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In this study, we aimed to prepare and validate an Indonesian version for the Screening Tool of Older People's Prescriptions STOPP , which is an instrument to identify inappropriate medications for elderly patients. The study design for this part was quasi-experimental with purposive sampling for members of the translator's team, expert's team, and respondents in the pretest, but they were different from field testing that used purposive and postsurvey sampling for respondents.
Internal consistency was measured with Cronbach's alpha coefficient. The expert panel agreed on a list of 81 criteria. Five The research subjects in the psychometric test had respondents, 5 2. There were 5 criteria that not valid statistically, they could not be removed from the instrument because they can influence content and construct of the instrument. In , the prevalence of morbidity for the elderly in Indonesia reached This caused susceptibility the body to disease.
The ageing process in the elderly also resulted in changes in body composition, pharmacokinetic and pharmacodynamics that could increase sensitivity to certain drugs. Multimorbidity and the use of large amounts of medicines caused potentially inappropriate medications PIM , polypharmacy,[ 4 ] hospitalization, adverse drug reactions,[ 5 , 6 ] and fall in elderly patients.
The identification of appropriate medications in elderly patients was critically important because they were susceptible to diseases. This study aimed to adapt the English version of STOPP to Indonesian culture and to measure the validity and reliability of the instrument. The development of the instrument was carried out through the adaptation process of the STOPP version 2 criteria. Informed consent was given to subjects before participating. The research was conducted on a multicenter of Indonesian hospitals.
They were independent translators, didn't know each other, were fluent in Indonesian and English and had different scientific backgrounds. The synthesis of the forward translation and back translation was undertaken by the researcher and translators through confirmation and discussion for the differences of meanings. Each correction of translation was recorded as data in the translation process.
The stage of adaptation of instrument is presented as follows: [ Figure 1 ]. The papers were sent to members of the expert team for initial reviewing, followed by an expert panel, and were sent back to review more. The composition of this expert team consisted of two geriatricians, one pharmacologist, one endocrinologist, one cardiologist, one neurologist, one clinical pharmacist, and one linguist who was also a translator member.
The study design in the pretest was a quasi-experimental study with the test—retest method. Respondents were pharmacists who met the inclusion and exclusion criteria and were chosen using a purposive sampling technique in March The minimum number of the needed subjects was 30 respondents.
Hospital pharmacists who served in managerial pharmacy or served outside the hospital pharmacy installation were excluded. The design of this part of our study was quasi-experimental with the one-shot method. The data were taken using a purposive sampling technique through survey post in July—October Respondents were a pharmacist who required of the inclusion and exclusion criteria, such as pretest respondent qualification.
The data analysis was presented qualitatively for the modified criteria. The construct validity and reliability were tested and reported with a Pearson correlation and Cronbach's alpha coefficient. There were 30 The instrument feasibility assessment showed that 5 The total number of subjects at the pretest stage was 34 respondents.
The basic characteristics of respondents are presented in Table 2. The internal consistency showed that item criteria were not relevant. Therefore, a retest was carried out on these items. The internal consistency of the first test and retest is presented in Table 3. In the field test stage, respondents were pharmacists from hospitals in Indonesia and obtained Five respondents did not complete the questionnaire, and the characteristics of respondents are presented in Table 2.
The Cronbach's alpha was 0. This study used a different validation method from the study of Luz et al. They used the Delphi two-round method. It aimed to get the right word selection and reduce the ambiguous meanings, so produced a better instrument equivalence. This process aimed to reduce errors in translation results, correct sentences to be easily understood, and assess the quality of translations with the original version.
Data were obtained from regional 1 to regional 5, which means that it could represent the entire territory of Indonesia. The measurement of content validity in this study was obtained from qualitative and quantitative measurements. Qualitative measurements resulted from the consideration of the expert team validity by assumption ,[ 24 ] which resulted in a modification in the STOPP criteria as in Table 1.
