Odnos bolnikov s pljučnim rakom na Kliniki Golnik do odpredpisovanja zdravil

Oberstar, Sara (author), Knez, Lea (mentor), Horvat, Nejc (comentor)

Odpredpisovanje zdravil je sistematičen proces ukinjanja potencialno neprimernih zdravil pod nadzorom zdravstvenega delavca z namenom urejanja polifarmakoterapije in izboljšanja zdravstvenih izidov. Zaviralci protonske črpalke so pogosto predpisani neprimerno in lahko vplivajo na učinkovitost nekaterih protirakavih učinkovin, kar poudarja potrebo po premisleku o odpredpisovanju te skupine zdravil pri onkoloških bolnikih. V sklopu magistrske naloge smo na Kliniki Golnik opravili presečno raziskavo, v kateri smo s pomočjo prilagojenega vprašalnika rPATD (ang. Revised Patients’ Attitudes Towards Deprescribing) pridobili mnenja bolnikov s pljučnim rakom o odpredpisovanju zdravil ter odpredpisovanju zaviralcev protonske črpalke. Zanimalo nas je, ali so bolniki s pljučnim rakom pripravljeni sodelovati v procesu odpredpisovanja in kateri so ključni dejavniki, ki vplivajo na ta odnos. V raziskavi smo uporabili dve vrsti vprašalnika rPATD odvisno od tega, ali so imeli bolniki v redni terapiji predpisan tudi zaviralec protonske črpalke ali ne. Rezultate smo ovrednotili s pomočjo opisne in sklepne statistike. V raziskavo smo vključili 120 bolnikov s pljučnim rakom, od tega 63,3 % bolnikov (76/120) ni prejemalo zaviralca protonske črpalke v redni terapiji. Med bolniki je bilo 50,8 % moških (61/120), povprečna starost je bila 65,6 leta. V povprečju so jemali 3,0 redna zdravila, ki niso namenjena sistemskemu zdravljenju raka. Večina bolnikov je pripravljenih prenehati z jemanjem enega ali več rednih zdravil, če bi jim to predlagal zdravnik (93,1 %, 109/117 veljavnih odgovorov), medtem ko je manjša pripravljenost za prenehanje, če bi jim to predlagal farmacevt (42,0 %, 47/112 veljavnih odgovorov). Prav tako je večina bolnikov, ki je prejemala zaviralec protonske črpalke, pripravljenih prenehati z jemanjem zaviralca protonske črpalke (78,6 %, 33/42 veljavnih odgovorov), če bi jim to predlagal zdravnik, medtem ko je pripravljenost za prenehanje, če bi jim to predlagal farmacevt, manjša (40,4 %, 17/42 veljavnih odgovorov). Bolniki z nižjo stopnjo izobrazbe in bolniki, ki bolje poznajo svoja zdravila, so bolj naklonjeni odpredpisovanju zdravil. Zdravstveni delavci, vključeni v proces odpredpisovanja pri bolnikih s pljučnim rakom, so lahko prepričani, da so skoraj vsi bolniki pripravljeni prenehati jemati eno ali več svojih rednih zdravil, znaten delež pa tudi z jemanjem zaviralca protonske črpalke.

• Language: Slovenian
• Keywords: odpredpisovanje, pljučni rak, zaviralci protonske črpalke, klinična farmacija, sistemsko zdravljenje raka
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2024
• PID: 20.500.12556/RUL-159325
• Publication date in RUL: 06.07.2024

Secondary language

• Language: English
• Title: Attitudes toward deprescribing in patients with lung cancer treated at the University Clinic Golnik

Abstract

Deprescribing of medicine is a systematic process of discontinuing potentially inappropriate medicines under the supervision of a healthcare professional to reduce polypharmacy and improve healthcare outcomes. Proton pump inhibitors are often prescribed inappropriately and may affect the effectiveness of some anticancer agents, highlighting the need to consider deprescribing of this group of medicine in cancer patients. As part of the master's thesis, we conducted a cross-sectional study to obtain the opinions of patients with lung cancer from the University Clinic Golnik on deprescribing of medicine and deprescribing of proton pump inhibitors. The adapted version of the rPATD questionnaire was used to investigate whether patients with lung cancer are willing to participate in the process of deprescribing and whether there are any key factors influencing their attitude towards it. Two types of questionnaires were used in the study, depending on whether patients have regularly prescribed a proton pump inhibitor or not. The results were evaluated using descriptive and test statistics. The study involved 120 oncology patients with lung cancer, 63.3% patients (76/120) without a proton pump inhibitor in regular therapy. 50.8% of participating patients were men (61/120), the mean age was 65.6 years. On average, they regularly took 3.0 medicines that were not intended for systemic cancer treatment. Most patients are willing to stop taking one or more regular medicines if suggested by their physician (93.1%, 109/117 valid responses), while they are less willing to stop if suggested by a pharmacist (42.0%, 47/112 valid responses). Also, most patients receiving a proton pump inhibitor are willing to stop taking a proton pump inhibitor (78.6%, 33/42 valid responses) if suggested by their physician, while they are less willing to stop if suggested by a pharmacist (40.4%, 17/42 valid responses). Patients with lower level of education and patients who know their medications better are more willing to agree with deprescribing. Healthcare professionals involved in the deprescribing process for patients with lung cancer can be confident that almost all these patients are willing to stop taking one or more of their regular medicines, with a significant proportion of patients that are also willing to stop taking a proton pump inhibitor.

• Keywords: deprescribing, lung cancer, proton pump inhibitors, clinical pharmacy, systemic cancer treatment