Title Znanja, stavovi i iskustva ljekarnika o primjeni biljnih lijekova i dodataka prehrani u trudnoći Author Anita Živković Mentor Marija Kindl (mentor)Committee member Sanda Vladimir-Knežević (predsjednik povjerenstva)Committee member Marija Kindl (član povjerenstva)Committee member Vladimir Trkulja (član povjerenstva)Granter University of Zagreb Defense date and country 2022-09-26, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Cilj istraživanja: Primjena biljnih lijekova i dodataka prehrani među trudnicama je u porastu
jer im pruža osjećaj neštetnosti i sigurnosti, što može dovesti do neracionalne upotrebe takvih
pripravaka i povećati rizik od nepovoljnog ishoda trudnoće. Kako bi se osigurala učinkovita i
sigurna upotreba pripravaka za samoliječenje u trudnoći, vrlo je važna uloga javnih ljekarnika
kao najdostupnijih zdravstvenih djelatnika. Stoga je cilj ovog istraživanja ispitati znanja,
stavove i iskustva ljekarnika u Republici Hrvatskoj o primjeni biljnih lijekova i dodataka
prehrani u trudnoći.
Ispitanici i metode: U ovom radu provedeno je istraživanje na uzorku od 98 javnih ljekarnika.
U istraživanju su sudjelovali magistri farmacije s najmanje jednom godinom staža u javnoj
ljekarni. Istraživanje je provedeno putem anonimnog upitnika koji je kreiran za potrebe rada.
Na početku anketnog upitnika prikupljeni su sociodemografski podaci o ispitanicima (dob,
spol, godine rada u ljekarni, veličina mjesta u kojem se nalazi ljekarna i dodatno školovanje),
a preostala pitanja bila su vezana uz njihova znanja, iskustva i stavove o primjeni biljnih
lijekova i dodataka prehrani u trudnoći. Istraživanje je provedeno u javnim ljekarnama na
području Hrvatske u razdoblju od svibnja do srpnja 2020. godine.
Rezultati: Najviše ljekarnika (60 %) savjetuje trudnice nekoliko puta mjesečno. Trudnice ih
uglavnom traže savjete vezano uz probavne tegobe povezane s trudnoćom i u slučaju simptoma
prehlade/viroze. Upotrebu biljnih lijekova i dodataka prehrani najviše ispitanika (60-79 %)
savjetuje kod mučnine i povraćanja, proljeva, zatvora i hemoroida. Najčešće korišteni pripravci
kontraindicirani u trudnoći bili su oni koji sadrže medvjetku (N = 20) te biljne droge s
antracenskim derivatima (N = 7). Uočene nuspojave uglavnom su bile probavne tegobe (N =
11) povezane s primjenom pripravaka koji sadrže željezo (pojedinačno ili multivitaminsko
mineralne formule), omega-3 masne kiseline ili đumbir. Ljekarnici su kod tri trudnice uočili
klinički značajnu interakciju između željeza i levotiroksina. Nezadovoljstvo dostupnošću
stručnih informacija o primjeni biljnih lijekova i dodataka prehrani u trudnoći izrazilo je nešto
više od polovice ispitanika. Za savjetovanje trudnica većina ljekarnika koristi brzo i lako
dostupne izvore informacija, pisanu uputu o biljnom lijeku odnosno deklaraciju dodatka
prehrani i/ili stručnu literaturu. Gotovo svi ljekarnici smatraju da se biljni lijekovi i dodaci
prehrani trebaju izdavati uz savjet ljekarnika, te je polovica zabrinuta zbog sigurnosti primjene
dodataka prehrani u trudnoći. Iako se veliki dio ispitanika smatra kompetentnim savjetovati
trudnice o primjeni biljnih lijekova i dodataka prehrani, čak 98 % iskazalo je potrebu za
dodatnim stručnim edukacijama iz ovog područja.
