| Abstract | Cilj istraživanja bio je identificirati terapijske probleme i odrediti njihovu učestalost u hospitaliziranih bolesnika sa šećernom bolesti tipa 2. Provedeno istraživanje bilo je presječno opservacijsko-deskriptivnog oblika i provedeno u razdoblju od 1. rujna do 15. listopada 2015. godine na Klinici za unutarnje bolesti Kliničke bolnice Dubrava na odjelima gastroenterologije i endokrinologije. U prikupljanje podataka bili su uključeni bolesnici primljeni hitnim ili elektivnim prijemom na zavode Klinike. Uključujući kriteriji bile su prisutnost šećerne bolesti tipa 2 u osnovnoj dijagnozi ili kao jedan od komorbiditeta te potpisani informirani pristanak. Proces prikupljanja podataka provodio se intervjuiranjem bolesnika pomoću standardiziranog upitnika (Prilog 2.), koji je dizajniran specifično za potrebe istraživanja, a uključuje nekoliko kategorija pitanja koja daju detaljan uvid u bolesnikovo zdravstveno stanje, medikacijsku povijest i trenutnu farmakoterapiju. Podaci su također prikupljani i uvidom u temperaturne liste, medicinsku dokumentaciju dostupnu na odjelima i u Bolničkom informacijskom sustavu,, konzultacijama s nadležnim liječnikom internistom i ostalim medicinskim osobljem na odjelu. Po potrebi su se informacije prikupljale i od liječnika obiteljske medicine, rodbine i/ili bolesnikovih skrbnika. Odobrenje za provedbu ovog istraživanja dobiveno je od Etičkog povjerenstva Kliničke bolnice Dubrava.U istraživanje je bilo uključeno ukupno 76 ispitanika (39 muškaraca i 37 žena). Prosječna životna dob bolesnika iznosila je 66,7 ± 10,6 godine (u rasponu od 43 do 87), a u prosjeku su imali 7,63 ± 3,14 dijagnoza (u rasponu od 1 do 17, ukupno zabilježeno 580). Na ispitivanom uzorku bolesnika propisana su ukupno 653 lijeka s prosjekom po bolesniku od 8,59 ± 3,24 (raspon 3 – 17). Ukupan broj terapijskih problema prepoznatih pomoću Cipolle-ova alata za identifikaciju i opis terapijskih problema iznosio je 376, odnosno 4,94 ± 3,86 terapijska problema po bolesniku. Utvrđeno je da najveći broj identificiranih terapijskih problema spada u kategoriju nepotrebne farmakoterapije (N=72) i kategoriju potrebne dodatne farmakoterapije (N=72). Treća najbrojnija kategorija terapijskih problema bila je kategorija preniske doze (N= 68). Ovo istraživanje je pokazalo visoku učestalost terapijskih problema u populaciji hospitaliziranih bolesnika sa šećernom bolesti tipa 2. Kako bi se smanjili, potrebno je u fokus djelovanja staviti terapijske potrebe i probleme bolesnika. Samo takav pristup omogućava postizanje željenih terapijskih ishoda i najbolju moguću zdravstvenu skrb za bolesnika. |
| Abstract (english) | The aim of this study was to identify and determine the incidence of drug therapy problems in hospitalized patients with type 2 diabetes. A cross-sectional observational study was conducted in the period from September 1st to October 15th 2015 at the Clinic for Internal Medicine, University Hospital Dubrava in the departments of gastroenterology and endocrinology. Patients included in the study were admitted via emergency or elective admission to the departments of the Clinic. Inclusion criteria for all patients who participated in this study were the presence of type 2 diabetes in primary diagnosis or as a comorbidity and a singned informed consent. The data collection process was performed primarily through interviews with patients who were hospitalized in the departments of the Clinic using a standardized questionnaire (Appendix 2), which was designed specifically for the needs of this research. It included several categories of questions that provided detailed insight into the patient's health status, medication history and current pharmacotherapy. The data were also collected by examining the temperature charts, medical records available in the departments and the hospital information system (BIS), consultations with physicians and other medical personel and interviews with relatives and/or carriers of the patients if needed. Approval for the conduction of this study was granted by the Ethics Committee of the Clinical Hospital Dubrava. The study included a total of 76 subjects (39 men and 37 women). The average age of patients was 66.7 ± 10.6 years (range 43 - 87). The patients had an average of 3.14 ± 7.63 diagnoses (in the range of 1 to 17, a total of 580 recorded in the study). A total of 653 medicines was proscribed, with the average of 8.59 ± 3.24 (range 3 - 17) per patient. Total number of drug therapy problems identified by Cipolle's tools for the identification and description of the drug therapy problems was 376, or 4.94 ± 3.86 therapeutic problems per patient. It was found that the largest number of identified therapeutic problems were related to the category of unnecessary medication (N=72) and category related to the requirement of additional medication (N=72). The third most common kind of therapeutic problem was too low dose (N=68). This study showed a high incidence of drug therapy problems in the population of hospitalized patients with type 2 diabetes. In order to reduce this, it is necessary to actively work on a system that implies a multidisciplinary approach to patients and focuses on their therapeutic needs and problems. Only this kind of approach allows achieving the most desired therapeutic outcomes and provides the best medical care for patients there is. |
