Drug Utilization Pattern Study of Antihypertensives in Elderly HHD Patients at the Polyclinic of RSUP Dr. Mohammad Hoesin Palembang

Authors

  • Aliya Yasmin Khairani Medical Professional Study Program, Faculty of Medicine, Sriwijaya University, 30114, Palembang, Indonesia
    Indonesia
  • Taufik Indrajaya Department of Internal Medicine, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Sriwijaya University, 30126, Palembang, Indonesia
    Indonesia
  • Yudhie Tanta Department of Pharmacology, Faculty of Medicine, Sriwijaya University, 30114, Palembang, Indonesia
    Indonesia
  • Erwin Sukandi Department of Pharmacology, Faculty of Medicine, Sriwijaya University, 30114, Palembang, Indonesia
    Indonesia
  • Syarinta Adenina Department of Pharmacology, Faculty of Medicine, Sriwijaya University, 30114, Palembang, Indonesia
    Indonesia

DOI:

https://doi.org/10.23917/pharmacon.v23i1.13196

Keywords:

Antihypertensive, Elderly, Hypertensive Heart Disease

Abstract

Hypertensive heart disease is a significant cause of morbidity and mortality globally that tends to increase with age. The high prevalence of uncontrolled blood pressure leads to an increase in the occurrence of HHD, so the optimal use of antihypertensive drugs is essential in preventing and controlling HHD. This study aims to determine the drug utilization pattern of antihypertensives in elderly hypertensive heart disease patients at the polyclinic of RSUP Dr. Mohammad Hoesin Palembang, Period of January - June 2023. This research is a descriptive study in the form of a drug utilization pattern study, with a sample of 157 patients. Data were collected using the total sampling technique, using secondary data from patient medical records. The most common therapeutic regimen was a combination of 2 antihypertensive drugs (42.7%), with the most frequent drug class combination being CCB + ARB (21.7%). Based on PERHI 2021 recommendations, 97.3% of drugs were in the correct dose, and 88.8% were in the correct frequency of administration. Most drug combinations, dosages, and frequencies of antihypertensives administered to patients were appropriate, with the most common combination being two drugs: CCB and ARB.

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References

Akri, N. T., Nurmainah, N., & Andrie, M. (2022). Analysis of Antihypertensive Medication Adherence among Geriatric Outpatients with Hypertension in Relation to Blood Pressure Control. Journal Syifa Sciences and Clinical Research, 4. https://ejurnal.ung.ac.id/index.php/jsscr/article/view/14793/4479

Alharthi, M. E., Almailabi, A. O., & Altayeb, A. T. (2017). Use of Two Agents Calcium Channels Blockers (CCBs) in Angina. International Journal of Healthcare Sciences. https://www.researchpublish.com/upload/book/Use%20of%20Two%20Agents%20Calcium-5394.pdf

Assalwa, U., Ningrum, G. P., Tindawati, T. M., Zahro, S., Trisfalia, R. R., Yuliani, A. P., Syarifudin, F., Najah,

A. L. N., Devi, A. S., Irmatiara, F., & Priyandani, Y. (2021). Profile of Medication Management Behavior among the Elderly. Jurnal Farmasi Komunitas (e-Journal), 8, 9–14. https://doi.org/10.20473/jfk.v8i1.21916

Astuti, Y., Azam, M., & Rahayu, S. R. (2021). Factors Associated with the Incidence of Uncontrolled Hypertension in Prolanis Patients in Semarang City. Public Health Perspective Journal, 6. https://journal.unnes.ac.id/nju/index.php/phpj/article/view/27992/11548

Bell, K., Twiggs, J., & Olin, B. R. (2015). Hypertension: The Silent Killer: Updated JNC-8 Guideline Recommendations. Continuing Education, 1–8.

