Abstract | Uvod: Depresija je javnozdravstveni psihički poremećaj koji pogađa više od 264 milijuna ljudi
u svijetu. Depresivni se poremećaji pojavljuju u bilo kojoj životnoj dobi, vrlo često u osoba
mlađe životne dobi i češće ženskog spola. Liječenje se provodi farmakoterapijom,
psihoterapijom ili kombinacijom obje, a ponekad i drugim metodama, kao što je
elektrokonvulzivna terapija. Usprkos brojnim terapijskim opcijama, u velikog broja oboljelih
ne postižu se terapijski ciljevi, a bolest se smatra rezistentnom na terapiju. S obzirom na složenu
patofiziologiju bolesti i neizvjesne ishode liječenja, važan je multidiscipliniran pristup i
uključenje svih dionika koji skrbe o bolesniku, pri čemu je uloga farmaceuta kao najdostupnijeg
zdravstvenog djelatnika od velike važnosti.
Cilj istraživanja: Cilj rada je dobiti uvid u indikacije za koje se propisuju antidepresivi, te koji
su stavovi pacijenata o propisanoj terapiji. Opservacijsko istraživanje provedeno je na uzorku
bolesnika koji podižu svoju terapiju u Ljekarnama PRIMA PHARME. Na osnovu prikupljenih
podataka pomoću posebno kreiranog upitnika dobit će se uvid za koje se indikacije propisuju
antidepresivi te procijeniti odgovor, uspješnost, adherentnost i zadovoljstvo pacijenata
propisanom terapijom.
Ispitanici i metode: Opservacijsko istraživanje u ovom radu provedeno je na 22 pacijenta koji
su u razdoblju u kojem se istraživanje provodilo (kolovoz – listopad 2020.) podizali svoju
terapiju u ljekarni te su pristali sudjelovati u istraživanju. U istraživanju je korišten upitnik
kreiran za potrebe rada kojim su se bilježili i ispitivali: medicinska anamneza, propisani lijekovi
na recept, bezreceptni pripravci koje pacijent koristi, primijećene nuspojave i zadovoljstvo
propisanom terapijom. Od pacijenata je zatražen informirani pristanak za sudjelovanje u
istraživanju. Istraživanje je odobreno od Povjerenstva za etičnost eksperimentalnog rada
Farmaceutsko – biokemijskog fakulteta Sveučilišta u Zagrebu.
Rezultati: Na uzorku od 22 ispitanika njih 69% ima dijagnosticiranu depresiju, dok se kod 31%
ispitanika antidepresivi propisuju zbog drugih indikacija. Najčešće propisivani antidepresivi su
escitalopram i sertralin, dok je venlafaksin nešto rjeđe propisivan lijek. Osim antidepresiva,
ispitanici imaju lijekove za liječenje drugih bolesti. Hipertenzija i hipotireoza su najčešće
zabilježene kronične bolesti, dok se gastritis javlja kao posljedica uzimanja veće količine
lijekova. Dio pacijenata koristi hipnotike i anksiolitike za primjenu po potrebi, najčešće zbog
problema sa spavanjem. Pregledom bezreceptnih pripravaka, manji dio ispitanika koristi
dodatke prehrani sa magnezijem i vitaminima B skupine. Odgovori na pitanja koja obuhvaćaju
životni stil ispitanika, ukazuju da većina redovito puši cigarete (1 – 2 kutije dnevno), dok se
alkohol konzumira prigodno. Nuspojave navodi samo jedan ispitanik, a odnose se na porast
apetita.
Zaključak: Premda se ovo istraživanje temelji na malom broju pacijenata, rezultati pokazuju
da depresija i drugi psihički poremećaji sa sobom nose niz simptoma koje treba liječiti, ali je i
praćena različitim komorbiditetima, što traži multidiscipliniran i individualiziran pristup
svakom pacijentu. Uloga ljekarnika je od iznimne važnosti kod praćenja ishoda liječenja budući
da su ljekarnici zdravstveni djelatnici koji izdaju propisanu terapiju, savjetuju pacijenta, te prate
ishode liječenja. Preduvjet za kvalitetnu ljekarničku skrb je stalna edukacija i osobni razvoj,
kao i prilagodba pacijentima s kojima smo svakodnevno u kontaktu. |
Abstract (english) | Introduction: Depression is a public health mental disorder that affects more than 264 million
people worldwide. Depressive disorders occur at any age, very often in people of younger age
and more often females. Treatment is carried out with pharmacotherapy, psychotherapy, or a
combination of both, and sometimes by other methods, such as electroconvulsive therapy.
Despite numerous therapeutic options, a large number of patients do not achive therapeutic
goals, and the disease is considered resistant to therapy. Given the complex pathophysiology of
the disease and the uncertain outcome of treatment, a multidisciplinary approach and
involvement of all stakeholders caring for the patient is important, with the role of the
pharmacist as the most accessible health professional being of great importance.
Objectives: The aim of this paper is to gain insight into the indications for which
antidepressants are prescribed, and what are the attitudes of patients about the prescribed
therapy. The observational study was conducted on a sample of patients who raise their therapy
in PRIMA PHARMA Pharmacies. Based on the collected data, a specially created questionare
will provide insight into the indications for which antidepressants are prescribed and assess the
response, success, cooperation and satisfaction of patients with the prescribed therapy.
Respondents and methods: Observational research in this study was conducted on 22 patients
who in the period in which the study was conducted (August - October 2020) raised their
therapy in the pharmacy and agreed to participate in the study. The research used a
questionnaire created for the purposes of work that was recorded and examined: medical
history, prescribed prescription drugs, over-the-counter preparations used by the patient,
observed side effects and satisfaction with the prescribed therapy. Patients were asked for
informed consent to participate in the study. The research was approved by Ethics Committee
for Experimental Work of the Faculty of Pharmacy and Biochemistry, University of Zagreb.
Results: In a sample of 22 subjects, 69% of them were diagnosed with depression, while 31%
of subjects were prescribed antidepressants due to other indications. The most commonly
prescribed antidepressants are escitalopram and sertraline, while venlafaxine is a somewhat less
commonly prescribed drug. In addition to antidepressants, subjects have medications to treat
other illnesses. Hypertension and hypothyroidism are the most commonly reported chronic
diseases, while gastritis occurs as a result of taking larger amounts of medication. Some patients
use hypnotics and anxiolytics for use as needed, most often due to sleep problems. By reviewing
over-the-counter preparations, a smaller proportion of respondents use dietary supplements
with magnesium and B vitamins. The answers to the questions covering the lifestyle of the
respondents indicate that most people smoke cigarettes regularly (1-2 boxes a day), while
alcohol is consumed occasionally. Side effects are reported by one respondent and relate to an
increase in appetite.
Conclusion: Although this research is based on a small number of patients, the results show
that depression and other mental disorders carry with them a number of symptoms that need to
be treated, but is also accompanied by different comorbidities, which requires a
multidisciplinary and individual approach to each patient. The role of the pharmacist is
extremely important in monitoring the outcomes of treatment since pharmacists are health
professionals who prescribe the prescribed therapy, advise the patient, and monitor the
outcomes of treatment. A prerequisite for quality patient care is constant education and personal
development, as well as adaptation to patients with whom we are in daily contact |