Publication: Erişkin kemik iliği transplantasyon ünitesi’nde yatan hastalarda profil kaydının oluşturulması ve hastaların yaşam kalitelerinin değerlendirilmesi
Abstract
Amaç: Kemik iliği nakli öncesi ve sonrasında yaşanan komplikasyonlar, uzun ve zorlu tedavi sürecinin yarattığı korku, belirsizlik düşüncesi, invaziv girişimler, radyoterapi, kemoterapi ve izolasyon süreçleri hastanın psikolojik durumunu doğrudan etkilemekte, hastada anksiyete yaratmakta ve yaşam kalitesini düşürmektedir. Bu çalışmada iki amaç vardır. Birincil amaç, Functional Assessment of Cancer Therapy - Bone Marrow Transplantation (FACT-BMT) ölçeği ile kemik iliği nakli olan hastaların yaşam kalitesini değerlendirmektir. İkincil amaç, olası ilaç etkileşimlerini değerlendirmektir. Gereç ve Yöntem: Bu çalışma, Türkiye'de özel bir hastanenin erişkin kemik BMT ünitesinde Ocak-Haziran 2021 tarihleri arasında yapılmış prospektif ve tanımlayıcı bir çalışmadır. Hastaların sosyodemografik özellikleri kaydedilmiştir. İlaç etkileşimleri, Medscape ve Lexicomp ilaç etkileşimi veritabanları kullanılarak analiz edilmiştir. Hastanın yaşam kalitesi çalışmanın başlangıcında ve bir ay sonra FACT-BMT skalası ile ölçülmüştür. Analiz için SPSS 15 kullanılmıştır. Bulgular: Çalışmaya dahil edilen 40 hastanın 22'sinin (%55) erkek hastalar olduğu ve yaş ortalamasının 46 olduğu tespit edilmiştir. Hastaların çoğuna multipl miyelom (%35) tanısının konulduğu ve %58'inde en az bir komorbid hastalık olduğu tespit edilmiştir. Hastaların %85'i nakil öncesi hastaneye yatırılırken, hastaların %78'i miyeloablatif tedavi ile tedavi edilmiştir. Yüksek doz melfalan rejimi en çok uygulanan rejim (%25) olarak bulunmuştur. Trombositopeni en sık görülen yan etki (%14) olarak tespit edilmiştir. Lexicomp veri tabanında tespit edilen etkileşim sayısı, Medscape veri tabanından istatistiksel olarak daha fazla olduğu belirlenmiştir (299 vs 244; p<0.05). Genel olarak yaşam kalitesinde anlamlı bir düşüş olmamasına rağmen, sosyal durum kısmının anlamlı ölçüde arttığı bulunmuştur (p<0.05). Sonuç: Çalışmamızda kemik iliği nakli hastalarında komorbid hastalık sayısı daha fazla olduğu gözlenmiştir. Bu hastaların akılcı tedavi ve izlem gerektiren ilaç etkileşimleri ve yan etki sayıları yüksek olabilmektedir. Bu ünitelerde hasta takibi, ilaç etkileşimlerinin yönetimi ve yaşam kalitesinin iyileştirilmesinde klinik eczacıların önemli bir rolü olduğunu düşünüyoruz.
Objective: Bone marrow treatment (BMT) is a long and difficult process with various complications which affect the psychological state of the patient, creating anxiety in the patient and decreasing the quality of life. In this study, there are two aims. Primary aim is to evaluate the quality of life of patients with bone marrow transplantation via using the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT). the secondary aim is to evaluate the possible drug interactions in patients. Material and Methods: This was a prospective and descriptive study conducted in an adult bone BMT unit in a private hospital in Turkey between January-June 2021. Sociodemogphrapics of the patients were recorded. Drug interactions were analyzed via Medscape and Lexicomp drug interaction checker. The quality of life of the patient was measured with the FACT-BMT scale at the initiation of the study and one month after. SPSS 15 was used for analysis. Results: Of 40 patients 22 (55%) were male and the mean age was 46. Most of the patients were diagnosed with multiple myeloma (35%) and 58% of the patients had at least one comorbid disease. While 85% of the patients were hospitalized for pretransplantation, 78% of the patients were treated with myeloablative treatment. High dose melphalan regimen was found to be the most administrated regimen (25%). Thrombocytopenia was found to be the most common side effect (14%). The number of interactions detected in the Lexicomp database was statistically higher than in the Medscape database (299 vs 244; p<0.05) Although there was no significant decrease in the quality of life in general, the social status part increased significantly (p<0.05). Conclusion: The number of comorbid diseases was found to be higher in this population. Additionally, drug interactions and side effects requiring rationale management and follow-up of the patients were found to be high. We think that clinical pharmacists have an important role in patient monitoring, management of drug interactions, and improving the quality of life in BMT units.
Objective: Bone marrow treatment (BMT) is a long and difficult process with various complications which affect the psychological state of the patient, creating anxiety in the patient and decreasing the quality of life. In this study, there are two aims. Primary aim is to evaluate the quality of life of patients with bone marrow transplantation via using the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT). the secondary aim is to evaluate the possible drug interactions in patients. Material and Methods: This was a prospective and descriptive study conducted in an adult bone BMT unit in a private hospital in Turkey between January-June 2021. Sociodemogphrapics of the patients were recorded. Drug interactions were analyzed via Medscape and Lexicomp drug interaction checker. The quality of life of the patient was measured with the FACT-BMT scale at the initiation of the study and one month after. SPSS 15 was used for analysis. Results: Of 40 patients 22 (55%) were male and the mean age was 46. Most of the patients were diagnosed with multiple myeloma (35%) and 58% of the patients had at least one comorbid disease. While 85% of the patients were hospitalized for pretransplantation, 78% of the patients were treated with myeloablative treatment. High dose melphalan regimen was found to be the most administrated regimen (25%). Thrombocytopenia was found to be the most common side effect (14%). The number of interactions detected in the Lexicomp database was statistically higher than in the Medscape database (299 vs 244; p<0.05) Although there was no significant decrease in the quality of life in general, the social status part increased significantly (p<0.05). Conclusion: The number of comorbid diseases was found to be higher in this population. Additionally, drug interactions and side effects requiring rationale management and follow-up of the patients were found to be high. We think that clinical pharmacists have an important role in patient monitoring, management of drug interactions, and improving the quality of life in BMT units.