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Sağlık Bakanlığının Dönemsel Ücretsiz İlaç Politikasının Sigara Bırakma Polikliniğine Olan Etkisi

Year 2020, Volume: 22 Issue: 1, 13 - 16, 30.04.2020
https://doi.org/10.18678/dtfd.656144

Abstract

Amaç: Bu çalışmanın amacı Sağlık Bakanlığı’nın dönemsel ücretsiz ilaç uygulamalarının Sigara Bırakma Polikliniği (SBP)’ne olan etkisi ve kullanılan tedavi yöntemlerinin başarı oranlarının değerlendirilmesidir.
Gereç ve Yöntemler: Bu çalışmaya 1 Ocak ve 31 Aralık 2017 tarihleri arasında Şanlıurfa’da bulunan bir ilçe devlet hastanesinde SBP’ye başvuran toplam 1861 hasta dahil edildi. En az altı ay boyunca sigara içmeyen hastalar sigarayı bırakmış olarak kabul edildi. Her hastanın en az altı ay süreyle takibi yapıldı. Elde edilen veriler sayı ve yüzde olarak hesaplandı.
Bulgular: Aylara göre en yüksek başvurunun Aralık ayında olduğu görüldü. Temmuz ve Kasım aylarında ise SBP’ye başvuran hasta sayılarında belirgin bir düşme vardı. Hastaların %80,0’inin davranış terapisi aldığı, %20,0’sinin ise farmakolojik tedavi aldığı tespit edildi. Farmakolojik tedavi uygulaması en düşük hiç hastanın olmadığı Temmuz ayında ve en yüksek ise %96,8 ile Kasım ayında idi. Farmakolojik tedavi ile bırakma oranı %27,4 iken davranış terapisi ile bırakma oranı ise %18,9 idi.
Sonuç: Sağlık Bakanlığı’nın dönemsel ücretsiz ilaç uygulama politikası SBP’yi direkt olarak etkilemektedir. Bu durum, hastalarda davranış terapisi ile sigara bırakmaya karşı bir direnç nedeni olabilmektedir. Sigara bırakma tedavilerinin yıl boyu karşılanması gereklidir. Ücretsiz ilaç tedavilerinin tüm ilaçları kapsaması ve rapor karşılığı eczanelerden temini yoluna gidilmesi önerilir. Bu düzenlemeler ile hastaların tedaviye uyumu ve sigara bırakma kararlılığının artacağını düşünmekteyiz.

References

  • Uzaslan EK. Sigarayı bırakma yöntemleri. Özyardımcı EN, editör. Sigara ve sağlık. Bursa: 2002. s.441-66.
  • Çan G, Öztuna F, Özlü T. The evaluation of outpatient smoking cessation clinic results of Karadeniz Technical University. Tuber Toraks. 2004;52(1):69-74.
  • Fiore MC, Bailey WC, Cohen SJ, Dorfman S, Goldstein M, Gritz ER, et al. Treating tobacco use and dependence. Rockville (MD): US Department of Health and Human Service; 2000.
  • West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax. 2000;55(12):987-99.
  • Bakkevig O, Steine S, von Hafenbrädl K, Laerum E. Smoking cessation. A comparative, randomised study between management in general practice and the behavioural programme SmokEnders. Scand J Prim Health Care. 2000;18(4):247-51.
  • Yaşar Z, Kar Kurt Ö, Talay F, Kargı A. One-year follow up results of smoking cessation outpatient clinic: Factors affecting the cessation of smoking. Eurasian J Pulmonol. 2014;16(2):99-104.
  • Çelik İ, Yüce D, Hayran M, Erman M, Kılıçkap S, Buzgan T, et al. Nationwide smoking cessation treatment support program--Turkey project. Health Policy. 2015;119(1):50-6.
  • Tadzimirwa GY, Day C, Esmail A, Cooper C, Kamkuemah M, Dheda K, et al. Challenges for dedicated smoking cessation services in developing countries. S Afr Med J. 2019;109(6):431-6.
  • Elbek O, Kılınç O, Aytemur ZA, Akyıldız L, Uyanusta Küçük Ç, Özge C, et al. Tobacco control in Turkey. Turk Thorac J. 2015;16(3):141-50.
  • Pıçakçıefe M, Akkaya V, Erbaş E, Doğu B. Evaluation of the referrals to the smoking cessation polyclinic betwen 2015-2016 in Muğla. Nobel Med. 2019;15(1):21-7.
  • Karadoğan D, Önal Ö, Şahin DS, Kanbay Y, Alp S, Şahin Ü. Treatment adherence and short-term outcomes of smoking cessation outpatient clinic patients. Tob Induc Dis. 2018;16:38.
  • Berkeşoğlu Ç, Özgür ES, Demir AU. Factors affecting the success of smoking cessation. Mersin Univ Saglık Bilim Derg. 2018;11(3):355-65.
  • Kanatsız B, Başlılar Ş, Şaylan B, Albay A, Uçak Basat S. Evaluation of the factors affecting success rate and medical treatments in smoking cessation. Euras J Fam Med. 2017;6(2):65-71.
  • Fai SC, Yen GK, Malik N. Quit rates at 6 months in a pharmacist-led smoking cessation service in Malaysia. Can Pharm J (Ott). 2016;149(5):303-12.
  • Lin H, Xiao D, Liu Z, Shi Q, Hajek P, Wang C. National survey of smoking cessation provision in China. Tob Induc Dis. 2019;17:25.
  • Slama K, Redman S, Perkins J, Reid ALA, Sanson-Fisher RW. The effectiveness of two smoking cessation programmes for use in general practice: A randomized clinical trial. BMJ. 1990;300(6741):1707-9.
  • Fidan F, Pala E, Ünlü M, Sezer M, Kara Z. Factors affecting smoking cessation and success rates of the treatment methods used. Kocatepe Med J. 2005;6(3):27-34.
  • Hays JT, Leischow SJ, Lawrence D, Lee TC. Adherence to treatment for tobacco dependence: association with smoking abstinence and predictors of adherence. Nicotine Tob Res. 2010;12(6):574-81.
  • Balmford J, Borland R, Hammond D, Cummings KM. Adherence to and reasons for premature discontinuation from stop-smoking medications: data from the ITC Four-Country Survey. Nicotine Tob Res. 2011;13(2):94-102.
  • Notley C, Gentry S, Livingstone-Banks J, Bauld L, Perera R, Hartmann-Boyce J. Incentives for smoking cessation. Cochrane Database Syst Rev. 2019;7:CD004307.
  • Milcarz K, Polańska K, Balwicki Ł, Makowiec-Dąbrowska T, Hanke W, Bąk-Romaniszyn L, et al. Perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland. Int J Occup Med Environ Health. 2019;32(3):363-77.
  • El-Khoury Lesueur F, Bolze C, Melchior M. Factors associated with successful vs. unsuccessful smoking cessation: Data from a nationally representative study. Addict Behav. 2018;80:110-5.
  • Zhu S, Melcer T, Sun J, Rosbrook B, Pierce JP. Smoking cessation with and without assistance: a population-based analysis. Am J Prev Med. 2000;18(4):305-11.

