İnflamatuar Romatizmal Hastaların Tedaviyi Bırakma ve İlaç Dışı Tedavilere Başvuru Yönteminin Değerlendirilmesi

Abstract

Amaç: İnflamatuar romatizmal hastalıklar her yaşta görülebilen remisyon ve alevlenmelerle seyreden kronik hastalıklardır. Bu anket çalışması, hastaların tedavilerini kesmelerine etki eden faktörleri araştırmak ve hangi tedavi yöntemlerini seçtiklerini belirlemek amacıyla düzenlenmiştir.
Gereç ve Yöntem: Bu çalışma Ocak 2019-Aralık 2019 arasında Romatoloji Bilim Dalında yapıldı. Çalışmaya 18 yaş üzeri hayatının bir döneminde tedavisini kesen 150 hasta alındı. Çalışmaya romatoid artrit, ankilozan spondilit, bağ doku hastalığı tanısı olan hastalar dahil edildi.
Bulgular: Kliniğimizde değerlendirilen 150 hastanın 101 tanesi kadın, 49 tanesi erkekti. Hastaların yaş ortalaması 46 olarak bulundu. Hastaların tanılarına göre değerlendirildiğinde romatoid artrit %50, ankilozan spondilit %19,3, bağ doku hastalığı %14, diğerleri %16 bulundu. Hastaların tedaviyi kesme nedeni en sık ilaç ilaç yan etkisi %32,7 olup diğerleri sosyal
güvenlik sorunları %23,3, hastalığın iyileştiğini düşünme %16, tedaviye inanmama %12,7, hamilelik %6, görsel medya %3, tamamlayıcı ve alternatif tıb (TAT) %6, diğerleri %2 olarak bulundu. Hastaların eğitim düzeyi, yaşadığı yer, tanı farklılıkları ile medikal tedaviyi kesme ilişkisi bulunmadı. Tedaviyi kesen hastaların %80,6’sı hiçbir ilaç almadığı %19,4’ü TAT yöntemlerine
başvurduğu bulundu. En sık kullanılan TAT yöntemi %68 bitkisel yöntemdi.Medikal tedaviyi kesen hastalarda alternatif tedavi seçimi ile eğitim, yaşadığı yer arasında ilişki bulunmadı. Medikal tedaviyi kesen romatoid artrit hastalarında %72, ankilozan spondilit hastalarında %65,5, bağ doku hastalığında %57,1 oranında ilk 6 ay içinde hastalık alevlenmesi gözlendi.
Tartışma-Sonuç: İnflamatuar romatizmal hastalarında hayatının bir döneminde tıbbi tedaviyi bırakarak takip dışı kaldığı gözlenmiştir. Bu nedenle hastalar medikal tedavinin sürekli olması gerektiği ve ilaçların hastalık üzerinde etkileri konusunda bilgilendirilmelidir. Medikal tedaviyi kesen hastaların ilk 6 ayda hastalık alevlenmesi nedeniyle medikal tedaviye başladığı gözlenmiştir. 

Keywords

• romatizmal hastalık
• ilaç kesme
• tamalayıcı ve alternatif tıp

The Reason of Discontinuation of Inflammatory Romatism Patients and Evaluation of the Application Method for Non-Drug Treatment

Abstract

Introduction: Inflammatory rheumatic diseases are chronic diseases with
remission and exacerbations which can be seen at any age. This study was
designed to investigate the factors that affect patients' discontinuation and to
determine which treatment methods they choose.
Material and Method: This retrospective study was performed in Division of
Rheumatology, between January 2019-December2019. The study included
150 patients over the age of 18 who discontinued medical treatment at some
point in their life. Patients with rheumatoid arthritis, ankylosing spondylitis and
connective tissue disease were included in the study.
Results: Of the 150 patients evaluated in our clinic, 101 were female and
49 were male. The mean age of the patients was 46 years. According to the
diagnosis of the patients, rheumatoid arthritis was found in 50%, ankylosing
spondylitis in 19.3%, connective tissue disease in 14% and others in 16%. The
most common reasons for discontinuation of the treatment were drug side
effects of 32.7%, others with social security problems 23.3%, thinking that
the disease was cured 16%, disbelief 12.7%, pregnancy 6%, visual media 3%,
complementary and alternative medicine (CAM) 6%, others 2%. There was no
relationship between education level, place of residence, diagnosis differences
and discontinuation of medical treatment. It was found that 80.6% of the
patients who discontinued the treatment did not take any drugs and 19.4%
applied to CAM methods. The most commonly used CAM method was 68%
herbal method. No relationship was found between the choice of alternative
treatment and education and place of residence in patients discontinuing
medical treatment. In the first 6 months, 72% of patients with rheumatoid
arthritis, 65.5% of patients with ankylosing spondylitis, 57.1% of patients
with connective tissue disease who had discontinued medical therapy had
exacerbation.
Discussion-conclusion: It was observed that patients with inflammatory
rheumatologic disease were discontinued by stopping medical treatment at
some time in their lives. Therefore, patients should be informed about the need
for continuous medical treatment and the effects of drugs on the disease. It
was observed that patients who discontinued medical treatment started
medical treatment due to exacerbation of disease in the first 6 months

Keywords

• rheumatic disease
• drug discontinuation
• complementary and alternative medicine

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