Efektivitas dan Keamanan Terapi Benzodiazepin pada Pasien Gangguan Ansietas dengan Riwayat Penyalahgunaan Obat
Abstract
Gangguan ansietas merupakan salah satu gangguan mental yang paling banyak dijumpai. Beberapa faktor dapat memicu terjadinya gangguan ansietas, salah satunya adalah riwayat penyalahgunaan obat. Tatalaksana terapi pada pasien ansietas dengan riwayat penyalahgunaan obat membutuhkan berbagai pertimbangan, pasalnya penggunaan benzodiazepin pada kondisi ini dapat memicu terjadinya ketergantungan. Penelitian ini bertujuan untuk mengetahui hubungan riwayat penyalahgunaan obat terhadap efektivitas dan keamanan terapi benzodiazepin pada pasien gangguan ansietas. Penelitian ini merupakan jenis penelitian observasional analitik dengan rancangan cohort retrospektif pada pasien rawat jalan dengan gangguan ansietas periode Januari 2018–Oktober 2020 di RS Bethesda Yogyakarta. Efektivitas terapi benzodiazepin dinilai dari respon terapi berupa perbaikan gejala dan kondisi pasien, sementara keamanan terapi dinilai dari adanya gejala yang mengarah ke ketergantungan terhadap benzodiazepin selama 6 bulan masa pengamatan. Jumlah sampel penelitian yakni 91 pasien, yang terbagi atas 2 kelompok yakni 52 pasien dengan riwayat penyalahgunaan obat, sementara 39 lainnya tanpa riwayat. Berdasarkan hasil uji chi-square diketahui bahwa riwayat penyalahgunaan obat memiliki hubungan signifikan dengan efektivitas benzodiazepin (p=0,031), namun tidak berlaku pada kejadian ketergantungan (p=0,45). Pasien dengan riwayat penyalahgunaan obat memiliki kecenderungan untuk tidak mengalami perbaikan dalam 6 bulan penggunaan benzodiazepin (RR 1,65; 95%CI 1,055–2,581). Sementara itu riwayat penyalahgunaan obat tidak berhubungan dengan keamanan terapi benzodiazepin.
Kata kunci: Benzodiazepin, gangguan ansietas, ketergantungan, respon terapi, riwayat penyalahgunaan obat
The Efficacy and Safety of Benzodiazepine in Anxiety Disorder Patient with Drug Abuse History
Abstract
Anxiety disorder is generally perceived as one of the predominant mental health conditions. Particular factors are known to induce the occurrence, including drug abuse history. The effective management of anxiety requires several considerations, due to the high dependence risk of benzodiazepine. Therefore, this study aimed at determining the relationship between the efficacy and safety of benzodiazepine in anxiety disorder with drug abuse history. The analysis employed an observational approach using cohort retrospective design in outpatients at Bethesda Yogyakarta hospital between January 2018-October 2020. Subsequently, benzodiazepine efficacy was assessed by therapeutic response, such as symptom improvement, while the safety was determined using symptoms that led to the condition. Based on 91 outpatients data, 52 showed previous drug abuse experiences, while 39 had no history. Chi-square analysis further reported a significant relationship between drug abuse history and benzodiazepine efficacy (p=0.031), but not applicable to the dependency (p=0.45). Therefore, patients with records of drug abuse appeared unresponsive during the 6 months of benzodiazepine therapy (RR 1.65; 95%CI 1.055–2.581), but these were not associated with safety.
Keywords: Anxiety disorder, benzodiazepine, dependency, history of drug abuse, therapeutic response
Keywords
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DOI: https://doi.org/10.15416/ijcp.2021.10.3.190
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