The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic

Year 2020, Volume: 22 Issue: 1, 13 - 16, 30.04.2020
https://doi.org/10.18678/dtfd.656144

Abstract

Aim: The aim of this study is to evaluate the effect of periodic free drug applications of the Ministry of Health on Smoking Cessation Polyclinic (SCP) and the success rates of the treatment methods used.
Material and Methods: A total of 1861 patients applied to SCP in a county state hospital in Şanlıurfa between January 1 and December 31, 2017 were included in this study. Patients not smoke for at least six months were accepted as non-smokers. Each patient was followed up for at least six months. The data was calculated as number and percentage.
Results: According to months the highest application was seen in December. In July and November, there was a significant decrease in the number of patients applying to SCP. It was determined that 80.0% of the patients received behavior therapy, 20.0% received pharmacological treatment. Utilization of pharmacological treatment was the lowest in July with no patient and the highest in November with 96.8%. The rate of quitting with pharmacological treatment was 27.4% while this rate was 18.9% with behavioral therapy.
Conclusion: The Ministry of Health's periodic free drug application policy has a direct impact on SCPs. This may be the reason for resistance in patients to smoking cessation with behavioral therapy. Smoking cessation treatments should be provided throughout the year. It is recommended that free drug treatments include all drugs and supply from pharmacies through report. We think that with these arrangements, the compliance of patients to treatment and their determination to quit smoking will increase.

