Title Stavovi pacijenata o depreskripciji terapije Title (english) Patients' attitudes towards deprescribing Author Patricia Dragović Mentor Maja Ortner Hadžiabdić (mentor)Committee member Maja Ortner Hadžiabdić (predsjednik povjerenstva)Committee member Renata Jurišić Grubešić (član povjerenstva)Committee member Lidija Bach-Rojecky (član povjerenstva)Granter University of Zagreb Defense date and country 2020-09-07, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Uslijed starenja populacije i porasta prevalencije kroničnih bolesti te politerapije, polipragmazije i nuspojava lijekova,
javila se potreba za racionalizacijom terapije te u pojedinim slučajevima depreskripcijom lijekova. Depreskripcija
podrazumijeva strukturirani proces prestanka uzimanja neprikladnog lijeka ili smanjenja njegove doze, pod nadzorom
zdravstvenih stručnjaka, s ciljem unapređenja ishoda liječenja. Većoj uspješnosti depreskripcije pridonosi
razumijevanje pacijentovih stavova o depreskripciji što je i bio cilj ovog diplomskog rada. Stavovi pacijenata su bili
istraženi putem revidiranog PATD upitnika čime je prvi puta u Hrvatskoj provedeno ovakvo istraživanje. U
istraživanje su bili uključeni pacijenti iznad 40. godine života koji uzimaju lijekove u kroničnoj terapiji barem mjesec
dana. Ispitanici su osim revidiranog PATD upitnika, odgovarali i na pitanja vezana za uključenost ljekarnika u proces
depreskripcije, a imali su mogućnost napisati i koje lijekove iz svoje terapije bi voljeli ukloniti i one koje bi svakako
voljeli zadržati u terapiji. Također su se prikupili opći i klinički podaci ispitanika. Ovo presječno opažajno istraživanje
se provodilo u javnim ljekarnama u Zagrebu od siječnja do ožujka 2020. godine. Etičko povjerenstvo Gradske ljekarne
Zagreb je odobrilo provedbu istraživanja.
U istraživanje je uključeno 112 ispitanika kojima je medijan godina bio 70 (raspon 41-90), dok je medijan lijekova
koji su uzimali bio 4 (raspon 1-11). Analiza rezultata revidiranog PATD upitnika ukazala je na visoku uključenost
pacijenata u svoju terapiju, nisko opterećenje vlastitim lijekovima te nisku zabrinutost zbog ukidanja terapije, uz
vjerovanje u prikladnost lijekova u terapiji. Statistički značajne razlike su uočene između starijih i mlađih pacijenata;
pacijenti mlađi od 65 godina su osjećali veću zabrinutost zbog ukidanja terapije (p=0,011). Statistički značajna je bila
razlika među skupinama pacijenata koji su uzimali četiri ili manje lijekova te onih koji su uzimali pet ili više lijekova;
naime pacijenti koji su u terapiji imali veći broj lijekova osjećali su veće opterećenje vlastitom terapijom (p<0,001) i
pokazali su veću uključenost u svoju terapiju (p=0,016). Dodatno, čak 94,6% ispitanika se složilo da bi voljelo prestati
uzimati jedan ili više lijekova ukoliko bi im liječnik rekao da je to moguće, a 75% ispitanika bi se osjećalo ugodno
ukoliko bi i ljekarnik bio uključen u proces depreskripcije. Zaključno, prema dobivenim rezultatima, pacijentovi
stavovi, upućuju na spremnost pacijenata u ispitivanoj populaciji na depreskripciju lijekova, uz potrebu da se nadiđu
manje barijere.
Abstract (english) Due to the aging of the population and the increase in the prevalence of chronic diseases, as well as polytherapy and
drug’s side effects, there is a need to rationalize therapy and in some cases to deprescribe drugs. Deprescribing
represents a structured process of stopping an inappropriate drug or reducing its dose, under the supervision of health
professionals, with the goal of improving treatment outcomes. Understanding the patient's attitudes about
deprescription, which was the goal of this thesis, contributes to the greater success of deprescribing. Patients' attitudes
were surveyed through a revised PATD questionnaire, which is the first time such a survey has been conducted in
Croatia. The study included patients over the age of 40 who were taking drugs in chronic therapy for at least a month.
In addition to the revised PATD questionnaire, the respondents answered questions related to the involvement of
pharmacists in the process of deprescribing, and had the opportunity to write which drugs they would like to remove
from their therapy and those they would like to keep in therapy. General and clinical data of the subjects were also
collected. This cross-sectional observational study was conducted in public pharmacies in Zagreb from January to
March 2020. The Ethics Committee of the Gradske ljekarne Zagreb approved the implementation of the research.
The study included 112 subjects whose median age was 70 (range 41-90), while the median number of medications
they were taking was 4 (range 1-11). Analysis of the results of the revised PATD questionnaire indicated high patient
involvement in their therapy, low burden from their medications, and low concern about discontinuation of therapy,
with a high belief in the appropriateness of drugs in their therapy. Statistically significant differences were observed
between older and younger patients; patients younger than 65 years felt greater concern about discontinuation of
therapy (p = 0.011). There was a statistically significant difference between the groups of patients who took four or
less drugs and those who took five or more drugs; patients who had a higher number of drugs in therapy felt a greater
burden of their own therapy (p <0.001) and showed greater involvement in their therapy (p = 0.016). In addition, as
many as 94.6% of respondents agreed that they would like to stop taking one or more medications if their doctor told
them it was possible, and 75% of respondents would feel comfortable if a pharmacist was involved in the
deprescribing process. In conclusion, according to the obtained results, the patient's attitudes indicate the readiness of
patients in the study population to deprescribe drugs with the need to overcome smaller barriers.
Keywords
depreskripcija
politerapija
polipragmazija
osobe starije životne dobi
stavovi pacijenata
Keywords (english)
deprescribing
polytherapy
polypragmasy
elderly people
patients' attitudes
Language croatian URN:NBN urn:nbn:hr:163:195781 Study programme Title: Pharmacy Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-04-28 15:33:53
