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KRONİK HASTALIĞI OLAN YAŞLI BİREYLERİN AĞRI DÜZEYİ VE İLAÇ UYUMU: KESİTSEL ÇALIŞMA

Year 2024, Volume: 12 Issue: 2, 644 - 656, 20.06.2024
https://doi.org/10.33715/inonusaglik.1446110

Abstract

Bu çalışma kronik hastalığı olan yaşlı bireylerin ilaç uyumu, ağrı düzeyi ve ağrı düzeyini etkileyen faktörlerin belirlenmesi amacıyla kesitsel tipte yapıldı. Çalışmaya 154 yaşlı birey dahil edildi. Veriler Hasta Tanıtım Formu, Geriatrik Ağrı Ölçeği ve İlaç Uyumunu Bildirim Ölçeği ile toplandı. Verilerin analizinde sayı, yüzde, ortalama, standart sapma, minimum ve maksimum değerler gibi tanımlayıcı istatistikler, Independent samples t test, One-Way ANOVA ve çoklu doğrusal regresyon analizi kullanıldı. Yaş ortalaması 71.82±5.78 olan katılımcıların, %56.5’i erkek, %43.5’i ilkokul mezunu, çoğu hipertansiyon (%68.8) ve diyabet (%40.3) hastasıdır. Yaşlı bireylerin İlaç Uyumunu Bildirim Ölçeği toplam puanı 19.73±5.38 ve Geriatrik Ağrı Ölçeği puanı 53.33±27.68’dir. Modele dahil edilen değişkenlerden; cinsiyet, eğitim durumu, hastalık sayısı ve ağrı kesici kullanma durumu değişkenlerinin geriatrik ağrı düzeyini etkilediği (p<0.05) ve varyansın %47’sini açıkladığı saptandı (R2=0.474, F=10.579, p<0.001). Sonuç olarak yaşlı bireylerin ilaç uyumlarının yüksek ve ağrı şiddeti orta düzeyde olduğu belirlendi. Kadınların, eğitim durumu düşük olanların, birden fazla kronik hastalığa sahip olanların ve her gün/birkaç günde bir ağrı kesici kullananların ağrı düzeylerinin daha yüksek olduğu ve bu değişkenlerin yaşlı bireylerin ağrı düzeyini etkilediği tespit edildi.

