Gastrointestinal sistem kanaması sebebiyle yatan hastalarda akılcı ilaç kullanımı ve geleneksel tamamlayıcı tıp kullanımının incelenmesi

Yıl 2023, Cilt: 4 Sayı: 5, 436 - 443, 27.10.2023

Füsun Afşar , Hatice Erdoğan , Nilay Küçük Ekinci , Zeynep Karaali , Rukiye Pınar

https://doi.org/10.47582/jompac.1340956

Cited By: 1

Öz

AMAÇ: Bu çalışmada dahiliye kliniğinde gastrointestinal sistem kanaması sebebiyle yatan hastalarda akılcı ilaç kullanımı bilgi düzeylerinin ve geleneksel ve tamamlayıcı tıpa ilişkin tutumların saptanması ve aralarındaki ilişkinin belirlenmesi amaçlandı.
YÖNTEM: Tanımlayıcı ve kesitsel tipteki bu çalışma bir eğitim araştırma hastanesinin 01.06-01.10.2022 tarihleri arasında dahiliye kliniğinde gastrointestinal kanama teşhisi ile yatan 143 hasta ile yürütüldü.
Demografik ve klinik özellikleri içeren Bilgi Formu, Akılcı İlaç Kullanımı (AİK) ile Geleneksel ve Tamamlayıcı Tıp Ölçeği (Complementary, Alternative, and Conventional Medicine Attitudes Scale (CACMAS) uygulandı. Verilerin istatistiksel analizi IBM SPSS 23.0 programında yapılmıştır
BULGULAR: GİS kanama tanısıyla yatan hastaların AKİ puan ortalaması 19,8±4,17 iken; CACMAS toplam puan ortalaması 96,76±15 olarak belirlendi. CACMAS alt boyut puan ortalamalarının tamamlayıcı tıbba düşünsel bakış 28,15±9,42, modern tıbba karşı tıptan memnuniyetsizlik 23,23±10,39, Sağlığa bütüncül bakış 45,38±8,18 olduğu saptandı.
AKİ puanları kadınlarda (20,33±4,37; 0,04), gelir durumu iyi olanlarda (22,17±4,02;0,03) ve ağrı kesici kullanmayanlarda (21,21±4; 0,01) diğer gruplara göre anlamlılık gösterecek şekilde yüksek bulunmuştur. Tamamlayıcı tıbba düşünsel alt bakış puanı erkeklerde (29,77±9,52; 0,03), bekarlarda (36,33±9,06;0,002) ve antikoagülan kullananlarda(32,95±10,77; 0,04), modern tıbba karşı memnuniyetsizlik puanı kadınlarda (26,04±9,74; 0,03), gelir durumu kötü olanlarda (30±15,17; 0,03) ve ağrısı olduğunda ağrı kesici kullananlarda (26±10,67; 0,01), sağlığa bütüncül bakış puanı, kadınlarda (47,24±7,33; 0,02) ve düzenli ilaç kullananlarda (46,49±8,34; 0,02) diğer gruplara göre anlamlılık gösterecek şekilde yüksek bulunmuştur.
Akılcı ilaç kullanımı, modern tıbbi tıpa karşı memnuniyetsizlik arasında istatistiksel olarak anlamlı olan negatif yönde (r=-0.381;p<0.001), sağlığa bütüncül bakış arasında istatistiksel olarak anlamlı olan pozitif yönde (r=0.472;p<0.001) korelasyon bulunmuştur. Alternatif tıp ölçeğinin alt boyutları olan 3 nicel değişkeninin birlikte Akılcı ilaç kullanımı ile arasındaki ilişkiyi ölçmek amacı ile Regresyon Analizi- Backward uygulanmıştır. İkinci modele ilişkin doğru denklemi istatistiksel olarak anlamlı bulunmuştur (F=21.759;p<0.001).
SONUÇ: Çalışmamızda gastrointestinal kanama sebebiyle dahiliye kliniğine yatış verilen hastaların akılcı ilaç kullanımının düşük olduğu ve akılcı ilaç kullanımı ile doğru orantılı olacak şekilde sağlığa bütüncül bakışın etkilendiği belirlenmiş olup, akılcı ilaç kullanımı ile ilgili sağlık eğitimi ile koruyucu sağlık hizmetlerinin geliştirilmesinin hastaneye yatış ve mortalite oranları üzerine pozitif etkisinin olacağı düşüncesindeyiz.

