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master's thesis
Klinički ishodi i njihova povezanost s potencijalno neprikladnim lijekovima
Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry, 2016. urn:nbn:hr:163:622031
Marić, Patricia
University of Zagreb
Faculty of Pharmacy and Biochemistry

Institutional repository: Repository of Faculty of Pharmacy and Biochemistry University of Zagreb

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Marić, P. (2016). Klinički ishodi i njihova povezanost s potencijalno neprikladnim lijekovima (Master's thesis). Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry. Retrieved from https://urn.nsk.hr/urn:nbn:hr:163:622031

Marić, Patricia. "Klinički ishodi i njihova povezanost s potencijalno neprikladnim lijekovima." Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, 2016. https://urn.nsk.hr/urn:nbn:hr:163:622031

Marić, Patricia. "Klinički ishodi i njihova povezanost s potencijalno neprikladnim lijekovima." Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, 2016. https://urn.nsk.hr/urn:nbn:hr:163:622031

Marić, P. (2016). 'Klinički ishodi i njihova povezanost s potencijalno neprikladnim lijekovima', Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, accessed 22 November 2024, https://urn.nsk.hr/urn:nbn:hr:163:622031

Marić P. Klinički ishodi i njihova povezanost s potencijalno neprikladnim lijekovima [Master's thesis]. Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry; 2016 [cited 2024 November 22] Available at: https://urn.nsk.hr/urn:nbn:hr:163:622031

P. Marić, "Klinički ishodi i njihova povezanost s potencijalno neprikladnim lijekovima", Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, 2016. Available at: https://urn.nsk.hr/urn:nbn:hr:163:622031

Metadata
TitleKlinički ishodi i njihova povezanost s potencijalno neprikladnim lijekovima
Title (english)Assessment of potentially inappropriate medications and clinical outcomes
AuthorPatricia Marić
MentorIva Mucalo (mentor)
MentorMaja Ortner Hadžiabdić (mentor)
Committee memberIva Mucalo (predsjednik povjerenstva)
Committee memberMaja Ortner Hadžiabdić (član povjerenstva)
Committee memberŽivka Juričić (član povjerenstva)
GranterUniversity of Zagreb
Faculty of Pharmacy and Biochemistry
Zagreb
Defense date and country2016-09-30, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Pharmacy
Pharmacy
Abstract
Cilj istraživanja bio je odrediti PNL-e u bolesnika starije životne dobi koristeći Sveobuhvatni protokol te odrediti učestalost povezanosti PNL-a s mjerenim kliničkim ishodima. Prospektivno opservacijsko istraživanje provedeno je u razdoblju od listopada 2014. do prosinca 2015. godine u Klinici za unutarnje bolesti Kliničke bolnice Dubrava. U istraživanje su bili uključeni akutno i elektivno hospitalizirani bolesnici u dobi od 65 i više godina starosti koji su u terapiji imali najmanje jedan redoviti receptni lijek. Za svakoga bolesnika prikupljeni su podaci o lijekovima prije hospitalizacije i pri otpustu, podaci o komorbiditetima te osnovni laboratorijski nalazi uvidom u medicinsku dokumentaciju, temperaturnu listu, iz razgovora s bolesnicima, a prema potrebi s liječnicima obiteljske medicine, skrbnicima i/ili članovima obitelji. Podaci o kliničkim ishodima prikupljeni su putem telefonskog razgovora s bolesnicima ili članovima obitelji dva ili više mjeseca nakon njihovog otpusta iz bolnice. Ishodi su uključivali podatke o ponovnoj hospitalizaciji, prijemu u hitnu medicinsku službu, neplaniranom odlasku liječniku obiteljske medicine, promjeni terapije i nuspojavama. U istraživanje je bilo uključeno 248 bolesnika prosječne dobi 72,9 ± 6,2 godina koji su u prosjeku koristili 5,9 ± 3,3 lijekova te imali 6,7 ± 3,0 dijagnoza. Pomoću Sveobuhvatnog protokola otkriveno je 177 PNL-a te 148 potencijalno opasnih lijek-lijek interakcija. Najčešće propisivani PNL-ovi su bili benzodiazepini, moksonidin te antikoagulansi. Upotreba lijekova koji mogu uzrokovati hiperkalijemiju bila je najučestalija interakcija. Klinički ishodi ustanovljeni su u 117 (47,2%) pacijenata. Za 23 PNL-a smatramo da su povezani s nepovoljnim kliničkim ishodima. Najčešći ishodi uključivali su krvarenje korištenjem varfarina i antikoagulansa te vrtoglavicu i opću slabost primjenom benzodiazepina. Pomoću Sveobuhvatnog protokola identificirana je velika prevalencija PNL-ova čijim se sprječavanjem može postići racionalnije propisivanje lijekova, smanjiti rizik od nastanka nuspojava i interakcija te smanjiti ukupni troškovi liječenja.
Abstract (english)
The objective of this study was to identify PIMs by using a validated originally developed protocol and assess their impact on measured clinical outcomes. A cross-sectional observational study was conducted in the period from October 2014 to December 2015 in Department of Internal Medicine, University Hospital Dubrava. Patients older than 65 years submitted by emergency or elective admission and with at least one drug after discharge were included. For each patient full drug history at hospital admission and discharge, comorbidities and basic laboratory reports were retrieved. Clinical outcomes were obtained by telephone interview following two or more months hospital discharge and included the incidence of hospital readmission and emergency department visits, side-effects and therapy amendments. There were included 248 patients in this study average age 72,9 ± 6,2 that had average 5,9 ± 3,3 medications and 6,7 ± 3,0 comorbidities. Using comprehensive protocol, there were 177 PIMs detected, and 148 potentially dangerous drug-drug interactions (DDIs). The most common prescribed medications were long-acting benzodiazepines, moxonidine and anticoagulant and antiplatelet drugs. Concomitant use of drugs that possibly lead to hyperkalemia is detected as most usual interaction. A total of 117 clinical outcomes were obtained and 23 were associated with PIMs. The most common were bleeding caused by warfarin and other anticoagulant drug and dizziness and general weakness using benzodiazepines. Using comprehensive protocol a high incidence of PIMs was detected whose prevention may achieve more rational prescribing, decrease a risk of side-effects and interactions including total costs of treatment.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:163:622031
Study programmeTitle: Pharmacy
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
Type of resourceText
File originBorn digital
Access conditionsAccess restricted to students and staff of home institution
Terms of useLicence In copyright icon
Created on2016-12-06 13:56:38