Evaluation of drug use in rheumatoid arthritis patients at the outpatient installation of Dr. H. Abdul Moeloek Bandar Lampung Regional Hospital
DOI:
10.29303/sjp.v7i1.467Downloads
Abstract
Rheumatoid Arthritis (RA) is an autoimmune disease characterized by the main symptoms of pain, swelling, stiffness in the joints and joint inflammation. Joint pain in RA can reduce quality of life and can interfere with work and social activities. This study aims to determine the characteristics of rheumatoid arthritis patients and analyze the evaluation of drug use in rheumatoid arthritis patients in the outpatient installation of RSUD Dr. H. Abdul Moeloek Bandar Lampung. This research is non-experimental in nature using data collection techniques in the form of purpose sampling. The patient population studied was aged ≥ 18 years with a minimum sample size of 65 patients. The results of research regarding the characteristics of rheumatoid arthritis patients in the outpatient installation of RSUD Dr. H. Abdul Moeloek Bandar Lampung showed that RA patients were dominated by age 40-50 years as much as 35% with female gender as much as 86.15%, and consuming methotrexate as much as 78% with the most symptoms being pain as much as 97% and accompanied by hypertension as comorbidities were 12.3%. Evaluation of drug use in rheumatoid arthritis patients in the outpatient installation of Dr. H. Abdul Moeloek Bandar Lampung Hospital obtained rationality results of 9.2% irrational and 90.8% rational with categories of appropriate indications of 100%, appropriate drugs of 100%, appropriate dosage of 90.7%, and appropriate patients of 100%.
Keywords:
DMARD, Methotrexate, Rheumatoid Arthritis, Treatment EvaluationReferences
AC, C., & JR, O. (2020). Traditional DMARDs: Methotrexate, Leflunomide, Sulfasalazine, Hydroxychloroquin, and Combination Therapies. (F. GS, B. RC, G. SE, K. GA, M. IB, & O. JR, Eds.; 11th ed Elsevier). Firestein & Kelley’s Textbook of Rheumatology.
Alfaro, R. A., & Davis, D. D. (2024). Diclofenac.
American College of Rheumatology. (2012). Rheumatoid Arthritis. Diakses 08 Maret 2024, Www.Rheumatology.Org.
Bandyopadhyay, D., Banerjee, U., Modi, A. V., Haddadin, F., Estrella, M. A., Sud, K., Ghosh, K. R., Hajra, A., Rajeeve, S., Chakraborty, S., & Palazzo, M. A. (2018). Tren Komplikasi Jantung pada Pasien Artritis Reumatoid: Sebuah Wawasan Dari Sampel Rawat Inap Nasional;2005-2014. AHAIASA Journals, 138.
Bobek, D., Banić Stipetić, A., Franić, M., Lucijanić, M., Lucijanić, J., Gudelj Gračanin, A., Mijačika, L., & Perić, P. (2022). USE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS IN PATIENTS WITH ADVANCED ACTIVE RHEUMATOID ARTHRITIS. Acta Clinica Croatica, 61(4), 588–598. https://doi.org/10.20471/acc.2022.61.04.04
Brunier, L., Bleterry, M., Merle, S., Derancourt, C., Polomat, K., Dehlinger, V., Deligny, C., Jean-Baptiste, G., Arfi, S., Banydeen, R., & De Bandt, M. (2017). Prevalence of rheumatoid arthritis in the French West Indies: Results of the EPPPRA study in Martinique. Joint Bone Spine, 84(4), 455–461. https://doi.org/10.1016/j.jbspin.2016.09.003
Bullock, J., Rizvi, S. A. A., Saleh, A. M., Ahmed, S. S., Do, D. P., Ansari, R. A., & Ahmed, J. (2018). Rheumatoid Arthritis: A Brief Overview of the Treatment. Medical Principles and Practice, 27(6), 501–507. https://doi.org/10.1159/000493390
Cajas, L. J., Casallas, A., Medina, Y. F., Quintana, G., & Rondón, F. (2019). Pannus and rheumatoid arthritis: Historic and pathophysiological evolution. Revista Colombiana de Reumatología (English Edition), 26(2), 118–128. https://doi.org/10.1016/j.rcreue.2018.10.005
Chauhan, K., Jandu, J. S., Brent, L. H., & Al-Dhahir, M. A. (2023). Rheumatoid Arthritis.
Del Grossi Moura, M., Cruz Lopes, L., Silva, M. T., Barberato-Filho, S., Motta, R. H. L., & Bergamaschi, C. de C. (2018). Use of steroid and nonsteroidal anti-inflammatories in the treatment of rheumatoid arthritis. Medicine, 97(41), e12658. https://doi.org/10.1097/MD.0000000000012658
Dennison, E. M., & Cooper, C. (1998). Corticosteroids in rheumatoid arthritis. BMJ (Clinical Research Ed.), 316(7134), 789–790. https://doi.org/10.1136/bmj.316.7134.789
Departemen Kesehatan Republik Indonesia (Depkes RI). (2019). Lansia. Departemen Kesehatan Republik Indonesia (Depkes RI).
