Ustrajnost pacijenata s kroničnim bolestima pri terapiji lijekovima u Gradu Zagrebu

doctoral thesis

• Title (english): Patient medication adherence in chronic diseases in city of Zagreb
• Author: Jelena Bošković
• Mentor: Josip Čulig (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Viktorija Erdeljić Turk (član povjerenstva)
• Committee member: Vesna Bačić Vrca (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2021-02-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy
• Universal decimal classification (UDC): 615 - Pharmacology. Therapeutics. Toxicology

Abstract

Veliki problem u terapiji kroničnih bolesti predstavlja niski stupanj adherencije. Pretpostavka je da je stvarna
adherencija u farmakoterapiji kroničnih bolesti u Hrvatskoj manja od 50 % te ovisi o nizu čimbenika: dobi,
obrazovanju, vrsti bolesti, politerapiji, nerazumijevanju svrhe terapije i uputa koje bi pacijenti trebali dobiti
od liječnika i/ili ljekarnika. Ljekarnik i pacijent imaju različiti pristup značaju problema adherencije pri
dugotrajnoj terapiji. Ciljevi istraživanja su: ustanoviti stupanj adherencije pacijenata s kroničnim bolestima u
gradu Zagrebu; istražiti povezanost sociodemografskih i kliničkih čimbenika s adherencijom pacijenata;
utvrditi razloge nedovoljne adherencije te istražiti stavove javnih ljekarnika i pacijenata o adherenciji u
farmakoterapiji. U ovom istraživanju adherencija je mjerena dvjema metodama za mjerenje adherencije:
metodom upitnika i metodom pretraživanja ljekarničkih elektroničkih baza podataka s izračunavanjem omjera
posjedovanja lijeka prema propisanoj dozi (MPR). Pri mjerenju adherencije metodom upitnika korištena je
skala za mjerenje adherencije pacijenata u terapiji svih kroničnih bolesti (Čuligova skala) koja je razvijena za
potrebe ovog istraživanja, a čiji je Cronbach koeficijent 0,89. Ovom metodom identificirani su glavni razlozi
za neadherenciju pacijenata u terapiji kroničnih bolesti, kao i glavne odrednice neadherencije. Adherencija
pacijenata (n=635) izmjerena metodom upitnika bila je 41,7 %, a metodom izračunavanja MPR-a (n=150) 37
%. Ustanovljeno je da na adherenciju veći utjecaj od sociodemografskih karakteristika ima stav prema
liječenju te odnos s liječnikom, a glavni razlog za neadherencije je zaboravnost. Ovo istraživanje je pokazalo
da pacijenti ne prepoznaju savjetodavnu ulogu ljekarnika u terapiji kroničnih bolesti.

Abstract (english)

Poor medication adherence is an important issue in the pharmacotherapy of chronic diseases. The hypothesis is that rate
of adherence in phatmacotherapy of chronic diseases in Croatia is low, less than 50 % and that it depends on several
factors such as: age, education, type of disease, polytherapy as well as understanding of purpose of the treatment and
instructions provided by physician or pharmacist. Patients and pharmacists have different approach toward the
importance of adherence in long-term therapy.The aim of this reasearch was to determine level of adherence in longterm therapy in city of Zagreb, investigate relationship between socio-demographic and clinical parameters and
adherence, determine the reasons for non-adherence as well as to investigate attitudes of pharmacists and patients
regarding adherence. In this research patients' medication adherence was measured by using two, the most commonly
used metods for measuring medication adherence: self-reported questionnaire and pharmacy data claims with calculating
Medication Possesion Ratio (MPR). As questionnaire Čulig scale was used. This scale with very good internal consisteny
(Cronbach α= 0,89) is suitable for measurement of adherence to all chronic diseases and was originally developed for
the purpose of this research. Patients' medication adherence measured by self-reported questionnaire (635 participants)
was 41,7% and when measured using pharmacy claims (150 participants) data was 37%. It was found out that patient’
attitudes toward therapy and relationship with physician have greater impact on patient medication adherence than
sociodemographic characteristics and that the main reason for non-adherence is forgetfulness.. The results of this
research shown that the counselling role of pharmacist is not recognized by patients.

• Keywords: adherencija; farmakoterapija; kronične bolesti; upitnik; ljekarničke baze podataka; MPR
• Keywords (english): medication adherence; pharmacotherapy of chronic diseases; questionnaire; pharmacy claims data; MPR
• Language: croatian
• URN:NBN: urn:nbn:hr:163:661621
• Promotion: 2021
• 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
• Created on: 2024-02-06 12:17:49