Survey on appropriateness of drug administration in elderly patients at The Internal Medicine Ward dr. Cipto Mangunkusumo Hospital.

AIM: to evaluate the appropriateness of drug administration in elderly patients hospitalized at the Internal Medicine Ward dr. Cipto Mangunkusumo Hospital based on indication, dosage, duration of treatment, potential adverse events, contraindication, and potential drug interactions. METHODS: a cross sectional observational study was performed in patients aged over >or= 60 years old staying at the Internal Medicine Ward. Appropriateness of drug administration was evaluated based on the support from literature. The supporting references being used were guidelines at the Internal Medicine Department, reference textbooks, and drug brochures for newly approved drugs but had not been listed in references nor guidelines. RESULTS: from 347 drug administrations in 43 patients, 228 of the drug administrations (67.71%) were considered appropriate for indication, 15.85% slightly inappropriate for indication, and 18.44% with inappropriate indication. From 228 drug administrations, 206 (90.35%) were administered with adequate dosage, 2.63% subtherapeutic dosage, 3.95% overdosage, and 3.07% undefined dosage. From 126 drug administration evaluated for duration of therapy, there were 77.78% administered with appropriate duration of therapy, 18.25% with inappropriate duration, and 3.97% undefined duration. Out of 347 drug administration there were 2 possibilities of adverse drug events, 5 drugs were actually contraindicated and 25 potential drug interaction. CONCLUSION: there were 67% of drugs appropriately administered for indication. From this number, 90% were using accurate dosage, of all drug administration there were 2 possibilities of adverse drug events, 5 drugs were contraindicated and 25 potentially interacted drugs. From 126 drugs evaluated for duration of therapy, 77.78% received the right duration of therapy.

Determinants of systolic blood pressure in Indonesian elderly men: In factor analysis perspective (A study in four Indonesian big cities).

The objective of this study was to assess the determinants of systolic blood pressure in elderly men. A cross sectional study was undertaken in 4 big cities in Indonesia using multistage random sampling. The respondents were 320 elderly men who were the sub-sample of 981 sample of a larger population study. Data were collected through anthropometric measurements, biochemical blood analysis, nutrient intake assessment, activity index and stress score. Two type of statistical analysis techniques were used to determine the determinants of systolic blood pressure in elderly men; multiple regression analysis and factor analysis. This study shows that determinants of systolic blood pressure, analyzed with these two types of analysis, multiple regression and factor analysis, resulting in no contradictory result. Direct multiple regression analysis to all independent variables showed that there was correlation between systolic blood pressure with fat mass, and LDL cholesterol. Multiple regression analysis to components resulting from factor analysis showed that there was positive correlation between systolic blood pressure with fat mass, body mass index (BMI), sum of skin-folds and waist circumference.

Nutritional status of hyperlipidemics elderly in Indonesia according to body mass lndex (study in four Indonesian big cities).

The objective of this study was to assess the nutritional status of hyperlipidemics elderly. A cross sectional study was undertaken in 4 big cities in Indonesia using multistage random sampling. The respondents were 656 hyperlipidemics and non hyperlipidemics elderly who were the subsample of 1261 sample of a larger population study. Data were collected through anthropometric measurements and biochemical blood analysis. To determine the nutritional status by Body Mass Index (BMI) the criteria used for elderly men and women are as follows, underweight BMI ≤ 18.5 kg/m2, normoweight BMI 18.5 - 24.9 kg/m2, overweight BMI 25 - 29.9 kg/m2, and obese BMI ≥ 30 kg/m2. To determine lipid status, the criteria used are as follows, hyperlipidemics elderly, those who had plasma total cholesterol ≥ 240 mg/dl and or triglycerides ≥ 200 mg/dl. Prevalence of hyperlipidemics in elderly women is higher then elderly men, 56.2% vs 47.0%. The BMI of hyperlipidemics is mostly overweight (60.4%) and obese (57.1%) for elderly men; and mostly normoweight (59.1%) and overweight (59.5%) for elderly women. The prevalence of hyperlipidemics among undernourished elderly men and women were also quite high, 38.7% and 31.6% respectively.

Lipid peroxides level in the Indonesian elderly.

A cross-sectional study was done to see the possible association of plasma lipid peroxides in the elderly with age and other factors. Plasma lipid peroxides is a product of free radical reactions which according to the latest theory of aging is the cause of aging process. Lipid peroxides were also found high in coronary heart disease. Four hundred forty relatively healthy elderly, age 55-85 years, were randomly chosen from free living elderly under guidance of health care centers (PUSKESMAS) in Jakarta. Anamnesis and physical examination were done in the morning in the health centers. Blood samples were taken in fasting conditions, plasma lipids and lipid peroxides were measured according to standard methods. There was an age difference of lipid peroxides level in the elderly, which increased with age up to 70 years old. Elderly 70 years old and over had low plasma lipid peroxides. The level was not related to high plasma lipids. Higher level was found when more chronic degenerative diseases were found.