Boentara, S. F., Parisa, N., & Theodorus, T. (2022). Drug Pattern Study on Angiotensin II Receptor Blocker in Outpatients at Mohammad Hoesin Hospital Palembang. Majalah Kedokteran Sriwijaya, 54. https://doi.org/10.32539/mks.v54i4.19664

Dai, H., Bragazzi, N. L., Younis, A., Zhong, W., Liu, X., Wu, J., & Grossman, E. (2021). Worldwide Trends in Prevalence, Mortality, and Disability-Adjusted Life Years for Hypertensive Heart Disease from 1990 to 2017. Hypertension, 77, 1223–1233. https://doi.org/10.1161/hypertensionaha.120.16483

Darussalam, M., & Warseno, A. (2019). Factors Associated with Uncontrolled Hypertension among Patients at Primary Health Care Centers. Jurnal Keperawatan Klinis Dan Komunitas (Clinical and Community Nursing Journal), 1, 72–80. https://jurnal.ugm.ac.id/jkkk/article/view/49111/25317

Fauziah, H., Mulyana, R., & Martini, R. D. (2020). Polypharmacy in Geriatric Patients. Human Care Journal, 5(3), 804. https://doi.org/10.32883/hcj.v5i3.796

Georgiopoulou, V. V, Kalogeropoulos, A. P., Raggi, P., & Butler, J. (2010). Prevention, Diagnosis, and Treatment of Hypertensive Heart Disease. Cardiology Clinics, 28, 675–691. https://doi.org/10.1016/j.ccl.2010.07.005

González, A., Ravassa, S., López, B., Moreno, M. U., Beaumont, J., San José, G., Querejeta, R., Bayés-Genís, A., & Díez, J. (2018). Myocardial Remodeling in Hypertension. Hypertension, 72(3), 549–558. https://doi.org/10.1161/HYPERTENSIONAHA.118.11125

Gradman, A. H., Basile, J. N., Carter, B. L., & Bakris, G. L. (2011). Combination Therapy in Hypertension. The Journal of Clinical Hypertension, 13(3), 146–154. https://doi.org/10.1111/j.1751-7176.2010.00397.x

Hastuti, D. (2022). Profile of Antihypertensive Drug Prescribing among Hypertensive Patients at Afina Pharmacy. Majalah Farmaseutik, 18. https://doi.org/10.22146/farmaseutik.v18i3.77737

Hernandorena, I., Bailly, H., Piccoli, M., Beunardeau, M., Cohen, A., & Hanon, O. (2019). Hypertension in The Elderly. La Presse Médicale, 48(2), 127–133.

https://doi.org/https://doi.org/10.1016/j.lpm.2018.11.011

Hill, R. D., & Vaidya, P. N. (2020). Angiotensin II Receptor Blockers (ARB). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537027/

Hitner, H., Nagle, B., Kaufman, M. B., Ariel, H., & Lalehzarzadeh, Y. P. (2021). Pharmacology: An Introduction (8th ed.). McGraw Hill.

Katzung, B. G. (2017). Basic & Clinical Pharmacology (14th ed.). McGraw Hill.

Ministry of Health Republic Indonesia. (2011). Rational Drug Use Module. https://farmalkes.kemkes.go.id/unduh/modul-penggunaan-obat-rasional/

Ministry of Health Republic Indonesia. (2019). Indonesia Enters the Aging Population Period. https://www.kemkes.go.id/article/view/19070500004/indonesia-masuki-periode-aging-population.html

Lu, Y., & Lan, T. (2022). Global, Regional, and National Burden of Hypertensive Heart Disease during 1990–2019: an Analysis of the Global Burden of Disease Study 2019. BMC Public Health, 22(1), 841. https://doi.org/10.1186/s12889-022-13271-0

Masenga, S. K., & Kirabo, A. (2023). Hypertensive Heart Disease: Risk Factors, Complications and Mechanisms. Frontiers in Cardiovascular Medicine, 10, 1–16. https://doi.org/10.3389/fcvm.2023.1205475

Muhadi. (2016). JNC 8: Evidence-Based Guidelines for the Management of Adult Hypertension. Jurnal CDK-236, 43, 54–59. https://media.neliti.com/media/publications/398491-jnc-8-evidence-based-guideline-penangana-831d9d1d.pdf

Naryati, N., & Priyono, N. N. P. (2022). Factors Affecting Blood Pressure Control among Patients with Hypertension in RW 03 Jagakarsa, South Jakarta. Malahayati Nursing Journal, 4, 156–172. https://ejurnalmalahayati.ac.id/index.php/manuju/article/view/5725/pdf

Olive, P. (2019). Evaluation of Combination Antihypertensive Drug Use in Patients with Hypertensive Heart Disease at RSUD Undata Central Sulawesi Period of 2017-2018. https://repository.untad.ac.id/2427/

