Publication: Renal transplantasyon hastalarında ilaç tedavi profilinin ve hasta uyumunun değerlendirilmesi
Abstract
1. ÖZET Tezin başlığı : Renal Transplantasyon Hastalarında İlaç Tedavi Profilinin ve Hasta Uyumunun Değerlendirilmesi Öğrencinin Adı Soyadı : İzel Dede Danışmanın Adı Soyadı : Prof. Dr. Mesut Sancar Programın Adı : Klinik Eczacılık Yüksek Lisans Amaç: Renal transplantasyon hastalarında ilaçla tedaviye uyumun değerlendirilmesi ve ilaç ilişkili sorunların saptanmasında klinik eczacının transplant ekibine sağlayabileyeceği katkıların gösterilmesi amaçlanmıştır. Gereç ve Yöntem: Prospektif gözlemsel bir çalışma olarak planlanan bu Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi Nefroloji Polikliniğinde yürütülmüştür. Hastanın böbrek nakli sonrası tedavisine ve (varsa) eşlik eden hastalıklarına ilişkin uygulanan tedavilerine uyumunu ölçmek amacıyla Morisky Green Levine Scale Uyum Ölçeği ve İmmunsupresif Tedaviye Uyum Ölçeği (İTUÖ) kullanılmıştır. Hastaların tedavi planında karşılaşılan ilaç ilişkili sorunlar Hepler-Strand Sınıflandırmasına göre sınıflandırılmıştır. Ayrıca 65 yaş ve üzerindeki hastaların ilaç tedavileri Beers 2023 kriterine göre değerlendirilmiştir. Bulgular: Hastaların yaş ortalaması ve standart sapması 43,5413,43 olup %55’i (%53,92) kadındır. Hastaların 19’u (%18,63) kadavradan, 83’ü (%81,37) canlı donörden böbrek almıştır. Hastalar İTUÖ’den 11,081,06 (12 üzerinden); Morisky Uyum Ölçeğinden 2,901,11 (4 üzerinden) puan almıştır. 7 geriatrik hastanın 17 ilacı Beers Kriterleri’ne (2023) girmiştir. Hem İTUÖ hem de MORİSKY uyum ölçeklerinde uyumlu olarak değerlendirilen hasta sayısı 39 (%38,24) olmuştur. İTUÖ ve MORİSKY uyum ölçeklerinden alınan puanlar arasındaki ilişki pozitif yönde zayıf bir korelasyon (r=0.280; p<0.05) olarak saptanmıştır. Cinsiyet, yaş, eğitim düzeyi, hiperpolifarması, kullanılan ilaç sayısı, etkileşim sayısı, komorbidite, kreatinin değeri ile uyum ölçeklerinin puanları arasında istatistiksel açıdan anlamlı bir ilişki bulunamamıştır (p>0.05). Sonuç: Bu çalışma klinik eczacının varlığı ile tespit edilebilecek tedavi uyumsuzlukları ve ilaç ilişkili sorunlara işaret ederek klinik eczacının transplant ekibine sunabileceği katkılar hakkında bir çerçeve çizmiştir. Renal transplantasyon, tedaviye uyum, İTUÖ, klinik eczacı
2. SUMMARY Title of Thesis: Evaluation of Medication Profile and Patient Adherence In Renal Transplantation Patients Student Name, Surname: İzel Dede Supervisor Name : Prof. Mesut Sancar Program Name : Clinical Pharmacy MSc Program Objective: It is aimed to evaluate medication adherence in renal transplant patients, classify drug-related problems and show the contributions that the clinical pharmacist can provide to the transplant team. Materials and Methods: This master's thesis planned as a prospective observational study, was conducted at Marmara University Pendik Education and Research Hospital Nephrology Outpatient Clinic for a period of 4 months (02.01.2022-02.05.2022). The Morisky Green Levine Scale and the Immunosuppressive Therapy Adherence Scale (ITAS) were applied to measure the patient's adherence to the treatment after kidney transplantation and the treatments applied for the accompanying diseases (if any). Drug-related problems encountered in the patients' treatment plan were classified according to the Hepler-Strand Classification. In addition, the drug treatments of patients aged 65 and older were evaluated according to the Beers 2023 criteria. Results: The mean age and its standard deviation of the patients was 43.54+13.43. 55% (53.92%) are female. 19 of the patients (18.63%) received kidneys from cadavers, 83 (81.37%) received kidneys from living donors. Patients received a score of 11.081.06 (12) from ITAS and 2.901.11 (4) from MORISKY scale. 7 geriatric patients had 17 drugs included in Beers Criteria (2023). The number of patients evaluated as compatible in both ITAS and MORISKY scales was 39 (38.24%). The relationship between the scores obtained from the ITAS and MORISKY adherence scales was found to be statistically positive and weakly significant (r=0.280; p<0.05). There was no statistically significant relationship between gender, age, education level, hyperpolypharmacy, number of drugs used, number of interactions, comorbidity, creatinine value and adherence scales (p>0.05). Conclusion: This study provides a framework for the contribution that the clinical pharmacist can make to the transplant team by pointing out the treatment non-adherent, drug-related problems of the patients that can be detected by the presence of the clinical pharmacist. Renal transplantation, medication adherence, ITAS, clinical pharmacist
2. SUMMARY Title of Thesis: Evaluation of Medication Profile and Patient Adherence In Renal Transplantation Patients Student Name, Surname: İzel Dede Supervisor Name : Prof. Mesut Sancar Program Name : Clinical Pharmacy MSc Program Objective: It is aimed to evaluate medication adherence in renal transplant patients, classify drug-related problems and show the contributions that the clinical pharmacist can provide to the transplant team. Materials and Methods: This master's thesis planned as a prospective observational study, was conducted at Marmara University Pendik Education and Research Hospital Nephrology Outpatient Clinic for a period of 4 months (02.01.2022-02.05.2022). The Morisky Green Levine Scale and the Immunosuppressive Therapy Adherence Scale (ITAS) were applied to measure the patient's adherence to the treatment after kidney transplantation and the treatments applied for the accompanying diseases (if any). Drug-related problems encountered in the patients' treatment plan were classified according to the Hepler-Strand Classification. In addition, the drug treatments of patients aged 65 and older were evaluated according to the Beers 2023 criteria. Results: The mean age and its standard deviation of the patients was 43.54+13.43. 55% (53.92%) are female. 19 of the patients (18.63%) received kidneys from cadavers, 83 (81.37%) received kidneys from living donors. Patients received a score of 11.081.06 (12) from ITAS and 2.901.11 (4) from MORISKY scale. 7 geriatric patients had 17 drugs included in Beers Criteria (2023). The number of patients evaluated as compatible in both ITAS and MORISKY scales was 39 (38.24%). The relationship between the scores obtained from the ITAS and MORISKY adherence scales was found to be statistically positive and weakly significant (r=0.280; p<0.05). There was no statistically significant relationship between gender, age, education level, hyperpolypharmacy, number of drugs used, number of interactions, comorbidity, creatinine value and adherence scales (p>0.05). Conclusion: This study provides a framework for the contribution that the clinical pharmacist can make to the transplant team by pointing out the treatment non-adherent, drug-related problems of the patients that can be detected by the presence of the clinical pharmacist. Renal transplantation, medication adherence, ITAS, clinical pharmacist