Racionalnost primjene inhibitora protonske pumpe i potreba za njihovom depreskripcijom: presječno istraživanje u domovima za starije i nemoćne osobe

master's thesis

• Title (english): The rationality of proton pump inhibitors use and the need for deprescription: a cross-sectional study in nursing homes
• Author: Luna Ibrahimpašić
• Mentor: Maja Ortner Hadžiabdić (mentor)
• Committee member: Maja Ortner Hadžiabdić (predsjednik povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Committee member: Miranda Sertić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2023-05-23, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Otkad su se pojavili na tržištu, inhibitori protonske pumpe postali su jedni od najčešće propisivanih lijekova te im iz
godine u godinu raste potrošnja. Iako se smatraju vrlo sigurnim lijekovima, dugotrajnim korištenjem mogu biti
potencijalno štetni i uzrokovati ozbiljne nuspojave. Posebno osjetljiva skupina su osobe starije životne dobi, a budući su
oni često na politerapiji u kojoj je prisutan IPP, javlja se potreba za racionalizacijom terapije i potencijalnom
depreskripcijom. Depreskripcija je proces ukidanja neprikladnog lijeka iz terapije ili smanjenje doze prema određenim
smjernicama, uz nadzor zdravstvenih stručnjaka, s ciljem najboljeg terapijskog ishoda za pacijenta. Cilj je ovog
istraživanja bio utvrditi racionalnost primjene IPP-a u osoba starije životne dobi i ustanoviti koji bi pacijenti mogli imati
korist od depreskripcije. U ovom istraživanju sudjelovalo je 225 korisnika domova za starije osobe na području
Dalmacije, Slavonije i Grada Zagreba, a podatci su prikupljeni pomoću standardiziranog interRAI upitnika te njegovog
dodatka. Za potrebe istraživanja, na temelju smjernica za depreskripciju IPP-a, definirano je pet kriterija prema kojima
se određivala potreba za depreskripcijom. Utvrđeno je da 98 ispitanika u terapiji ima IPP, a njih 58 (59,2 %) bili bi
potencijalni kandidati za depreskripciju. Najviše ispitanika je zadovoljilo kriterij B-indikacija je prisutna u bolesnikovoj
anamnezi, ali ne uključuje dugotrajno korištenje IPP-a te je trenutno trajanje terapije predugo (68,97 %). Zaključno,
dobiveni rezultati ukazuju na potrebu za racionalnijom primjenom inhibitora protonske pumpe te na značajan udio
ispitanika koji bi mogli imati koristi od njihove depreskripcije.

Abstract (english)

Since they appeared on the market, proton pump inhibitors have become one of the most prescribed drugs and their
consumption is increasing year by year. Although they are considered very safe drugs, with long-term use they can be
potentially harmful and cause serious side effects. The elderly are the most sensitive group of patients and since they are
often on polytherapy in which PPIs are present, the need for rationalization of therapy and potential deprescription has
appeared. Deprescription is the process of removing an inappropriate drug from therapy or reducing the dose according
to certain guidelines, under the supervision of health professionals, with the aim of the best therapeutic outcome for the
patient. The main purpose of this research was to determine the rationality of using PPI in elderly people and to check
how many elderly patients could benefit from deprescription. 225 users of nursing homes in Dalmatia, Slavonia and the
City of Zagreb participated in this research and the data were collected using the standardized interRAI questionnaire
and its additional data. For research purposes, based on the guidelines for PPI deprescription, five criteria were defined,
helping to determine the need for deprescription. It was discovered that 98 participants had PPIs in therapy and 58 of
them (59,2 %) were potential candidates for deprescription. The majority of them were candidates according to criteria
B - the indication is present in patient's history, but does not include long-term use of PPIs and the current duration of
therapy is overlong (68,97 %). In conclusion, the obtained results indicate the need for more rational use of proton pump
inhibitors and significant proportion of patients who could benefit from their deprescription.

• Keywords: inhibitori protonske pumpe; starija životna dob; depreskripcija
• Keywords (english): proton pump inhibitors; elderly age; deprescription
• Language: croatian
• URN:NBN: urn:nbn:hr:163:696513
• 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: Embargoed access; Embargo expiration date: 2025-05-23
• Created on: 2024-02-14 12:44:05