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

Yıl 2020, Cilt: 10 Sayı: 4, 609 - 612, 30.12.2020
https://doi.org/10.16899/jcm.671529

Öz

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. 

Kaynakça

  • 1. Karadağ A, Hayta E, Kaptanoğlu E, Konak A. Complementary and alternative treatment methods in chronic rheumatic diseases in the Central Anatolia. Electronic Journal of General Medicine. 2018;15(4).
  • 2. Pedersen O, Svendsen A, Ejstrup L, Skytthe A, Harris J, Junker P. Heritability estimates on ankylosing spondylitis. Clin Exp Rheumatol. 2006;24(4):463.
  • 3. Dagfinrud H, Hagen KB, Kvien TK. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database of Systematic Reviews. 2008(1).
  • 4. Rupp I, Boshuizen HC, Jacobi CE, Dinant HJ, van den Bos GA. Impact of fatigue on health‐related quality of life in rheumatoid arthritis. Arthritis Care & Research. 2004;51(4):578-85.
  • 5. Littlejohn EA. Pregnancy and rheumatoid arthritis. Best practice & research Clinical obstetrics & gynaecology. 2019.
  • 6. Jethwa H, Lam S, Smith C, Giles I. Does rheumatoid arthritis really improve during pregnancy? A systematic review and metaanalysis. The Journal of rheumatology. 2019;46(3):245-50.
  • 7. Littlejohn EA. Pregnancy and rheumatoid arthritis. Best Practice & Research Clinical Obstetrics & Gynaecology. 2019.
  • 8. Macfarlane GJ, El-Metwally A, De Silva V, Ernst E, Dowds GL, Moots RJ. Evidence for the efficacy of complementary and alternative medicines in the management of rheumatoid arthritis: a systematic review. Rheumatology. 2011;50(9):1672-83.
  • 9. Dıraçoğlu R. Complementary-alternative medicine in rheumatoid arthritis. Rheumatism. 2007;22(1):24-30.
  • 10. Lee M-S, Lee MS, Yang C-Y, Lee S-I, Joo M-C, Shin B-C, et al. Use of complementary and alternative medicine by rheumatoid arthritis patients in Korea. Clinical rheumatology. 2008;27(1):29-33.
  • 11. Michalsen A. The role of complementary and alternative medicine (CAM) in rheumatology—it’s time for integrative medicine. The Journal of Rheumatology; 2013.
  • 12. KAYIRAN SD, KIRICI S. Adana (Türkiye) Aktarlarında Tedavi Amacıyla Satılan Bitkisel Droglar. Tarim ve Doga Dergisi. 2019;22(2):183.
  • 13. Kajiyama H, Akama H, Yamanaka H, Shoji A, Matsuda Y, Tanaka E, et al. One third of Japanese patients with rheumatoid arthritis use complementary and alternative medicine. Modern rheumatology. 2006;16(6):355.
  • 14. Rao JK, Kroenke K, Mihaliak KA, Grambow SC, Weinberger M. Rheumatology patients' use of complementary therapies: Results from a one‐year longitudinal study. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2003;49(5):619-25.
  • 15. Jordan JM, Bernard SL, Callahan LF, Kincade JE, Konrad TR, DeFriese GH. Self-reported arthritis-related disruptions in sleep and daily life and the use of medical, complementary, and self-care strategies for arthritis: the National Survey of Self-care and Aging. Archives of Family Medicine. 2000;9(2):143-9.
  • 16. Solak Ö, Ulaşlı AM, Çevik H, Dikici A, Devrimsel G, İnal EE, et al. Romatizmal Hastalıklarda Tamamlayıcı ve Alternatif Tıp Yöntemlerine Başvuru. Kocatepe Tıp Dergisi. 2015;16:116-21

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

Yıl 2020, Cilt: 10 Sayı: 4, 609 - 612, 30.12.2020
https://doi.org/10.16899/jcm.671529

