The use of certain drugs is known to be an extrinsic factor the risk of falling in the elderly (elderly) because it can cause postural hypotension, sedation, dizziness, weakness, drowsiness, muscle weakness, and other side effects. This study aims to determine the profile of drug use that have the potential to fall in the elderly. This study used a cross-sectional descriptive design with purposive sampling technique. The study was carried out at two regional hospitals in Madiun (RSUD Dr. Soedono Madiun and RSUD Kota Madiun). The data is sourced from the outpatient's medical record of Neurology and Internal Medicine clinics and from the medication record in the Pharmacy Installation from May to October 2018. The results showed that there were 343 patients (64.11%) out of 535 patients involved in the study using fall risk medicines (FRM). Three FRM groups that were often prescribed were antihypertensive 52.71% (282 patients), anticonvulsants 20.19% (108 patients), and benzodiazepines 10.47% (56 patients). A number of 46.54% (249 patients) used FRM included in the low-risk category (Medication Fall Risk Score 1-5), and as many as 17.57% (94 patients) were included in high risk (Medication Fall Risk Score ≥ 6). The elderly that use 1 FRM was 24.86% (133 patients), followed by 2 drugs was 19.07% (102 patients). The results of this study realized that the use of fall risk medicines in the elderly is quite high, so it is necessary to weigh the risks and benefits of its use to prevent falls in the elderly.
Jatuh merupakan salah satu masalah kesehatan serius pada pasien lanjut usia (lansia). Risiko jatuh dapat disebabkan oleh beberapa faktor, salah satunya adalah penggunaan obat psikoaktif yang masuk ke dalam golongan Medication Fall Risk (MFR). Penelitian ini bertujuan untuk mengidentifikasi hubungan penggunaan obat psikoaktif dan karakteristiknya (dosis dan durasi penggunaan obat) terhadap risiko jatuh pada pasien lansia. Penelitian ini dilakukan secara observasional dengan pendekatan cross-sectional. Lokasi penelitian adalah Klinik Penyakit Dalam di dua Rumah Sakit di Kota Madiun (RSUD dr. Soedono Madiun dan RSUD Kota Madiun) pada bulan Oktober sampai Desember 2018. Risiko jatuh diukur menggunakan Time Up and Go (TUG) test. Penelitian diikuti oleh 290 pasien yang terbagi menjadi dua kelompok, yaitu kelompok risiko jatuh rendah (TUG ≤14) sejumlah 231 pasien dan kelompok risiko jatuh tinggi (TUG>14) sejumlah 59 pasien. Hasil penelitan ini menunjukkan adanya hubungan penggunaan obat psikoaktif dengan peningkatan risiko jatuh (adjusted OR 2,158 95% CI 1,176-3,961). Hasil adjusted multivariat menunjukkan dosis 0,1-0,5 DDD/hari atau lebih berhubungan dengan peningkatan risiko jatuh. Dosis obat >0,5 DDD/hari memiliki hubungan yang paling kuat dengan risiko jatuh (adjusted OR 4,463 95% CI 1,120-17,784). Perlu dipertimbangkan risiko dan keuntungan dalam pemberian obat psikoaktif pada pasien lansia. Pemberian dosis efektif seminimal mungkin perlu dipertimbangkan apabila pemberian obat psikoaktif diperlukan.
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