Analysis of the Relationship Between Predictors and Issues Related to Proton Pump Inhibitors Among Inpatients in 2024 at Dr. Mintohardjo Military Hospital
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The use of gastric acid suppressants such as Proton Pump Inhibitors (PPI) and Histamine-2 Receptor Antagonists (H2RA) is very common in inpatient settings, but inappropriate use is often found, posing risks to patient safety and cost efficiency. This study aims to analyze the relationship of predictors (age, number of drugs, number of comorbidities, and length of stay) to the occurrence of Drug-Related Problems (DRPs) in inpatients using gastric acid suppressants. This study was an observational study with a cross-sectional design was conducted retrospectively using patient medical record data at Rumkital Dr. Mintohardjo from January to December 2024. A sample of 432 patients was taken using a simple random sampling technique based on inclusion criteria. DRPs were identified using the Pharmaceutical Care Network Europe (PCNE) V9.00 instrument. Data analysis used the chi-square test for bivariate analysis and binary logistic regression for multivariate analysis. DRP characteristics were dominated by treatment safety issues (70.4%), particularly adverse drug events, with the most frequent drug interaction being ranitidine and ketorolac. Bivariate analysis showed that comorbidities (p=0.029), length of stay (p=0.010), and number of drugs (p=0.000) significantly influenced the number of DRPs. Multivariate analysis identified the number of drugs as the most influential predictor; inpatients receiving ≥10 drugs had a 2.733 times higher risk of experiencing ≥2 DRPs (p=0.000; OR 2,733; 95% CI 1.767-4.229)
Albugeaey, M., Alfaraj, N., Garb, J., Seiler, A., & Lagu, T. (2014). Do hospitalists overuse proton pump inhibitors? Data from a contemporary cohort. In Journal of Hospital Medicine (Vol. 9, Issue 11, pp. 731–733). John Wiley and Sons Inc. https://doi.org/10.1002/jhm.2249
Alqudah, M. A. Y., Al-Azzam, S., Alzoubi, K., Alkhatatbeh, M., & Rawashdeh, N. (2016). Overuse of proton pump inhibitors for stress ulcer prophylaxis in Jordan. International Journal of Clinical Pharmacology and Therapeutics, 54(8), 597–602. https://doi.org/10.5414/CP202533
Begg, M., Tarhuni, M., N. Fotso, M., Gonzalez, N. A., Sanivarapu, R. R., Osman, U., Latha Kumar, A., Sadagopan, A., Mahmoud, A., & Khan, S. (2023). Comparing the Safety and Efficacy of Proton Pump Inhibitors and Histamine-2 Receptor Antagonists in the Management of Patients With Peptic Ulcer Disease: A Systematic Review. Cureus. https://doi.org/10.7759/cureus.44341
Delyana Pratiwi, P., Rokhmiati, E., & Ghanesia Istiani, H. (2024). The Relationship between Age and Gender and the Risk of Non-Communicable Diseases (NCDs) Based on BPJS South Jakarta Health Screening Data in 2022. Journal of Nursing and Public Health, 13(1), 32–43.
Dewi Awali, J., Yuliyanda Pardilawati, C., Umiana Soleha, T., Zakiah Oktarlina, R., & Polypharmacy on Drug Safety in Geriatric Patients, K. (2024). Polypharmaceutical Study on Drug Safety in Geriatric Patients. Medula, 4(4), 739–745
Dewi, R. M., Perdhana, M. S., & Management, J. (2016). The Role of Gender, Age, and Education Level on Organizational Citizenship Behavior (OCB). Diponegoro Journal Of Management, 5(2), 1–9. http://ejournal-s1.undip.ac.id/index.php/dbr
Diamantidis, M. D., P. M., & H. E. (2021). Primary gastric non-Hodgkin lymphomas: Recent advances regarding disease pathogenesis and treatment. World Journal of Gastroenterology, 5, 5932–5945.
Yours truly, Joseph. T., Yee, Gary. C., Haines, Stuart. T., Nolin, Thomas. D., Ellingrod, Vicki. L., & Posey, L. M. (2013). Drug Information Handbook 22nd Ed (22nd ed., Vol. 22).
