Kejadian Drug-Related Problems (DRPs) Pada Pasien HIV dengan koinfeksi Tuberkulosis di Rumah Sakit Rujukan Jawa Tengah, Indonesia
Bilah Samping Artikel
Isi Artikel Utama
Page: 1750-1759
Abstrak
Pendahuluan: Koinfeksi tuberkulosis dan human immunodeficiency virus (TB-HIV) memerlukan kombinasi terapi antituberkulosis (OAT) dan antiretroviral (ARV) yang kompleks, sehingga meningkatkan risiko drug-related problems (DRPs). Namun, data mengenai pola DRPs pada pasien TB-HIV di rumah sakit rujukan Indonesia masih terbatas.Tujuan: Penelitian ini bertujuan mengidentifikasi dan menggambarkan jenis serta prevalensi DRPs pada pasien TB-HIV rawat jalan di rumah sakit rujukan Jawa Tengah, Indonesia. Metode: Studi observasional deskriptif dengan pendekatan retrospektif dilakukan menggunakan rekam medis pasien TB-HIV rawat jalan periode Januari 2024–Desember 2025. Sebanyak 111 pasien yang memenuhi kriteria inklusi dipilih menggunakan total sampling. Identifikasi DRPs berdasarkan klasifikasi Cipolle mencakup aspek indikasi, efektivitas, keamanan, dan kepatuhan. Hasil: Mayoritas pasien berjenis kelamin laki-laki (66,7%), usia dewasa (71,2%), menggunakan regimen OAT HRZE (91,0%), regimen ARV TDF+3TC+EFV (53,2%), serta berada pada fase intensif pengobatan TB (91,0%). Sebagian besar pasien mengalami ≥3 DRPs (64,9%) dengan rata-rata 2,98 DRPs per pasien. DRPs paling umum adalah interaksi obat yang menurunkan kadar atau efek obat (97,3%), diikuti interaksi obat yang meningkatkan kadar atau efek toksik (62,2%), kebutuhan terapi tambahan (37,8%), dan ketidakpatuhan pengobatan (34,2%). Kesimpulan: Kejadian DRPs pada pasien TB-HIV masih tinggi dengan dominasi interaksi obat yang berpotensi menurunkan efektivitas maupun meningkatkan toksisitas terapi. Pemantauan terapi rutin dan medication review oleh apoteker klinis sangat diperlukan untuk mengoptimalkan luaran pengobatan pasien TB-HIV.
Unduhan
Rincian Artikel
Artikel ini berlisensiCreative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Referensi
Kemenkes RI. pedoman nasional pelayanan kedokteran tata laksana tuberkulosis. vol. 8. 2019.
Kemenkes RI. Petunjuk Teknis Kolaborasi HIV/TB: Tatalaksana dan PPI TBC HIV. 2023.
DiPiro JT, Yee GC, Haines ST, Nolin TD, Ellingrod VL, Posey LM. DiPiro’s Pharmacotherapy: A Pathophysiologic Approach. 12th Editi. New York: McGraw-Hill Education; 2023.
Ignatius EH, Swindells S. Update on Tuberculosis / HIV Coinfections : Across the Spectrum From Latent Infection Through Drug- Susceptible and Drug-Resistant Disease 2022;30.
(WHO) WHO. consolidated guidelines on tuberculosis. 2025th ed. Geneva: World Health Organization; 2023.
Cipolle RJ, Strand LM, Morley PC. Chapter 5. Drug Therapy Problems. In: Cipolle RJ, Strand LM, Morley PC, editors. Pharmaceutical Care Practice: The Patient-Centered Approach to Medication Management Services, 3e, New York, NY: The McGraw-Hill Companies; 2012.
Khotimah K, Sutrisna EM. Identifikasi Drug-Related Problems (DRPs) pengobatan tuberkulosis tahap intensif pada pasien geriatri di RSUP Surakarta. Medical Sains : Jurnal Ilmiah Kefarmasian 2023;8:945–54.
Abdissalam E, Rahman FDA, Hanifa DNC, Ghozali MT, Susanto Y. Evaluasi Implementasi Kebijakan Standar Pelayanan Kefarmasian Di Puskesmas Wilayah Perifer Kota Samarinda. JIIS (Jurnal Ilmiah Ibnu Sina): Ilmu Farmasi Dan Kesehatan 2025;10:107–26.
Tuegeh FF, Pareta DN, Tampa’i R, Tumbel SL. Analisis Drug Related Problems (DRPs) Pada Pasien Tuberkulosis di Rawat Inap Rumah Sakit Tipe C Noongan. Biofarmasetikal Tropis 2020;3:25–30. https://doi.org/10.55724/j.biofar.trop.v3i1.252.
Resende NH de, Miranda SS de, Ceccato M das GB, Haddad JPA, Reis AMM, Silva DI da, Carvalho W da S. Drug therapy problems for patients with tuberculosis and HIV/AIDS at a reference hospital. Einstein (Sao Paulo, Brazil) 2019;17:eAO4696. https://doi.org/10.31744/einstein_journal/2019AO4696.
Kemenkes RI. Pedoman Nasional Pengendalian Tuberkulosis. 2020.
Kemenkes R. Pedoman Nasional Penatalaksanaan Klinis Infeksi HIV. Revisi 202. Jakarta: Direktorat Jenderal Pencegahan dan Pengendalian Penyakit, Kementerian Kesehatan RI; 2023.
Indonesia KKR. Petunjuk Teknis Kolaborasi TBC HIV. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023.