Quantitative measurements were obtained from two subjects, namely from the expert team and respondents in the pretest stage. The face validity qualitatively showed that a correlation was obtained from the reviews and opinions of the expert team, related to the consistency of the style and format of the writing, while from respondents in the pretest stage, related to the readability and clarity of the language, not confusing, unambiguous, a sentence was not too long or too short.
This was being caused by some matter, among others: in criterion A1, had an incomplete sentence. In old age, oedema can occur due to poor circulation sitting too often , so causing a buildup of fluid in the lower body, especially at the ankles and feet.
The correction was a using of criterion that had been agreed by the expert team; in criterion B10, had an imperfection of sentence order. The correction of C3 was an adding of the name of medicines. We hope the instrument can be used in clinical practice and research on medication among the elderly.
The final adapted and validated version of the questionnaire is available online in the journal's website as a [ Supplement Table 1 ]. All authors contributed to the design, the questionnaire developing, data collection, and analysis. All authors participated in the editing, reviewing, and approval of the final version of the manuscript.
We express our gratitude and a special appreciation Prof. Ger, M. We would like to thank the team of experts namely Prof. Armen Muchtar, DAF. Budi Wahyono, SpS. Yulia Trisna, M. National Center for Biotechnology Information , U. J Res Pharm Pract. Published online Mar Author information Article notes Copyright and License information Disclaimer. Mintohardjo Navy Hospital, Jakarta, Indonesia. Address for correspondence: Mrs. Siti Fauziyah, E-mail: moc. Maksum Radji, E-mail: di. Received Jun 15; Accepted Nov This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.
Abstract Objective: In this study, we aimed to prepare and validate an Indonesian version for the Screening Tool of Older People's Prescriptions STOPP , which is an instrument to identify inappropriate medications for elderly patients. Findings: The expert panel agreed on a list of 81 criteria.
Open in a separate window. Figure 1. Flowchart of adaptation of instrument in the Indonesian version. Table 2 Basic demographic characteristics of respondents. Table 3 Internal consistency of the first test and retest of item criteria. Diuretik tiazid memperberat hipokalemia, hiponatremia, hiperkalsemia, dan penyakit pirai. Antihipertensi kerja sentral kurang dapat ditoleransi oleh pasien usia lanjut. Berisiko tinggi terjadi perdarahan. Penghentian tiba-tiba menimbulkan risiko gejala putus obat 33 D1 Antipsychotics i.
Renal system criteria Bagian E. Contoh: Omeprazole, lansoprazole, pantoprazole, Esomeprazole 50 F3 Drugs likely to cause constipation e. Terapi kortikosteroid inhalasi yang lebih efektif 54 G3 Anti-muscarinic bronchodilators e. Dapat memperparah glaucoma atau obstruksi aliran kandung kemih Dapat menyebabkan retensi urin 55 G4 Benzodiazepines with acute or chronic respiratory failure, i.
Conflicts of interest There are no conflicts of interest. Acknowledgments We express our gratitude and a special appreciation Prof. National Socioeconomic Survey Results. Central Bureau of Statistics. Jakarta: Indonesia; Elderly Population Statistics Niccoli T, Partridge L. Ageing as a risk factor for disease. Curr Biol. Potentially inappropriate drug prescribing in elderly hospitalized patients: An analysis and comparison of explicit criteria.
Hiperfosfatemia ialah suatu gangguan elektrolit yang melibatkan adanya peningkatan paras abnormal fosfat di dalam darah. Purata paras fosforus patut berada pada antara 0. Tanda dan gejala termasuk pengkalsiuman ektopi , hiperparatiroidisme sekunder, dan osteodistrofi ginjal. Hipoparatiroidisme : Dalam keadaan ini, ada paras rendah bagi hormon paratiroid PTH. PTH secara normal merencat penyerapan semula ginjal bagi fosfat, dan maka tanpa PTH secukupnya ada lebih penyerapan semula fosfat. Kegagalan ginjal kronik : Apabila ginjal tidak berfungsi dengan baik, ada peningkatan penahanan fosfat.