Anahtar Kelimeler

Gastrointestinal kanama, Alternatif Tıp, Akılcı ilaç kullanımı, Hasta

Destekleyen Kurum

Destekleyen kurum bulunmamaktadır

An examination of rational drug use and traditional complementary medicine in patients hospitalised because of gastrointestinal system bleeding

Öz

AIM: The aim of this study was to determine the knowledge levels of rational drug use, the attitudes to traditional and complementary medicine, and the relationship between these in patients admitted to the Internal Medicine Clinic because of gastrointestinal system bleeding.
METHOD: This descriptive, cross-sectional study was conducted with 124 patients hospitalised in the Internal Medicine Clinic of a training and research hospital with a diagnosis of gastrointestinal bleeding between 01.06.2022 and 01.10.2022.
An Information Form including demographic and clinical characteristics, the Rational Drug Use Scale (RDUS), and the Complementary, Alternative, and Conventional Medicine Attitudes Scale (CACMAS) were applied to the patients. The data obtained were analyzed statistically using SPSS vn. 23.0 software.
RESULTS: For the whole sample of patients hospitalised with a diagnosis of gastrointestinal system bleeding, the mean RDUS points were determined to be 19.8±4.17 and the mean total CACMAS points were 96.76±15. In the subscales of the CACMAS, the mean points were determined to be 28.15±9.42 for philosophical congruence with complementary medicine, 23.23±10.39 for dissatisfaction with conventional medicine, and 45.38±8.18 for holistic balance.
The RDUS points were found to be significantly higher in females (20.33±4.37, p:0.04), patients with a good income status (22.17±4.02, p:0.03) and those who did not use painkillers (21.21±4.00, p:0.01) compared to other subgroups. The CACMAS subscale mean points for philosophical congruence with complementary medicine were determined to be significantly higher in males (29.77±9.52, p:0.03), patients who were single (36.33±9.06, p:0.002), and those who used anticoagulants (32.95±10.77, p: 0.04). The dissatisfaction with conventional medicine subscale points were determined to be significantly higher in females (26.04±9.74, p: 0,03), patients with a low income (30±15.17, p: 0.03) and those who used painkillers (26±10.67, p:0.01), and the holistic balance points were determined to be significantly higher in females (47.24±7.33, p: 0.02) and those who used medication regularly (46.49±8.34, p:0.02) compared to other sub-groups. A statistically significant negative correlation was found between rational drug use and dissatisfaction with conventional medicine (r=-0.381, p<0.001), and a statistically significant positive correlation between rational drug use and holistic balance (r=0.472;p<0.001). Backward step regression analysis was performed to measure the relationship between rational drug use and the 3 quantitative variables of the CACMAS. The linear equation of the relationship to the second model was found to be statistically significant (F =21.759, p<0.001).
CONCLUSION: The results of this study demonstrated that rational drug use was low and rational drug use had a proportionate effect on holistic balance in patients hospitalised in the Internal Medicine Clinic because of gastrointestinal bleeding. It can be considered that the development of preventative healthcare services with health education related to rational drug use would have a positive effect on hospitalisations and mortality rates.