Zaključci: Zahvaljujući svojim znanjima i vještinama, kao i dostupnosti pacijentu, javni
ljekarnici su u prilici savjetovati trudnice o racionalnoj upotrebi biljnih lijekova i/ili dodataka
prehrani kod bolesti prikladnih za samoliječenje, a također mogu prepoznati kada je neki
pripravak kontraindiciran, izaziva nuspojave ili stupa u interakcije. S obzirom na iskazanu
nesigurnost u donošenju terapijskih odluka kod samoliječenja trudnica, ljekarnicima su
potrebne dodatne edukacije kako bi poboljšali svoje stručne kompetencije vezane uz ovu temu
i tako trudnicama pružili adekvatnu ljekarničku skrb.
Abstract (english) Objectives: Increased use of herbal drugs and dietary supplements among pregnant women,
because of their feeling of harmlessness and safety, may lead to unreasonable use of such
products and enhance the risk of unfavorable pregnancy outcome. To ensure efficient and safe
use of products for self-medication during pregnancy, the role of public pharmacists as the
most accessible healthcare professionals is outstandingly important. The goal of this research
is to examine knowledge, attitude and experience of pharmacists in the Republic of Croatia
with regard to usage of herbal drugs and dietary supplements during pregnancy.
Respondents and Methods: In this work research has been carried out on a sample of 98
public pharmacists. The participants in the research were masters of pharmacy with at least one
year of internship in public pharmacy. The research was carried out by means of an anonymous
questionnaire created for this purpose. At the beginning of the survey questionnaire
sociodemographic data of respondents (age, sex, years of working experience in pharmacy,
size of city where pharmacy is located, further education) were collected. Remaining questions
were about their knowledge, experience and attitude in application of herbal drugs and dietary
supplements during pregnancy. Research was carried out in public pharmacies on the territory
of Croatia in the period from May to July 2020.
Results: Majority of pharmacists (60 %) advise pregnant women several times a month.
Pregnant women mostly seek counsel related to digestive problems linked to pregnancy and
related to symptoms of cold/viruses. The majority of respondents (60-79 %) advise the use of
herbal drugs and dietary supplements in a case of nausea, vomiting, diarrhea, constipation or
hemorrhoids. Most commonly used products contraindicated during pregnancy were those
containing bearberry (N = 20) and herbal drugs with anthracene derivatives (N = 7). Observed
side effects were mostly digestive problems (N = 11) linked to use of products containing iron
(in isolation or within multivitamin formulae), omega 3 fatty acids or ginger. In three
pregnancies pharmacists reported clinically relevant interaction between iron and
levothyroxine. Slightly more than half of respondents have stated their dissatisfaction related
to the availability of official information on usage of herbal drugs and dietary supplements
during pregnancy. To advise pregnant women, the majority of pharmacists use easily
obtainable sources of information, written instruction and declaration on dietary supplements
and/or professional literature. Almost all pharmacists believe that herbal drugs and dietary
supplements should be handed out after professional counsel. Half of them are concerned about
the safety of use of dietary supplements during pregnancy. Despite the fact that the vast
majority of respondents consider themselves competent in advising pregnant women about the
application of herbal drugs and dietary supplements, 98 % still expressed the need for further
professional education in this domain.
Conclusions: Public pharmacists, thanks to their knowledge and skill as well as their
accessibility to the patients, have the opportunity to counsel pregnant women on rational use
of herbal drugs and/or dietary supplements related to diseases appropriate for self- medication.
They are able to recognize if some product is contraindicated, causes side effects or enters into
interactions. Taking into account the uncertainty in therapy decision making, stated by
pharmacists, with regard to self-medication of pregnant women, pharmacists are in need of
further education to improve their professional competence linked to this topic. Only then will
they be able to offer adequate pharmaceutical care to pregnant women.
Keywords
biljni lijekovi
dodaci prehrani
trudnoća
uloga ljekarnika
Keywords (english)
herbal drugs
dietary supplements
pregnancy
role of pharmacist
Language croatian URN:NBN urn:nbn:hr:163:968524 Study programme Title: Phytopharmacy with dietotherapy Type of resource Text File origin Born digital Access conditions Embargoed access Terms of use Created on 2022-11-10 15:31:17
