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

Yıl 2025, Cilt: 27 Sayı: 3, 324 - 329, 25.12.2025
https://doi.org/10.24938/kutfd.1725178

Öz

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.

Kaynakça

  • Celli B, Fabbri L, Criner G, et al. Definition and nomenclature of chronic obstructive pulmonary disease: Time for its revision. Am J Respir Crit Care Med. 2022;206(11):1317–1325.
  • Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022;10(5):447–458.
  • Varmaghani M, Dehghani M, Heidari E, Sharifi F, Saeedi Moghaddam S, Farzadfar F. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis. East Mediterr Health J. 2019:25(1):47–57.
  • Ntritsos G, Franek J, Belbasis L, et al. Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2018;13:1507–1514.
  • Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34(3):648–654.
  • Casaburi R. Activity promotion: a paradigm shift for chronic obstructive pulmonary disease therapeutics. Proc Am Thorac Soc. 2011;8(4):334-337.
  • Guthrie B, Makubate B, Hernandez-Santiago V, Dreischulte T. The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995–2010. BMC Med. 2015;13(1):74.
  • Bourgeois FT, Shannon MW, Valim C, Mandl KD. Adverse drug events in the outpatient setting: an 11-year national analysis. Pharmacoepidemiol Drug Saf. 2010;19(9):901-910.
  • Johnell K, Klarin I. The relationship between number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register. Drug Saf. 2007;30(10):911-918.
  • Westerik JAM, Metting EI, Van Boven JFM, Tiersma W, Kocks JWH, Schermer TR. Associations between chronic comorbidity and exacerbation risk in primary care patients with COPD. Respir Res. 2017;18(1):31.
  • Franssen FM, Spruit MA, Wouters EF. Determinants of polypharmacy and compliance with GOLD guidelines in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2011;6:493-501.
  • Hanlon P, Nicholl BI, Jani BD, et al. Examining patterns of multimorbidity, polypharmacy and risk of adverse drug reactions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study. BMJ Open. 2018;8(1):e018404.
  • Derhem B, Özsari S. Frailty and polypharmacy in primary care. Biol Res Nurs. 2023;25(4):658–663.
  • Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. The Lancet. 2013;381(9868):752–762.
  • Chou YY, Lee YS, Lin CS, et al. Gender-specific linkages: frailty, polypharmacy, anti-cholinergic burden, and 5-year mortality risk—a real-world analysis. PeerJ. 2023 21;11:e16262.
  • Global Strategy For Prevention, Diagnosis And Management of Copd: 2025 Report, Erişim Tarihi: 29.04.2025: https://goldcopd.org/2025-gold-report.
  • Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54(7):581–586.
  • Alwafi H, Naser AY, Ashoor DS, et al. Prevalence and predictors of polypharmacy and comorbidities among patients with chronic obstructive pulmonary disease: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia. BMC Pulm Med. 2024 14;24(1):453.
  • Sirois C, Ouali A, Simard M. Polypharmacy among older individuals with COPD: Trends between 2000 and 2015 in Quebec, Canada. COPD J Chronic Obstr Pulm Dis. 2019 4;16(3–4):234–239.
  • Gutierrez-Valencia M, Izquierdo M, Cesari M, et al. The relationship between frailty and polypharmacy in older people: a systematic review. Br J Clin Pharmacol. 2018;84:1432–1444.
  • Fried TR, O’Leary J, Towle V et al. Health outcomes associatedwith polypharmacy in community-dwelling older adults: a sys-tematic review. J Am Geriatr Soc. 2014;62:2261–2272.
  • Sganga F, Landi F, Ruggiero C, et al. Polypharmacy and healthoutcomes among older adults discharged from hospital: resultsfrom the CRIME study. Geriatr Gerontol Int. 2015;15:141–146.
  • Ierodiakonou D, Theodorou E, Sifaki-Pistolla D, et al. Clinical characteristics and outcomes of polypharmacy in chronic obstructive pulmonary disease patients: A cross-sectional study from Crete, Greece. Clin Respir J. 2021;15(12):1310-1319.
  • Hanlon P, Nicholl BI, Jani BD, et al. Examining patterns ofmultimorbidity, polypharmacy and risk of adverse drug reac-tions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study. BMJ Open. 2018;8(1):e018404.
  • Franssen FM, Spruit MA, Wouters EFM. Determinants ofpolypharmacy and compliance with GOLD guidelinesin patients with chronic obstructive pulmonary disease. IntJ COPD. 2011;6(1):493-501.

