Publication: Kardiyovasküler problemi olan yaşlılarda ilaç kullanım hatalarının incelenmesi
Abstract
Giriş: Yaşlılarda ilaç yan etkileri çok yaygındır. Bu araştırma kardiyovasküler ilaç kullanım hatalarının incelenmesi amacıyla 120 yaşlıda gerçekleştirilmiştir. Hastalar ve Yöntem: Araştırma Mart-Haziran 2003 tarihlerinde huzurevlerinde yaşayan 458 ve Florence Nightingale Kardiyoloji Servisi’ne başvuran 60 yaş ve üzerindeki 100 hasta ile yapılmıştır. Veriler anket yardımıyla toplanmış ve SPSS ile değerlendirilmiştir. Bulgular: Yaşlıların yarıdan fazlası (%80) 3 ya da 4 grup ilacı birlikte kullanmaktadır. Olgu başına düşen kardiyovasküler ilaç sayısı 3.15’dir. Yaşlıların %29.2’sinde yan etki ortaya çıkmıştır. En fazla yan etki görülen ilaç grupları sırasıyla beta blokerler (%22.9), dijital türevleri (%18.8), antiaritmikler (%17.2), ACE inhibitörleri (%13.5) ve ca antagonistleridir (%12.8). Yan etkilerin %94.3 oranı ile kontrolsüz ilaç kullanımından kaynaklandığı ve polifarmasi ile ilişkili olduğu saptanmıştır (P<0.01). Yaşlıların %62.5’ine ilaçları konusunda hiç bilgi verilmemiştir; %84.2’si ilaçlarının kullanım amacını, %94.2’si yan etkilerini ve %95.8’i kullandığı ilaçları nın birbiriyle etkileşimini bilmemektedir. Bilgi almak istediğinde sağlık personeline ulaşamadı ğını ve ilacı bittiğinde doktor kontrolü olmaksızın yeniden ilaç alarak kullanmaya devam ettiğini ifade eden olguların oranı sırasıyla %46.7 ve %50’dir. İlaçlar hakkında bilgi verilen grupta ilaçlarını düzenli kullanma (P<0.01) ve ilaçların tekrar kullanımında hekime başvurma oranları beklenenin üzerinde (P<0.001); ilaçlarını düzenli kullanan grupta ise yan etki oranı beklenenin altındadır (P<0.05). Sonuç: Hataların azaltılması, hekim, hasta ve/veya bakıcısı arasında koordinasyon sağlanması ve sorun olan yaşlıların hekime kolay ulaşımının düzenlenmesi ile sağlanabilir.
Background: The incidence of drug side-effects is very high in the elderly. This research was conducted with 120 elderly people with the purpose of studying and defining the patterns of misuse of cardiovascular drugs. Patients and Methods: 458 patients who live in Nursing homes and 100 patients from the Department at Cardiology of Florence Nighingale Hospital were included. Data were collected by using a questionnaire and analysed by using SPSS. Results: More than half of the elderly subjects (80%) were using 3 or 4 drug types concurrently. The mean number of drugs used was 3.15. Adverse effects were experienced by 29.2% of the subjects. Most common side effects were related with beta-blockers (22.9%), digitalis glycosides (18.8%), antiarrhythmics (17.2%), ACE inhibitors (13.5%) and calcium canal blocker (12.8%) consumption. It was defined that 94.3% of adverse effects was related to uncontrolled drug use and polypharmacy (P<0.01). The percentage of elderly who were not given any information about their medication was 62.5%. Most of elderly didn&#8217;t know the purpose of used medications (84.2%), adverse affects (94.2%), and interactions of their medications (95.8%). Of the subjects, 46.7% couldn&#8217;t contact with health professionals when they needed information about medications, 50% bought and continued drug intake without consulting the physician, after depleting the medications. Patients who given information on drugs were using their drugs more regularly (P<0.01) and were going the physician to consult when their drugs depleted (P<0.001). Adverse effects were slight lower in patients used their drugs regularly (P<0.05). Conclusion: The misuse of the drugs can only be decreased by furnishing coordination among patient, physician and patients carer.
Background: The incidence of drug side-effects is very high in the elderly. This research was conducted with 120 elderly people with the purpose of studying and defining the patterns of misuse of cardiovascular drugs. Patients and Methods: 458 patients who live in Nursing homes and 100 patients from the Department at Cardiology of Florence Nighingale Hospital were included. Data were collected by using a questionnaire and analysed by using SPSS. Results: More than half of the elderly subjects (80%) were using 3 or 4 drug types concurrently. The mean number of drugs used was 3.15. Adverse effects were experienced by 29.2% of the subjects. Most common side effects were related with beta-blockers (22.9%), digitalis glycosides (18.8%), antiarrhythmics (17.2%), ACE inhibitors (13.5%) and calcium canal blocker (12.8%) consumption. It was defined that 94.3% of adverse effects was related to uncontrolled drug use and polypharmacy (P<0.01). The percentage of elderly who were not given any information about their medication was 62.5%. Most of elderly didn&#8217;t know the purpose of used medications (84.2%), adverse affects (94.2%), and interactions of their medications (95.8%). Of the subjects, 46.7% couldn&#8217;t contact with health professionals when they needed information about medications, 50% bought and continued drug intake without consulting the physician, after depleting the medications. Patients who given information on drugs were using their drugs more regularly (P<0.01) and were going the physician to consult when their drugs depleted (P<0.001). Adverse effects were slight lower in patients used their drugs regularly (P<0.05). Conclusion: The misuse of the drugs can only be decreased by furnishing coordination among patient, physician and patients carer.