Genel dahiliye polikliniğine başvuran yaşlı hastalarda ilaç-ilaç etkileşimlerinin ve tedaviye uyumun araştırılması
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Date
2023
Authors
Tatar, Mustafa
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Yaşlanmayla birlikte kronik hastalıklar ve geriatrik sendromlar artmaktadır. Bunun sonucu olarak kullanılan ilaç sayısı ve polifarmasi oranları da artmaktadır. Çalışmamızda yaşlı hastalarda polifarmasi ve potansiyel ilaç-ilaç etkileşim oranlarının belirlenmesi amaçlandı. Prospektif kesitsel bir çalışma olarak planlandı. Etik kurul onayı alındıktan sonra Bursa Uludağ Üniversitesi Tıp Fakültesi Hastanesi Genel Dahiliye Polikliniğine başvuran yaşlı hastalara yüz yüze anket uygulayarak mevcut kronik hastalıkları, kullandıkları ilaçları, ilaç kullanım hataları detaylı olarak kaydedildi. Sonrasında 2 farklı tarama aracı kullanılarak potansiyel ilaç-ilaç etkileşim oranları belirlendi. Çalışmaya 266 kadın ve 171 erkek olmak üzere toplam 437 hasta dahil edildi. En sık eşlik eden kronik hastalıklar hipertansiyon (%77,8), diyabetes mellitus (%48,1) ve dislipidemi (%37,3); geriatrik sendromlar ise inkontinans (%28,6), kronik ağrı (%24,3) ve uyku bozuklukları (%23,3) idi. Günlük kullanılan ortalama ilaç sayısı: 5,78, polifarmasi oranı: %56,5, hiperpolifarmasi oranı: %10,5, ilaç kullanım hatası oranı: %32,3, farklı ölçeklere göre potansiyel uygunsuz ilaç kullanımı oranı; %46,7 ile %51,7 arası bulundu. Potansiyel ilaç-ilaç etkileşimi açısından hastaların verileri Lexicomb ve Medscape tarama araçları kullanılarak değerlendirildi. Lexicomb’a göre hastaların %24’ünde majör, %73,2’sinde orta ve %35,5’inde minör etkileşim saptandı. Medscape’e göre ise; %22,2’sinde majör, %71,2’sinde orta ve %41,2’sinde minör etkileşim saptandı ve iki tarama aracı sonuçları benzerdi. Polifarmasi alan hastalarda potansiyel ilaç-ilaç etkileşim oranları belirgin olarak daha yüksekti. Sonuç olarak, bu çalışmada yaşlı hastalarda kronik hastalıkların ve polifarmasinin sık görüldüğü ve buna bağlı olarak potansiyel ilaç-ilaç etkileşim oranlarının yüksek olduğu görüldü.
Chronic diseases and geriatric syndromes increase with aging. As a result, the number of drugs used and the rates of polypharmacy are also increasing. In our study, it was aimed to determine polypharmacy and potential drug-drug interaction rates in elderly patients. It was planned as a prospective cross-sectional study. After obtaining the ethics committee approval, a face-to-face questionnaire was applied to the elderly patients who applied to the Bursa Uludağ University Medical Faculty Hospital General Internal Medicine Polyclinic, and their current chronic diseases, drugs they used, and drug use errors were recorded in detail. Then, potential drug-drug interaction rates were determined using 2 different screening tools. A total of 437 patients, 266 women and 171 men, were included in the study. The most common accompanying chronic diseases were hypertension (77.8%), diabetes mellitus (48.1%) and dyslipidemia (37.3%); geriatric syndromes were incontinence (28.6%), chronic pain (24.3%) and sleep disorders (23.3%). Average number of drugs used daily: 5.78, polypharmacy rate: 56.5%, hyperpolypharmacy rate: 10.5%, medication error rate: 32.3%, potential inappropriate drug use rate according to different scales; It was found between 46.7% and 51.7%. Data of patients were evaluated for potential drug-drug interactions using Lexicomb and Medscape screening tools. According to Lexicomb, 24% of the patients had major, 73.2% moderate and 35.5% minor interactions. According to Medscape; Major interaction was found in 22.2%, moderate in 71.2%, and minor in 41.2%, and the results of the two screening tools were similar. Potential drug-drug interaction rates were significantly higher in patients receiving polypharmacy. In conclusion, in this study, it was observed that chronic diseases and polypharmacy were common in elderly patients and therefore potential drug-drug interaction rates were high.
Chronic diseases and geriatric syndromes increase with aging. As a result, the number of drugs used and the rates of polypharmacy are also increasing. In our study, it was aimed to determine polypharmacy and potential drug-drug interaction rates in elderly patients. It was planned as a prospective cross-sectional study. After obtaining the ethics committee approval, a face-to-face questionnaire was applied to the elderly patients who applied to the Bursa Uludağ University Medical Faculty Hospital General Internal Medicine Polyclinic, and their current chronic diseases, drugs they used, and drug use errors were recorded in detail. Then, potential drug-drug interaction rates were determined using 2 different screening tools. A total of 437 patients, 266 women and 171 men, were included in the study. The most common accompanying chronic diseases were hypertension (77.8%), diabetes mellitus (48.1%) and dyslipidemia (37.3%); geriatric syndromes were incontinence (28.6%), chronic pain (24.3%) and sleep disorders (23.3%). Average number of drugs used daily: 5.78, polypharmacy rate: 56.5%, hyperpolypharmacy rate: 10.5%, medication error rate: 32.3%, potential inappropriate drug use rate according to different scales; It was found between 46.7% and 51.7%. Data of patients were evaluated for potential drug-drug interactions using Lexicomb and Medscape screening tools. According to Lexicomb, 24% of the patients had major, 73.2% moderate and 35.5% minor interactions. According to Medscape; Major interaction was found in 22.2%, moderate in 71.2%, and minor in 41.2%, and the results of the two screening tools were similar. Potential drug-drug interaction rates were significantly higher in patients receiving polypharmacy. In conclusion, in this study, it was observed that chronic diseases and polypharmacy were common in elderly patients and therefore potential drug-drug interaction rates were high.
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Keywords
Yaşlı, Polifarmasi, Potansiyel ilaç-ilaç etkileşimi, Elderly, Polypharmacy, Potential drug-drug interaction
Citation
Tatar, M. (2023). Genel dahiliye polikliniğine başvuran yaşlı hastalarda ilaç-ilaç etkileşimlerinin ve tedaviye uyumun araştırılması. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.