Hubungan antara Polifarmasi dan Kepatuhan Pasien dengan Multimorbiditas di RSUD dr R Goeteng Taroenadibrata Purbalingga
Keywords:
polypharmacy, multimorbid, adherence
Abstract
has a major impact on a person's quality of life. Patients with multimorbidity have the potential to prescribe polypharmacy. This study aims to determine the level of patient adherence and the relationship between polypharmacy and adherence of multimorbid patients at the Internal Medicine Clinic RSUD dr R Goeteng Taroenadibrata Purbalingga. A cross-sectional study using the convenience sampling method was conducted on 342 multimorbid patients receiving polypharmacy prescriptions. Data were collected using demographic questionnaires and the Morisky Medication Adherence Scale (MMAS-8) questionnaire. The average age of the respondents in this study was 57.81 ± 10.596, with an average patient taking 9.8 ± 3.2 drugs per day and having an average diagnosis / number of diseases suffered 3.56 ± 1.06 diagnoses. Patients with low adherence category were 106 people (31%), medium were 125 people (36.5%) and high were 111 people (32.5). Conclusion: There is a significant relationship between polypharmacy (p<0.05) and adherence to taking medication in multimorbid patients (p=0.000), where the more medication the patient gets (polypharmacy), the lower the patient's compliance in taking medication. It is recommended that the hospital carry out evaluations and interventions to improve treatment compliance.
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References
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Almutairi AS, Alhazmi TM, Alotaibi YH, Alfraidi AA, Alsaad AM, Matrood RA, et al. Medication Adherence Among Multimorbid Patients With Polypharmacy and Its Relation to Social Support at National Guard Primary Health Care Centers, Riyadh. Cureus. 2022;14.
Sampaio R, Azevedo LF, Dias CC, Lopes JMC. Non-adherence to pharmacotherapy: A prospective multicentre study about its incidence and its causes perceived by chronic pain patients. Patient Prefer Adherence. 2020;14:321–32.
Shareinia H, Sadeghmoghadam L, Mokhtarzadeh MR, Zahrayi SM, Jafari N, Noori R. Relationship Between Polypharmacy and Medication Adherence in the Hypertensive Elderly Patients. Dis Diagnosis. 2020;9:153–7.
Riani DA. Validasi 8-item Morisky Medication Adherence Scale versi Indonesia pada pasien hipertensi dewasa di puskesmas kabupaten Sleman dan kota Yogyakarta. Universitas Gajah Mada; 2017.
Sastroasmoro S. Dasar - dasar metodologi Penelitian Klinis. Sagung Seto; 2014. 522 p.
Cebrino J, Portero de la Cruz S. Polypharmacy and associated factors: a gender perspective in the elderly Spanish population (2011–2020). Front Pharmacol. 2023;14:1–11.
Santalucia P, Franchi C, Djade CD, Tettamanti M, Pasina L, Corrao S, et al. Gender difference in drug use in hospitalized elderly patients. Eur J Intern Med. 2015;26:483–90.
Zhang N, Sundquist J, Sundquist K, Ji J. An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study. Front Pharmacol. 2020;11:1–10.
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Termos M, Holzer KJ, Vaughn MG, Kelton K. Gender Differences in Prescription Medications among Transitioning Justice-Involved Individuals. J Correct Heal Care. 2022;28:198–202.
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Stafford M, von Wagner C, Perman S, Taylor J, Kuh D, Sheringham J. Social connectedness and engagement in preventive health services: an analysis of data from a prospective cohort study. Lancet Public Heal. 2018;3:e438–46.
Sarwar MR, Iftikhar S, Sarfraz M. Influence of education level of older patients on polypharmacy, potentially inappropriate medications listed in Beer’s criteria, and unplanned hospitalization: A cross-sectional study in Lahore, Pakistan. Med. 2018;54:1–14.
Pallesen AVJ, Kristiansen M, Westendorp RGJ, Mortensen LH. Polypharmacy occurrence and the related risk of premature death among older adults in Denmark: A nationwide register-based cohort study. PLoS One. 2022;17:1–21.
Neumann-Podczaska A, Tobis S, Antimisiaris D, Mossakowska M, Puzianowska-Kuznicka M, Chudek J, et al. Polypharmacy in Polish Older Adult Population—A Cross-Sectional Study: Results of the PolSenior Project. Int J Environ Res Public Health. 2022;19.
Oliveira PJ, Malva JO. Aging. Vol. 6, Academic Press. London: Stacy Masucci; 2023. 821 p.
Coppard BM, Coover K, Faulkner MA, Flynn B. Use of Medications by Elders. Occup Ther with Elders Strateg COTA Fourth Ed. 2019;170–85.
