Ika Norcahyanti, Adelia Firandi, Zainol Ihsan Mauladi, Afifah Machlaurin

Evaluation of The Treatment in Hospitalized Geriatric Stroke Patients at Elizabeth Hospital Situbondo for The Period November 2022-August 2023

Introduction

Evaluation of the treatment in hospitalized geriatric stroke patients at elizabeth hospital situbondo for the period november 2022-august 2023. Evaluates stroke treatment in elderly hospitalized patients at Elizabeth Hospital Situbondo (Nov 2022-Aug 2023). Analyzes PIMs using Beers Criteria 2019, revealing high inappropriate drug use.

Abstract

Potentially Inappropriate Medicines (PIMs) cause a significant issue, particularly when dealing with elderly patients. Aging in the elderly results in a decline in physiological body functions, impacting the response to medications. Furthermore, aging leads to decreased elasticity of blood vessels, increasing the risk of cardiovascular diseases such as stroke. The management of stroke requires special attention to minimize the risk of complications and enhance recovery opportunities. This study aims to analyze patient profiles, treatment profiles, and evaluate the treatment based on the Beers Criteria 2019. It is a retrospective descriptive study using a cross-sectional research design and purposive sampling technique for sample selection. The study sample includes elderly patients diagnosed with stroke who were hospitalized at RS Elizabeth Situbondo. Patient medical record data was collected through a specifically designed Data Collection Sheet (DCS) to evaluate drug utilization in these patients. The research findings indicate that the patients are predominantly male (53.2%), aged 60-69 (62.3%), and have a Length of Stay of 1-6 days (84.4%). All patients have payment status through BPJS. The treatment profile involves the administration of medications for stroke management, with ticagrelor as the primary drug (66.2%) and citicoline as the most commonly prescribed supplementary drug (97.4%). Treatment evaluation identified 193 events of drug use that potentially met the 2019 Beers Criteria. The highest category was potentially inappropriate drugs (134 events), with pantoprazole being the most commonly used drug (71 events).

Review

The study, titled "Evaluation of The Treatment in Hospitalized Geriatric Stroke Patients at Elizabeth Hospital Situbondo for The Period November 2022-August 2023," addresses a critical public health concern: the use of Potentially Inappropriate Medicines (PIMs) in elderly stroke patients. Given the physiological changes associated with aging and the inherent complexities of stroke management, assessing medication appropriateness is paramount to minimize complications and optimize recovery. This retrospective descriptive study utilizes the well-established Beers Criteria 2019 to evaluate drug utilization, providing valuable insights into prescribing practices within a specific hospital setting over a defined period. The clear objective of analyzing patient profiles, treatment profiles, and PIM incidence lays a strong foundation for understanding current therapeutic approaches. The research offers important findings regarding both patient characteristics and treatment patterns. The patient cohort predominantly consisted of males aged 60-69, with a relatively short length of hospital stay (1-6 days for 84.4%), and exclusively utilizing BPJS payment. Regarding treatment, ticagrelor was identified as the primary anti-stroke medication for a significant portion of patients (66.2%), while citicoline emerged as an almost universally prescribed supplementary drug (97.4%). Crucially, the evaluation against the 2019 Beers Criteria revealed a significant number of PIM events (193 events), with "potentially inappropriate drugs" constituting the largest category (134 events). The identification of pantoprazole as the most frequently implicated PIM (71 events) is a particularly noteworthy finding, suggesting a common area for potential de-prescribing or re-evaluation in this vulnerable patient population. These results underscore the ongoing challenge of optimizing pharmacotherapy in geriatric stroke patients and highlight specific drugs that warrant closer scrutiny. While the study provides valuable descriptive data, certain limitations inherent in its design should be considered. As a single-center, retrospective descriptive study utilizing purposive sampling, the generalizability of these findings to broader populations or other healthcare settings may be limited. The abstract does not detail the clinical outcomes associated with PIM use, making it difficult to ascertain the direct impact of these inappropriate prescriptions on patient morbidity or mortality. Future research could benefit from investigating the clinical consequences of identified PIMs, exploring the rationale behind their prescription by healthcare providers, and comparing PIM rates across multiple institutions. Additionally, intervention studies aimed at reducing PIM use and improving prescribing practices in this patient group would be highly beneficial. Despite these limitations, this study serves as an important initial assessment, offering a baseline for quality improvement initiatives focused on enhancing medication safety for hospitalized geriatric stroke patients.

Full Text

Comments

You need to be logged in to post a comment.