References

  • KAYNAKLAR Ágh, T., Dömötör, P., Bártfai, Z., Inotai, A., Fujsz, E. ve Mészáros, Á. (2015). Relationship between medication adherence and health related quality of life in subjects with COPD: a systematic review. Respiratory Care, 60(2), 297-303. https://doi.org/10.4187/respcare.03123
  • Alçınar, R. ve Şahin, M. K. (2023). The association between medication adherence and quality of life in patients with diabetes receiving primary healthcare centers: A cross-sectional study. TJFMPC, 17(3), 360-369. https://doi.org/10.21763/tjfmpc.1312415
  • Altıntas, H. K., Aslan, G. K., Sısman, N. Y. ve Kesgin, M. T. (2018). Effects of pain and sleep quality on falls among nursing home residents in Turkey. Research in Gerontological Nursing, 11(5), 257-264. https://doi.org/10.3928/19404921-20180810-01
  • Amer, M. A. K., Mohiuddin, S. I. ve Shafeeque Shaikh, D. Z. T. (2023). Enhancing medication adherence in chronic patients. Saudi J Med Pharm Sci, 9(6), 346-351. https://doi.org/10.36348/sjmps.2023.v09i06.001
  • Aydın, E., Doğan, A. ve Hayri Bektaş, M. (2023). Uluslararası Ağrı Araştırmaları Derneği (IASP) ağrı tanımının klinik ve felsefi yönden tartışılması: 2020’de Neler Değişti?. Hipokrat Tıp Dergisi, 3(2), 95-101. https://doi.org/10.58961/hmj.1312720
  • Bahat, G., Akpınar, T., Tufan, F., Erten, N. ve Karan, M. A. (2012). Yaşlılarda akılcı ilaç kullanımı. J Gerontol Geriatrik Arş. 1(1), 2-8.
  • Bartley, E. J. ve Fillingim, R. B. (2013). Sex differences in pain: a brief review of clinical and experimental findings. British Journal of Anaesthesia, 111(1), 52-58. https://doi.org/10.1093/bja/aet127
  • Bilgili, N. ve Karatay, G. (2005). Sait Yazıcı sağlık ocağı bölgesinde yaşayan bireylerin ilaç tüketimi ile ilgili bazı uygulamalarının belirlenmesi. Hacettepe Üniversitesi Hemşirelik Yüksekokulu Dergisi, 12, 39-48.
  • Burnier, M., Polychronopoulou, E. ve Wuerzner, G. (2020). Hypertension and drug adherence in the elderly. Frontiers in Cardiovascular Medicine, 7(49), 1-9. https://doi.org/10.3389/fcvm.2020.00049
  • Centers for Disease Control and Prevention (2022). About chronic diseases. National Center for Chronic Disease Prevention and Health Promotion. https://www.cdc.gov/chronicdisease/about/index.htm
  • Cincioğlu, E., Oksal, H., Durat, G. ve Tekeoğlu, İ. (2021). Assessment of pain, depression and somatization symptoms in elderly individuals who apply to the physical therapy unit. Cukurova Medical Journal, 46(1), 22-31. https://doi.org/10.17826/cumj.789793
  • Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., ...Helmick, C. (2018). Prevalence of chronic pain and high-impact chronic pain among adults-United States, 2016. Morbidity and Mortality Weekly Report, 67(36), 1001-1006.
  • da Mata AR, Alvares, J. ve Diniz, L. M. (2016). Quality of life of patients with Diabetes Mellitus Types 1 and 2 from a referal health centre in Minas Gerais, Brazil. Expert Rev Clin Pharmacol, 9(5), 739-746. https://doi.org/10.1586/17512433.2016.1152180
  • Dursun, G. ve Bektas, H. (2017). Cultural validation and reliability of the Turkish version of the Geriatric Pain Measure in the Elderly. Pain Practice, 17(4), 505-513. https://doi.org/10.1111/papr.12473
  • Hermans, L., Van Oosterwijck, J., Goubert, D., Goudman, L., Crombez, G., Calders, P. ve Meeus, M. (2016). Inventory of personal factors influencing conditioned pain modulation in healthy people: a systematic literature review. Pain Practice, 16(6), 758-769. https://doi.org/10.1111/papr.12305
  • Horne, R. ve Hankins, M. (2001). The Medication Adherence report Scale (MARS), 2001. [Database record]. APA PsycTests.
  • Ferrell, B. A., Stein, W. M. ve Beck, J. C. (2000). The Geriatric Pain Measure: Validity, reliability and factor analysis. J Am Geriatr Soc. 48, 1669-1673.
  • George, D. ve Mallery P. (2019). IBM SPSS statistics 26 step by step: A simple guide and reference. Routledge. Güler, G., Güler, N., Kocataş, S. ve Akgül, N. (2009). Yaşlıların sağlık bakım gereksinimleri. Cumhuriyet Tıp Dergisi, 31, 367-373.
