ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA

Abstract

Amaç: Çoklu ilaç kullanımının, Kronik Obstrüktif Akciğer Hastalığı (KOAH) semptomları üzerine etkisini araştırmaktır. Gereç ve Yöntemler: Bu tanımlayıcı kesitsel çalışmaya Şubat- 2025 ve Nisan-2025 tarihleri arasında Kırıkkale Tıp Fakültesi Aile Hekimliği ve Göğüs Hastalıkları Anabilim Dallarına başvuran 50 yaş ve üzeri 96 hasta dâhil edilmiştir. KOAH semptom derecesini değerlendiren Değiştirilmiş Tıbbi Araştırma Konseyi ölçeği (mMRC) ve S76 KOAH değerlendirme testi puanı (CAT) ile beraber sosyodemografik verileri içeren form da hastalar ile yüz yüze görüşülerek doldurulmuştur. Görüşme sırasında hastalardan kendilerine bir doktor tarafından reçete edilen tüm ilaçları belirtmeleri istenmiş ve bunlar sağlık kayıt sisteminden doğrulanmıştır. Bulgular: Hastaların ortalama CAT skoru 24,3±10,36 ve tüm katılımcıların ortalama kullandığı ilaç sayısı 5,87±2,84 olarak saptanmıştır. Toplam kullanılan ilaç sayısı ile mMRC düzeyi ve CAT skoru arasında istatistiksel olarak anlamlı düzeyde ve güçlü bir pozitif korelasyon bulundu (r=0,630, p<0,01 ve r=0,717, p<0,01 sırasıyla). Sonuç: Özellikle birinci basamakta aile hekimleri tarafından ilaç reçete edilirken, bütüncül bir yaklaşımla hastanın kullandığı tüm ilaçlar göz önüne alınarak karar verilmeli, KOAH semptomları gözden geçirilmeli, çoklu ilaç kullanımının kaçınılmaz olduğu kanıtlanırsa, akılcı seçimler yapılmalı ve belirli ilaçlara öncelik verilerek, ilaç yükü azaltılmalıdır.

Keywords

• Aile hekimliği
• çoklu ilaç kullanımı
• kronik obstrüktif akciğer hastalığı
• polifarmasi

The Effect of Polypharmacy on Chronic Obstructive Pulmonary Disease Symptoms: An Observational Study

Abstract

Objective: To investigate the effect of polypharmacy on symptoms of chronic obstructive pulmonary disease (COPD). Material and Methods: This descriptive cross-sectional study included 96 patients aged 50 years and older who were admitted to Kırıkkale Medical Faculty, Departments of Family Medicine and Pulmonology between February-April 2025. The modified Medical Research Council (mMRC) and the COPD Assessment Test (CAT) questionnaires assessing COPD symptom severity and a form including sociodemographic data were completed through face-to-face interviews. During the interview, patients were asked to indicate all medications prescribed to them by a physician and these were verified from the health record system. Results: The mean CAT score of the patients was 24.3±10.36 and the mean number of medications used by all participants was 5.87±2.84. A statistically significant and strong positive correlation was found between the total number of medications used and mMRC level and CAT score (r=0.630, p<0.01 and r=0.717, p<0.01, respectively). Conclusion: When prescribing medications by family physicians, especially in primary care, a holistic approach should be taken, taking into account all medications used by the patients, COPD symptoms should be reviewed; if polypharmacy proves to be inevitable, rational choices should be made and the medication burden should be reduced by prioritizing certain medications.

Keywords

• Family medicine
• multi drug use
• chronic obstructive pulmonary disease
• polypharmacy

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