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Ocenjevanje skladnosti zdravljenja hospitaliziranih bolnikov z zaviralci protonske črpalke s terapevtskimi smernicami na Kliniki Golnik
Šubic, Eva (Author), Knez, Lea (Mentor) More about this mentor... This link opens in a new window

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Abstract
Zaviralci protonske črpalke spadajo med najpogosteje uporabljene zdravilne učinkovine v Sloveniji. Kljub temu da so običajno indicirani za krajše obdobje uporabe, se ob njihovem relativno ugodnem varnostnem profilu vse pogosteje uporabljajo tudi dolgotrajno. Namen raziskave je bil opisati značilnosti uporabe zaviralcev protonske črpalke pred sprejemom in ob odpustu iz bolnišnice ter oceniti ustreznost njihove uporabe glede na smernice zdravljenja. V opazovalno raziskavo smo vključili odrasle internistične bolnike, ki so bili hospitalizirani na Kliniki Golnik. Podatke o zgodovini zdravljenja z zdravili in spremljajočih boleznih smo pridobili iz pogovora z bolniki in bolnišničnega e-informacijskega sistema. Med vključenimi 382 bolniki jih je 181 (47,4 %) že pred sprejemom v bolnišnico prejemalo zaviralce protonske črpalke. Največ bolnikov je prejemalo pantoprazol (71,8 %), najpogosteje v visokih odmerkih (53,0 %) in večinoma redno (81,8 %). Najpogostejša indikacija je bila profilaktična uporaba ob sočasni uporabi nesteroidnih antirevmatikov (41,4 %) ter zdravljenje gastroezofagalne refluksne bolezni (32,0 %). Pred sprejemom je imelo le 57 bolnikov (31,5 %) terapijo skladno s smernicami zdravljenja. Najpogostejša so bila neskladja zaradi predolgega zdravljenja z zaviralci protonske črpalke pri bolnikih z gastroezofagalno refluksno boleznijo in zaradi previsokih odmerkov pri profilaktični uporabi ob nesteroidnih antirevmatikih. Med hospitalizacijo je bilo zdravljenje z zaviralci protonske črpalke spremenjeno pri 77 bolnikih (20,2 %), predvsem z uvedbo zdravljenja z zaviralci protonske črpalke pri 46 bolnikih (12,0 %). Med vsemi izvedenimi spremembami je bilo zdravljenje skladno pri 41 bolnikih (53,2 %). Ob odpustu iz Klinike Golnik je imelo zdravljenje z zaviralci protonske črpalke skladno s smernicami zdravljenja skupno 79 bolnikov (36,6 %). Skoraj polovica odraslih internističnih bolnikov prejema zaviralce protonske črpalke že pred sprejemom v bolnišnico in njihova uporaba ni skladna s smernicami zdravljenja pri večini bolnikov. Za bolj smotrno uporabo zaviralcev protonske črpalke je nujno ustrezno dokumentiranje razloga za njihovo uvedbo in večkratna ocena učinkovitosti in potrebe po nadaljevanju zdravljenja z zaviralci protonske črpalke po uvajalnem obdobju.

Language:Slovenian
Keywords:Zaviralci protonske črpalke, smernice zdravljenja, gastroezofagalna refluksna bolezen, nesteroidna protivnetna zdravila, zgodovina zdravljenja z zdravili.
Work type:Master's thesis/paper (mb22)
Organization:FFA - Faculty of Pharmacy
Year:2021
Views:123
Downloads:45
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Secondary language

Language:English
Title:Evaluation of proton pump inhibitors use according to treatment guidelines in hospitalized patients at the University Clinic Golnik
Abstract:
Proton pump inhibitors are among the most prescribed drugs in Slovenia. Even though they are usually indicated for short-term, they are often used for prolonged periods. The aim of the study was to describe the characteristics of proton pump inhibitor use prior to hospital admission and at discharge, and to evaluate its appropriateness according to treatment guidelines. This observational study included adult medical patients hospitalised at the Univerity Clinic Golnik. Drug history and medical history were obtained through interviews with patients and from the hospital information system. The study included 382 patients, of which 181 (47,4 %) were using proton pump inhibitors prior to hospital admission. Most were prescribed pantoprazole (71,8 %), often in high doses (53,0 %), with most of patients using proton pump inhibitors regularly (81,8 %). Among the indications for proton pump inhibitors’ use were chronic treatment with nonsteroidal anti-inflammatory drugs (41,4 %) and gastroesophageal reflux disease (32,0 %). Proton pump inhibitors’ use prior to hospital admission was concordant with treatment guidelines in only 57 patients (31,5 %), often due to prolonged use for gastroesophageal reflux disease and use of doses, higher than recommended, in chronic nonsteroidal anti-inflammatory drugs users. Therapy with proton pump inhibitors was changed during the hospitalization in 77 patients (20,2 %), often due to initiation of proton pump inhibitor therapy in 46 patients (12,0 %). In patients in which therapy with proton pump inhibitors changed, this was concordant with treatment guidelines in 41 patients (53,2 %). Overall, at hospital discharge, therapy with proton pump inhibitors was concordant with treatment guidelines in 79 patients (36,6 %). Almost half of hospitalized adult medical patients used proton pump inhibitors prior to admission, their use not being concordant with treatment guidelines in the majority of patients. To improve use of proton pump inhibitors, the indication for their use should be clearly documented, their effectiveness and the need for continuous therapy should be evaluated regularly.

Keywords:Proton pump inhibitors, treatment guidelines, gastroesophageal reflux disease, nonsteroidal anti-inflammatory drugs, medication history.

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