Masalah-Masalah Terkait Obat (DRPs) pada Penggunaan Obat Antiretroviral (ARV/ART): Sebuah Tinjauan Cakupan
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Alfa Frista Arta, Beta Herilla Sekti, Moh. Firmansah (2026). Masalah-Masalah Terkait Obat (DRPs) pada Penggunaan Obat Antiretroviral (ARV/ART): Sebuah Tinjauan Cakupan . Journal of Pharmaceutical and Sciences, JPS Volume 9 Nomor 4 (2026). https://doi.org/10.36490/journal-jps.com.v9i4.1737
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Latar Belakang: Terapi antiretroviral (ART) telah mengubah infeksi HIV menjadi penyakit kronis yang dapat dikelola. Namun, penggunaan ART seumur hidup dan meningkatnya komorbiditas dikaitkan dengan berbagai Drug-Related Problems (DRPs) yang berisiko menyebabkan kegagalan virologis, resistensi obat, rawat inap, serta peningkatan biaya pelayanan kesehatan. Tujuan: Mengidentifikasi dan memetakan jenis, prevalensi, serta faktor risiko DRPs yang terkait dengan penggunaan obat ARV/ART berdasarkan literatur yang dipublikasikan antara 1 Januari 2015 dan 29 Mei 2026, yang mencerminkan era inhibitor integrase dan terapi dual modern. Metode: Scoping review menggunakan kerangka PCC (Population, Concept, Context) dengan pencarian pada database PubMed, Scopus, dan Cochrane Library untuk artikel periode 1 Januari 2015 – 29 Mei 2026 (pencarian terakhir pada 29 Mei 2026). Seleksi studi dan ekstraksi data dilakukan secara independen oleh dua reviewer menggunakan Mendeley sesuai pedoman PRISMA-ScR, serta penilaian kualitas studi observasional primer dilakukan menggunakan Newcastle-Ottawa Scale (NOS). Hasil: Dari 3.298 artikel yang teridentifikasi, 18 artikel memenuhi kriteria inklusi, mencakup 12.981 partisipan dari 11 studi observasional primer serta >60.900 partisipan kumulatif yang dirangkum dalam 7 artikel tinjauan sistematis dan meta-analisis. DRPs utama meliputi interaksi obat (drug-drug interactions/DDIs), reaksi obat yang tidak dikehendaki (adverse drug reactions/ADRs), polifarmasi, ketidakpatuhan (non-adherence), kesalahan pengobatan (medication errors), dan ketidaktepatan regimen. Prevalensi DDI berkisar antara 7,0% untuk interaksi kontraindikasi hingga 65,5% untuk seluruh tingkat keparahan (dengan 47,5%–77,0% interaksi yang signifikan secara klinis dan berpotensi relevan secara klinis). Studi meta-analisis di Ethiopia melaporkan prevalensi gabungan (pooled prevalence) ADRs terkait ART sebesar 36,7%, sedangkan polifarmasi ditemukan pada 33,0% ODHA secara global. Kesimpulan: DRPs dalam penggunaan ARV/ART bersifat multidimensional dan dipengaruhi oleh faktor regimen, pasien, serta sistem kesehatan. Integrasi apoteker klinis, skrining DDI rutin, dan penyederhanaan regimen merupakan strategi utama untuk mengoptimalkan farmakoterapi ART, disertai perlunya penelitian lebih lanjut terkait klasifikasi DRP spesifik HIV serta penguatan bukti di negara berkembang, termasuk di Indonesia,
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Referensi
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