  • Jahanpour, F., Rafiei, Z., Ravanipour, M. ve Motamed, N. (2015). Assessment of medication adherence in elderly patients with cardiovascular diseases based on demographic factors in Bushehr City in the year 2013. Jundishapur Journal of Chronic Disease Care, 4(3), 49-53. https://doi.org/10.5812/jjcdc.28399v2
  • Kalender, N. ve Sütçü Çiçek, H. (2014). Kronik hastalıkların yönetimindeki engeller. Turkiye Klinikleri J Nurs Sci, 6(1), 46-53.
  • Kapucu, S. ve Ünver, G. (2017). Pain and Frailty in Elderly Females with Osteoporosis. Turkish Journal of Geriatrics, 20(4), 306-314.
  • Karadag Arli, S., Bakan, A. B., Varol, E. ve Aslan, G. (2018). Investigation of pain and life satisfaction in older adults. Geriatrics & Gerontology İnternational, 18(1), 5-11. https://doi.org/10.1111/ggi.13125
  • Kuzu, A., Aydın, C., Yıldız, M., Erik, H. E., Keskinkılıç, H. G., Aslan, D. ve Şengelen, M. (2019). Dünya sağlık örgütü Avrupa Bölgesi’nde yaşlanma ile ilgili seçilmiş bazı ölçütlerin değerlendirilmesi. STED, 28(1), 17-27.
  • Öztürk, Z. ve Gülen-Uğraş, K. (2017). Yaşlı hastalarda ilaç kullanımı ve polifarmasi. Tepecik Eğitim Hastanesi Dergisi, 27(2), 103-108. https://doi.org/10.5222/terh.2017.103
  • Pouliot, A., Vaillancourt, R., Stacey, D. ve Suter, P. (2018). Defining and identifying concepts of medication literacy: an international perspective. Res Social Adm Pharm, 14, 797-804. https://doi.org/10.1016/j.sapharm.2017.11.005
  • Punnapurath, S., Vijayakumar, P., Platty, P. L., Krishna, S. ve Thomas, T. (2021). A study of medication compliance in geriatric patients with chronic illness. Journal of Family Medicine and Primary Care, 10(4), 1644-1648. https://doi.org/1644. 10.4103/jfmpc.jfmpc_1302_20
  • Puto, G., Repka, I. ve Muszalik, M. (2023). Factors correlating with functional capacity in older people with chronic pain. International Journal of Environmental Research and Public Health, 20(3), 2748. https://doi.org/10.3390/ijerph20032748
  • Saka, S. D. ve Gözüm, S. (2020). Toplumda yaşayan yaşlılarda ağrı prevalansı ve ağrı öz yönetim uygulamaları. Cukurova Medical Journal, 45(2), 595-603. https://doi.org/10.17826/cumj.639994
  • Sayın Kasar, K. ve Erzincanlı, S. (2021). Kalp yetersizliği olan hastalarda ilaç uyumunun değerlendirilmesi. Kardiyovasküler Hemşirelik Dergisi, 12(28), 94-99. https://doi.org/10.5543/khd.2021.28247
  • Sezer, Ö., Devran, D. ve Dağdeviren, HN. (2021). Yaşlılarda kronik ağrı durumu ve etkileyen faktörlerin değerlendirilmesi. Türk Aile Hek Derg. 25(3), 76-83. https://doi.org/10.5222/tahd.2021.92400
  • Şimşek, Ş., Oymak Soysal, A. N. ve Kaş Özdemir, A. (2023). Association between Pain Intensity, Pain Belief, and Coping Strategies in Older Adults. Experimental Aging Research, 49(3), 244-251. https://doi.org/10.1080/0361073X.2022.2101304
  • Temeloğlu Şen, E., Sertel-Berk, Ö. ve Sindel, D. (2019). İlaç Uyumunu Bildirim Ölçeği'nin Türkçe uyarlamasının geçerlik ve güvenirlik çalışması. İstanbul Tıp Fakültesi Dergisi, 82(1), 52-61. https://doi.org/10.26650/IUITFD.413637
  • Turhan, Ö., Kibar, E., Ekren, E., Engin, O., Ercan, D., Erdal, A., ...Bilir, N. (2014). Medication adherence in elderly: a university hospital-based and descriptive study. Nobel Medicus, 10(2), 31-38. Wang, Y., Liu, F., Yao, Y., Chen, M., Wu, C., Yan, Y. ve Xiang, H. (2022). Associations of long-term exposure to ambient air pollutants with metabolic syndrome: The Wuhan Chronic Disease Cohort Study (WCDCS). Environmental Research, 206, 112549. https://doi.org/10.1016/j.envres.2021.112549
  • World Health Organization. (2022). Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
  • Yaman Aktaş, Y. ve Hendekci, A. (2022). A correlational study on pain and depression in geriatric patients scheduled for orthopaedic surgery. Psychogeriatrics, 22(6), 851-858. https://doi.org/10.1111/psyg.12892
  • Zimmer, Z., Fraser, K., Grol-Prokopczyk, H. ve Zajacova, A. (2022). A global study of pain prevalence across 52 countries: examining the role of country-level contextual factors. Pain, 163(9), 1740-1750. https://doi.org/10.1097/j.pain.0000000000002557
  • Özer, Z., Turan, G. B. ve Atan, G. (2021). Pain Management and Life Satisfaction in Elderly Individuals: A Single Centred Study. Clinical and Experimental Health Sciences, 11(3), 405-411. https://doi.org/10.33808/clinexphealthsci.733524

