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All Journal Pharmaciana: Jurnal Kefarmasian JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)
Malihi, La
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Health Professions Medicine & Pharmacology Public Health

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Undesirable events in the use of high-alert medicine geriatric patients at RSUPN Dr. Cipto Mangunkusumo Malihi, La; Supadmi, Woro; Trisna , Yulia; Purwanto , Barkah Djaka
Pharmaciana Vol. 15 No. 1 (2025): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/pharmaciana.v15i1.29643

Abstract

High-Alert Medications (HAM) are drugs that have a high risk of causing significant harm to patients if misused. It is estimated that one in ten geriatric patients experiences undesirable events during hospitalization related to medication use. Detect undesirable events due to the use of high-alert insulin and high-alert heparin drugs in geriatric patients at Rumah Sakit Umum Pusat Nasional (RSUPN) Dr Cipto Mangunkusumo using the trigger tool method based on positive predictive value (PPV) and determine the effect of using high-alert insulin and high alert heparin drugs on undesirable events. A retrospective cohort study will review secondary data from patient medical records (MR). The sample used was from 300 geriatric patients, 82 patients used insulin and 79 patients used heparin which met the inclusion criteria. Data were analyzed in the form of frequencies and percentages (%), calculation of PPV values, and the effect of using high-alert insulin and high-alert heparin on undesirable events using the Chi-Square test. There were 8 trigger-positive patients with undesirable events in the form of hypoglycemia from 82 insulin patients and 4 trigger-positive patients with undesirable events in the form of extended activated partial thromboplastin time (aPTT) values from 79 heparin patients. Based on the PPV value, both insulin (9.75%) and heparin (5.33%), the trigger tool has not been able to detect undesirable events when using high-alert insulin and high-alert heparin. Based on statistical tests, the p-value= 0.033 (p<0.05) for insulin and heparin p-value= 0.043 (p<0.05) meaning that there is an influence of the use of high-alert insulin and high-alert heparin on undesirable events when using both drugs. The trigger tool method cannot detect undesirable events when using high-alert insulin and high-alert heparin drugs based on laboratory triggers.
Patterns of High-Alert Medicine Use in Geriatric Patients at Rumah Sakit Umum Pusat Dr. Cipto Mangunkusumo Malihi, La; Supadmi, Woro; Trisna, Yuliana; Purwanto, Barkah Djaka
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 15, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.97181

Abstract

Background: Geriatric patients are patients who are often associated with multiple diseases and decreased organ function so they are at greater risk of developing unwanted drug reactions due to drug use when compared to other adults. High Alert Medication (HAM) are drugs that have a high risk of causing significant harm to patients if used incorrectly.Objectives: This study aims to determine the pattern of HAM use among inpatient geriatric patients at Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta.Methods: Retrospective cohort study by reviewing primary data from medical records (MR) of inpatient geriatric patients who used HAM for the period January 1 to December 31, 2023. The sample consisted of 300 geriatric patients who met the inclusion criteria using a purposive sampling technique. Descriptive data analysis includes data in the form of frequencies and percentages (%).Results: Based on gender, women with a total of 162 (54%) patients dominated. Based on age, the age range of 60 to 70 years with a total of 104 (68.87%) patients with a diagnosis of hypertension dominated compared to other ages. Based on the type of HAM used namely Insulin group HAM with 53 (20.38%) times of administration with the type of insulin in the form of novorapid flexpen 3 ml (13,532%) and anticoagulant group HAM with 49 (18,84%) times of administration with the type of anticoagulant in the form of heparin sodium 5 ml (13,181%) with the diagnosis of hypertension.Conclusion: The types of HAM that dominate the use in the therapy of hospitalized geriatric patients are novorapid flexpen 3 ml and heparin sodium 5 ml given parenterally with a diagnosis of hypertension.
Co-Authors Purwanto , Barkah Djaka Purwanto, Barkah Djaka Trisna , Yulia Trisna, Yuliana Woro Supadmi