Publication: Varfarin kullanan hastaların hasta eğitimi ve takibinde klinik eczacının rolü
Abstract
1. ÖZET Varfarin Kullanan Hastaların Hasta Eğitimi Ve Takibinde Klinik Eczacının Rolü Sevda Çelik; Danışman: Prof.Dr. Fikret Vehbi İzzettin, Klinik Eczacılık Amaç: Çalışmamızda, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi Kardiyoloji Polikliniği ve Dr. Siyami Ersek Göğüs ve Kalp Hastanesi Kardiyoloji Polikliniği’nde Varfarin ile antikoagülasyon amaçlanan hastaların, tedavi sürecine eczacının dâhil olmasıyla yaşam tarzı ve ilaç kullanımı konusunda yapılan eğitim ve danışmanlık müdahalelerinin tedavinin terapötik sonuçlarına katkısını görmek amaçlanmıştır. Gereç ve Yöntem: 50 hastanın ilk görüşmede demografik özellikleri toplanmış, OAK (Oral Anticoagulation Knowledge) Test, SF-36 (Short Form-36, Kısa Form-36) ve DASS (Duke Anticoagulation Satisfaction Scale) testleri yapılmıştır. Kontrol grubu rutin tedavisini alırken, müdahale grubuna yaşam tarzı ve ilaç kullanımı konusunda eğitim ve danışmanlık hizmeti verilmiştir. 90. günde müdahale grubundaki hastalara ilk görüşmede yapılan testler tekrar yapılmış ve sonuçları karşılaştırılmıştır. Kontrol grubuyla müdahale edilen grubun hedef INR aralığında kalma başarısı ve komplikasyon sıklığı karşılaştırılmıştır. Bulgular: Müdahale grubunun ön ve son testlerinin sonuçları incelendiğinde Kısa Form 36’nın fiziksel ve mental komponent skorlarında (p= 0,001; p=0,001), OAK Testin sonuçlarında (p≤0,001), DASS’ın limit, yük ve pozitif etki komponentlerinde (p= 0,005; p<0,001; p=0,001) anlamlı iyileşmeler görülmüştür. Müdahale ve kontrol grubunun hedef INR aralığında kalma başarısı karşılaştırıldığında, müdahale grubunda anlamlı başarı üstünlüğü görülmüştür (p= 0,027). Kontrol grubunda 3 kat daha fazla komplikasyon gelişmiştir. Sonuç: Çalışma sonunda, eczacının eğitim ve danışmanlık desteğinin tedavinin terapötik sonuçlarına olumlu katkısı gösterilmiştir. Anahtar Sözcükler: varfarin, klinik eczacı, antikoagülan klinik, hasta eğitimi, oral anikoagülan tedavi 2.
The Role Of Clinical Pharmacist in Monitoring and Patient Education on Patients Under Warfarin Treatment Sevda Çelik; Supervisor: Prof.Dr. Fikret Vehbi İzzettin, Clinical Pharmacy Department Objective: We performed this study on patients, who is under anticoagulation treatment with Warfarin , from outpatient cardiology clinics of Kartal Koşuyolu and Dr. Siyami Ersek Research and Training Hospitals. We aimed to determine the effectiveness of pharmacist consultation, education and intervention on each patient’s therapeutic results. Methods: Demographical data of 50 patients were collected and OAK (Oral Anticoagulation Knowledge) Test, SF-36 (Short Form-36), DASS (Duke Anticoagulation Satisfaction Scale) were applied. Control group resumed their routine anticoagulation treatment while Intervention group were received patient education and consultation on life style and anticoagulant usage issues from a pharmacist. Same tests were also applied to Intervention group at 90th day of the study and the results were compared with initial test results. Persistence within target INR range and complication rates were compared between Control and Intervention groups. Results: Pretest and posttest results of the intervention group revealed statistically significant improvements at physical, mental score components of SF-36 (p=0,001; p=0,001), OAK test scores (p≤0,001) and limitation, burden, positive effect components of DASS (p= 0,005; p<0,001; p=0,001). Persistence within target INR success is significantly higher at intervention group (p=0,027). Complication rate of control group is 3 times higher when compared to intervention group. Conclusion: At the end of this study we demostrated positive effects of Pharmacist consultation and education on therapeutic results. Key Words: warfarin, clinical pharmacist, anticoagulation clinic, patient education, oral anticoagulant treatment.
The Role Of Clinical Pharmacist in Monitoring and Patient Education on Patients Under Warfarin Treatment Sevda Çelik; Supervisor: Prof.Dr. Fikret Vehbi İzzettin, Clinical Pharmacy Department Objective: We performed this study on patients, who is under anticoagulation treatment with Warfarin , from outpatient cardiology clinics of Kartal Koşuyolu and Dr. Siyami Ersek Research and Training Hospitals. We aimed to determine the effectiveness of pharmacist consultation, education and intervention on each patient’s therapeutic results. Methods: Demographical data of 50 patients were collected and OAK (Oral Anticoagulation Knowledge) Test, SF-36 (Short Form-36), DASS (Duke Anticoagulation Satisfaction Scale) were applied. Control group resumed their routine anticoagulation treatment while Intervention group were received patient education and consultation on life style and anticoagulant usage issues from a pharmacist. Same tests were also applied to Intervention group at 90th day of the study and the results were compared with initial test results. Persistence within target INR range and complication rates were compared between Control and Intervention groups. Results: Pretest and posttest results of the intervention group revealed statistically significant improvements at physical, mental score components of SF-36 (p=0,001; p=0,001), OAK test scores (p≤0,001) and limitation, burden, positive effect components of DASS (p= 0,005; p<0,001; p=0,001). Persistence within target INR success is significantly higher at intervention group (p=0,027). Complication rate of control group is 3 times higher when compared to intervention group. Conclusion: At the end of this study we demostrated positive effects of Pharmacist consultation and education on therapeutic results. Key Words: warfarin, clinical pharmacist, anticoagulation clinic, patient education, oral anticoagulant treatment.