Pain Level and Medication Compliance of Elderly Individuals with Chronic Diseases: Cross-Sectional Study

Year 2024, Volume: 12 Issue: 2, 644 - 656, 20.06.2024
https://doi.org/10.33715/inonusaglik.1446110

Abstract

This study was conducted in cross-sectional type to determine the medication compliance, pain level and factors affecting the pain level of elderly individuals with chronic diseases. 154 elderly individuals were included in the study. Data were collected with the Patient Information Form, Geriatric Pain Scale and Medication Compliance Reporting Scale. In the analysis of data; descriptive statistics such as number, percentage, mean, standard deviation, minimum and maximum values, Independent samples t test, One-Way ANOVA and multiple linear regression analysis were used. Of the participants whose average age was 71.82±5.78, 56.5% were male, 43.5% were primary school graduates, and most of them were hypertension (68.8%) and diabetes (40.3%) patients. The total score of the Medication Compliance Reporting Scale of elderly individuals is 19.73±5.38 and the Geriatric Pain Scale score is 53.33±27.68. Among the variables included in the model; gender, educational status, number of illnesses and painkiller use were found to affect the level of geriatric pain (p<0.05) and was determined to explain 47% of the variance (R2=0.474, F=10.579, p<0.001). As a result, it was determined that elderly individuals' medication compliance was high and pain intensity was moderate. It was determined that women, those with low education, those with more than one chronic disease, and those who used painkillers every day/every few days had higher pain levels, and these variables affected the pain level of elderly individuals.

