Title Značajke bolesnika koje utječu na suradljivost tijekom kroničnog liječenja
Title (english) Factors Affecting Patient's Compliance During Chronic Therapy
Author Dijana Vidošević
Mentor Damir Fabijanić (mentor)
Committee member Nediljko Pivac (predsjednik povjerenstva)
Committee member Rahela Orlandini (član povjerenstva)
Committee member Damir Fabijanić (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2015-09-30, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Uspjeh liječenja ne ovisi samo o lijeku nego i bolesniku, poglavito njegovom pridržavanju uputa o liječenju. Uspješno liječenje traži dosljednu primjenu propisanih lijekova. U dosadašnjim kliničkim ispitivanjima uočeno je da se manje od 50% bolesnika pridržava uputa o liječenju. Značajke bolesnika koje utječu na uzimanje lijekova su: dob, spol, društveno-ekonomski čimbenici, cijena lijekova, krivo shvaćene upute od zdravstvenog osoblja, zaboravljivost, duljina liječenja, broj lijekova. Cilj ovog istraživanja je bio utvrditi značajke loše suradljivosti u primjeni propisanog liječenja te, na temelju rezultata dati smjernice za njihovo poboljšanje. Provedeno je presječno istraživanje u koje je uključeno 135 bolesnika oba spola starijih od 18 godina, hospitaliziranih u Zavodu za bolesti srca i krvnih žila Kliničkog bolničkog centra Split. Uvjet uključivanja u istraživanje bila je propisana kronična medikamentozna terapija koja je uključivala uzimanje >1 lijeka. Podatci su prikupljeni samostalnim ispunjavanjem anonimnog upitnika. Analizom rezultata nismo dokazali statistički značajnu spolnu razliku u suradljivosti pri uzimanju medikamentozne terapije (p=0,318). Osobe mlađe životne dobi češće prestaju uzimati lijekove u odnosu na starije u slučaju poboljšanja (p=0,003) ili pogoršanja (p=0,003) kliničkog stanja. Ispitanici bez obzira na duljinu liječenja preferiraju uzimanje lijeka pri ustajanju (p=0.043). Broj lijekova i njihovih dnevnih doza nije utjecao na provođenje liječenja (p=0,14). Najveći broj ispitanika koji se striktno drži uputa o uzimanju lijekova, uzimao je lijekove do godine dana, dok su se uputa najlošije pridržavali ispitanici koji su lijekove primjenjivali 1-2 godine. Povećanjem broja hospitalizacija smanjuje se točnost primjenjivanja lijekova (p=0.029). Bolesnici su skloniji samoinicijativnoj promjeni doze lijeka, nego provođenju preporučenih higijensko-dijetetskih mjera; čak 69% ispitanika samostalno usklađuje propisano liječenje s vrijednostima arterijskog tlaka. Najveći broj ispitanika (64%) razgovara s liječnikom o osobitostima i nuspojavama uzimanja lijeka. Rezultati istraživanja upućuju da se pridržavanje uputa o liječenju može poboljšati jednostavnijom primjenom lijekova, po mogućnosti u jednoj jutarnjoj dozi te aktivnom suradnjom bolesnika koja podrazumijeva dobru komunikaciju sa zdravstvenim djelatnicima s ciljem upoznavanja s učincima lijekova i značenju popratnih nefarmakoloških postupaka.
Abstract (english) The success of treatment depends not only on the medicine prescribed but also on the patient, especially his or hers adherence to the treatment instructions. Successful treatment requires the consistent administration of prescribed drugs. In previous clinical trials, it was observed that less than 50% of patients comply with the given instructions for the treatment. Factors that affect patients taking medications are: age, gender, socio-economic status, the price of drugs, misunderstood instructions given by health care professionals, forget fulness, length of treatment and the number of medications. The aim of this study was to determine the characteristics of poor compliance in applying the appropriate treatment, and based on the results provide guidance for their improval. A cross-sectional study was carried out involving 135 patients of both sexes aged over 18 years old, hospitalized in the Department of heart disease and blood vessels, University Hospital Split. The criteria for inclusion in this study was prescribed chronic therapy which included taking more than one drug. Data was collected by anonymous questionnaire filled by patients. Analyzing the results we demonstrated a statistically significant gender difference in compliance when taking medical therapy (p = 0.318). Younger patients often stop taking medication compared to older ones in the event of an improvement (p = 0.003) or worsening (p = 0.003) of their clinical condition. Patients favour taking prescribed medication in the morning hours, regardless of duration of treatment (p = 0.043).The number of drugs and the daily dose did not affect compliance (p = 0.14) . The largest number of patients have taken their medication regularly in a period of the first year, while the worst compliance was in a period of one to two years. Study also showed that number of days of hospital stay reduce the patient's compliance (p = 0.029). Furthermore, patients are inclined to change the prescribed dosage of drugs rather than implement the life-style changes they were previously advised by their physician. Sixty-nine percent of patients change the prescribed antihypertensive drug dosage according to values of blood pressure by themselves.
The largest number of subjects (64%) talk to their physician about the characteristics and adverse effects of the drug. Research results indicate that patient's compliance can be improved by simpler drug administration, preferably in a single morning dose, and by active participation of patient in his treatment which implies a good communication with the health professionals in order to comprehend the effects of different medication and the meaning of non-pharmacological interventions.
Keywords
Uspješno liječenje
propisani lijekovi
suradljivost
Keywords (english)
Successful treatment
prescribed drugs
compliance
Language croatian
URN:NBN urn:nbn:hr:176:846143
Study programme Title: Nursing (university/graduate) Study programme type: university Study level: graduate Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-05-15 08:29:42