Öz

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

Kaynakça

  • 1. Karadağ A, Hayta E, Kaptanoğlu E, Konak A. Complementary and alternative treatment methods in chronic rheumatic diseases in the Central Anatolia. Electronic Journal of General Medicine. 2018;15(4).
  • 2. Pedersen O, Svendsen A, Ejstrup L, Skytthe A, Harris J, Junker P. Heritability estimates on ankylosing spondylitis. Clin Exp Rheumatol. 2006;24(4):463.
  • 3. Dagfinrud H, Hagen KB, Kvien TK. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database of Systematic Reviews. 2008(1).
  • 4. Rupp I, Boshuizen HC, Jacobi CE, Dinant HJ, van den Bos GA. Impact of fatigue on health‐related quality of life in rheumatoid arthritis. Arthritis Care & Research. 2004;51(4):578-85.
  • 5. Littlejohn EA. Pregnancy and rheumatoid arthritis. Best practice & research Clinical obstetrics & gynaecology. 2019.
  • 6. Jethwa H, Lam S, Smith C, Giles I. Does rheumatoid arthritis really improve during pregnancy? A systematic review and metaanalysis. The Journal of rheumatology. 2019;46(3):245-50.
  • 7. Littlejohn EA. Pregnancy and rheumatoid arthritis. Best Practice & Research Clinical Obstetrics & Gynaecology. 2019.
  • 8. Macfarlane GJ, El-Metwally A, De Silva V, Ernst E, Dowds GL, Moots RJ. Evidence for the efficacy of complementary and alternative medicines in the management of rheumatoid arthritis: a systematic review. Rheumatology. 2011;50(9):1672-83.
  • 9. Dıraçoğlu R. Complementary-alternative medicine in rheumatoid arthritis. Rheumatism. 2007;22(1):24-30.
  • 10. Lee M-S, Lee MS, Yang C-Y, Lee S-I, Joo M-C, Shin B-C, et al. Use of complementary and alternative medicine by rheumatoid arthritis patients in Korea. Clinical rheumatology. 2008;27(1):29-33.
  • 11. Michalsen A. The role of complementary and alternative medicine (CAM) in rheumatology—it’s time for integrative medicine. The Journal of Rheumatology; 2013.
  • 12. KAYIRAN SD, KIRICI S. Adana (Türkiye) Aktarlarında Tedavi Amacıyla Satılan Bitkisel Droglar. Tarim ve Doga Dergisi. 2019;22(2):183.
  • 13. Kajiyama H, Akama H, Yamanaka H, Shoji A, Matsuda Y, Tanaka E, et al. One third of Japanese patients with rheumatoid arthritis use complementary and alternative medicine. Modern rheumatology. 2006;16(6):355.
  • 14. Rao JK, Kroenke K, Mihaliak KA, Grambow SC, Weinberger M. Rheumatology patients' use of complementary therapies: Results from a one‐year longitudinal study. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2003;49(5):619-25.
  • 15. Jordan JM, Bernard SL, Callahan LF, Kincade JE, Konrad TR, DeFriese GH. Self-reported arthritis-related disruptions in sleep and daily life and the use of medical, complementary, and self-care strategies for arthritis: the National Survey of Self-care and Aging. Archives of Family Medicine. 2000;9(2):143-9.
  • 16. Solak Ö, Ulaşlı AM, Çevik H, Dikici A, Devrimsel G, İnal EE, et al. Romatizmal Hastalıklarda Tamamlayıcı ve Alternatif Tıp Yöntemlerine Başvuru. Kocatepe Tıp Dergisi. 2015;16:116-21
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Muhammet Limon 0000-0002-5693-7885

Dilek Tezcan 0000-0002-8295-9770

Semral Gülcemal 0000-0002-6085-9939

Sema Yilmaz 0000-0001-5076-1500

Çağrı Turan 0000-0002-6111-4314

Yayımlanma Tarihi 30 Aralık 2020
Kabul Tarihi 14 Temmuz 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 10 Sayı: 4

Kaynak Göster

AMA Limon M, Tezcan D, Gülcemal S, Yilmaz S, Turan Ç. İnflamatuar Romatizmal Hastaların Tedaviyi Bırakma ve İlaç Dışı Tedavilere Başvuru Yönteminin Değerlendirilmesi. J Contemp Med. Aralık 2020;10(4):609-612. doi:10.16899/jcm.671529