IDENTIFIKASI PERESEPAN POLIFARMASI DAN POTENSI INTERAKSI OBAT PADA PASIEN GERIATRIK DI RSUD SITI FATIMAH PALEMBANG

ABSTRAK

Latar Belakang: Pasien geriatrik umumnya mengalami lebih dari satu penyakit kronis sehingga memerlukan penggunaan beberapa obat secara bersamaan (polifarmasi). Kondisi tersebut dapat meningkatkan risiko terjadinya potensi interaksi obat yang dapat memengaruhi keamanan dan efektivitas terapi. Penelitian ini bertujuan untuk mengetahui gambaran peresepan polifarmasi serta potensi interaksi obat pada pasien geriatrik rawat jalan di RSUD Siti Fatimah Palembang berdasarkan data rekam medis periode Januari–Maret 2026.
Metode: Penelitian ini merupakan penelitian non-eksperimental dengan desain deskriptif retrospektif. Sampel penelitian sebanyak 100 resep pasien geriatrik yang memenuhi kriteria inklusi dan dipilih menggunakan teknik purposive sampling. Variabel yang diteliti meliputi distribusi jumlah obat, kombinasi obat dengan potensi interaksi tingkat mayor, serta potensi interaksi obat berdasarkan mekanisme dan tingkat keparahan. Identifikasi potensi interaksi obat dilakukan menggunakan aplikasi Drugs.com, sedangkan data dianalisis secara univariat dan disajikan dalam bentuk distribusi frekuensi.
Hasil: Distribusi jumlah obat didominasi oleh resep yang berisi 5–9 jenis obat (99%), sedangkan resep dengan jumlah obat ≥10 sebesar 1%. Sebanyak 94% resep memiliki potensi interaksi obat. Berdasarkan mekanismenya, interaksi farmakodinamik merupakan yang paling banyak ditemukan (66%), sedangkan interaksi farmakokinetik sebesar 34%. Berdasarkan tingkat keparahannya, interaksi kategori moderate merupakan yang paling banyak ditemukan (77%), diikuti kategori mayor (15%) dan minor (8%). Kombinasi obat dengan potensi interaksi tingkat mayor yang paling sering ditemukan adalah spironolakton dan candesartan sebanyak 16 kejadian, diikuti amlodipin dan simvastatin sebanyak 8 kejadian.
Kesimpulan: Peresepan polifarmasi pada pasien geriatrik rawat jalan di RSUD Siti Fatimah Palembang didominasi oleh resep yang memenuhi kriteria polifarmasi dan sebagian besar memiliki potensi interaksi obat. Potensi interaksi obat didominasi oleh mekanisme farmakodinamik dengan tingkat keparahan moderate, sedangkan kombinasi obat yang paling banyak berpotensi menimbulkan interaksi tingkat mayor adalah spironolakton dan candesartan.
Kata kunci: geriatrik, interaksi obat, peresepan, polifarmasi, resep.
ABSTRACT

Background: Geriatric patients commonly experience multiple chronic diseases, requiring the use of several medications simultaneously (polypharmacy). This condition may increase the risk of potential drug interactions, which can affect the safety and effectiveness of therapy. This study aimed to identify polypharmacy prescribing patterns and potential drug interactions among geriatric outpatients at RSUD Siti Fatimah Palembang based on medical records from January to March 2026.
Methods: This was a non-experimental study with a descriptive retrospective design. A total of 100 prescriptions from geriatric patients meeting the inclusion criteria were selected using purposive sampling. The variables studied included the distribution of the number of drugs per prescription, drug combinations with the potential for major drug interactions, and potential drug interactions based on their mechanism and severity. Potential drug interactions were identified using Drugs.com, and the data were analyzed using univariate analysis and presented as frequency distributions.
Results: Most prescriptions contained 5–9 medications (99%), while prescriptions containing ≥10 medications accounted for 1%. Potential drug interactions were identified in 94% of the prescriptions. Based on the mechanism, pharmacodynamic interactions were the most common (66%), followed by pharmacokinetic interactions (34%). Based on severity, moderate interactions were the most frequently identified (77%), followed by major (15%) and minor (8%) interactions. The most common drug combination with the potential for major interaction was spironolactone and candesartan (16 cases), followed by amlodipine and simvastatin (8 cases).
Conclusion: Polypharmacy prescribing among geriatric outpatients at RSUD Siti Fatimah Palembang was predominantly characterized by prescriptions meeting the criteria for polypharmacy, and most prescriptions had the potential for drug interactions. Potential drug interactions were predominantly pharmacodynamic with moderate severity, while spironolactone and candesartan were the most common drug combination associated with potential major interactions.
Keywords: drug interaction, geriatric, polypharmacy, prescribing, prescription.