Stavovi i uvjerenja pacijenata na terapiji inhalacijskim kortikosteroidima u astmi

master's thesis

• Title (english): Attitudes and beliefs of patients on inhaled corticosteroids in asthma
• Author: Laura Ivančić
• 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: 2019-07-18, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Inhalacijski kortikosteroidi temeljni su lijekovi u terapiji astme koji preveniraju simptome bolesti, egzacerbacije
i hospitalizacije. Unatoč njihovoj dobroj učinkovitosti, neadherencija kod uzimanja inhalacijskih kortikosteroida
i dalje je značajan problem. Analiza uvjerenja i stavova pacijenata o njihovim lijekovima važna je za procjenu
same adherencije. U tu svrhu koriste se validirani upitnici, a jedan od njih je i Upitnik o uvjerenjima o
lijekovima, tzv. BMQ upitnik (eng. Beliefs about Medicines Questionnaire). Cilj ovog istraživanja bio je,
koristeći BMQ i MMAS-4 upitnik, ispitati stavove i uvjerenja pacijenata na terapiji inhalacijskim
kortikosteroidima, te ustanoviti povezanost stavova i uvjerenja s adherencijom pacijenata. Nadalje, korištenjem
dodatnih otvorenih pitanja procijenilo se pacijentovo razumijevanje terapije inhalacijskim kortikosteroidom. U
istraživanje je bilo uključeno 97 pacijenata (69,1% žena, medijan dobi 37 godina (18-84) koji su na terapiji
inhalacijskim kortikosteroidom. Analizom pojedinih dijelova BMQ upitnika pokazalo se da pacijenti većinom
nisu zabrinuti zbog uzimanja inhalacijskog kortikosteroida te da općenito vjeruju u pozitivne učinke i dobrobit
samih lijekova. Analizom MMAS-4 upitnika, koji procjenjuje adherenciju pacijenata, utvrđen je značajan
stupanj neadherentnosti pacijenata (srednja vrijednost na MMAS-4 skali iznosila je 2,52±,05). Primijećena je
bolja adherencija kod starijih pacijenata u odnosu na mlađe. Studenti su imali slabije izražena uvjerenja o
nužnosti inhalacijskog kortikosteroida pa je to mogao biti jedan od uzroka slabije adherencije kod njih. Također
se pokazalo da su adherentniji bili pacijenti s višim stupnjem obrazovanja. Kvalitativni dio upitnika pokazao je
da većina pacijenta odlično ili dobro razumije razlog uzimanja inhalacijskog kortikosteroida (indikacija).
Nadalje, većina ispitanika (89,7%) smatra inhalacijski kortikosteroid učinkovitim. Njih 10,3% iskusilo je
nuspojavu inhalacijskog kortikosteroida. Ovo istraživanje je po prvi puta u populaciji pacijenata s astmom u
Hrvatskoj dalo uvid u pacijentove stavove, uvjerenja i razumijevanje terapije kortikosteroidima, kao i njihovu
adherenciju. Rezultati ovog istraživanja mogu pridonijeti osmišljavanju strategija za poboljšanje pacijentove
adherencije, a time i ishoda liječenja

Abstract (english)

Inhaled corticosteroids (ICS) are the mainstay of asthma treatment, preventing asthma symptoms, exacerbations and
hospitalisations. Despite the effectiveness of current asthma treatments, non-adherence to inhaled corticosteroids
remains a significant problem. An analysis of the patients’ beliefs about medicines is of great importance due to its
association with the patients’ adherence . Validated questionnaires are used for this purpose, and one of them is
Beliefs about Medicines Questionnaire (BMQ). The aim of this study was to evaluate patients’ adherence and
beliefs about their inhaled corticosteroids therapy and drugs in general using the BMQ and MMAS-4 questionnaires
as well as explore the association of patients’ beliefs and adherence. Additionally, we explored patients’
understanding of the inhaled corticosteroid therapy focusing on the indication, safety and effectiveness. 97 asthma
patients (69,1% women, median age being 37 years (18-84)) on inhaled corticosteroids therapy, participated in the
study. The results have shown that patients are mostly not concerned about taking inhaled corticosteroids and
generally believe in the positive effects and the benefits of the medications themselves. The analysis of the MMAS4 questionnaire, demonstrated non-adherence as an important issue (MMAS-4 score was...). There was a higher
adherence in older patients compared to younger patients. The students had weaker beliefs about the necessity of
inhaled corticosteroids, and this could be one of the reasons for their lower adherence. Moreover, patients with
higher level of education were more adherent. A qualitative part of the questionnaire showed that most patients
have very good understanding of why they take an inhaled corticosteroid (indication). Furthermore, most
respondents (89.7%) consider inhaled corticosteroids to be effective. 10.3% experienced a side effect of inhaled
corticosteroids. The BMQ questionnaire has not been used in the population of asthmatic patients on inhaled
corticosteroids therapy in Croatia so far, and this research obtained first results for better understanding of patients’
beliefs and their understanding of the therapy as well as the adherence. The results of this study could contribute in
developing the strategies for increasing adherence and consequently better therapy outcomes

• Keywords: astma; adherencija; inhalacijski kortikosteroidi
• Keywords (english): asthma; adherence; inhaled corticosteroids
• Language: croatian
• URN:NBN: urn:nbn:hr:163:253239
• 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: Open access
• Created on: 2020-02-21 15:31:48