Lahdji A, Anggraini MT, Raynalda A. Education level and Economic Status in Increasing Adherence to Medication of Pulmonary Tuberculosis Patients. 2022;73–7.
Fernandez-Lazaro CI, Adams DP, Fernandez-Lazaro D, Garcia-González JM, Caballero-Garcia A, Miron-Canelo JA. Medication adherence and barriers among low-income, uninsured patients with multiple chronic conditions. Res Soc Adm Pharm. 2019;15:744–53.
Wang W, Luan W, Zhang Z, Mei Y. Association between medication literacy and medication adherence and the mediating effect of self-efficacy in older people with multimorbidity. BMC Geriatr. 2023;23:1–9.
Neiman AB, Ruppar T, Ho ; Michael, Garber L, Paul ;, Weidle J, et al. Morbidity and Mortality Weekly Report CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management-Innovations and Opportunities Innovative Strategies to Improve Medication Adherence for Chronic Disease Management. Morb Mortal Wkly Rep. 2017;66:1248–51.
Nadery Y, Khorasani P, Feizi A, Parvizy S. Causes of nonadherence to treatment in people with myocardial infarction: Content analysis. J Educ Health Promot. 2021;1–6.
González-Bueno J, Sevilla-Sánchez D, Puigoriol-Juvanteny E, Molist-Brunet N, Codina-Jané C, Espaulella-Panicot J. Factors associated with medication non-adherence among patients with multimorbidity and polypharmacy admitted to an intermediate care center. Int J Environ Res Public Health. 2021;18.
Kim SJ, Kwon OD, Han EB, Lee CM, Oh SW, Joh HK, et al. Impact of number of medications and age on adherence to antihypertensive medications: A nationwide population-based study. Med (United States). 2019;98.
Gopineni D, Reddy MY, Mahesh RN, Kumar KJ, Pharmaceu Sci GJ. Heralding the Drug Related Problems by Using Hepler-Strand Classification in a Tertiary Care Teaching Hospital. Glob J Pharm Pharm Sci. 2020;7:1–5.
Al-Temimi AA, Krishnan S, Sandhu AK, Ali Bangash NS. Medication Nonadherence: Implications for patient health outcomes in pharmacy practice. Indones J Pharm. 2021;32:416–28.
Marcum ZA, Gellad WF. Medication Adherence to Multidrug Regimens. Clin Geriatr Med. 2012;28:287–300.
Gellad WF, Grenard JL, Marcum ZA. A systematic review of barriers to medication adherence in the elderly: Looking beyond cost and regimen complexity. Am J Geriatr Pharmacother. 2011;9:11–23.
Pérez-Jover V, Mira JJ, Carratala-Munuera C, Gil-Guillen VF, Basora J, López-Pineda A, et al. Inappropriate use of medication by elderly, polymedicated, or multipathological patients with chronic diseases. Int J Environ Res Public Health. 2018;15.
Gast A, Mathes T. Medication adherence influencing factors - An (updated) overview of systematic reviews. Syst Rev. 2019;8:1–17.
Kvarnström K, Westerholm A, Airaksinen M, Liira H. Factors contributing to medication adherence in patients with a chronic condition: A scoping review of qualitative research. Pharmaceutics. 2021;13:1–41.
Gentizon J, Hirt J, Jaques C, Lang PO, Mabire C. Instruments assessing medication literacy in adult recipients of care: A systematic review of measurement properties. Int J Nurs Stud. 2021;113:103785.
Tresnowati GI, Kusuma IY, Sunarti S. Monitoring of Medication Compliance in Type 2 Diabetes Mellitus Patients with Media Adherence Pill Box Unit Daily Dose. JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X. 2022;14:97–104.
González-Bueno J, Sevilla-Sánchez D, Puigoriol-Juvanteny E, Molist-Brunet N, Codina-Jané C, Espaulella-Panicot J. Improving medication adherence and effective prescribing through a patient-centered prescription model in patients with multimorbidity. Eur J Clin Pharmacol. 2022;78:127–37.
Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies. J Comorbidity. 2019;9:2235042X1987093.
Consortium TS. Polypharmacy Management by 2030: a patient safety challenge, 2nd edition. 2nd ed. the SIMPATHY consortium; 2017.
BPS. Statistik Penduduk Lanjut Usia 2022. Jakarta: Badan Pusat Statistik; 2022. 348 p.
Hussain MA, Huxley RR, Al Mamun A. Multimorbidity prevalence and pattern in Indonesian adults: An exploratory study using national survey data. BMJ Open. 2015;5:1–10.
Soejono CH, Rizka A. Polypharmacy and Drug Use Pattern among Indonesian Elderly Patients Visiting Emergency Unit. Acta Med Indones. 2021;53:60–76.
