Usporedba zadovoljstva pacijenata na varfarinu i novim oralnim antikoagulansima

master's thesis

• Title (english): Comparison of patients´ satisfaction with warfarin and new oral anticoagulants
• Author: Antonija Bošnjaković
• Mentor: Maja Ortner Hadžiabdić (mentor)
• Committee member: Maja Ortner Hadžiabdić (predsjednik povjerenstva)
• Committee member: Dubravka Vitali Čepo (član povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2018-07-03, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Iako je dugo vremena varfarin bio najkorišteniji oralni antikoagulans, unazad nekoliko godina umjesto njega sve više se koriste NOAK-i (novi oralni antikoagulansi - dabigatran, apiksaban rivaroksaban). Analiza zadovoljstva bolesnika njihovom terapijom važna je za procjenu utjecaja zadovoljstva na kvalitetu života. U tu svrhu koriste se validirani upitnici, a jedan od takvih je DASS upitnik. Do sada je u Hrvatskoj ispitivanje zadovoljstva antikoagulansima pomoću DASS-a provedeno samo za varfarin.
Cilj istraživanja bio je usporediti zadovoljstvo pacijenata varfarinom i NOAK-ima te povezati rezultate DASS upitnika s adherencijom. Istraživanje je provođeno od studenog 2017. do svibnja 2018. uz pomoć javnih ljekarni na području grada Zagreba te Slavonskog Broda i okolice. Pacijenti stariji od 18 godina i na terapiji dulje od tri mjeseca potpisali su informirani pristanak te ispunili su DASS upitnik, upitnik o adherenciji i pitanja o demografskim i kliničkim podacima.
U istraživanje je bilo uključeno 88 pacijenata, od kojih je 46 bilo na varfarinu, a 42 na NOAK-ima. Od ukupnog broja pacijenata na NOAK-ima, polovica je prije sadašnje terapije koristila varfarin. Prosječni DASS zbroj svih pacijenata ukupno pokazao je visoko zadovoljstvo terapijom (56,14 ± 21,79). Pacijenti na NOAK-ima pokazali su statistički značajno veće zadovoljstvo od onih na varfarinu (p=0,007). U kategoriji psiholoških učinaka isto su pokazali i oni koji su sada na NOAK-u, a ranije su koristili varfarin u odnosu na one koji ga ranije nisu koristili. Dobivena je statistički značajna povezanost pojave krvarenja i lošijeg zadovoljstva te niže adherencije i lošijeg zadovoljstva terapijom.
Važno je saznati kako se pacijenti osjećaju u vezi svoje terapije i koliko znaju o njoj te povezati zadovoljstvo s određenim podskupinama pacijenata s obzirom na demografske i kliničke podatke u cilju poboljšanja kvalitete njihova života. Isto tako je bitno procijeniti stupanj adherencije, njezin utjecaj na terapiju i zadovoljstvo te identificirati razloge loše adherencije kako bi zdravstveni djelatnici znali kako postupiti u svrhu njezinog poboljšanja.

Abstract (english)

Although long-term warfarin was the most commonly used oral anticoagulant, the NOACs (new oral anticoagulants - dabigatran, apixaban and rivaroxaban) are increasingly used instead. Patients' satisfaction with their therapy is important for assessing the impact of satisfaction on quality of life. Validated questionnaires are used for this purpose, and one of these is the DASS questionnaire. Until now, in Croatia, testing of anticoagulants satisfaction with DASS was carried out only for warfarin.
The aim of the study was to compare the satisfaction of patients with warfarin and NOAC and link the DASS questionnaires with adherence. The research was conducted from November 2017 to May 2018 with the help of public pharmacies in the area of Zagreb and Slavonski Brod and its surroundings. Patients over the age of 18 who use therapy for more than three months have signed an informed consent and filled out the DASS questionnaire, adherence questionnaire and demographic and clinical information questions.
The study included 88 patients, of whom 46 were on warfarin and 42 on NOACs. Of the total number of patients on NOACs, half of the patients had used warfarin before the present therapy. The average DASS sum of all patients in total showed high satisfaction with therapy (56.14 ± 21.79). Patients on NOACs showed statistically significantly greater satisfaction than those on warfarin (p = 0.007). In the category of psychological effects, those who currently use NOAC and have used warfarin earlier have also shown greater sastifaction than those who have not previously used it. There was a statistically significant correlation between bleeding and poorer satisfaction, as much as poorer satisfaction and lower adherence.
It is important to realize how patients feel about their therapy and how much they know about it and also connect their satisfaction to certain patient subgroups with regard to demographic and clinical data in order to improve the quality of their life. It is also important to assess the degree of adherence, its impact on therapy, and satisfaction, and identify the reasons for poor adherence so that healthcare professionals know how to act for its improvement.

• Keywords: antikoagulansi; varfarin; NOAK; zadovoljstvo pacijenata; DASS; adherencija
• Keywords (english): anticoagulants; warfarin; NOACs; patient's sastifaction; DASS; adherence
• Language: croatian
• URN:NBN: urn:nbn:hr:163:579592
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-04-12 10:30:46