References

  • KAYNAKLAR Ágh, T., Dömötör, P., Bártfai, Z., Inotai, A., Fujsz, E. ve Mészáros, Á. (2015). Relationship between medication adherence and health related quality of life in subjects with COPD: a systematic review. Respiratory Care, 60(2), 297-303. https://doi.org/10.4187/respcare.03123
  • Alçınar, R. ve Şahin, M. K. (2023). The association between medication adherence and quality of life in patients with diabetes receiving primary healthcare centers: A cross-sectional study. TJFMPC, 17(3), 360-369. https://doi.org/10.21763/tjfmpc.1312415
  • Altıntas, H. K., Aslan, G. K., Sısman, N. Y. ve Kesgin, M. T. (2018). Effects of pain and sleep quality on falls among nursing home residents in Turkey. Research in Gerontological Nursing, 11(5), 257-264. https://doi.org/10.3928/19404921-20180810-01
  • Amer, M. A. K., Mohiuddin, S. I. ve Shafeeque Shaikh, D. Z. T. (2023). Enhancing medication adherence in chronic patients. Saudi J Med Pharm Sci, 9(6), 346-351. https://doi.org/10.36348/sjmps.2023.v09i06.001
  • Aydın, E., Doğan, A. ve Hayri Bektaş, M. (2023). Uluslararası Ağrı Araştırmaları Derneği (IASP) ağrı tanımının klinik ve felsefi yönden tartışılması: 2020’de Neler Değişti?. Hipokrat Tıp Dergisi, 3(2), 95-101. https://doi.org/10.58961/hmj.1312720
  • Bahat, G., Akpınar, T., Tufan, F., Erten, N. ve Karan, M. A. (2012). Yaşlılarda akılcı ilaç kullanımı. J Gerontol Geriatrik Arş. 1(1), 2-8.
  • Bartley, E. J. ve Fillingim, R. B. (2013). Sex differences in pain: a brief review of clinical and experimental findings. British Journal of Anaesthesia, 111(1), 52-58. https://doi.org/10.1093/bja/aet127
  • Bilgili, N. ve Karatay, G. (2005). Sait Yazıcı sağlık ocağı bölgesinde yaşayan bireylerin ilaç tüketimi ile ilgili bazı uygulamalarının belirlenmesi. Hacettepe Üniversitesi Hemşirelik Yüksekokulu Dergisi, 12, 39-48.
  • Burnier, M., Polychronopoulou, E. ve Wuerzner, G. (2020). Hypertension and drug adherence in the elderly. Frontiers in Cardiovascular Medicine, 7(49), 1-9. https://doi.org/10.3389/fcvm.2020.00049
  • Centers for Disease Control and Prevention (2022). About chronic diseases. National Center for Chronic Disease Prevention and Health Promotion. https://www.cdc.gov/chronicdisease/about/index.htm
  • Cincioğlu, E., Oksal, H., Durat, G. ve Tekeoğlu, İ. (2021). Assessment of pain, depression and somatization symptoms in elderly individuals who apply to the physical therapy unit. Cukurova Medical Journal, 46(1), 22-31. https://doi.org/10.17826/cumj.789793
  • Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., ...Helmick, C. (2018). Prevalence of chronic pain and high-impact chronic pain among adults-United States, 2016. Morbidity and Mortality Weekly Report, 67(36), 1001-1006.
  • da Mata AR, Alvares, J. ve Diniz, L. M. (2016). Quality of life of patients with Diabetes Mellitus Types 1 and 2 from a referal health centre in Minas Gerais, Brazil. Expert Rev Clin Pharmacol, 9(5), 739-746. https://doi.org/10.1586/17512433.2016.1152180
  • Dursun, G. ve Bektas, H. (2017). Cultural validation and reliability of the Turkish version of the Geriatric Pain Measure in the Elderly. Pain Practice, 17(4), 505-513. https://doi.org/10.1111/papr.12473
  • Hermans, L., Van Oosterwijck, J., Goubert, D., Goudman, L., Crombez, G., Calders, P. ve Meeus, M. (2016). Inventory of personal factors influencing conditioned pain modulation in healthy people: a systematic literature review. Pain Practice, 16(6), 758-769. https://doi.org/10.1111/papr.12305
  • Horne, R. ve Hankins, M. (2001). The Medication Adherence report Scale (MARS), 2001. [Database record]. APA PsycTests.
  • Ferrell, B. A., Stein, W. M. ve Beck, J. C. (2000). The Geriatric Pain Measure: Validity, reliability and factor analysis. J Am Geriatr Soc. 48, 1669-1673.
  • George, D. ve Mallery P. (2019). IBM SPSS statistics 26 step by step: A simple guide and reference. Routledge. Güler, G., Güler, N., Kocataş, S. ve Akgül, N. (2009). Yaşlıların sağlık bakım gereksinimleri. Cumhuriyet Tıp Dergisi, 31, 367-373.
  • Jahanpour, F., Rafiei, Z., Ravanipour, M. ve Motamed, N. (2015). Assessment of medication adherence in elderly patients with cardiovascular diseases based on demographic factors in Bushehr City in the year 2013. Jundishapur Journal of Chronic Disease Care, 4(3), 49-53. https://doi.org/10.5812/jjcdc.28399v2
  • Kalender, N. ve Sütçü Çiçek, H. (2014). Kronik hastalıkların yönetimindeki engeller. Turkiye Klinikleri J Nurs Sci, 6(1), 46-53.
