Potencijalne interakcije lijekova u terapiji hospitaliziranih pacijenata starije životne dobi

master's thesis

• Title (english): Potential drug interactions among hospitalised elderly patients
• Author: Lucija Živković
• Mentor: Vesna Bačić Vrca (mentor)
• Committee member: Vesna Bačić Vrca (predsjednik povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Committee member: Jelena Filipović-Grčić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2019-09-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Procesom starenja nastaju brojne fiziološke promjene zbog kojih raste rizik od razvoja raznih oboljenja. Osobe starije životne dobi, zbog često velikog broja komorbiditeta, u terapiji imaju velik broj lijekova. Zbog politerapija češće nastaju medikacijske pogreške, a politerapija se smatra i najčešćim uzrokom pojave interakcija lijekova. U ovoj je studiji istražena prisutnost, količina i vrsta potencijalnih klinički značajnih interakcija u terapijama 179 pacijenata te su uspoređene potencijalne interakcije u terapiji prije prijema prema najboljoj mogućoj medikacijskoj povijesti i iste u terapiji dobivenoj prilikom otpusta iz bolnice. Ispitanici su bili stariji od 65 godina, imali su barem 2 lijeka u terapiji i bili su hospitalizirani u Kliničkoj bolnici Dubrava unutar Klinike za unutarnje bolesti. Ostali ciljevi rada bili su: utvrditi najčešći broj potencijalnih interakcija u terapijama ispitanika, najčešće potencijalne interakcije lijekova određenog stupnja kliničke značajnosti te najčešće lijekove koje sudjeluju u potencijalnim interakcijama. Interakcije su utvrđene pomoću programa Lexicomp. Ukupno je više potencijalnih klinički značajnih interakcija utvrđeno u terapijama otpusta u odnosu na BPMH (1218 vs. 1094), ali manje njih kategorija D i X. Kod većeg broja bolesnika utvrđena je barem jedna potencijalna interakcija D i/ili X stupnja kliničke značajnosti u terapiji otpusta u odnosu na terapije BPMH (118 vs. 108).
Dobiveni rezultati ukazuju na veliku potrebu za nadzorom i usklađivanjem terapija hospitaliziranih pacijenata starije životne dobi, što ukazuje na nužnu uključenost kliničkih farmaceuta u rad zdravstvenih timova.

Abstract (english)

Elderly people have a higher risk of developing diseases than young people because of physiological changes which occur with aging. Therefore, elderly often use many medications, which makes the incidence of medication errors higher. Also, polypharmacy is the leading cause of drug interactions. The aim of the research was to monitor the incidence and type of potential clinically significant drug interactions in 179 elderly patients (over 65 years) hospitalised at the Clinical Department of Internal Medicine, University Hospital Dubrava, and compare those interactions found in best possible history of medications used prior to admission with the ones in the list of medications prescribed at hospital discharge. The research also determines the most common number of potential clinically significant interactions as well as the drugs that most frequently participate in those interactions and the most common drug-drug interactions. Lexicomp drug interaction software was used for the screening of potential interactions. The data was collected by interviewing the patients, their relatives, family physicians and pharmacists as well as by studying their medical documentation. Total number of potential interactions found in the discharge medication lists was bigger than in the list of drugs prior to admission (1218 vs. 1094), but there were less potential interactions of D and X level of clinical significance. On the contrary, the number of patiens in whose medication list at least one potential clinically significant interaction of the level D and/or the same of the level X was bigger in the discharge list than in the list of medication prior to admission (118 vs. 108). The results show the high need of screening and medication reconciliation for the elderly hospitalised patients, which implies an involvement of clinical pharmacists in the team of healthcare professionals.

• Keywords: interakcije lijekova; osobe starije životne dobi; farmakoterapija; hospitalizacija
• Keywords (english): drug interactions; elderly people; pharmacotherapy; hospitalisation
• Language: croatian
• URN:NBN: urn:nbn:hr:163:338195
• 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: 2021-04-22 13:16:23