Title Stavovi, uvjerenja i adherencija bolesnika na terapiji direktnim oralnim antikoagulansima Title (english) Attitudes, beliefs, and adherence of patients on direct oral anticoagulant therapy Author Ema Barić Mentor Maja Ortner Hadžiabdić (mentor)Mentor Slaven Falamić (mentor)Committee member Maja Ortner Hadžiabdić (predsjednik povjerenstva)Committee member Slaven Falamić (član povjerenstva)Committee member Dubravka Vitali Čepo (član povjerenstva)Granter University of Zagreb Defense date and country 2023-09-28, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Poremećaj u zgrušavanju krvi koji dovodi do tromboembolijske bolesti predstavlja veliki javnozdravstveni problem zbog visokog mortaliteta kojim rezultira, kako u razvijenim zemljama svijeta, tako i u Hrvatskoj. Liječenje kroničnog poremećaja koji „ne boli“ i koji je pacijentima neopipljiv, a izuzetno opasan, jako ovisi o samoj adherenciji ispitanika. Kao novija generacija lijekova, DOAK-i se sve češće propisuju zbog svojih boljih farmakokinetičkih karakteristika u odnosu na starije lijekove.Cilj ovog diplomskog rada bio je istražiti koji je najčešći DOAK u terapiji ispitanika, od kojih bolesti boluju ispitanici i provjeriti adherenciju ispitanika na DOAK-e. Istražiti stavove i uvjerenja o lijekovima i bolesti općenito kao bitnim čimbenicima o kojima ovisi adherencija te promotriti koji socio-demografski i klinički čimbenici utječu na adherenciju i na stavove i uvjerenja o lijekovima.Provedeno je presječno, opservacijsko istraživanje u koje su uključeni ispitanici na terapiji nekim od direktnih oralnih antikoagulansa. Adherencija je mjerena pomoću Upitnika o uzimanju lijekovima za procjenu adherencije (engl. Medication Adherence Report Scale, MARS-5), a
stavovi i uvjerenja o lijekovima pomoću BMQ upitnika (engl. Beliefs about Medicines Questionnaire).U istraživanju je sudjelovalo 63 ispitanika, 30 žena (47.6%) i 33 muškaraca (52.4%).Medijan dobi bio je 73.5 godina (interkvartilni raspon 61.5-78). Najmlađi ispitanik imao je 25 godina, a najstariji 91 godinu. Rješavanjem MARS-5 upitnika pokazali su visoku adherenciju što nam pokazuje srednja vrijednost bodova koja iznosi 24.11± 1.493. Najčešći uzrok neadherencije bilo je propuštanje i zaboravljanje lijeka. Ostali socio-demografski i klinički podaci nisu pokazali značajan utjecaj na adherenciju.Stavovi i uvjerenja o lijekovima ispitanika su izuzetno pozitivni. Statistički značajna razlika pronađena je između visoko adherentnih bolesnika i onih s nešto nižom adherencijom utvrđena je za skalu ˝Zabrinutost zbog lijekova˝ iz Specifičnog dijela upitnika.(p= 0.008) , između mlađih
od 65 godina i onih sa 65 godina i starijih za skalu „Nužnost“ iz Općeg dijela (p=0.036) te između osoba različitog stupnja obrazovanja za skale „Osjetljivost na lijekove“ – Opći dio i „Nužnost“ – Specifični dio. (p= 0.008;p=0.019) Ovim istraživanjem ustanovljeni su neki čimbenici koji utječu na adherenciju, stavove i uvjerenja o lijekovima te međusobni utjecaj stavova i uvjerenja o lijekovima na adherenciju. Bolje poznavanje čimbenika koji utječu na adherenciju, stavove i uvjerenja pomaže promjeni i poboljšanju istih.
Abstract (english) A blood clotting disorder leading to thromboembolic diseases represents a significant public health issue due to the elevated mortality it results in, both in developed countries worldwide and in Croatia. The treatment of a chronic disorder that is "silent" and imperceptible to patients yet exceedingly perilous heavily relies on the adherence of the subjects involved. As a more recent generation of medications, Direct Oral Anticoagulants (DOACs) are increasingly prescribed owing to their superior pharmacokinetic profiles compared to older drugs. The objective of this dissertation was to investigate the most common DOAC used in the therapy of subjects, identify the ailments afflicting the subjects, and assess the adherence of subjects to DOACs. The study aimed to explore attitudes and beliefs about medications and illnesses in general, as pivotal factors influencing adherence. Additionally, it aimed to examine the socio-demographic and clinical factors influencing both medication adherence and attitudes and beliefs about medications.A crosssectional observational study was conducted, involving subjects under treatment with some form of direct oral anticoagulant. Adherence was gauged using the Medication Adherence Report Scale (MARS-5), while attitudes and beliefs about medications were assessed using the Beliefs about Medicines Questionnaire (BMQ). The study enrolled 63 participants, with 30 females (47.6%) and 33 males (52.4%). The median age was 73.5 years (interquartile range 61.5-78). The youngest participant was 25 years old, and the oldest was 91 years old. By completing the MARS-5 questionnaire, participants demonstrated high adherence, as indicated by the
mean score of 24.11±1.493. The most frequent cause of non-adherence was skipping doses and forgetting medication. Other sociodemographic and clinical data did not exhibit significant influence on adherence.Participant attitudes and beliefs about medications were notably positive. A statistically significant difference was identified between highly adherent patients and those with slightly lower adherence in the "Concerns about Medications" scale of the Specific section (p=0.008). Furthermore, differences were observed between individuals younger than 65 and those aged 65 and older in the "Necessity" scale of the General section (p=0.036), and between individuals with different educational levels for the "Perceived Sensitivity to Medications" scale of the General section and the "Necessity" scale of the Specific section (p=0.008; p=0.019).This research has elucidated certain factors influencing medication adherence, attitudes, and beliefs about medications, as well as the mutual impact of attitudes and beliefs on adherence. Enhanced comprehension of the factors affecting adherence, attitudes, and beliefs can facilitate their modification and improvement.
Keywords
adherencija
direktni oralni antikoagulansi
Keywords (english)
adherence
direct oral anticoaguants
Language croatian URN:NBN urn:nbn:hr:163:438332 Study programme Title: Pharmacy Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-02-12 14:13:49
