Kronik Hastalığı Olan Hastaların Reçetesiz İlaç (OTC) Kullanım Tutumları ve İlaç Uyumu: Bir Yapısal Eşitlik Modellemesi Analizi

Öz

Bu çalışmanın amacı, kronik hastalığı olan hastalarda reçetesiz ilaç (over-the-counter-OTC) kullanımını, OTC tutumlarını ve ilaç uyumunu değerlendirmektir. Çalışmaya kronik hastalığı olan 276 hasta katılmış olup, veriler Mayıs-Eylül 2023 tarihleri arasında toplanmıştır. Çalışmanın verileri OTC kullanımı, OTC tutumları ve ilaç uyumunu sorgulayan bir anket kullanılarak toplanmıştır. OTC ile ilgili ifadeler ve hastaların ilaç uyumu durumları arasındaki fark için tek yönlü ANOVA kullanılmıştır. “H1: Kronik hastalığı olan hastalarda OTC tutumları ilaç uyumunu etkiler” hipotezini test etmek için yol analizi yöntemi kullanılmıştır. Katılımcıların toplam %52,2'si OTC kullanmaktadır. Daha olumlu OTC tutumları daha düşük ilaç uyumu puanı ile ilişkilendirilmiştir. “OTC'nin hiçbir yan etkisi ya da olumsuz etkisi yoktur” ifadesine katılmayan hastalar, emin olmayanlara göre 0,402 kat daha az ilaç uyumuna sahipti (t=2,409; p=0,016). Hastalar genel olarak OTC'ye yönelik olumsuz tutumlara sahip olsalar da OTC kullanımının teşvik edilmesi konusunda iyimser bir görüşe sahiptirler. Bu çalışmanın sonuçları, OTC kullanımının yaygın olduğunu ve OTC'ye yönelik olumlu tutumların kronik hastalığı olan hastalarda ilaç uyumunu azalttığını ortaya koymuştur. Bununla birlikte, ilaç uyumu puanları yüksek olan hastalar OTC kullanımını desteklemeye isteklidir. Kronik hastalığı olan hastalar OTC hakkında bilgiye ihtiyaç duyabilir. Hemşireler ve diğer sağlık çalışanları, hastaların potansiyel OTC kullanımını, ilaç-ilaç etkileşimlerini veya ilaç-gıda etkileşimlerini dikkate alabilir. Hastaların ihtiyaçlarına göre, bakımda yapılandırılmış eğitim programları uygulanabilir.

Anahtar Kelimeler

• Kronik hastalık
• ilaç uyumu
• reçetesiz ilaçlar
• yapısal eşitlik modeli.

Over-the-Counter Medicine (OTC) Attitudes and Medication Adherence in Patients with Chronic Diseases: A Structural Equation Modelling Analysis

Öz

This study aimed to evaluate over-the-counter medicine (OTC) use, OTC attitudes, and medication adherence (MA) in patients with chronic diseases. Data were collected from May to September 2023, and 276 patients with chronic diseases participated. OTC use, OTC attitudes, and MA were assessed using a questionnaire. One-way ANOVA was used to examine differences in OTC-related parameters and MA. The path analysis method was used to test “H1: OTC attitudes affect MA in patients with chronic diseases.” A total of 52.2% of the participants used OTC. More positive OTC attitudes were associated with lower MA scores. The patients who disagreed with the statement "OTC have no side effects or negative effects" had 0.402 times less MA than those who were not sure (t=2.409; p=0.016). Even though the patients had negative attitudes toward OTC in general, they had an optimistic view of being encouraged to use OTC. The results of this study revealed that OTC use is common, and positive attitudes toward OTC decrease MA in patients with chronic diseases. However, patients with high MA are willing to support OTC use. Patients with chronic diseases may need information on OTC. Nurses and other healthcare professionals can take the potential OTC use of patients, drug-drug interactions, or drug-food interactions into account. According to the needs of patients, structured education programs can be implemented in care.

Anahtar Kelimeler

• Chronic disease
• medication adherence
• over-the-counter drugs
• structural equation modeling

