Potencijalno neprikladni lijekovi i ishodi liječenja osoba starije životne dobi s arterijskom hipertenzijom

master's thesis

• Title (english): Potentially inappropriate medications and treatment outcomes in elderly patients with arterial hypertension
• Author: Martina Lauš
• Mentor: Maja Ortner Hadžiabdić (mentor)
• Committee member: Maja Ortner Hadžiabdić (predsjednik povjerenstva)
• Committee member: Iva Mucalo (član povjerenstva)
• Committee member: Ivan Pepić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2016-09-19, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Politerapija je česta u osoba starije životne dobi, a aktivnim motrenjem primjene lijekova dolazimo do važnih
spoznaja o doziranju, nuspojavama i interakcijama, što utječe na uspjeh terapije i kvalitetu života bolesnika. Cilj
istraživanja bio je odrediti kakva je zastupljenost potencijalno neprikladnih lijekova (PNL) u terapiji ispitanika
starije životne dobi koji boluju od hipertenzije te mogu li se ishodi liječenja ispitanika dovesti u vezu s uzimanjem
lijekova koje EU(7)-lista lijekova navodi kao neprikladne u starijih bolesnika. Opservacijsko presječno istraživanje
provedeno je na odjelu kardiologije Klinike za unutarnje bolesti Kliničke bolnice Dubrava te telefonskim putem u
razdoblju od 3 do 5 mjeseci nakon otpusta ispitanika iz bolnice. Svi su ispitanici bolovali od hipertenzije, imali 65
ili više godina i uzimali najmanje dva lijeka u vrijeme uključenja u istraživanje. Prema protokolu u EU(7)-listi
lijekova ustanovljena je učestalost propisivanja PNL-ova, a potom su uspoređeni prikupljeni podatci o ishodima
terapije s opisima u EU(7)-listi i Sažetcima opisa svojstava lijekova. Na uzorku od 54 ispitanika prosječne životne
dobi 73,8 godina otkriveno je u prosjeku 7,2 komorbiditeta te 8,6 korištenih lijekova. 77,8% ispitanika imalo je u
terapiji barem jedan PNL, od čega je najučestaliji bio pantoprazol. 83,3% ispitanika nakon otpusta iz bolnice
prijavilo je neželjene ishode terapije, od kojih nisu svi dovedeni u vezu s korištenjem PNL-ova. Naime,
usporedbom s EU(7)-listom lijekova zaključeno je da je u 17,1% slučajeva PNL mogao uzrokovati prijavljeni
ishod liječenja, dok je usporedbom sa Sažetkom opisa svojstava lijeka isto zaključeno u 55,3% slučajeva.
Istraživanjem je ustanovljena visoka stopa propisivanja PNL-ova koji su naknadno povezani s neželjenim ishodima
terapije ispitanika. EU(7)-lista lijekova dobar je protokol za otkrivanje PNL-ova i racionalizaciju terapije starijih
bolesnika kako bi se postigla što veća učinkovitost i što manja štetnost terapije.

Abstract (english)

Polytherapy is very common in elderly patients and the usage of medicines has to be actively observed in order
to comprehend how dosages, side effects and interactions affect the quality of therapy and subsequently
patients’ lives. The aim of study was to determine the incidence of potentially inappropriate medicines (PIMs)
in elderly patients with hypertension and to examine the connection between treatment outcomes and PIMs
according to the EU(7)-PIM list. An observational cross-sectional study was carried out in Cardiology Ward at
the Department of Internal Medicine, University Hospital Dubrava. After 3 to 5 months from release,
examinees were contacted via telephone to collect additional data. Patients included in the study suffered from
hypertension, were aged 65 years or older, and were taking at least 2 medicines. PIMs were determined using
EU(7)-PIM list. Afterwards, treatment outcomes were compared to PIMs’ descriptions in EU(7)-list and
Summary of Product Characteristics. The study included 54 examinees with median age 73,8 years, who had
7,2 diagnoses and used 8,6 medicines in average. The EU(7)-list detected PIMs in 77,8% of examinees, with
pantoprazole being the most common. 88,3% of examinees reported relevant treatment outcomes occurring
after release from hospital, some of which were connected to usage of PIMs. When compared to description in
EU(7)-list, it was concluded that in 17,1% of cases PIMs provoked relevant outcomes, while that number was
significantly higher when PIMs outcomes were compared to Summary of Product Characteristics (55,3%). The
study concluded that there is high percentage of PIMs in elderly with hypertension, many of which can be
linked to undesirable treatment outcomes. EU(7)-list is a protocol which offers assistance in detecting PIMs
and achieving a favorable benefit-risk medication ratio.

• Keywords: starija životna dob; potencijalno neprikladni lijekovi; EU(7)-lista
• Keywords (english): elderly patients; potentially inappropriate medications; EU(7)-PIM list
• Language: croatian
• URN:NBN: urn:nbn:hr:163:348877
• 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: Access restricted to students and staff of home institution
• Created on: 2017-11-22 13:50:28