Anahtar Kelimeler

Gastrointestinal bleeding, Alternative Medicine, Rational Drug Use, Patinet

Kaynakça

• Kaçmaz H. Approach to acute gastrointestinal bleeding. In: Serdar Olt, eds. Health&Science: Internal Medicine Emergencies. Efeakademi Publishing. 2022:151-160.
• Nkurunziza L, Bacha H, Gharbi T, Benzzoubeir N, Errabih I. Upper gastrointestinal bleeding:a prospective epidemiological study about 72 cases and review of the literature. SJMPS. 2022;8(7):319-326. doi:10.36348/sjmps.2022.v08i07.001
• Rodrigues A, Carrilho A, Almeida N, et al. Interventional algorithm in gastrointestinal bleeding-an expert consensus multimodal approach based on a multidisciplinary team. Clin Appl Thromb Hemost. 2020;26:1-19. doi:10.1177/1076029620931943
• Luo PJ, Lin X-H, Lin C-C, et al. Risk factors for upper gastrointestinal bleeding among aspirin users: an old issue with new findings from a population-based cohort study. J Formos Med Assoc. 2019;118(5):939-944. doi:10.1016/j.jfma.2018.10.007
• Panchal NK, Sabina EP. Non-steroidal anti-inflammatory drugs (NSAIDs):A current insight into its molecular mechanism eliciting organ toxicities. Food Chem Toxicol. 2023;172:113598. doi:10.1016/j.fct.2022.113598
• Bahraini A, Koneri R. Prescription pattern analysis of nonsteroidal antiÿ inflammatory drugs in the Southeastern Karnataka population, India. APP. 2021;11(1):116-119.
• Hosnia M, Rahala M, Tamimb H, et al. Increased rebleeding and mortality in patients with gastrointestinal bleeding treated with anticoagulant drugs compared to antiplatelet drugs. Eur J Gastroenterol Hepatol. 2021;33(1):e490-e498. doi:10.1097/MEG.0000000000002148.
• Alshammri MR, Altamimi NO, Dera RM, et al. The use of over the counter aspirin as prophylaxis for cardiovascular diseases among adult people in Saudi Arabia. Med Sci. 2022;26:136e2155. doi:10.54905/disssi/v26i122/ms136e2155
• García Rodríguez L, Lanas A, Soriano-Gabarró M, Vora P, Cea Soriano L. Effect of proton pump inhibitors on risks of upper and lower gastrointestinal bleeding among users of low-dose aspirin:a population-based observational study. J Clin Med. 2020;9(4):928. doi:10.3390/jcm9040928
• Awuchi CG. Medicinal Plants:the medıcal, food, and nutrıtıonal bıochemıstry and uses. IJAAR. 2019;5(11):220-241. doi:10.46654/ij.24889849
• Banerjee S. Safety concerns of dietary and herbal supplements for typical patients. Int J Pharm Chem Anal. 2021;8(4):141-144. doi:10.18231/j.ijpca.2021.027
• Abebe W. Review of herbal medications with the potential to cause bleeding:dental implications, and risk prediction and prevention avenues. EPMA J. 2019;10(1):51-64. doi:10.1007/s13167-018-0158-2.
• Dağlar N, Dağdeviren HN. The place of phytotherapy in traditional and complementary medicine applications. Euras J Fam Med. 2018;7(3):73-77.
• Demirtaş Z, Dağtekin G, Sağlan R, et al. Validity and reliabilty of rational drug use scale. ESTÜDAM J Public Health. 2018;3(3):37-46.
• Köse E, Ekerbiçer HÇ, Erkorkmaz Ü. Complementary, alternative and conventional medicine attitude scale: Turkish validity reliability study. Sakarya Med J. 2018;8(4):726-736. doi:10.31832/smj.478148
• Oral S. Information and behavior of patients about rational drug use. Abant Med J. 2021;10(3):330-344. doi:10.47493/abantmedj.2021.870503.
• Apaydın M. Investıgatıon of the knowledge and attıtudes regardıng ratıonal drug use, and affectıng factors of adults who apply to an internal medıcıne outpatıent In: Bahçecik N. Master Thesis. İstanbul. 2022
• Kuyifatih A, Yenimahalleli YG, Günaltay MM. Rational drug use: an application in Ankara University Faculty of Health Sciences. FSECON. 2022;6(1):251-277. doi:10.25295/fsecon.1040173.
• Acar AB, Özen M. Evaluation of aspirin use in patients admitted to the family medicine outpatient clinic. Cukurova Med J. 2021;46(3):1026-1032. doi:10.17826/cumj.907395
• Soriano LC, Lanas A, Soriano-Gabarró M, Garcia Rodriguez LA. Incidence of upper and lower gastrointestinal bleeding in new users of low-dose aspirin. Clin Gastroenterol Hepatol. 2019;17(5):887-895. doi:10.1016/j.cgh.2018.05.061
• Biçer İ, Yalçın Balçık P. Tradıtıonal and complementary medıcıne:investıgatıon of Turkey and the selected countrıes. Hacettepe J Health Administration. 2019;22(1):245-257.
• Özer Z, Turan G.B, Bakır E. Attitude of patients admitted to internal diseases polyclinic towards conventional and complementary medicine and the affecting factors. J Health Pro Res. 2020;2(3):102-112.
• Foley H, Steel A, Cramer H, Wardle J, Adams J. Disclosure of complementary medicine use to medical providers: a systematic review and meta-analysis. Sci Rep. 2019;9(1):1573. doi:10.1038/s41598-018-38279-8.
• Solak Y, Kaya E, Yoldaşcan BE. Knowledge and attitudes about herbal products and herbal medicine in people applying to family health care center. Fırat Med J. 2020;25(4):213-218
• Barlin D, Ercan A, Conditions of use of food and vegetable products in the adults having digestive system problems. Turk J Acad Gastroenterol. 2020;19(1):31-37. doi:10.17941/agd.708506
• Carlsson JM, Vestin M, Bjerså K. Use of complementary and alternative medicine (CAM) among emergency department (ED) patients in Sweden. BMC Complementary Med Ther. 2020;20(1):327. doi:10.1186/s12906-020-03126-9
• Şensoy N, Özdinç Ş, Yılmaz O, et al. The attıtudes and behavıors of patıents admıtted to unıversıty hospıtal towards complementary and alternatıve therapies. Kocatepe Med J. 2020;21(3):258-263. doi:10.18229/kocatepetip.676401
• Çavuşoğlu M, Yılmaz M. Attitudes and behaviors of migrated people from bulgaria regarding traditional and complementary therapy methods. JPHN. 2020;2(2):57-72.
• Kaur J, Hamajima N, Yamamoto E, et al. Patient satisfaction on the utilization of traditional and complementary medicine services at public hospitals in Malaysia. CTIM. 2019;42:422-428. doi:10.1016/j.ctim.2018.12.013