Kaynakça

1. Abdullah, I. S., Chaw, L. L., Koh, D., Hussain, Z., Goh, K. W., Abdul Hamid, A. A. T., & Ming, L. C. (2022). Over-the-counter medicine attitudes and knowledge among university and college students in Brunei Darussalam: findings from the first national survey. International Journal of Environmental Research and Public Health, 19(5), 2658. https://doi.org/10.3390/ijerph19052658
2. Ágh, T., Dömötör, P., Bártfai, Z., Inotai, A., Fujsz, E., & 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
3. Algarni, M., Hadi, M. A., Yahyouche, A., Mahmood, S., & Jalal, Z. (2021). A mixed-methods systematic review of the prevalence, reasons, associated harms and risk-reduction interventions of over-the-counter (OTC) medicines misuse, abuse and dependence in adults. Journal of Pharmaceutical Policy and Practice, 14, 76. https://doi.org/10.1186/s40545-021-00350-7
4. Alghamdi, A., Qadhi, O. A., Syed, W., Samarkandi, O. A., & Basil A Al-Rawi, M. (2024). A cross-sectional evaluation of knowledge of medicine safety and frequency of reading medication leaflets and its predictors–insights from Saudi Adults in Riyadh, Saudi Arabia. International Journal of General Medicine, (17), 175-186. https://doi.org/10.2147/IJGM.S446041
5. Alqifari, S. F., Alrasheedi, G. A., & Alkhiari, K. (2022). Evaluating social media addiction and self-medicating behavior in adults in Saudi Arabia: A pilot study. Medical Science, 26(125),1-6. https://doi.org/10.54905/disssi/v26i125/ms281e2371
6. Altuntas, O., Aki, E., & Huri, M. (2015). A qualitative study on the effect of drug use in chronic diseases on the quality of life and social participation. Journal of Occupational Therapy and Rehabilitation, 3(2), 79-86.
7. Dulęba, J., Religioni, U., Słodka, E., Fal, A., Krysiński, J., & Merks, P. (2021). The Awareness of risks associated with OTC drugs available in non-pharmacy outlets among polish patients—a cross-sectional study. In Healthcare, 9(2), 187. https://doi.org/10.3390/healthcare9020187
8. El-Gamal, F., Alsahafi, B. A., Alsammak, I., Darwesh, E., Albogami, R., & Taha, A. (2022). Knowledge, Attitude, and Practice towards Over-the-Counter Drugs (OTC) use among adult population in Jeddah, Saudi Arabia. Middle East Journal of Family Medicine, 20(6), 84-90. DOI: 10.5742/MEWFM.2022.9525056

9. Kaya, M. (2022). Determination of side effects and rational drug use in patients using nonsteroidal anti - inflammatory drugs applying to Pamukkale university family practice polyclinics. (Publication No: 768123) [Specialization in Medicine, Pamukkale University]. Available in https://hdl.handle.net/11499/49945.
10. Kelly, M., McCarthy, S., & Sahm, L. J. (2014). Knowledge, attitudes and beliefs of patients and carers regarding medication adherence: a review of qualitative literature. European Journal of Clinical Pharmacology, 70, 1423-1431. https://doi.org/10.1007/s00228-014-1761-3
11. Kim, H. J., Yang, Y. M., & Choi, E. J. (2018). Use patterns of over-the-counter (OTC) medications and perspectives on OTC medications among Korean adult patients with chronic diseases: gender and age differences. Patient Preference and Adherence, 1597-1606. https://doi.org/10.2147/PPA.S173873
12. Kline, R. B. (2023). Principles and practice of structural equation modeling (5th ed.). New York Guilford publications.
13. Niclós, G., Olivar, T., & Rodilla, V. (2018). Factors associated with self-medication in Spain: a cross-sectional study in different age groups. International Journal of Pharmacy Practice, 26(3), 258-266. https://doi.org/10.1111/ijpp.12387
14. Ozturk, S., Basar, D., Ozen, İ.C., & Ciftci, A. Ö. (2019). Socio-economic and behavioral determinants of prescription and non-prescription medicine use: the case of Turkey. DARU Journal of Pharmaceutical Sciences, 27(2), 735-742. https://doi.org/10.1007/s40199-019-00311-1
15. Piña, I. L., Di Palo, K. E., Brown, M. T., Choudhry, N. K., Cvengros, J., Whalen, D., ... & Johnson, J. (2021). Medication adherence: importance, issues and policy: a policy statement from the American Heart Association. Progress in Cardiovascular Diseases, 64, 111-120. https://doi.org/10.1016/j.pcad.2020.08.003
16. Roberts, E., Nunes, V. D., Buckner, S., Latchem, S., Constanti, M., Miller, P., ... & Conaghan, P. G. (2016). Paracetamol: not as safe as we thought? A systematic literature review of observational studies. Annals of the Rheumatic Diseases, 75(3), 552-559. https://doi.org/10.1136/annrheumdis-2014-206914
17. Sinuraya, R. K., Wulandari, C., Amalia, R., & Puspitasari, I. M. (2023). Public knowledge, attitudes, and practices regarding the use of over-the-counter (OTC) analgesics in Indonesia: a cross-sectional study. Patient Preference and Adherence, 2569-2578. https://doi.org/10.2147/PPA.S426290 Temeloglu Sen E, Sertel Berk O, Sindel D. (2019). The validity and reliability study of the Turkish adaptation of the medical adherence report scale. (Original Work Published in Turkish) Journal of Istanbul Faculty of Medicine, 82(1):52-61. DOI :10.26650/IUITFD.413637
18. Tesfamariam, S., Anand, I. S., Kaleab, G., Berhane, S., Woldai, B., Habte, E., & Russom, M. (2019). Self-medication with over the counter drugs, prevalence of risky practice and its associated factors in pharmacy outlets of Asmara, Eritrea. BMC Public Health, 19, 1-9. https://doi.org/10.1186/s12889-019-6470-5 Tripković, K., Nešković, A., Janković, J., & Odalović, M. (2018). Predictors of self-medication in Serbian adult population: cross-sectional study. International Journal of Clinical Pharmacy, 40, 627-634. https://doi.org/10.1007/s11096-018-0624-x