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Vpliv storitve pregled uporabe zdravil na pacientovo breme pri zdravljenju z zdravili
ID Bačič, Bianka (Author), ID Kos, Mitja (Mentor) More about this mentor... This link opens in a new window, ID Nabergoj Makovec, Urška (Co-mentor)

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Abstract
Uvod: Breme pri zdravljenju z zdravili zaradi kroničnih bolezni in polifarmakoterapije narašča in posledično vodi do slabših kliničnih izidov in kakovosti življenja posameznikov. Gre za večdimenzionalno breme, ki vključuje skrbi zaradi uporabe zdravil, finančno breme, breme zaradi neželenih učinkov in druge težave, ki ovirajo pacientov vsakdan. V Sloveniji je od leta 2014 na voljo storitev pregled uporabe zdravil, ki optimizira in racionalizira uporabo zdravil posameznega pacienta. Zmanjšanje bremena pri zdravljenju je ena izmed njenih ključnih točk na poti do izboljšanja pacientove z zdravjem povezane kakovosti življenja. Namen: Namen magistrske naloge je bil ovrednotiti vpliv storitve pregled uporabe zdravil, pacientovih lastnosti in lastnosti njegovih zdravil na breme pri zdravljenju z zdravili. Metode: V 30 zunanjih lekarnah po celotni Sloveniji smo izvedli randomizirano kontrolirano klinično raziskavo. V okviru raziskave smo izvedli dve srečanji s pacienti. Na srečanju 1 so pacienti v testni skupini prejeli storitev pregled uporabe zdravil. Na srečanjih smo od pacientov pridobili demografske podatke in podatke o zdravilih, breme pri zdravljenju z zdravili pa smo vrednotili z Vprašalnikom o življenju z zdravili (©LMQ). S primerjavo kontrolne in testne skupine smo preverili, ali ima storitev pregled uporabe zdravil statistično značilen vpliv na zmanjšanje bremena med srečanjema. S statističnimi testi smo vrednotili vpliv pacientovih lastnosti na breme in vpliv storitve pregled uporabe zdravil na breme ter posamezna področja bremena. Rezultati: Obeh srečanj se je udeležilo 140 pacientov (68 iz kontrolne in 72 iz testne skupine). V povprečju so bili stari 68,3 ± 9,89 let in uporabljali 7 zdravil za redno jemanje. Vzorec je sestavljalo 57 % žensk in 43 % moških. V raziskavo so bili vključeni pacienti, ki breme pri zdravljenju z zdravili večinoma (56 %) ocenjujejo kot minimalno. Tisti s slabše ocenjenim zdravstvenim stanjem so izrazili večje breme. Storitev pregled uporabe zdravil ni imela statistično značilnega vpliva na zmanjšanje bremena pri zdravljenju z zdravili. Uspeli pa smo dokazati, da storitev zmanjša breme, povezano z odnosom in skrbmi zaradi uporabe zdravil, ki so se že v začetku izkazali kot najbolj obremenjujoča domena (p = 0,029). Zaključki: Pregled uporabe zdravil zmanjša zaskrbljenost pacientov glede dolgoročnih škodljivih učinkov zdravil, ki se pogosto izkažejo kot najbolj izstopajoče breme pri zdravljenju z zdravili. V prihodnje bi tako bilo storitev smiselno usmeriti v boljše prepoznavanje in vključevanje teh pacientov in pacientov z višjim začetnim bremenom.

Language:Slovenian
Keywords:pregled uporabe zdravil (PUZ), breme pri zdravljenju z zdravili, ©LMQ, randomizirana kontrolirana klinična raziskava
Work type:Master's thesis/paper
Organization:FFA - Faculty of Pharmacy
Year:2019
PID:20.500.12556/RUL-112537 This link opens in a new window
Publication date in RUL:23.10.2019
Views:1260
Downloads:231
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Secondary language

Language:English
Title:Impact of Medicines Use Review on patients' medication burden
Abstract:
Introduction: Due to chronic diseases and polypharmacy, the medication-related burden for patients is steadily increasing and consequently leading to worse clinical results and an overall decrease in the quality of patients’ lives. This multidimensional burden includes concerns regarding the use of medicines, financial difficulties, unwanted side effects and other problems that have a negative impact on the patient’s everyday life. Since 2014, the Medicines Use Review service is available in Slovenia with the aim to optimize and rationalize the use of medicines in individual patients. Alleviating the medication-related burden is one of the key focal points on the way to improve the patient’s health and quality of life. Aim: The aim of this Master’s thesis is to evaluate the impact of the Medicines Use Review service, patient’s characteristics and the properties of patient’s medicines on the medication-related burden. Methodology: We carried out a randomized controlled trial in 30 community pharmacies throughout Slovenia. Two meetings with patients were held in the framework of our research. During the first meeting, the patients in the test group were subject to the Medicines Use Review service. Demographic information and information regarding used medicines was obtained from the patients, whereas medication-related burden was measured using the Living with Medicines Questionnaire (©LMQ). By comparing the control and test group, we were trying to determine whether the Medicines Use Review service had a statistically significant impact on the alleviation of the patients’ burden between both sessions. Results: Meetings were attended by 140 patients in total (68 in the control group and 72 in the test group). On average, their age was 68.3 ± 9.89 years and they were regularly taking 7 different medicines. The sample consisted of 57% women and 43% men. The research included patients who mostly (56%) assess their medication-related burden as minimal. Patients in a worse medical condition indicated that their burden is greater. We established that the Medicines Use Review service did not have a statistically significant impact on the reduction of medication-related burden. We managed to prove, however, that the service does in fact reduce the burden related to attitude and concerns regarding the use of medicines, which have been identified already in the beginning as the most troublesome aspect in this regard (p=0.029). Conclusions: The Medicines Use Review does alleviate the patients’ concern regarding long-term negative effects of medicines, which is often manifested as the most prevalent burden in medical treatment. In the future, it would be sensible to focus the service on better recognition and inclusion of said patients and patients with a higher initial burden.

Keywords:Medicines Use Review, medication-related burden, ©LMQ, randomized controlled trial

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