Firmansyah, D., & Dede. (2022). Teknik Pengambilan Sampel Umum dalam MetodologiPenelitian: Literature Review. Jurnal Ilmiah Pendidikan Holistik (JIPH), 1(2), 85–114.
Fraenkel, L., Bathon, J. M., England, B. R., St.Clair, E. W., Arayssi, T., Carandang, K., Deane, K. D., Genovese, M., Huston, K. K., Kerr, G., Kremer, J., Nakamura, M. C., Russell, L. A., Singh, J. A., Smith, B. J., Sparks, J. A., Venkatachalam, S., Weinblatt, M. E., Al‐Gibbawi, M., Akl, E. A. (2021). 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care & Research, 73(7), 924–939. https://doi.org/10.1002/acr.24596
Guo, Q., Wang, Y., Xu, D., Nossent, J., Pavlos, N. J., & Xu, J. (2018). Rheumatoid arthritis: Pathological mechanisms and modern pharmacologic therapies. In Bone Research (Vol. 6, Issue 1). Sichuan University. https://doi.org/10.1038/s41413-018-0016-9
Hamijo, L., & Suarjana, N. I. (2020). Buku Saku Rheumatologi. In Buku Saku Reumatologi (pp. 27–32). Perhimpunan Reumatologi Indonesia.
Hidayat, R., Putu Bagus, Kurniaty, L., Ariane, A., Yanti, R., Adnan, E., & Sumariyono. (2021). Diagnosis dan Pengelolaan Artritis Reumatoid. Perhimpunan Reumatologi Indonesia.
Hua, C., Buttgereit, F., & Combe, B. (2020). Glucocorticoids in rheumatoid arthritis: current status and future studies. RMD Open, 6(1), e000536. https://doi.org/10.1136/rmdopen-2017-000536
Inui, K., & Koike, T. (2016). Combination therapy with biologic agents in rheumatic diseases: current and future prospects. Therapeutic Advances in Musculoskeletal Disease, 8(5), 192–202. https://doi.org/10.1177/1759720X16665330
Jorge, A., Ung, C., Young, L. H., Melles, R. B., & Choi, H. K. (2018). Hydroxychloroquine retinopathy - implications of research advances for rheumatology care. Nature Reviews. Rheumatology, 14(12), 693–703. https://doi.org/10.1038/s41584-018-0111-8
Köhler, Günther, Kaudewitz, & Lorenz. (2019). Current Therapeutic Options in the Treatment of Rheumatoid Arthritis. Journal of Clinical Medicine, 8(7), 938. https://doi.org/10.3390/jcm8070938
Lin, Y.-J., Anzaghe, M., & Schülke, S. (2020). Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis. Cells, 9(4). https://doi.org/10.3390/cells9040880
Lopez-Olivo, M. A., Siddhanamatha, H. R., Shea, B., Tugwell, P., Wells, G. A., & Suarez-Almazor, M. E. (2014). Methotrexate for treating rheumatoid arthritis. The Cochrane Database of Systematic Reviews, 2014(6), CD000957. https://doi.org/10.1002/14651858.CD000957.pub2
McWilliams, D. F., Thankaraj, D., Jones-Diette, J., Morgan, R., Ifesemen, O. S., Shenker, N. G., & Walsh, D. A. (2021). The efficacy of systemic glucocorticosteroids for pain in rheumatoid arthritis: a systematic literature review and meta-analysis. Rheumatology (Oxford, England), 61(1), 76–89. https://doi.org/10.1093/rheumatology/keab503
Monti, S., Klersy, C., Gorla, R., Sarzi-Puttini, P., Atzeni, F., Pellerito, R., Fusaro, E., Paolazzi, G., Rocchetta, P. A., Favalli, E. G., Marchesoni, A., & Caporali, R. (2017). Factors influencing the choice of first- and second-line biologic therapy for the treatment of rheumatoid arthritis: real-life data from the Italian LORHEN Registry. Clinical Rheumatology, 36(4), 753–761. https://doi.org/10.1007/s10067-016-3528-y
Nirk, E. L., Reggiori, F., & Mauthe, M. (2020). Hydroxychloroquine in rheumatic autoimmune disorders and beyond. EMBO Molecular Medicine, 12(8), e12476. https://doi.org/10.15252/emmm.202012476
Nitiyoso, N. (2020). Pilihan Pengobatan Artritis Rematoid. CDK-285, 47(4).
Papadogianni, P., & Lambrou, G. I. (2023). Rheumatoid Arthritis and Pannus. Journal of Research and Practice on the Musculoskeletal System, 7(2), 44–49. https://doi.org/10.22540/JRPMS-07-044
Perhimpunan Reumatologi Indonesia. (2014). Diagnosis dan Pengelolaan Arthritis Reumatoid. Perhimpunan Reumatologi Indonesia.