González-Bueno J, Calvo-Cidoncha E, Sevilla-Sánchez D, Molist-Brunet N, Espaulella-Panicot J, Codina-Jané C. Patient-centered prescription model to improve therapeutic adherence in patients with multimorbidity. Farm Hosp. 2018;42:128–34.
Wimmer BC, Cross AJ, Jokanovic N, Wiese MD, George J, Johnell K, et al. Clinical Outcomes Associated with Medication Regimen Complexity in Older People: A Systematic Review. J Am Geriatr Soc. 2017;65:747–53.
Almutairi AS, Alhazmi TM, Alotaibi YH, Alfraidi AA, Alsaad AM, Matrood RA, et al. Medication Adherence Among Multimorbid Patients With Polypharmacy and Its Relation to Social Support at National Guard Primary Health Care Centers, Riyadh. Cureus. 2022;14.
Sampaio R, Azevedo LF, Dias CC, Lopes JMC. Non-adherence to pharmacotherapy: A prospective multicentre study about its incidence and its causes perceived by chronic pain patients. Patient Prefer Adherence. 2020;14:321–32.
Shareinia H, Sadeghmoghadam L, Mokhtarzadeh MR, Zahrayi SM, Jafari N, Noori R. Relationship Between Polypharmacy and Medication Adherence in the Hypertensive Elderly Patients. Dis Diagnosis. 2020;9:153–7.
Riani DA. Validasi 8-item Morisky Medication Adherence Scale versi Indonesia pada pasien hipertensi dewasa di puskesmas kabupaten Sleman dan kota Yogyakarta. Universitas Gajah Mada; 2017.
Sastroasmoro S. Dasar - dasar metodologi Penelitian Klinis. Sagung Seto; 2014. 522 p.
Cebrino J, Portero de la Cruz S. Polypharmacy and associated factors: a gender perspective in the elderly Spanish population (2011–2020). Front Pharmacol. 2023;14:1–11.
Santalucia P, Franchi C, Djade CD, Tettamanti M, Pasina L, Corrao S, et al. Gender difference in drug use in hospitalized elderly patients. Eur J Intern Med. 2015;26:483–90.
Zhang N, Sundquist J, Sundquist K, Ji J. An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study. Front Pharmacol. 2020;11:1–10.
Orlando V, Mucherino S, Guarino I, Guerriero F, Trama U, Menditto E. Gender differences in medication use: A drug utilization study based on real world data. Int J Environ Res Public Health. 2020;17.
Termos M, Holzer KJ, Vaughn MG, Kelton K. Gender Differences in Prescription Medications among Transitioning Justice-Involved Individuals. J Correct Heal Care. 2022;28:198–202.
Delara M, Murray L, Jafari B, Bahji A, Goodarzi Z, Kirkham J, et al. Prevalence and factors associated with polypharmacy: a systematic review and Meta-analysis. BMC Geriatr. 2022;22:1–12.
Freiberger E, Sieber CC, Kob R. Mobility in Older Community-Dwelling Persons: A Narrative Review. Front Physiol. 2020;11:1–13.
Gorman M, Jones S, Turner J. Older people, mobility and transport in low- and middle-income countries: A review of the research. Sustain. 2019;11:1–15.
Wandera SO, Kwagala B, Ntozi J. Determinants of access to healthcare by older persons in Uganda: A cross-sectional study. Int J Equity Health. 2015;14:1–10.
Aljawadi MH, Khoja AT, Alaboud NM, AlEnazi ME, Al-Shammari SA, Khoja TA, et al. Prevalence of Polypharmacy and Factors Associated with it Among Saudi Older Adults – Results from the Saudi National Survey for Elderly Health (SNSEH). Saudi Pharm J. 2022;30:230–6.
Stafford M, von Wagner C, Perman S, Taylor J, Kuh D, Sheringham J. Social connectedness and engagement in preventive health services: an analysis of data from a prospective cohort study. Lancet Public Heal. 2018;3:e438–46.
Sarwar MR, Iftikhar S, Sarfraz M. Influence of education level of older patients on polypharmacy, potentially inappropriate medications listed in Beer’s criteria, and unplanned hospitalization: A cross-sectional study in Lahore, Pakistan. Med. 2018;54:1–14.
Pallesen AVJ, Kristiansen M, Westendorp RGJ, Mortensen LH. Polypharmacy occurrence and the related risk of premature death among older adults in Denmark: A nationwide register-based cohort study. PLoS One. 2022;17:1–21.
Neumann-Podczaska A, Tobis S, Antimisiaris D, Mossakowska M, Puzianowska-Kuznicka M, Chudek J, et al. Polypharmacy in Polish Older Adult Population—A Cross-Sectional Study: Results of the PolSenior Project. Int J Environ Res Public Health. 2022;19.
