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Intervencije za izboljšanje adherence bolnikov s kronično boleznijo pri zdravljenju z zdravili in njihova učinkovitost : diplomsko delo
ID Manojlović, Aleksandra (Author), ID Kvas, Andreja (Mentor) More about this mentor... This link opens in a new window, ID Kamenšek, Tina (Co-mentor)

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Abstract
Uvod: Adherenca bolnika s kronično boleznijo pri jemanju zdravil je ključna, da lahko izkoristi učinek zdravila za čim boljše zdravstveno stanje. Slaba adherenca jemanja zdravil je pomemben globalni javnozdravstveni problem, ki vodi k neugodnemu zdravstvenemu stanju, povečani obolevnosti in umrljivosti bolnikov ter večjim stroškom zdravljenja. Obstajajo intervencije, s katerimi lahko bolnikovo adherenco pri jemanju zdravil izboljšamo in vzdržujemo. Namen: Namen diplomskega dela je na podlagi znanstvenih dokazov predstaviti intervencije za izboljšanje adherence bolnikov s kronično boleznijo pri zdravljenju z zdravili, in njihovo učinkovitost. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom strokovne in znanstvene literature, objavljene med letoma 2007 in 2017 v angleškem jeziku. Iskanje literature je bilo opravljeno z uporabo podatkovnih baz: CINAHL, Medline, PubMed, ScienceDirect, Cochrane Library. Vključili smo le randomizirane kontrolirane raziskave, v katerih so preiskovali učinek intervencij na adherenco odraslih bolnikov s kronično boleznijo pri zdravljenju z zdravili in posledično njihovo zdravstveno stanje. Rezultati: Vključitvenim in izključitvenim kriterijem je ustrezalo 21 raziskav. Največkrat so bili v raziskavah vključeni bolniki s povišanim krvnim tlakom. Učenje oziroma informiranje bolnika je bila najpogosteje izvedena intervencija za izboljšanje adherence jemanja zdravil, zdravstveni delavci, predvsem farmacevti pa največkrat izvajalci intervencij. V 10 raziskavah so ugotovili statistično značilen učinek intervencij na adherenco jemanja zdravil pri bolnikih s kronično boleznijo v primerjavi s kontrolno skupino in sočasno tudi statistično značilno izboljšanje zdravstvenega stanja bolnikov. Razprava in sklep: Višja zastopanost raziskav glede na najpogostejše kronično stanje vključenih bolnikov je odraz visoke številnosti istih bolnikov tudi v realnem življenju z resnim tveganjem za slabše zdravje. Večanje znanja bolnika je nujno potrebno za ustrezno sledenje navodilom pri jemanju zdravil, vendar ni vedno zadostno. Velika raznolikost raziskav in metodološke omejitve so onemogočile potrjevanje učinkovitosti določenih intervencij za izboljšanje adherence bolnikov s kronično boleznijo pri zdravljenju z zdravili. Kljub temu se kot pomembna kažeta individualno prilagojena in kontinuirana podpora bolnikom s kronično boleznijo ter timsko sodelovanje strokovnjakov, bolnika in bližnjih. Potrebno je nadaljnje raziskovanje učinkovitosti intervencij, namenjenih adherenci pri zdravljenju z zdravili med bolniki s kronično boleznijo.

Language:Slovenian
Keywords:farmakološko zdravljenje, sodelovanje bolnika, upoštevanje predpisanih navodil, dolgotrajna bolezen, zdravstveno stanje
Work type:Bachelor thesis/paper
Organization:ZF - Faculty of Health Sciences
Year:2018
PID:20.500.12556/RUL-101927 This link opens in a new window
COBISS.SI-ID:5461355 This link opens in a new window
Publication date in RUL:13.07.2018
Views:2026
Downloads:327
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Secondary language

Language:English
Title:Interventions for improving medication adherence in chronic patients and their effectiveness : diploma work
Abstract:
Introduction: Medication adherence is essential for a chronic patient in order to receive full benefits of the prescribed therapy, which would result in a better clinical outcome. Inadequate medication adherence is a significant global public health concern leading to poor health outcomes, increased morbidity and mortality as well as higher health care costs. The support for improving and maintaining patients' medication adherence is possible through various interventions. Purpose: The purpose of this thesis is to present interventions for improving medication adherence in chronic patients and their effectiveness based on the findings of existing studies. We are interested to determine the effect of interventions on medication adherence and, consequently, the impact on the outcome of the treatment. Methods: A descriptive review of scientific literature was carried out using the following databases: CINAHL, Medline, PubMed, ScienceDirect, and Cochrane Library. The search was limited to English literature published between 2007 and 2017. In addition, only randomized controlled trials measuring the effect of interventions on medication adherence and the clinical outcomes in adult chronic patients were included in the review. Results: 21 studies met the eligibility criteria and were included in the review. High blood pressure was frequently observed among many different chronic patients. Education of patients was the most frequent intervention for improving their medication adherence. Different interventions were undertaken mainly by health workers, especially by pharmacists. 10 studies have shown a statistically significant intervention effect on medication adherence in chronic patients compared to the control group and also found a statistically significant improvement regarding treatment outcomes. Among other four studies, which established no statistically significant intervention effect on medication adherence, two studies reported a statistically significant improvement in clinical outcomes compared to the control group. Discussion and conclusion: Higher representation of studies considering most frequent chronic illness of included patients is reflection of a large number of the same patients in real life and their serious health risk. Improving patients’ knowledge so they can follow the recommendations for their medication routine is absolutely necessary but not always sufficient. Due to a wide range of studies and methodological limitations, it was not possible to draw clear conclusions on the effectiveness of certain interventions for improving medication adherence in chronic patients. Nevertheless, the continuity of support that would be tailored to the patient’s needs and the collaboration between different professionals, the patient and their family seem to be very important. Further research is needed to explore the effects of medication adherence interventions among chronic patients.

Keywords:pharmacological therapy, patients' involvement, following the recommendations, long-term disease, health status

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