Potencijalne klinički značajne interakcije lijekova u propisanoj farmakoterapiji izvanbolničkih pacijenata i modeli ljekarničkih intervencija

doctoral thesis

• Title (english): Potential clinically significant drug-drug interactions in prescribed pharmacotherapy of non-hospitalized patients and models of pharmacists interventions
• Author: Ivana Samardžić
• Mentor: Vesna Bačić Vrca (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Renata Jurišić Grubešić (član povjerenstva)
• Committee member: Srećko Marušić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2021-10-07, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy
• Universal decimal classification (UDC): 615 - Pharmacology. Therapeutics. Toxicology

Abstract

Uvod: Interakcije lijekova su važan aspekt u sigurnosti primjene lijeka i velik izazov za zdravstveni sustav. Ljekarnik je u obavezi i mogućnosti utjecati na prevenciju i upravljanje interakcijama lijekova.
Svrha rada: Utvrditi pojavnost potencijalnih klinički značajnih interakcija lijekova u propisanoj farmakoterapiji izvanbolničkih pacijenata u Republici Hrvatskoj (RH). Za iste odrediti modele ljekarničkih intervencija te ispitati stavove ljekarnika o interakcijama lijekova i ljekarničkim intervencijama.
Metode i ispitanici: Provedeno je retrospektivno konsekutivno uzorkovanje propisane farmakoterapije iz 40 randomiziranih javnih ljekarni u RH. Koristeći Lexi-Interact™ Online analizirana je farmakoterapija te su za utvrđene interakcije potom određeni modeli ljekarničkih intervencija. U uključenim ljekarnama je proveden i upitnik koji ispituje stav ljekarnika o interakcijama lijekova i ljekarničkim intervencijama.
Rezultati: Sveukupno je uključeno 4107 pacijenata i utvrđeno 14175 klinički značajnih interakcija. Barem jedna interakcija utvrđena je kod 78,6 % pacijenata, a izloženost pacijenata određenom tipu interakcija iznosila je za interakcije stupnja C 74,1 %, za stupanj D 31,4 % i za stupanj X 4,1 %. Najučestaliji modeli ljekarničkih intervencija bili su modeli kategorije II (intervencije koje ljekarnik provodi u suradnji s liječnikom). Upitnik je ispunilo 97,9 % ljekarnika. Većina se složila da je upravljanje interakcijama lijekova važan segment ljekarničke skrbi te da treba razviti standardiziranu strategiju upravljanja interakcijama lijekova.
Zaključak: Istraživanje pokazuje opću izloženost izvanbolničkih pacijenata u RH potencijalnim klinički značajnim interakcijama lijekova. Istraživanje također daje uvid u zastupljenost i vrstu modela ljekarničkih intervencija kojima bi se unaprijedila ljekarnička skrb i sigurnost pacijenta.

Abstract (english)

Background: Drug-drug interactions (DDIs) are a big challenge for any healthcare system. Pharmacists are obligated to prevent and manage DDIs.
Aims: To determine potential clinically significant DDI incidence in prescribed outpatient pharmacotherapy in Croatia. Furthermore, the aim was to set pharmacists' intervention models and to determine pharmacists' stance on DDIs and pharmacists' interventions.
Patients and methods: This was a retrospective study which consecutively analyzed prescribed outpatient pharmacotherapy from 40 randomly selected community pharmacies in Croatia. DDIs were identified using Lexi-Interact™ Online. Models of pharmacy interventions were determined for the most common identified interactions. Furthermore, a survey was conducted among pharmacists in seleceted pharmacies to evaluate their stance towards DDIs and pharmacist interventions.
Results: Overall, 4107 patients were incluced and 14175 clinically significant DDIs were identified. Atleast one DDI was found in 78.6 % of patients, with patient exposure to C, D and X category of 74.1 %, 31.4 % and 4.1 %, respectively. The most frequent models of pharmacist interventions were category II models (pharmacist intervention in cooperation with physicians). The survey was completed by 97.9 % of pharmacists. The results showed that most pharmacists agree that pharmacist interventions are an important segment of pharmaceutical care and that development of stadardized strategy of pharmacist interventions is needed.
Conclusion: The study found high outpatient exposure to potential clinically significant DDIs. The study gives an insight to possible models of pharmacist interventions which could improve pharmaceutical care and increase patient safety.

• Keywords: interakcije lijekova; izvanbolnički pacijenti; farmakoterapija; ljekarničke intervencije
• Keywords (english): drug-drug interactions; outpatients; pharmacotherapy; pharmacist interventions
• Language: croatian
• URN:NBN: urn:nbn:hr:163:794273
• Promotion: 2022
• Study programme: Title: Pharmacy and biochemistry; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor znanosti (doktor znanosti)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access; Embargo expiration date: 2023-10-07
• Created on: 2022-11-07 12:53:48