Radu, A.-F., & Bungau, S. G. (2021). Management of Rheumatoid Arthritis: An Overview. Cells, 10(11). https://doi.org/10.3390/cells10112857
Rezuș, E., Macovei, L. A., Burlui, A. M., Cardoneanu, A., & Rezuș, C. (2021). Ischemic Heart Disease and Rheumatoid Arthritis—Two Conditions, the Same Background. Life, 11(10), 1042. https://doi.org/10.3390/life11101042
Riskesdas. (2018). Hasil Utama Riset Kesehata Dasar (RISKESDAS). 44(8).
Ruffer, N., Krusche, M., Beil, F. T., Amling, M., Kötter, I., &
Rolvien, T. (2022). Clinical features of methotrexate osteopathy in rheumatic musculoskeletal disease: A systematic review. Seminars in Arthritis and Rheumatism, 52, 151952. https://doi.org/10.1016/j.semarthrit.2022.151952
Rusmini, H., Primadiamanti, A., & Oktavian, R. D. (2018). Gambaran Rasionalitas Terapi Awal Pasien Reumatoid Artritis di Poli Penyakit Dalam dan Poli Bedah Tulang RSUD Abdul Moeloek Provinsi Lampung. Jurnal Ilmu Kedokteran Dan Kesehatan, 5(2).
Sah, S. K., Ramaswamy, S., & Ramesh, M. (2022). Frequency and risk factors for the development of drug related problems among rheumatoid arthritis patients. Clinical Epidemiology and Global Health, 13, 100969. https://doi.org/10.1016/j.cegh.2022.100969
Schapink, L., van den Ende, C. H. M., Gevers, L. A. H. A., van Ede, A. E., & den Broeder, A. A. (2019). The effects of methotrexate and hydroxychloroquine combination therapy vs methotrexate monotherapy in early rheumatoid arthritis patients. Rheumatology (Oxford, England), 58(1), 131–134. https://doi.org/10.1093/rheumatology/key275
Shetty, A., Cho, W., Alazawi, W., & Syn, W.-K. (2017). Methotrexate Hepatotoxicity and the Impact of Nonalcoholic Fatty Liver Disease. The American Journal of the Medical Sciences, 354(2), 172–181. https://doi.org/10.1016/j.amjms.2017.03.014
Singh, J. A., Saag, K. G., Bridges, S. L., Akl, E. A., Bannuru, R. R., Sullivan, M. C., Vaysbrot, E., McNaughton, C., Osani, M., Shmerling, R. H., Curtis, J. R., Furst, D. E., Parks, D., Kavanaugh, A., O’Dell, J., King, C., Leong, A., Matteson, E. L., Schousboe, J. T., … McAlindon, T. (2016). 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis & Rheumatology (Hoboken, N.J.), 68(1), 1–26. https://doi.org/10.1002/art.39480
Smolen, J. S., Landewé, R., Breedveld, F. C., Buch, M., Burmester, G., Dougados, M., Emery, P., Gaujoux-Viala, C., Gossec, L., Nam, J., Ramiro, S., Winthrop, K., de Wit, M., Aletaha, D., Betteridge, N., Bijlsma, J. W. J., Boers, M., Buttgereit, F., Combe, B. van der Heijde, D. (2014). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease modifying antirheumatic drugs: 2013 update. Annals of the Rheumatic Diseases, 73(3), 492–509. https://doi.org/10.1136/annrheumdis-2013-204573
Surya, A., Kurniawati, D., Herawati, A., & Melviani. (2023). Studi Rasionalitas Penggunaan Obat Rheumatoid Arthritis Pada Pasien Rawat Jalan di RSUD Ulin Wilayah Banjarmasin. Jurnal Farmasi SYIFA, 1(2), 59–67.
Taylor, P. C., Atzeni, F., Balsa, A., Gossec, L., Müller-Ladner, U., & Pope, J. (2021). The Key Comorbidities in Patients with Rheumatoid Arthritis: A Narrative Review. Journal of Clinical Medicine, 10(3). https://doi.org/10.3390/jcm10030509
Wu, D., Luo, Y., Li, T., Zhao, X., Lv, T., Fang, G., Ou, P., Li, H., Luo, X., Huang, A., & Pang, Y. (2022). Systemic complications of rheumatoid arthritis: Focus on pathogenesis and treatment. Frontiers in Immunology, 13, 1051082. https://doi.org/10.3389/fimmu.2022.1051082
Yu, C., Liu, C., Jiang, J., Li, H., Chen, J., Chen, T., & Zhan, X. (2020). Gender Differences in Rheumatoid Arthritis: Interleukin-4 Plays an Important Role. Journal of Immunology Research, 2020, 4121524. https://doi.org/10.1155/2020/4121524
Z, M., & N, R. (2016). Penanganan Rematik dengan Pemeriksaan LED . 31–48.
License
Copyright (c) 2026 The Author(s)

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with Sasambo Journal of Pharmacy (SJP), agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Lisensi Creative Commons Atribusi 4.0 Internasional. This license allows authors to use all articles, data sets, graphics and appendices in data mining applications, search engines, web sites, blogs, and other platforms by providing an appropriate reference. The journal allows the author(s) to hold the copyright without restrictions and will retain publishing rights without restrictions.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Sasambo Journal of Pharmacy
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).