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

Yıl 2025, Cilt: 27 Sayı: 3, 324 - 329, 25.12.2025
https://doi.org/10.24938/kutfd.1725178

Öz

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.

Kaynakça

  • Celli B, Fabbri L, Criner G, et al. Definition and nomenclature of chronic obstructive pulmonary disease: Time for its revision. Am J Respir Crit Care Med. 2022;206(11):1317–1325.
  • Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022;10(5):447–458.
  • Varmaghani M, Dehghani M, Heidari E, Sharifi F, Saeedi Moghaddam S, Farzadfar F. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis. East Mediterr Health J. 2019:25(1):47–57.
  • Ntritsos G, Franek J, Belbasis L, et al. Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2018;13:1507–1514.
  • Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34(3):648–654.
  • Casaburi R. Activity promotion: a paradigm shift for chronic obstructive pulmonary disease therapeutics. Proc Am Thorac Soc. 2011;8(4):334-337.
  • Guthrie B, Makubate B, Hernandez-Santiago V, Dreischulte T. The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995–2010. BMC Med. 2015;13(1):74.
  • Bourgeois FT, Shannon MW, Valim C, Mandl KD. Adverse drug events in the outpatient setting: an 11-year national analysis. Pharmacoepidemiol Drug Saf. 2010;19(9):901-910.
  • Johnell K, Klarin I. The relationship between number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register. Drug Saf. 2007;30(10):911-918.
  • Westerik JAM, Metting EI, Van Boven JFM, Tiersma W, Kocks JWH, Schermer TR. Associations between chronic comorbidity and exacerbation risk in primary care patients with COPD. Respir Res. 2017;18(1):31.
  • Franssen FM, Spruit MA, Wouters EF. Determinants of polypharmacy and compliance with GOLD guidelines in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2011;6:493-501.
  • Hanlon P, Nicholl BI, Jani BD, et al. Examining patterns of multimorbidity, polypharmacy and risk of adverse drug reactions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study. BMJ Open. 2018;8(1):e018404.
  • Derhem B, Özsari S. Frailty and polypharmacy in primary care. Biol Res Nurs. 2023;25(4):658–663.
  • Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. The Lancet. 2013;381(9868):752–762.
  • Chou YY, Lee YS, Lin CS, et al. Gender-specific linkages: frailty, polypharmacy, anti-cholinergic burden, and 5-year mortality risk—a real-world analysis. PeerJ. 2023 21;11:e16262.
  • Global Strategy For Prevention, Diagnosis And Management of Copd: 2025 Report, Erişim Tarihi: 29.04.2025: https://goldcopd.org/2025-gold-report.
  • Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54(7):581–586.
  • Alwafi H, Naser AY, Ashoor DS, et al. Prevalence and predictors of polypharmacy and comorbidities among patients with chronic obstructive pulmonary disease: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia. BMC Pulm Med. 2024 14;24(1):453.
  • Sirois C, Ouali A, Simard M. Polypharmacy among older individuals with COPD: Trends between 2000 and 2015 in Quebec, Canada. COPD J Chronic Obstr Pulm Dis. 2019 4;16(3–4):234–239.
  • Gutierrez-Valencia M, Izquierdo M, Cesari M, et al. The relationship between frailty and polypharmacy in older people: a systematic review. Br J Clin Pharmacol. 2018;84:1432–1444.
  • Fried TR, O’Leary J, Towle V et al. Health outcomes associatedwith polypharmacy in community-dwelling older adults: a sys-tematic review. J Am Geriatr Soc. 2014;62:2261–2272.
  • Sganga F, Landi F, Ruggiero C, et al. Polypharmacy and healthoutcomes among older adults discharged from hospital: resultsfrom the CRIME study. Geriatr Gerontol Int. 2015;15:141–146.
  • Ierodiakonou D, Theodorou E, Sifaki-Pistolla D, et al. Clinical characteristics and outcomes of polypharmacy in chronic obstructive pulmonary disease patients: A cross-sectional study from Crete, Greece. Clin Respir J. 2021;15(12):1310-1319.
  • Hanlon P, Nicholl BI, Jani BD, et al. Examining patterns ofmultimorbidity, polypharmacy and risk of adverse drug reac-tions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study. BMJ Open. 2018;8(1):e018404.
  • Franssen FM, Spruit MA, Wouters EFM. Determinants ofpolypharmacy and compliance with GOLD guidelinesin patients with chronic obstructive pulmonary disease. IntJ COPD. 2011;6(1):493-501.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Baki Derhem 0000-0002-6989-9873