Eusebi, L. H., Ratnakumaran, R., Bazzoli, F., & Ford, A. C. (2018). Prevalence of Dyspepsia in Individuals With Gastroesophageal Reflux–Type Symptoms in the Community: A Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology, 16(1), 39-48.e1. https://doi.org/10.1016/j.cgh.2017.07.041
Fahmi, M. Z., Karuniawati, H., & Ismail, W. I. (2020). Drug-Related Problems in Chronic Obstructive Pulmonary Disease: Literature Review. Journal of Pharmaceutical Sciences, 2025(3), 1916–1922. https://doi.org/10.36490/journal-jps.com
Febriani, R. E., Karuniawati, H., & your Rahman, A. (2020). Incidence of Drug-Related Problems in Inpatients with Diabetes Mellitus Based on PCNE Criteria: A Literature Review. Journal of Pharmaceuticals and Science, 2025(3), 1937–1945. https://doi.org/10.36490/journal-jps.com
Garin, N., Sole, N., Lucas, B., Matas, L., Moras, D., Rodrigo-Troyano, A., Gras-Martin, L., & Fonts, N. (2021). Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-020-80560-2.
Gumi, V. C., Larasanty, L.P.F., & Udayani. (2013). Identification of Drug Related Problems in the Handling of Hypertension Patients at the Jembrana Health Center UPT. Udayana Journal of Pharmacy, 1(1), 50–57.
Hastono, Sutanto. P., & Sabri, Luknis. (2013). Health Statistics. Rajawali Press. ISBN: 978-979-769-691-7.
Hussain Sabir, S., Osama Talat, S., Ahmed Moinuddin, I., Aslam, M., Sardar Muhammad, N., Mahmood, A., Naz Tahir, F., & Professor, A. (2025). Efficacy of Proton Pump Inhibitors vs. H2-Receptor Antagonists in GERD Patients: A Double-Blind RCT Sajjad Hussain Sabir et al/Randomized Controlled Trial of Low-Dose Aspirin in Reducing Pregnancy Loss in Women with Antiphospholipid Syndrome Efficacy of Proton Pump Inhibitors vs. H2-Receptor Antagonists in GERD Patients: A Double-Blind RCT. International Journal of Pharmacy Research & Technology, 15(1), 1241–1249. https://doi.org/10.48047/ijprt/15.01.192
Indrawati, Teti. (2012). Gastroretentive Oral Drug Delivery System. National Institute of Science and Technology, 1, 8.
J. Dana, W., A. Fuller, M., P. Goldman, M., A. Golembiewski, J., P. Gonzales, J., Fisher Lowe, J., & Snoke, J. (2013). Drug Information Handbook (J. F. Alexander, A. Al-Jazairi, & N. Alqadheeb, Eds.; 22nd ed., Vol. 22).
Kate, S., Bodke, V., Badekar, R., Bagul, P., Birajdar, P., Dhoble, P., Pharm, M., & Dharkar, G. R. (2023). Assessment and Monitoring of Adverse Effect of Ranitidine with pharmacovigilance study. World Journal of Pharmaceutical Research, 12(11), 566. https://doi.org/10.20959/wjpr202311-28841.
Korayem, G. B., Alkanhal, R., Almass, R., Alkhunaizan, S., Alharthi, G., Sheraim, N. Bin, Alqahtani, S., & Alkofide, H. (2021). Patients, prescribers, and institutional factors associated with inappropriate use of acid suppressive therapy in medical wards: An experience of a single-center in saudi arabia. International Journal of General Medicine, 14, 5079–5089. https://doi.org/10.2147/IJGM.S328914.
Laoveeravat, P., Thavaraputta, S., Vutthikraivit, W., Mingbunjerdsuk, T., Motes, A., Nugent, K., Islam, E., & Islam, S. (2020). Proton Pump Inhibitors and Histamine-2 Receptor Antagonists on the Risk of Pancreatic Cancer: A Systematic Review and Meta-analysis. 3 Short running head: Association of PPI and H2RA and pancreatic cancer. QJM: An International Journal of Medicine, 113(2), 100–107. https://doi.org/10.1093/qjmed/hcz234/5567107
Luo, H., Fan, Q., Xiao, S., & Chen, K. (2017). Impact of clinical pharmacist interventions on inappropriate prophylactic acid suppressant use in hepatobiliary surgical patients undergoing elective operations. PLoS ONE, 12(10). https://doi.org/10.1371/journal.pone.0186302.
Mohamed Mohamed, A. E., Kamel, M. A., & Abd el Wahab, H. S. (2023). Adverse Drug Reactions of Proton Pump Inhibitors: A Review. Journal of Advanced Veterinary Research, 13(3), 553–557.
Octavia, M., Ikawati, Z., Tri, D., & Andayani, M. (2019). Study on the Effectiveness of Lansoprazole and Pantoprazol as Prophylaxis for Stress Ulcers in the Intensive Care Unit (ICU). In Media Pharmaceutica Indonesiana (Vol. 2, Issue 3).
