmed.2010.03.027.

Stockley. Stockley’s drug interactions. London: Pharmaceutical Press. 2008.

Tatro DS. Drug interaction facts 2013: The authority on drug interactions. Philadelphia: Lippincott Williams and Wilkins; 2012.

Dewi CA, Athiyah U, Mufarrihah, Nita Y. Drug therapy problems pada pasien yang menerima resep polifarmasi (studi di apotek farmasi airlangga Surabaya). J Farm Komunitas. 2014;1(1):18–23.

Guthrine B, Makubate B, Santiago VH, Dreischulte T. The rising tide of polypharmacy and drug-drug interactions: Population database analysis 1995–2010. BMC Med. 2015;13(74):1–10. doi: 10.1186/s12916-015-0322-7




DOI: https://doi.org/10.15416/ijcp.2020.9.1.9

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