HUBUNGAN RASIONALITAS PENGGUNAAN OBAT ANTIHIPERTENSI TERHADAP OUTCOME KLINIS PASIEN HIPERTENSI DI KLINIK IMANUEL MANADO
DOI:
https://doi.org/10.35799/pha.11.2022.39170Abstract
ABSTRACT
Hypertension is a chronic disease characterized by high blood pressure, causing morbidity and mortality, as well as increased risk of cardiovascular disease. Antihypertensive drug therapy is an option in the management of hypertension. Rational use of antihypertensive drugs is needed to achieve clinical outcomes to improve the quality of life. This study aims to determine correlation beetwen the rationality of antihypertensive drugs use to the achievement of clinical outcomes in the form of blood pressure. The study was observational analitic with cross sectional design undertaken in hypertensive patient at Manado Imanuel Clinic. Data were obtained retrospectively with consecutive sampling method in November 2021, as many as 90 patients. Data analysis used chi-square statistical test, where p < 0.05 value was considered statistically significant. The results showed that rationality of the use of antihypertensive drugs according to criteria: appropiate indication 100%, appropiate patient 95.56%, appropriate drugs 93.33% and appropiatedose100%. Patients who received rational antihypertensive therapy was 80 patients (88.89%) and 88 patients (97.78%) achieved clinical outcomes. There was a significant correlation beetwen the rationality of antihypertensive drugs use with clinical outcomes in the form of achieving blood pressure target in hypertensive patients at Manado Imanuel Clinic (p < 0.05).
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Keywords: hypertensive, rasionality of antihypertensive, clinical outcomes
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ABSTRAK
Hipertensi merupakan penyakit kronis yang ditandai dengan tekanan darah tinggi, sehingga menyebabkan morbiditas dan mortalitas, serta peningkatan resiko kardiovaskular. Terapi obat antihipertensi menjadi pilihan dalam tatalaksana hipertensi. Penggunaan obat antihipertensi yang rasional dibutuhkan untuk mencapai outcome klinis untuk meningkatkan kualitas hidup pasien. Penelitian ini bertujuan untuk mengetahui hubungan rasionalitas penggunaan obat antihipertensi terhadap pencapaian outcome klinis berupa tekanan darah. Penelitian ini merupakan jenis penelitian analitik observasional dengan rancangan penelitian cross sectional yang dilakukan pada pasien hipertensi di Klinik Imanuel Manado.Pengambilan data secara retrospektif dengan metode consecutive sampling untuk data periode bulan November 2021 dengan jumlah sampel sebanyak 90 rekam medis pasien. Analisis data menggunakan uji statistikchi-square, dimana nilai p< 0,05 dianggap signifikan secara statistik. Hasil penelitian menunjukkan rasionalitas penggunaan obat antihipertensi sesuai kriteria: tepat indikasi 100%, tepat pasien 95,56%, tepat obat 93,33% dan tepat dosis 100%. Pasien yang menerima terapi antihipertensi yang rasional sebanyak 80 pasien (88,89%) dan 88 pasien (97,78%) mencapai outcome klinis. Terdapat hubungan yang signifikan pada rasionalitas penggunaan obat antihipertensi dengan outcome klinis berupa tercapainya target tekanan darah pada pasien hipertensi di Klinik Imanuel Manado (p< 0,05).
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Kata kunci: hipertensi, rasionalitas antihipertensi, outcome klinis
References
Anggraini, T.D., Kusuma, E.E & Diandari, D. 2017.Pengaruh Rasionalitas Penggunaan Antihipertensi dengan Standar Guideline JNC 8 terhadap Keberhasilan Terapi Hipertensi di RS Panti Waluyo Surakarta.Journal of Pharmacy.6(1): 6-9.
Aristoteles.2018. Korelasi Umur dan Jenis Kelamin dengan Penyakit Hipertensi di Emergency Center Unit Rumah Sakit Islam Siti Khadijah Palembang 2017. Indonesia Jurnal Perawat.3(1): 9-16.
Benetos, A., Petrovic, M & Stanberg, T. 2019.Hypertension Management in Older and Frail Older Patients.Circulation Research.124(7): 1045-1060.
Burnier, M., Kjeldsen, S., Heagerty, A& Williams, B. 2018.Drug Treatment of Hypertension – In European Society of Cardiology/European Society of Hypertension Guidelines for the Management of Arterial Hypertension. Oxford University Press, England.
Canbakan, B. 2013. Rational approaches to the treatment of hypertension: drug therapy—monotherapy, combination, or fixed-dose combination. Kidney International Suplement.3(4): 349-351.
Choi, H.K., Soriano, L.C., Zhang, Y& Rodriguez, L.A.G. 2012. Antihypertensive drugs and risk of incident gout among patients with hypertension: Population based case-control study. BMJ Clinical Research.344.
Dahlan, M. 2013. Besar Sampel Dan Cara Pengambilan Sampel Dalam Penelitian Kedokteran Dan Kesehatan3rd ed. Salemba Medika, Jakarta.