Oliveira PJ, Malva JO. Aging. Vol. 6, Academic Press. London: Stacy Masucci; 2023. 821 p.
Coppard BM, Coover K, Faulkner MA, Flynn B. Use of Medications by Elders. Occup Ther with Elders Strateg COTA Fourth Ed. 2019;170–85.
Lahdji A, Anggraini MT, Raynalda A. Education level and Economic Status in Increasing Adherence to Medication of Pulmonary Tuberculosis Patients. 2022;73–7.
Fernandez-Lazaro CI, Adams DP, Fernandez-Lazaro D, Garcia-González JM, Caballero-Garcia A, Miron-Canelo JA. Medication adherence and barriers among low-income, uninsured patients with multiple chronic conditions. Res Soc Adm Pharm. 2019;15:744–53.
Wang W, Luan W, Zhang Z, Mei Y. Association between medication literacy and medication adherence and the mediating effect of self-efficacy in older people with multimorbidity. BMC Geriatr. 2023;23:1–9.
Neiman AB, Ruppar T, Ho ; Michael, Garber L, Paul ;, Weidle J, et al. Morbidity and Mortality Weekly Report CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management-Innovations and Opportunities Innovative Strategies to Improve Medication Adherence for Chronic Disease Management. Morb Mortal Wkly Rep. 2017;66:1248–51.
Nadery Y, Khorasani P, Feizi A, Parvizy S. Causes of nonadherence to treatment in people with myocardial infarction: Content analysis. J Educ Health Promot. 2021;1–6.
González-Bueno J, Sevilla-Sánchez D, Puigoriol-Juvanteny E, Molist-Brunet N, Codina-Jané C, Espaulella-Panicot J. Factors associated with medication non-adherence among patients with multimorbidity and polypharmacy admitted to an intermediate care center. Int J Environ Res Public Health. 2021;18.
Kim SJ, Kwon OD, Han EB, Lee CM, Oh SW, Joh HK, et al. Impact of number of medications and age on adherence to antihypertensive medications: A nationwide population-based study. Med (United States). 2019;98.
Gopineni D, Reddy MY, Mahesh RN, Kumar KJ, Pharmaceu Sci GJ. Heralding the Drug Related Problems by Using Hepler-Strand Classification in a Tertiary Care Teaching Hospital. Glob J Pharm Pharm Sci. 2020;7:1–5.
Al-Temimi AA, Krishnan S, Sandhu AK, Ali Bangash NS. Medication Nonadherence: Implications for patient health outcomes in pharmacy practice. Indones J Pharm. 2021;32:416–28.
Marcum ZA, Gellad WF. Medication Adherence to Multidrug Regimens. Clin Geriatr Med. 2012;28:287–300.
Gellad WF, Grenard JL, Marcum ZA. A systematic review of barriers to medication adherence in the elderly: Looking beyond cost and regimen complexity. Am J Geriatr Pharmacother. 2011;9:11–23.
Pérez-Jover V, Mira JJ, Carratala-Munuera C, Gil-Guillen VF, Basora J, López-Pineda A, et al. Inappropriate use of medication by elderly, polymedicated, or multipathological patients with chronic diseases. Int J Environ Res Public Health. 2018;15.
Gast A, Mathes T. Medication adherence influencing factors - An (updated) overview of systematic reviews. Syst Rev. 2019;8:1–17.
Kvarnström K, Westerholm A, Airaksinen M, Liira H. Factors contributing to medication adherence in patients with a chronic condition: A scoping review of qualitative research. Pharmaceutics. 2021;13:1–41.
Gentizon J, Hirt J, Jaques C, Lang PO, Mabire C. Instruments assessing medication literacy in adult recipients of care: A systematic review of measurement properties. Int J Nurs Stud. 2021;113:103785.
Tresnowati GI, Kusuma IY, Sunarti S. Monitoring of Medication Compliance in Type 2 Diabetes Mellitus Patients with Media Adherence Pill Box Unit Daily Dose. JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X. 2022;14:97–104.
González-Bueno J, Sevilla-Sánchez D, Puigoriol-Juvanteny E, Molist-Brunet N, Codina-Jané C, Espaulella-Panicot J. Improving medication adherence and effective prescribing through a patient-centered prescription model in patients with multimorbidity. Eur J Clin Pharmacol. 2022;78:127–37.
Published
2024-06-30
How to Cite
Hidayatun, A., Sunarti, S., & Prabandari, R. (2024). Hubungan antara Polifarmasi dan Kepatuhan Pasien dengan Multimorbiditas di RSUD dr R Goeteng Taroenadibrata Purbalingga. Jurnal Sehat Mandiri, 19(1), 103-117. https://doi.org/https://doi.org/10.33761/jsm.v19i1.1364
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