Publication: Senil Osteoporozlu kadınlarda Farmasötik bakım ihtiyaçlarının saptanması ve Alendronat tedavisinde hasta eğitimi ve tedavi izleminin önemi
Abstract
1. ÖZET Çalışmamızda, en az 3 aydır bifosfonat (alendronat) tedavisi almakta olan 65 yaş ve üzeri 46 senil osteoporozlu kadın hastada (1.grup) farmasötik bakım ihtiyaçlarını saptamayı ve yeni senil osteoporoz tanısıyla alendronat tedavisi almaya başlayacak olan 33 kadın hastada da (2.grup) hasta eğitimi ve tedavi izleminin önemini gözlemlemeyi amaçladık. Ayrıca tedavi izlem sürecinde serum kalsiyum (Ca), fosfor (P), alkalen fosfataz (ALP) ve paratiroid hormon (PTH) değerleri ve idrar kalsiyum/ kreatinin oranını ölçerek, tedavinin bu parametrelere etkisini değerlendirdik. 2.gruptaki hastalarda 3 aylık 70 mg/ hafta dozunda alendronat tedavisinden sonra serum ALP, kalsiyum ve fosfor düzeyinde istatistiksel olarak anlamlı bir düşüş ve serum PTH düzeyinde de bu değişikliklere cevap olarak anlamlı yükselme ve idrar kalsiyum/ kreatinin oranında istatistiksel olarak anlamlı düşme görüldü (p<0.05). Bu hasta grubuna verilen sözlü ve yazılı eğitimden önce ve 3 ay sonra uygulanan “osteoporoz bilgi ölçüm testi”nde genel olarak anlamlı fark saptandı. Hasta eğitimi almayan 1.gruptaki hastaların ise soruların büyük çoğunluğuna yanlış cevap verdiği saptandı. Ayrıca bu hasta grubunda uyuncun az olduğu görüldü (ort: skor 1.34). İlacın tok karnına alınması (n=9) en çok görülen ilaç kullanım hatasıydı. Sonuç olarak hasta eğitimi ve tedavi izleminde klinik eczacının önemli rolleri olduğu görülmektedir. Osteoporozdan korunma, komplikasyonlarının önlenmesi ve tedavide uyuncun arttırılmasında eczacı tarafından verilen sözlü ve yazılı hasta eğitiminin oldukça önemli bir role sahip olduğunu düşünmekteyiz. 2.
Determination of The Pharmaceutical Care Issues in Senile Osteoporotic Women and Impact of The Patient Education and Monitoring in Alendronate Treatment. In our study we aimed to determine the pharmaceutical care needs of 46 female patients of ≥65 years of age, receiving bisphosphonate (alendronate) treatment with a former diagnosis of senile osteoporosis (1st group) and to assess the outcomes of pharmacist-led patient education and therapy monitoring of 33 female patients newly diagnosed as senile osteoporosis and prescribed bisphosphonate (alendronate) treatment (2nd group). Also, the effects of bisphosphonate (alendronate) treatment on the parameters of serum calcium, phosphorus, alkaline phosphatase (ALP), parathyroid hormone (PTH) and urinary calcium/ creatinine ratio during the monitored period of the treatment were evaluated. In the newly diagnosed senile osteoporosis group, statistically significant decreases in serum ALP, calcium and phosphorus levels were observed and as a response to these alterations, serum PTH levels were increased and urinary calcium/ creatinine ratio was decreased significantly (p<0.05; both). The results of “osteoporosis knowledge test”, that were given to the patients in recently-diagnosed group, before and three months after the oral and written education were significantly different in general. The patients in the first group, that were not received the oral and written education were found to give false answers to the majority of the questions of the “osteoporosis knowledge test”. The patients in this group also had lower adherence rates (mean score: 1.34). Taking pills after meals (n=9) was the most common mistake. It can be concluded that clinical pharmacist has an important role in patient education and monitoring. We suggest that pharmacist-led oral and written education has a major importance in prevention of osteoporosis and its complications and in improvement of adherence, as well.
Determination of The Pharmaceutical Care Issues in Senile Osteoporotic Women and Impact of The Patient Education and Monitoring in Alendronate Treatment. In our study we aimed to determine the pharmaceutical care needs of 46 female patients of ≥65 years of age, receiving bisphosphonate (alendronate) treatment with a former diagnosis of senile osteoporosis (1st group) and to assess the outcomes of pharmacist-led patient education and therapy monitoring of 33 female patients newly diagnosed as senile osteoporosis and prescribed bisphosphonate (alendronate) treatment (2nd group). Also, the effects of bisphosphonate (alendronate) treatment on the parameters of serum calcium, phosphorus, alkaline phosphatase (ALP), parathyroid hormone (PTH) and urinary calcium/ creatinine ratio during the monitored period of the treatment were evaluated. In the newly diagnosed senile osteoporosis group, statistically significant decreases in serum ALP, calcium and phosphorus levels were observed and as a response to these alterations, serum PTH levels were increased and urinary calcium/ creatinine ratio was decreased significantly (p<0.05; both). The results of “osteoporosis knowledge test”, that were given to the patients in recently-diagnosed group, before and three months after the oral and written education were significantly different in general. The patients in the first group, that were not received the oral and written education were found to give false answers to the majority of the questions of the “osteoporosis knowledge test”. The patients in this group also had lower adherence rates (mean score: 1.34). Taking pills after meals (n=9) was the most common mistake. It can be concluded that clinical pharmacist has an important role in patient education and monitoring. We suggest that pharmacist-led oral and written education has a major importance in prevention of osteoporosis and its complications and in improvement of adherence, as well.