Palyatif Bakım Servisindeki Yaşlı Hastalarda Polifarmasi ve Uygunsuz İlaç Kullanımının Beers ve TIME-to-STOP Kriterlerine Göre Değerlendirilmesi

Öz

Kırılgan yaşlı popülasyondaki uygunsuz ilaçları belirleyerek farkındalık oluşturup klinisyenlere yol gösterici olması açısından bu çalışma planlandı. Retrospektif dosya taraması olarak planlanan çalışmamızda 65 yaş üzeri palyatif bakım ünitesine kabul edilen hastaların başvuru esnasında kullandıkları ilaçların TIME-to-STOP ve Beers kriterlerine göre değerlendirmesi yapılarak hastalardaki uygunsuz ilaç kullanım oranı değerlendirildi. Hastanemizde yatırılarak takip ve tedavisi yapılan 65 yaş üzeri 100 hasta dahil edildi. Hastaların yatış esnasındaki tanısı, yaş ve cinsiyeti, tıbbi özgeçmişi, kronik hastalıkları, düzenli olarak kullandıkları ilaçlar hastane elektronik arşivi üzerinden tarandı. Elde edilen ilaç preparat isimleri farmakolojik gruplara ayrılarak tek tek TIME-to-STOP ve Beers kriterlerine uygunluk açısından incelendi. Polifarmasi alan hasta oranının %47 olduğu gözlendi. Beers kriterlerine göre potansiyel uygunsuz ilaç oranı %8,3 olarak saptandı. TIME-to-STOP kriterlerine göre yapılan değerlendirmede potansiyel uygunsuz ilaç oranı %11,7 bulundu. Yaşlı, kırılgan bir hasta grubunun değerlendirildiği bu çalışmada polifarmasinin potansiyel uygunsuz ilaç kullanımını arttırabileceği görüldü. Dolayısıyla kırılgan bir popülasyonu içeren yaşlı hasta grubunda polifarmasiden kaçınılmalı eğer endikasyon dahilinde ilaç reçete ediliyorsa hasta uyumunu arttırmak için muhakkak ilaç kullanımıyla ilgili eğitim verilmelidir.

Anahtar Kelimeler

• polifarmasi
• uygunsuz ilaç
• beers kriterleri
• TIME-to-STOP
• palyatif bakım
• geriatrik hasta
• yaşlı

Evaluation of Polypharmacy and Potentially Inappropriate Drug Use in Elderly Patients in the Palliative Care Service by Beers and TIME-to-STOP Criteria

Öz

This study was planned in order to raise awareness by identifying inappropriate drugs in the fragile elderly population and to guide clinicians. Our study as a retrospective file scan study, included 100 patients over the age of 65 who were followed up and treated in our hospital. The diagnosis, age and sex, medical history, chronic diseases, and medications they regularly use during hospitalization were scanned through the hospital electronic archive. The obtained drug preparation names were divided into pharmacological groups and examined one by one for compliance with TIME-to-STOP and Beers criteria. It was observed that the rate of patients who underwent polypharmacy was 47%. The mean number of drugs used by the patients was found to be 4,7. Potentially inappropriate drug rate was determined as 8.3% according to Beers criteria. In the evaluation made according to the TIME-to-STOP criteria, the rate of potentially inappropriate drugs was found to be 11,7%. It was observed that there was a common drug group proton pump inhibitors in both groups. In this study, which evaluated a frail elderly patient group, it was seen that polypharmacy could increase the potential inappropriate drug use. Therefore, polypharmacy should be avoided in the geriatric patient group, which includes a fragile population, and if medication is prescribed within the indication, training on drug use should be given to increase patient compliance.

Anahtar Kelimeler

• polypharmacy
• potentially inapropriate medication
• Beers criteria
• TIME-to-STOP
• palliative care

Kaynakça

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