Title Suradljivost pri uzimanju lijekova u bolesnika na kroničnoj hemodijalizi. Title (english) Medication adherence in chronic hemodialysis patients. Author Dunja Bart Mentor Lada Zibar (mentor)Committee member Lada Zibar (predsjednik povjerenstva)Committee member Marko Jakić (član povjerenstva)Committee member Suzana Mimica-Matanović (član povjerenstva)Granter Josip Juraj Strossmayer University of Osijek Defense date and country 2017-09-21, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Cilj istraživanja: Utvrditi učestalost nesuradljivosti pri uzimanju lijekova u bolesnika na kroničnoj hemodijalizi (HD) s obzirom na propisane lijekove i one koje stvarno uzimaju („upornost“) te s obzirom na dob. Utvrditi suradljivost pomoću upitnika o propuštanju uzimanja lijekova („izvršenje“) i odnos između "stvarne" suradljivosti i one utvrđene upitnikom („upornost“ i „izvršenje“). Identificirati bolesnike u kojih je zbog nesuradljivosti pri uzimanju lijekova potreban dodatni nadzor. Ispitanici i postupci: U istraživanju je sudjelovalo 127 bolesnika (75 muških) na kroničnom HD-u u Kliničkom bolničkom centru (KBC) Osijek. Postupci istraživanja uključivali su preuzimanje demografskih i općih medicinskih podataka iz medicinskih zapisa te podataka o propisanim lijekovima iz protokola HD-a. Bolesnicima je bilo rečeno da donesu na uvid sve lijekove koje uzimaju radi utvrđivanja „stvarne“ suradljivosti. Proveden je upitnik End Stage Renal Disease Adherence Questionnaire o propuštanju uzimanja lijekova. Uspoređeni su podaci o propisanim lijekovima, stvarno uzimanim lijekovima te o propuštanju uzimanja lijekova. Rezultati: 19 bolesnika (15 %) nije riješilo upitnik, a njih 36 (28 %) nije donijelo na uvid lijekove koje uzima. Za 91 bolesnika (72 %) koji je donio na uvid lijekove koje aktualno uzima bilo je propisano prosječno 7,2 (SD 3), a stvarno su uzimali prosječno 6,5 (SD 3,1) vrsta lijekova (P = 0,005). Suradljivost se nije razlikovala s obzirom na dob. Oko dvije trećine bolesnika nije propuštalo uzimati lijekove ili su to činili vrlo rijetko. Zaključak: Bolesnici koji se liječe HD-om u KBC-u Osijek većinom su bili suradljivi pri uzimanju lijekova, iako je broj lijekova koje su stvarno aktualno uzimali bio statistički značajno manji od broja lijekova koji im je bio propisan (ali veličina te razlike nije bila velika). Pomoću upitnika utvrđeno je da većina bolesnika uglavnom ne propušta uzimati lijekove. Suradljivost je bila neovisna o dobi. Upitnik je dobar pokazatelj suradljivosti, njime se mogu identificirati bolesnici koji su nesuradljivi i kojima se treba posvetiti veća pozornost, iako ta, upitnikom ispitana suradljivost u smislu „izvršenja“, odnosno nepropuštanja uzimanja lijeka, nije imala značajan odnos s tzv. „upornošću“ kao vrstom nesuradljivosti (odnosi se na razliku u broju vrsta propisanih i uzimanih lijekova). Ipak, i ovaj udio nesuradljivih bolesnika ukazuje na potrebne dodatne napore liječnika i medicinskih sestara u komunikaciji i podršci oko redovitog uzimanja svih propisanih lijekova.
Abstract (english) Aim: To examine the non-adherence to drug therapy in chronic haemodialysis (HD) patients, in terms of prescribed and actually taken drugs (”persistence”), and in relation to their age. To determine the adherence using the questionnaire to find out whether the patients are taking the drugs (”execution”) and to examine the relation between ”persistence” and ”execution”. To identify the patients who need additional support due to non-adherence in taking their prescribed drugs. Patients and methods: Study included 127 chronic HD patients (75 males) at Clinical Hospital Centre Osijek (CHCO). Demographics and general medical data were taken from the medical records and data on the prescribed drugs from dialysis protocols. The patients were asked to bring all the drugs that they were taking to determine the “persistence”. The End Stage Renal Disease Adherence Questionnaire on omitting to take drugs was performed. The data on the prescribed drugs, the drugs that were actually taken, and the drugs that were omitted were compared. Results: 19 patients (15 %) did not fill in the questionnaire and 36 (28 %) of them did not provide the drugs that they were actually taking. For 91 (72 %) of the patients who brought their drugs, 7.2 kinds of drugs (SD 3) were prescribed and they were actually taking 6.5 kinds of drugs on average (SD 3.1), P = 0.005. There was no difference in adherence in relation to the patients’ age. Around two thirds of the patients answered that they did not omit to take drugs or that they did it very rarely. Conclusion: Majority of the chronic HD patients at the CHCO adhered to the drug therapy, although statistically the number of the drugs they were actually taking was significantly lower than the number of the drugs they were prescribed. However, the difference was not large. The answers to the questionnaire showed that most of the patients did not omit to take their drugs. The adherence was not related to the patients’ age. The questionnaire was a good indicator of adherence and a good tool for identifying non-adherent patients who require special attention, even though the “execution” which was examined in the questionnaire did not relate to the “persistence” (the difference between the prescribed kinds of drugs and the kinds of drugs that were actually being taken), as the other mode of non-adherence. However, even this smaller proportion of non-adherent patients requires additional efforts by physicians and nurses in communication and support regarding regular taking of all prescribed medication.
Keywords
suradljivost
hemodijaliza
lijekovi
upitnik
ESRD - AQ
Keywords (english)
adherence
haemodialysis
drugs
questionnaire
ESRD - AQ
Language croatian URN:NBN urn:nbn:hr:152:789078 Study programme Title: University undergraduate study Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2018-03-19 09:05:49