  • Kapucu, S. ve Ünver, G. (2017). Pain and Frailty in Elderly Females with Osteoporosis. Turkish Journal of Geriatrics, 20(4), 306-314.
  • Karadag Arli, S., Bakan, A. B., Varol, E. ve Aslan, G. (2018). Investigation of pain and life satisfaction in older adults. Geriatrics & Gerontology İnternational, 18(1), 5-11. https://doi.org/10.1111/ggi.13125
  • Kuzu, A., Aydın, C., Yıldız, M., Erik, H. E., Keskinkılıç, H. G., Aslan, D. ve Şengelen, M. (2019). Dünya sağlık örgütü Avrupa Bölgesi’nde yaşlanma ile ilgili seçilmiş bazı ölçütlerin değerlendirilmesi. STED, 28(1), 17-27.
  • Öztürk, Z. ve Gülen-Uğraş, K. (2017). Yaşlı hastalarda ilaç kullanımı ve polifarmasi. Tepecik Eğitim Hastanesi Dergisi, 27(2), 103-108. https://doi.org/10.5222/terh.2017.103
  • Pouliot, A., Vaillancourt, R., Stacey, D. ve Suter, P. (2018). Defining and identifying concepts of medication literacy: an international perspective. Res Social Adm Pharm, 14, 797-804. https://doi.org/10.1016/j.sapharm.2017.11.005
  • Punnapurath, S., Vijayakumar, P., Platty, P. L., Krishna, S. ve Thomas, T. (2021). A study of medication compliance in geriatric patients with chronic illness. Journal of Family Medicine and Primary Care, 10(4), 1644-1648. https://doi.org/1644. 10.4103/jfmpc.jfmpc_1302_20
  • Puto, G., Repka, I. ve Muszalik, M. (2023). Factors correlating with functional capacity in older people with chronic pain. International Journal of Environmental Research and Public Health, 20(3), 2748. https://doi.org/10.3390/ijerph20032748
  • Saka, S. D. ve Gözüm, S. (2020). Toplumda yaşayan yaşlılarda ağrı prevalansı ve ağrı öz yönetim uygulamaları. Cukurova Medical Journal, 45(2), 595-603. https://doi.org/10.17826/cumj.639994
  • Sayın Kasar, K. ve Erzincanlı, S. (2021). Kalp yetersizliği olan hastalarda ilaç uyumunun değerlendirilmesi. Kardiyovasküler Hemşirelik Dergisi, 12(28), 94-99. https://doi.org/10.5543/khd.2021.28247
  • Sezer, Ö., Devran, D. ve Dağdeviren, HN. (2021). Yaşlılarda kronik ağrı durumu ve etkileyen faktörlerin değerlendirilmesi. Türk Aile Hek Derg. 25(3), 76-83. https://doi.org/10.5222/tahd.2021.92400
  • Şimşek, Ş., Oymak Soysal, A. N. ve Kaş Özdemir, A. (2023). Association between Pain Intensity, Pain Belief, and Coping Strategies in Older Adults. Experimental Aging Research, 49(3), 244-251. https://doi.org/10.1080/0361073X.2022.2101304
  • Temeloğlu Şen, E., Sertel-Berk, Ö. ve Sindel, D. (2019). İlaç Uyumunu Bildirim Ölçeği'nin Türkçe uyarlamasının geçerlik ve güvenirlik çalışması. İstanbul Tıp Fakültesi Dergisi, 82(1), 52-61. https://doi.org/10.26650/IUITFD.413637
  • Turhan, Ö., Kibar, E., Ekren, E., Engin, O., Ercan, D., Erdal, A., ...Bilir, N. (2014). Medication adherence in elderly: a university hospital-based and descriptive study. Nobel Medicus, 10(2), 31-38. Wang, Y., Liu, F., Yao, Y., Chen, M., Wu, C., Yan, Y. ve Xiang, H. (2022). Associations of long-term exposure to ambient air pollutants with metabolic syndrome: The Wuhan Chronic Disease Cohort Study (WCDCS). Environmental Research, 206, 112549. https://doi.org/10.1016/j.envres.2021.112549
  • World Health Organization. (2022). Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
  • Yaman Aktaş, Y. ve Hendekci, A. (2022). A correlational study on pain and depression in geriatric patients scheduled for orthopaedic surgery. Psychogeriatrics, 22(6), 851-858. https://doi.org/10.1111/psyg.12892
  • Zimmer, Z., Fraser, K., Grol-Prokopczyk, H. ve Zajacova, A. (2022). A global study of pain prevalence across 52 countries: examining the role of country-level contextual factors. Pain, 163(9), 1740-1750. https://doi.org/10.1097/j.pain.0000000000002557
  • Özer, Z., Turan, G. B. ve Atan, G. (2021). Pain Management and Life Satisfaction in Elderly Individuals: A Single Centred Study. Clinical and Experimental Health Sciences, 11(3), 405-411. https://doi.org/10.33808/clinexphealthsci.733524
There are 37 citations in total.

Details

Primary Language Turkish
Subjects Nursing (Other)
Journal Section Araştırma Makalesi
Authors

Vahide Semerci Çakmak 0000-0003-3481-9500

Ebru Sönmez Sarı 0000-0001-7337-4853

Early Pub Date June 3, 2024
Publication Date June 20, 2024
Submission Date March 2, 2024
Acceptance Date April 25, 2024
Published in Issue Year 2024 Volume: 12 Issue: 2

Cite

APA Semerci Çakmak, V., & Sönmez Sarı, E. (2024). KRONİK HASTALIĞI OLAN YAŞLI BİREYLERİN AĞRI DÜZEYİ VE İLAÇ UYUMU: KESİTSEL ÇALIŞMA. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 12(2), 644-656. https://doi.org/10.33715/inonusaglik.1446110