Wells, B.G., Dipiro, J.T., Schwinghammer, T.L & Dipiro, C.V. 2015. Pharmachoterapy Handbook Ninth-Edition. McGraw-Hill Education, Amerika Serikat.
Garcia, C.G & Guera, A.F.R. 2018.Combination Therapy in Treatment Hypertension. Drugs in Context.7.
Gormer, B. 2010.Farmakologi Hipertensi, diterjemahkan oleh Lyrawati, Diana, 1-7, Jakarta.
JNC 7 (The Seventh Report of the Joint National Commite). 2004. Prevention, Detection, Evaluation and Treatment of High Blood Pressure. National Institute of Health (NIH), United State.
JNC 8 (Report From the Panel Members Appointed to the Eighth Joint National Committee). 2014. Evidence-Based Guideline for the Management of High Blood Pressure in Adults. JAMA.311(5): 507-520.
Kementerian Kesehatan RI. 2011. Modul penggunaan obat rasional. Kementerian Kesehatan Republik Indonesia, Jakarta.
Kowalski, R.E. 2007. The Blood Pressure Cure. John Wiley & Sons, Inc., New Jersey.
Kuwabara.M & Kume, I. 2011. Review Uric Acid and Hypertension. Kidney.34: 29-34.
Lemogoum, D. 2014. Challenge for hypertension prevention and control worldwide: the time for action. J Clin Hypertens.16(8):554–556.
Lacy, C.F., Armstrong, L.L., Goldman, M.P& Lance, L.L. 2015. Drug Information Hanbook, 24th ed. Lexi-Com Inc, Hudson, Ohio.
Mitchell, G.F., Lacourciere, Y., Ouellet, J.P., Izzo, J.L., Neutel, J., Kerwin, L.J., Block, A.J & Pfeffer, M.A. Determinants of elevated pulse pressure in middle-aged and older subjects with uncomplicated systolic hypertension: the role of proximal aortic diameter and the aortic pressure-flow relationship. Circulation.108:1592-1598.
Muhlis, M & Muslimah, L.I. 2021. Hubungan Kerasionalan Peresepan Obat Antihipertensi Dengan Outcome Klinis Pada Pasien Stroke Iskemik Rawat Inap RSUD Dr. Soegiri Lamongan. Jurnal Farmasi Indonesia.18(1): 47-59.
Murphy, E. 2011. Estrogen Signaling and Cardiovascular Disease.Circulation Research.109: 687–696.
Oparil, S & Weber, M. 2009. Angiotensin receptor blocker and dihydropyridine calcium channel blocker combinations: an emerging strategy in hypertension therapy. Postgrad Med. 121(2):25-39.
Perk, J., Backer, G.D., Gohlke, H., Graham, I., Reiner, Z & Verschuren, M. 2012. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). European Heart Journal.19: 585–667.
Rahman, A. 2019.Evaluasi Ketepatan Pemilihan Obat Hipertensi pada Pasien Lansia Di Puskesmas Kotagede II Daerah Istimewa Yogyakarta Periode Oktober 2017– Januari 2018.[Skripsi]. Universitas Ahmad Dahlan, Yogyakarta.
Badan Penelitian Pengembangan Kesehatan Departemen Kesehatan RI. 2013. Riset Kesehatan Dasar. Depkes RI, Jakarta.
Sa’idah, D., Sugihantoro, H., Hakim, A & Maimunah, S. 2019. Evaluasi Rasionalitas Penggunaan Obat Hipertensi di Instalasi Rawat Jalan RSUD Dr. Soegiri Lamongan Periode Tahun 2017. Jurnal Ilmu Kefarmasian Indonesia.12(1): 107-113.
Salem, C.B., Slim, R., Fathallah, M& Hmouda, H. Drug-Induced Hyperuricaemia and Gout. Rheumatology.56(5): 679-688.
Shaikh, A. 2017. A Practical Approach to Hypertension Management in Diabetes. Diabetes Therapy.8(5): 981-989.
Sing, S., Shankar, R & Sing, G.P. 2017. Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi. International Journal of Hypertension.2017(1): 1-10.
Smith, S.C., Benjamin, E.J., Bonow, R.O., Braun, L.T., Creager, M.A., Franklin, B.A., dkk. 2011. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. Journal of the American college of cardiology.58: 2432–2446.
Stangl, V. 2002. Coronary Atherogenic Risk Factors in Women. European Heart Journal.23: 1738–1752.
Vue, M.H & Setter, S.M. 2011. Drug-Induced Glucose Alterations Part 1: Drug-Induced Hypoglycemia. Diabetes Spectrum, 24: 171–177.
WHO. 2002. Promoting Rationale Use of Medicines: Core Components. WHO, Geneva.
WHO. 2014. Global Status Report on Noncommunicable Disease. WHO, Geneva.
Yansyah, A., Kusmardika, D.M & Ariska, A. 2019. Hubungan kesesuaian peresepan obat anti-hipertensi dengan penurunan tekanan darah pasien di puskesmas Panjang Bandarlampung. Wellness and Healthy Magizine.1(1):139-144.
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