Posada Bustos, S., De León Fernández, N., González Morales, R., Tihanyi Feldman, J., & Vera Chamorro, J. F. (2018). Prevalence of inappropriate prescription of acid suppression therapy among adults hospitalized at a general hospital in Bogotá. Colombian Journal of Gastroenterology, 33(1), 16–21. https://doi.org/10.22516/25007440.236
Satria, M. A., Andrajati, R., & Supardi, S. (2022). The Translation Process of Pharmaceutical Care Network Europe v9.00 to Bahasa Indonesia: An Instrument to Detect Drug-Related Problem. Malaysian Journal of Medical Sciences, 29(3), 133–144. https://doi.org/10.21315/mjms2022.29.3.13
Shanika, L. G. T., Reynolds, A., Pattison, S., & Braund, R. (2023). Proton pump inhibitor use: systematic review of global trends and practices. In European Journal of Clinical Pharmacology (Vol. 79, Issue 9, pp. 1159–1172). Springer Science and Business Media Deutschland GmbH. https://doi.org/10.1007/s00228-023-03534-z
Singh, A., Bodukam, V., Saigal, K., Bahl, J., Wang, Y., Hanlon, A., Lu, Y., & Davis, M. (2016). Identifying Risk Factors Associated with Inappropriate Use of Acid Suppressive Therapy at a Community Hospital. Gastroenterology Research and Practice, 2016. https://doi.org/10.1155/2016/1973086
Sinjal, J., Wiyono, W., & Mpila, D. (2018). Identification of Drug Related Problems (DRPs) in Congestive Heart Failure (CHF) Patients at the Inpatient Installation of Prof. Dr. R. D. Kandou Manado Hospital. In PHARMACONJurnal Scientific Pharmacy-UNSRAT (Vol. 7, Issue 4).
Tampa, R., Sumombo, J., & Lengkey, Y. (2021). Description of Drug Related Problems (DRPs) in Type 2 Diabetes Mellitus Patients at Tuminting Public Health Center. Indonesian Journal of Pharmacy, 11(1), 49–55. https://doi.org/10.2
Tezel Yalçın, H., Yalçın, N., & Allegaert, K. (2025). Real-World Safety Profile of Proton Pump Inhibitors in Infants as Reported in the FDA Adverse Event Reporting System (FAERS): Tiny Tummies, Key Decisions. Pharmaceuticals, 18(5), 2–17. https://doi.org/10.3390/ph18050730
Titiesari, Y. D., Nursalim, H. Y., & Nathania, J. (2022). Drug-Related Problems in Oncology Patients: What Should Pharmacists Look Out For? Pharmaceutical Magazine, 18(1), 51. https://doi.org/10.22146/farmaseutik.v18i1.71911
Utami, V. W., Pharmacy, S., Aini, S. R., & Puspitasari, C. E. (n.d.). Profile of Drug Related Problems (DRPs) in Schizophrenia Patients at the Inpatient Installation of Mutiara Sukma Mental Hospital, NTB Province in 2020. Pharmaceutical Jpournal of Imdonesia, 8(1), 87–94. Retrieved http://.pji.ub.ac.id
Wilmer, C. M., Huiskes, J. B., Natsch, S., Johannes, A., Rennings, M., Johannnes, B., Van Den Bemt, F., & Bos, J. M. (2015). Drug Related Problems in a clinical setting: a literature review and cross-sectional study evaluating factors to identify patients at risk. European Journal of Hospital Pharmacy, 1(1), 1–7. https://doi.org/10.1136/ejhpharm.
Yasta, P. A. (2023). Overview of Prescription Writing Compliance in BPJS Poly Internal Medicine Specialist Patients with National Formulary for the Period January – February 2021 AT RSI PKU Muhammadiyah Pekajangan. Journal of Adijaya, 440–447.
Zhou, X., Fang, H., Xu, J., Chen, P., Hu, X., Chen, B., Wang, H., Hu, C., & Xu, Z. (2019). Stress ulcer prophylaxis with proton pump inhibitors or histamine 2 receptor antagonists in critically ill adults-a meta-analysis of randomized controlled trials with trial sequential analysis. BMC Gastroenterology, 19(1). https://doi.org/10.1186/s12876-019-1105-y
Zulkarnaini, A., & Martini, R. D. (2019). Overview of Polypharmacy of Geriatric Patients in Several Polyclinics of Dr. M. Djamil Padang Hospital. In Andalas Health Journal (Vol. 8). http://jurnal.fk.unand.ac.id.
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