Aile Hekimliği Yaşlı Hasta İzlemi Kapsamında Polifarmasinin Değerlendirilmesi

Year 2022, Volume: 48 Issue: 3, 279 - 285, 30.12.2022

Sema Ketenci Nazife Gökçe Akpınar

https://doi.org/10.32708/uutfd.1143088

Abstract

Çalışmamızın amacı Sağlık Bakanlığı Hastane Medulla Sistemi kullanılarak polifarmasiye maruz kalan 65 yaş ve üstü hastalarda, ilaç-ilaç etkileşimlerinin belirlenip, ciddi etkileşimleri olan hastalarda klinik önlem alınması için farkındalık yaratmaktır. Çalışmamız Gebze 1 nolu Aile Sağlığı Merkezi’nden hizmet almakta olan 65 yaş üstü, Hasta Yönetim Platformu veri tabanında yer alan 188 hasta üzerinde yapılmıştır. Lexicomb® ilaç etkileşimi modülü ile hastaların kronik olarak kullandıkları ilaçlar listelenerek etkileşim düzeyleri değerlendirilmiştir. Bununla birlikte yaşlılarda uygunsuz ilaç kullanımı değerlendirilmesinde kullanılan kriterler üzerinde de durulmuştur. Çalışma sonuçlarımıza göre, 167 hastada toplamda 529 potansiyel ilaç-ilaç etkileşimi görüldü. Bu etkileşimlerin 52’sinde (%9,8) bilinen bir etkileşim saptanmadı ve risk kategorisi A olarak tespit edildi. B, C, D ve X risk kategorilerinde ilaç-ilaç etkileşimi sayıları sırasıyla, 74 (%13,9), 363(%68,6), 33 (%6,2) ve 7 (%1,3) idi. Çalışmadaki hastaların %54’ünde esansiyel hipertansiyon tanısı mevcuttu. En çok kullanılan ilaç ise asetilsalisilik asit (%26)’di. C kategorisinde ilaç-ilaç etkileşim potansiyelinin verilerimize göre anlamlı oranda yüksek çıkması, hastaların tedavisinin daha düzenli ve etkili bir şekilde monitorize edilmesinin gerekliliğini vurgulamaktadır. D ve X kategorisinde saptanan ilaç-ilaç etkileşimleri en fazla nonsteroidal antiinflamatuar ilaçlar, antihipertansif ilaçlar, antipelet ilaçlar ve santral sinir sistemi ilaçlar arasında meydana gelmiştir. Bu ilaçların takibine özellikle dikkat edilmelidir.

Keywords

İlaç- ilaç etkileşimi, Çoklu ilaç kullanımı, Yaşlı sağlığı

Thanks

Kocaeli İl Sağlık Müdürlüğü'ne çalışmamızı desteklemesinden ötürü teşekkür ederiz.

Evaluation of Polypharmacy in Elderly Individuals in the Scope of Family Medicine Elderly Patient Follow-up

Abstract

The aim of our study is to determine drug-drug interactions in patients aged 65 and over who are exposed to polypharmacy by using the Ministry of Health Hospital Medulla System, and to raise awareness to take clinical precautions in patients with serious interactions. Our study was carried out on 188 patients over the age of 65 who were receiving service from the Family Health Center No. 1 in Gebze and included in the Disease Management Platform database. The results of the follow-up and evaluation of the elderly over 65 years of age, the Lexicomb® drug interaction module, and the drugs used chronically by the patients were listed and their interaction levels were evaluated. In addition, the criteria used in the evaluation of inappropriate drug use in the elderly are also discussed. According to our study results, a total of 529 potential drug-drug interactions were detected in 167 patients. No known interaction was detected in 52 (9.8%) of 529 interactions and the risk category was determined as A. The number of drug-drug interactions in the B, C, D and X risk categories were 74 (13,9%), 363 (68,6%), 33 (6,2%) and 7 (1,3%), respectively. A diagnosis of essential hypertension was present in 54% of the patients in the study. The most commonly used drug was acetylsalicylic acid (26%). The fact that the drug-drug interaction potential in category C is significantly higher than our data highlights the necessity of monitoring the treatment of patients more regularly and effectively. Drug-drug interactions detected in categories D and X mostly occurred between nonsteroidal anti-inflammatory drugs, antihypertensive drugs, antipellet drugs, and central nerves system drugs. Particular attention should be paid to the follow-up of these drugs.

Keywords

Drug-drug interaction, Multiple drug use, Elderly health

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