References

  • Uzaslan EK. Sigarayı bırakma yöntemleri. Özyardımcı EN, editör. Sigara ve sağlık. Bursa: 2002. s.441-66.
  • Çan G, Öztuna F, Özlü T. The evaluation of outpatient smoking cessation clinic results of Karadeniz Technical University. Tuber Toraks. 2004;52(1):69-74.
  • Fiore MC, Bailey WC, Cohen SJ, Dorfman S, Goldstein M, Gritz ER, et al. Treating tobacco use and dependence. Rockville (MD): US Department of Health and Human Service; 2000.
  • West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax. 2000;55(12):987-99.
  • Bakkevig O, Steine S, von Hafenbrädl K, Laerum E. Smoking cessation. A comparative, randomised study between management in general practice and the behavioural programme SmokEnders. Scand J Prim Health Care. 2000;18(4):247-51.
  • Yaşar Z, Kar Kurt Ö, Talay F, Kargı A. One-year follow up results of smoking cessation outpatient clinic: Factors affecting the cessation of smoking. Eurasian J Pulmonol. 2014;16(2):99-104.
  • Çelik İ, Yüce D, Hayran M, Erman M, Kılıçkap S, Buzgan T, et al. Nationwide smoking cessation treatment support program--Turkey project. Health Policy. 2015;119(1):50-6.
  • Tadzimirwa GY, Day C, Esmail A, Cooper C, Kamkuemah M, Dheda K, et al. Challenges for dedicated smoking cessation services in developing countries. S Afr Med J. 2019;109(6):431-6.
  • Elbek O, Kılınç O, Aytemur ZA, Akyıldız L, Uyanusta Küçük Ç, Özge C, et al. Tobacco control in Turkey. Turk Thorac J. 2015;16(3):141-50.
  • Pıçakçıefe M, Akkaya V, Erbaş E, Doğu B. Evaluation of the referrals to the smoking cessation polyclinic betwen 2015-2016 in Muğla. Nobel Med. 2019;15(1):21-7.
  • Karadoğan D, Önal Ö, Şahin DS, Kanbay Y, Alp S, Şahin Ü. Treatment adherence and short-term outcomes of smoking cessation outpatient clinic patients. Tob Induc Dis. 2018;16:38.
  • Berkeşoğlu Ç, Özgür ES, Demir AU. Factors affecting the success of smoking cessation. Mersin Univ Saglık Bilim Derg. 2018;11(3):355-65.
  • Kanatsız B, Başlılar Ş, Şaylan B, Albay A, Uçak Basat S. Evaluation of the factors affecting success rate and medical treatments in smoking cessation. Euras J Fam Med. 2017;6(2):65-71.
  • Fai SC, Yen GK, Malik N. Quit rates at 6 months in a pharmacist-led smoking cessation service in Malaysia. Can Pharm J (Ott). 2016;149(5):303-12.
  • Lin H, Xiao D, Liu Z, Shi Q, Hajek P, Wang C. National survey of smoking cessation provision in China. Tob Induc Dis. 2019;17:25.
  • Slama K, Redman S, Perkins J, Reid ALA, Sanson-Fisher RW. The effectiveness of two smoking cessation programmes for use in general practice: A randomized clinical trial. BMJ. 1990;300(6741):1707-9.
  • Fidan F, Pala E, Ünlü M, Sezer M, Kara Z. Factors affecting smoking cessation and success rates of the treatment methods used. Kocatepe Med J. 2005;6(3):27-34.
  • Hays JT, Leischow SJ, Lawrence D, Lee TC. Adherence to treatment for tobacco dependence: association with smoking abstinence and predictors of adherence. Nicotine Tob Res. 2010;12(6):574-81.
  • Balmford J, Borland R, Hammond D, Cummings KM. Adherence to and reasons for premature discontinuation from stop-smoking medications: data from the ITC Four-Country Survey. Nicotine Tob Res. 2011;13(2):94-102.
  • Notley C, Gentry S, Livingstone-Banks J, Bauld L, Perera R, Hartmann-Boyce J. Incentives for smoking cessation. Cochrane Database Syst Rev. 2019;7:CD004307.
  • Milcarz K, Polańska K, Balwicki Ł, Makowiec-Dąbrowska T, Hanke W, Bąk-Romaniszyn L, et al. Perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland. Int J Occup Med Environ Health. 2019;32(3):363-77.
  • El-Khoury Lesueur F, Bolze C, Melchior M. Factors associated with successful vs. unsuccessful smoking cessation: Data from a nationally representative study. Addict Behav. 2018;80:110-5.
  • Zhu S, Melcer T, Sun J, Rosbrook B, Pierce JP. Smoking cessation with and without assistance: a population-based analysis. Am J Prev Med. 2000;18(4):305-11.
There are 23 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Şerif Kurtuluş 0000-0002-1082-3700

Remziye Can 0000-0001-5913-6007

Zafer Sak 0000-0002-2388-2259

Publication Date April 30, 2020
Submission Date December 6, 2019
Published in Issue Year 2020 Volume: 22 Issue: 1

Cite

APA Kurtuluş, Ş., Can, R., & Sak, Z. (2020). The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic. Duzce Medical Journal, 22(1), 13-16. https://doi.org/10.18678/dtfd.656144
AMA Kurtuluş Ş, Can R, Sak Z. The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic. Duzce Med J. April 2020;22(1):13-16. doi:10.18678/dtfd.656144
Chicago Kurtuluş, Şerif, Remziye Can, and Zafer Sak. “The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic”. Duzce Medical Journal 22, no. 1 (April 2020): 13-16. https://doi.org/10.18678/dtfd.656144.
EndNote Kurtuluş Ş, Can R, Sak Z (April 1, 2020) The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic. Duzce Medical Journal 22 1 13–16.
IEEE Ş. Kurtuluş, R. Can, and Z. Sak, “The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic”, Duzce Med J, vol. 22, no. 1, pp. 13–16, 2020, doi: 10.18678/dtfd.656144.
ISNAD Kurtuluş, Şerif et al. “The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic”. Duzce Medical Journal 22/1 (April 2020), 13-16. https://doi.org/10.18678/dtfd.656144.
JAMA Kurtuluş Ş, Can R, Sak Z. The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic. Duzce Med J. 2020;22:13–16.
MLA Kurtuluş, Şerif et al. “The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic”. Duzce Medical Journal, vol. 22, no. 1, 2020, pp. 13-16, doi:10.18678/dtfd.656144.
Vancouver Kurtuluş Ş, Can R, Sak Z. The Effect of the Ministry of Health’s Periodic Free Drug Policy on Smoking Cessation Polyclinic. Duzce Med J. 2020;22(1):13-6.