Mert Kızmaz 0009-0003-0530-0811

Aleyna Kaynar 0009-0007-0787-2847

Merve Su Polat 0009-0004-1199-2874

Seher Sokuoğlu 0009-0006-1976-9049

Derviş Emre Çopur 0009-0006-0722-3081

Gönderilme Tarihi 23 Haziran 2025
Kabul Tarihi 9 Ekim 2025
Yayımlanma Tarihi 25 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 27 Sayı: 3

Kaynak Göster

APA Derhem, B., Kızmaz, M., Kaynar, A., … Polat, M. S. (2025). ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA. The Journal of Kırıkkale University Faculty of Medicine, 27(3), 324-329. https://doi.org/10.24938/kutfd.1725178
AMA Derhem B, Kızmaz M, Kaynar A, Polat MS, Sokuoğlu S, Çopur DE. ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA. Kırıkkale Üni Tıp Derg. Aralık 2025;27(3):324-329. doi:10.24938/kutfd.1725178
Chicago Derhem, Baki, Mert Kızmaz, Aleyna Kaynar, Merve Su Polat, Seher Sokuoğlu, ve Derviş Emre Çopur. “ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA”. The Journal of Kırıkkale University Faculty of Medicine 27, sy. 3 (Aralık 2025): 324-29. https://doi.org/10.24938/kutfd.1725178.
EndNote Derhem B, Kızmaz M, Kaynar A, Polat MS, Sokuoğlu S, Çopur DE (01 Aralık 2025) ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA. The Journal of Kırıkkale University Faculty of Medicine 27 3 324–329.
IEEE B. Derhem, M. Kızmaz, A. Kaynar, M. S. Polat, S. Sokuoğlu, ve D. E. Çopur, “ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA”, Kırıkkale Üni Tıp Derg, c. 27, sy. 3, ss. 324–329, 2025, doi: 10.24938/kutfd.1725178.
ISNAD Derhem, Baki vd. “ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA”. The Journal of Kırıkkale University Faculty of Medicine 27/3 (Aralık2025), 324-329. https://doi.org/10.24938/kutfd.1725178.
JAMA Derhem B, Kızmaz M, Kaynar A, Polat MS, Sokuoğlu S, Çopur DE. ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA. Kırıkkale Üni Tıp Derg. 2025;27:324–329.
MLA Derhem, Baki vd. “ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA”. The Journal of Kırıkkale University Faculty of Medicine, c. 27, sy. 3, 2025, ss. 324-9, doi:10.24938/kutfd.1725178.
Vancouver Derhem B, Kızmaz M, Kaynar A, Polat MS, Sokuoğlu S, Çopur DE. ÇOKLU İLAÇ KULLANIMININ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI SEMPTOMLARI ÜZERİNE ETKİSİ: GÖZLEMSEL BİR ARAŞTIRMA. Kırıkkale Üni Tıp Derg. 2025;27(3):324-9.

Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.