Preston CL. Stockley’s Drug Interactions: A Source Book of Interactions, Their Mechanisms, Clinical Importance and Management. Pharmaceutical Press; 2019.
Haryani L, Ramadhani NR, Meirawan RF, Burmanajaya B. Gambaran Faktor Risiko Pasien HIV dengan Tuberkulosis di RSUD Kota Bogor. Jurnal Epidemiologi Kesehatan Indonesia 2023;7:7.
Machrumnizar M, Eryando T, Bachtiar A, Kusumaratna RK, Meiyanti M, Djuana E, Hidayah N, Alfiyyah A. Understanding the epidemiology of TB-HIV co-infection in Indonesia: evidence from the 2023 national TB registry. BMJ Public Health 2025;3:e003585. https://doi.org/10.1136/bmjph-2025-003585.
Laksono A, Agrietia A. Analisis karakteristik pasien koinfeksi tb-hiv. Action research 2024;8.
Mulyanto IL. Faktor Risiko Terjadinya Koinfeksi Tuberkulosis Paru Pada Pasien Hiv/Aids Di Rsud Krmt Wongsonegoro Semarang Studi pada Penderita Koinfeksi Tuberkulosis Paru-HIV di Rumah Sakit KRMT Wongsonegoro Semarang 2022.
Hairunisa N, Sabrina I, Amalia H, Mashabi Y, Zaina NA, Yousif E. Study on Factors Related to HIV Among Women in West Kalimantan, Indonesia. Jurnal Biomedika Dan Kesehatan 2023;6:89–107.
Organization WH. Global tuberculosis report 2023. Geneva: World Health Organization; 2023.
Islam F, Ahmad H, Nurbaya N, Ahmad M, Mursaha A, Ramadhan K, Syukri M, Arrazy S, Perdana A, Siregar D, Ningsih N, Astuti I, Hamid S, Pasaribu A. Factors Affecting Treatment Adherence Among Patients with Tuberculosis in Indonesia: Literature Review. Journal of Public Health and Pharmacy 2024;4:28–37. https://doi.org/10.56338/jphp.v4i1.5022.
Gebreweld K, al et. Factors influencing adherence to tuberculosis treatment in Ethiopia. Journal of Health, Population and Nutrition 2018;37:16. https://doi.org/10.1186/s41043-018-0158-6.
Cipolle RJ, Strand LM, Morley PC. Pharmaceutical Care Practice: The Patient-Centered Approach to Medication Management Services. 4th ed. New York: McGraw-Hill Education; 2022.
Yang Q, Han J, Shen J, al et. Diagnosis and treatment of tuberculosis in adults with HIV. Medicine (Baltimore) 2022;101:e30405. https://doi.org/10.1097/MD.0000000000030405.
Woldesemayat EM, Gari T. Tuberculosis treatment outcome of TB/HIV co-infected patients at Adare Hospital, Hawassa City Administration, Sidama Region. BMC Infectious Diseases 2024;24:1281. https://doi.org/10.1186/s12879-024-10181-x.
Hamidah KF, Rahmadi M, Abdissalam E, Septiani I, Utomo FN, Batubara WR. Medication complexity and COVID-19 pandemic impact on the cost burden in non-COVID elderly patients at the emergency department. Pharmacy Education 2023;23:264–8.
Dorward J, Lessells R, Drain PK, Naidoo K, de Oliveira T, Pillay Y, Abdool Karim SS, Garrett N. Dolutegravir for first-line antiretroviral therapy in low-income and middle-income countries: uncertainties and opportunities for implementation and research. The Lancet HIV 2018:1–6. https://doi.org/10.1016/S2352-3018(18)30093-6.
Navasardyan I, Miwalian R, Petrosyan A, Yeganyan S, Venketaraman V. HIV-TB Coinfection: Current Therapeutic Approaches and Drug Interactions. Viruses 2024;16. https://doi.org/10.3390/v16030321.
Hadayna S, Adisasmita AC, Murtiani F. Predicting Unfavorable Treatment Outcomes in Multi-Drug Resistance Tuberculosis Patients: A Retrospective Study in Jakarta, Indonesia. Indonesian Journal of Global Health Research 2025;7. https://doi.org/10.37287/ijghr.v7i5.6664.
Mbambala D, Munkombwe D, Muungu LT, Hangoma JM, Kampamba M. Assessment of drug therapy problems and associated factors among PLWHA and tuberculosis admitted to two referral hospitals in Lusaka, Zambia. BMC Infectious Diseases 2026;26:857. https://doi.org/10.1186/s12879-026-13024-z.
Pooranagangadevi N, Padmapriyadarsini C. Treatment of Tuberculosis and the Drug Interactions Associated With HIV-TB Co-Infection Treatment. Frontiers in Tropical Diseases 2022;Volume 3-2022.
Nahid P, Dorman SE, Alipanah N, Barry PM, Brozek JL, Cattamanchi A, Chaisson RE, Chaisson RE, Daley CL, Grzemska M, Higashi J, Ho CS, Hopewell PC, Keshavjee S, Lienhardt C, Menzies D, Merrifield C, Narita M, O’Brien R, Raftery A, Saukkonen J, Starke JR, Vernon A, Weiner M. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clinical Infectious Diseases 2016;63:e147–95. https://doi.org/10.1093/cid/ciw376.
Alipanah N, Jarlsberg L, Miller C, Linh NN, Falzon D, Jaramillo E, Nahid P. Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies. PLoS Medicine 2018;15:e1002595. https://doi.org/10.1371/journal.pmed.1002595.