Analisis Potensi Interaksi Obat pada Pasien Geriatri Rawat Jalan di Rumah Sakit Pendidikan Prof. dr. Chairuddin Panusunan Lubis Medan

Abstract

Background: The elderly population in Indonesia is increasing annually, in line with rising life expectancy. Geriatric patients are highly vulnerable to drug interactions due to age-related physiological changes, such as decreased renal and hepatic function, which affect drug metabolism. Additionally, the presence of multiple chronic conditions often necessitates the use of multiple medications (polypharmacy), significantly increasing the risk of drug interactions. Undetected interactions may result in reduced therapeutic efficacy, toxicity, and serious clinical consequences that threaten patient safety. Objective: To analyze the potential for drug interactions in geriatric outpatients at Prof. Dr. Chairuddin Panusunan Lubis Teaching Hospital in Medan, and to assess the relationship between patient characteristics and the occurrence of such interactions. Method: This study is a descriptive quantitative study with a cross-sectional approach design. Data were collected from medical records of geriatric patients during January–December 2023. Potential drug interactions were analyzed using the Lexicomp database and classified by severity and mechanism. Mann–Whitney test was used to analyze gender differences, and Spearman’s correlation test was used for age, number of clinics, number of diagnoses, and number of medications. Results: A total of 384 patients (91.40%) experienced potential drug interactions, with 1.276 interaction events recorded. Most were of moderate severity (65.30%) and predominantly pharmacodynamic in mechanism (74.40%). The most frequent drug combination was spironolactone + candesartan (109 cases). There was a very strong correlation between the number of medications and potential drug interactions (r=0.702; p0.05). The Mann–Whitney test also showed no significant difference based on gender (p>0.05). Conclusion: The incidence of drug interactions among geriatric outpatients is notably high, mostly of moderate severity and pharmacodynamic in nature. The number of medications was identified as the main risk factor. Routine therapy evaluation and close monitoring are essential to minimize adverse outcomes in elderly patients.