Pangribowo, S. (2022). Empowered Elderly, Prosperous Nation. InfoDatin, Center for Data and Information, Ministry of Health of the Republic of Indonesia. https://www.kemkes.go.id/downloads/resources/download/pusdatin/infodatin/Infodatin-Lansia-2022.pdf

PERHI. (2021). 2021 Hypertension Management Consensus: Update of the 2019 PERHI Consensus. Indonesian Society of Hypertension. https://www.studocu.com/id/document/universitas-muslim-indonesia/medical-faculty/konsensus-hipertensi-2021/27264042

PERKI. (2015). Guidelines for the Management of Hypertension in Cardiovascular Disease First Edition. Indonesian Heart Association.

Prakoso, A. (2019). Potential Drug Interactions in Hospitalized Geriatric Patients with Hypertensive Heart Disease at Dr. Moewardi Hospital Surakarta 2017. https://eprints.ums.ac.id/71362/

Roth, G. A., Mensah, G. A., Johnson, C. O., Addolorato, G., Ammirati, E., Baddour, L. M., Barengo, N. C., Beaton, A. Z., Benjamin, E. J., Benziger, C. P., Bonny, A., Brauer, M., Brodmann, M., Cahill, T. J., Carapetis, J., Catapano, A. L., Chugh, S. S., Cooper, L. T., Coresh, J., … Fuster, V. (2020). Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019. Journal of the American College of Cardiology, 76(25), 2982–3021. https://doi.org/10.1016/j.jacc.2020.11.010

Saedder, E. A., Thomsen, A. H., Hasselstrøm, J. B., & Jornil, J. R. (2019). Heart Insufficiency after Combination of Verapamil and metoprolol: a Fatal Case Report and Literature Review. Clinical Case Reports, 7, 2042–2048. https://doi.org/10.1002/ccr3.2393

Stevens, C. W., & Brenner, G. M. (2016). Brenner and Stevens’ Pharmacology (5th ed.). Elsevier.

Tackling, G., & Borhade, M. B. (2019). Hypertensive Heart Disease. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539800/

Tamburian, M. M., Moeis, E. S., & Gosal, F. (2016). Profile of Hypertensive Patients at the Hypertension Nephrology Clinic. E-CliniC, 4. https://doi.org/10.35790/ecl.v4i1.11034

Weber, T., Lang, I., Zweiker, R., Horn, S., Wenzel, R. R., Watschinger, B., Slany, J., Eber, B., Roithinger, F. X., & Metzler, B. (2016). Hypertension and coronary artery disease: epidemiology, physiology, effects of

treatment, and recommendations. Wiener Klinische Wochenschrift, 128(13–14), 467–479. https://doi.org/10.1007/s00508-016-0998-5

Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., … Wright, J. T. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(6). https://doi.org/10.1161/HYP.0000000000000065

Williams, B., Mancia, G., & Spiering, W. (2018). 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. European Heart Journal, 39, 3021–3104. https://doi.org/10.1093/eurheartj/ehy339

World Health Organization. (2015). World Report on Ageing and Health. World Health Organization. https://apps.who.int/iris/handle/10665/186463

World Health Organization. (2022). Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health#:~:text=Common%20conditions%20in%20older%20age

Wulandari, A. (2022). Evaluation of Antihypertensive Drug Prescribing and Use among Elderly Patients at Sukarami Primary Health Care Palembang. INPHARNMED Journal (Indonesian Pharmacy and Natural Medicine Journal), 5, 17. https://doi.org/10.21927/inpharnmed.v5i2.1919

Yang, R., Zhang, X., Bai, J., Wang, L., Wang, W., & Cai, J. (2023). Global, regional, and national burden of hypertensive heart disease among older adults in 204 countries and territories between 1990 and 2019: a trend analysis. Chinese Medical Journal, 136(20), 2421–2430. https://doi.org/10.1097/CM9.0000000000002863

Yunita, I. (2023). Evaluation of Drug Use among Outpatients with Hypertensive Heart Disease at dr. Soebandi Regional Hospital Jember. https://repository.unej.ac.id/handle/123456789/115972

Submitted

2025-10-05

Accepted

2026-06-25

Published

2026-06-30

Issue

Section

Articles