Potencijalno neprikladni lijekovi s djelovanjem na gastrointestinalni sustav u štićenika domova za starije osobe

master's thesis

• Title (english): Detection of potentially inappropriate drugs affecting the gastrointestinal system in residents of nursing homes
• Author: Ana Matković
• Mentor: Maja Ortner Hadžiabdić (mentor)
• Committee member: Maja Ortner Hadžiabdić (predsjednik povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Committee member: Anita Hafner (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2023-09-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Cilj istraživanja bio je utvrditi učestalost propisivanja PNL-ova s djelovanjem na gastrointestinalni sustav u starijoj životnoj dobi u domovima za starije i nemoćne osobe. U istraživanju je sudjelovalo 225 korisnika domova za starije i nemoćne osobe na području Dalmacije, Slavonije i Grada Zagreba, a podatci su prikupljani pomoću standardiziranog interRAI upitnika. Na temelju prikupljenih podataka, prikladnost lijekova u terapiji ispitivana je pomoću druge verzije STOPP kriterija koji su definirali četiri kriterija za određivanje PNL-ova s djelovanjem na gastrointestinalni trakt. Otkriveno je ukupno 139 PNL-ova, od čega je najveći udio IPP-ova kod nekompliciranog peptičkog ulkusa ili erozivnog peptičkog ezofagitisa u trajanju dužem od 8 tjedana (N=84), zatim lijekova s potencijalom uzrokovanja konstipacije u pacijenata s kroničnom konstipacijom (N=47), a nešto manja pojavnost bila je oralnog elementarnog željeza u dozama većim od 200 mg dnevno (N=8). Rezultati su pokazali da u ispitivanom uzorku nije bio neprikladno propisan metoklopramid bolesnicima s dijagnozom Parkinsonove bolesti. Otkriveno je ukupno 110 slučajeva PNL-ova s djelovanjem na gastrointestinalni sustav, što čini 48,89% ukupnog broja ispitanika. Među tim slučajevima, 83 ispitanika ispunjavaju jedan kriterij neprikladnog propisivanja, 26 ispitanika ispunjava dva kriterija, dok jedan ispitanik ispunjava sva tri kriterija. Zaključno, ovim istraživanjem pronađena je visoka prevalencija PNL-ova s djelovanjem na gastrointestinalni sustav. Nužno je provoditi mjere te starijim osobama propisivati minimalan potreban broj lijekova kako bi se smanjili rizici od nastanka nuspojava i interakcija među lijekovima što bi posljedično vodilo k racionalnijoj primjeni lijekova, boljoj kvaliteti života osoba starije životne dobi i nižim ukupnim troškovima liječenja.

Abstract (english)

The aim of the research was to determine the frequency of prescribing potentially inappropriate drugs affecting the gastrointestinal system in the older population residing in nursing homes.
The study included 225 residents of nursing homes in the Croatian regions of Dalmatia, Slavonia, and the city of Zagreb. Data were collected using the standardized interRAI questionnaire. Based on the collected data, the appropriateness of medications in therapy was assessed using the second version of the STOPP criteria, which defined four criteria for identifying potentially inappropriate drugs affecting the gastrointestinal tract. A total of 139 potentially inappropriate drugs were identified, with the highest proportion being proton pump inhibitors for uncomplicated peptic ulcer or erosive peptic esophagitis lasting more than 8 weeks (N=84), followed by drugs with potential to cause constipation in patients with chronic constipation (N=47). A slightly lower occurrence was noted for oral elemental iron in doses greater than 200 mg per day (N=8). In the studied sample, metoclopramide was not inappropriately prescribed to patients diagnosed with Parkinson's disease. Overall, potentially inappropriate drugs affecting the gastrointestinal system were found in 48.89% of participants (N=110). Among them, 83 participants met one criterion, 26 met two criteria, and one participant met all three criteria. In conclusion, this study identified a high prevalence of potentially inappropriate drugs affecting the gastrointestinal system. It is essential to implement measures and prescribe the minimum necessary number of medications to the older adults to reduce the risks of side effects and interactions among drugs, potentially leading to a more rational use of medications, improved quality of life, and lower overall treatment costs.

• Keywords: potencijalno neprikladni lijekovi; gastrointestinalni sustav; STOPP kriteriji; starije osobe
• Keywords (english): potentially inappropriate medications; gastrointestinal system; STOPP criteria; elderly
• Language: croatian
• URN:NBN: urn:nbn:hr:163:721333
• 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: Embargoed access; Embargo expiration date: 2024-09-12
• Created on: 2024-01-25 11:55:46