Yıl: 2014 Cilt: 17 Sayı: 2 Sayfa Aralığı: 125 - 133 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY

Öz:
Giriş: Bu çalışmada bir toplum sağlığı hizmet bölgesinde yaşayan yaşlıların uygunsuz ilaç kullanma olasılığının ve ilaç uyumsuzluğunun değerlendirilmesi ile potansiyel uygunsuz ilaç kullanımıve ilaç uyumsuzluğu için risk faktörlerinin belirlenmesi amaçlanmıştır.Gereç ve Yöntem: Kesitsel tipteki çalışma Türkiye'nin İsparta ilindeki bir Toplum Sağlığı Bölgesinde yaşayan 65 yaş üzeri 687 yaşlı bireyi kapsamaktadır. Araştırmanın bağımlı değişkenleriuygunsuz ilaç kullanma olasılığı ve ilaç uyumsuzluğudur. Araştırmanın bağımlı ve bağımsız değişkenlerini içeren yapılandırılmış anket, yaşlılara evlerinde yüz-yüze görüşme yöntemiyle uygulanmıştır. Veri analizinde ki-kare, bağımsız gruplarda t-testi ve lojistik regresyon kullanılmıştır.Bulgular: Her gün en az bir ilaç kullanan yaşlıların %17,6'sı en az bir adet uygunsuz ilaç kullanım olasılığını tanımlamışlardır. Non-steroid anti-inflamatuar ilaçlar ve digoxin (>0,125 mg/gün)en sık uygunsuz kullanılan ilaçlardı. Yaşlıların %40,6'sında ilaç uyumsuzluğu saptandı. İlaç uyumsuzluğunu belirleyen davranışlar içinde "ilaç içmeyi unutma" en sık görüldü. Çok değişkenli analizlerde polimorbidite (p=0,001) ve polifarmasi (p=0,016) uygunsuz ilaç kullanma olasılığı için riskfaktörleriydi. İlaç uyumsuzluğu için tek risk faktörü "kullanılan ilaçların çoğu yan etkisini bilmemek"ti (p=0,018).Sonuç: Bu çalışmada uygunsuz ilaç kullanma olasılığı ve ilaç uyumsuzluğu sıklığı diğer çalışmaların çoğundan daha düşüktü. Polifarmasi ve polimorbiditenin uygunsuz ilaç kullanma olasılığıiçin risk faktörleri olması nedeniyle hekimler polimorbiditesi olan yaşlı hastalarda ilaç seçimindedikkatli olmalıdır
Anahtar Kelime:

Konular: Cerrahi

TOPLUMDA YAŞLILARDA UYGUNSUZ İLAÇ KULLANMA OLASILIĞI VE İLAÇ UYUMSUZLUĞUNUN DEĞERLENDİRİLMESİ, KESİTSEL BİR ÇALIŞMA

Öz:
Introduction: The objectives of the study were to evaluate potentially inappropriate drug useand medical non-adherence and to determine the risk factors for potentially inappropriate druguse and medical non-adherence in the elderly dwelling in a community health center service area. Materials and Method: The cross-sectional study included all individuals aged 65 years andolder (n=687) dwelling in the area of a community health center in Isparta, Turkey. The dependent variables of the study were potentially inappropriate drug use and medical non-adherence.The structured questionnaire, comprising both dependent and independent variables, was administered to elderly people by conducting face-to-face interviews at home. Chi-square, independentsamples t-test, and logistic regression were used for data analysis. Results: Among the elderly using at least one drug per day, 17.6% were using at least onepotentially inappropriate medication. Non-steroidal anti-inflammatory drugs and digoxin (in doses>0.125 mg/day) were the most common drugs that were used inappropriately. Medical non-adherence was determined in 40.6% of the elderly. The most common non-adherent behavior was"forgetting to take the medication." In the multivariate analysis, polymorbidity (p=0.001) and polypharmacy (p=0.016) were risk factors for potentially inappropriate drug use. The only risk factorfor medical non-adherence was "not knowing most of the side effects of the drug" (p=0.018).Conclusion: In this study, lower prevalence rates than those for most previous studies werefound for both potentially inappropriate drug use and medical non-adherence. Since polymorbidity and polypharmacy were risk factors for potentially inappropriate drug use, physicians shouldbe cautious in the selection of drugs for elderly patients with polymorbidity
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Cornelius C. Drug use in the elderly: Risk or protection? Curr Opin Psychiatry 2004;17(6):443-7.
  • The Merck Manual for Health Care Professionals. Drug-Related Problems in the Elderly. [Internet] Available from: http://www.merckmanuals.com/professional/geriatrics/drug_th erapy_in_the_elderly/drug-related_problems_in_the_elderly. html#vl 133525. Accessed: 9.9.2013.
  • Hughes CM. Medication non-adherence in the elderly. How Big is the problem? Drugs Aging 2004;21(12):793-811. (PMID:15382959).
  • Williams CM. Using medications appropriately in older adults. Am Fam Physician 2002;66(10):1917-25. (PMID:12469968).
  • Morisky DE, Green LW, Levine DM. Concurrent and predic- tive validity of a self-reported measure of medication adherence. Med Care 1986;24(l):67-74. (PMID:3945130).
  • Roth MT, Ivey JL. Self-reported medication use in community- residing older adults: A pilot study. Am J Geriatr Pharmacother 2005;3(3):196-204. (PMID:16257822).
  • Sirey JA, Greenfield A, Weinberger MI, Bruce ML. Medication beliefs and self-reported adherence among community-dwelling older adults. Clin Ther 2013;35(2):153-60. (PMID:23357585).
  • Ertan T, Eker E. Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: Are there different factor structures for different cultures? Int Psychogeriatr 2000;12(2):163-72. (PMID:10937537).
  • Gama EV, Damian JE, Perez de Molino J, Lopez MR, Lopez Perez M, Gavira Iglesias FJ. Association of individual activities of daily living with self-rated health in older people. Age Ageing 2000;29(3):267-70. (PMID:10855912).
  • The Anatomical Therapeutic Chemical Classification System with Defined Daily doses (ATC/DDD) Index 2013. [Internet] Available from: Accessed: 4.11.2013.
  • Sonmez Y, Konakci SK, Duksal T, Ucku R. The characteristics of drug use in the elderly in the community STED 2008;17(11):149-54. (in Turkish).
  • Shah SM, Carey IM, Harris T, DeWilde S, Cook DG. Quality of prescribing in care homes and the community in England and Wales. Br J Gen Pract 2012:62(598):e329-36. (PMID:22546592).
  • Lechevallier-Michel N, Gautier-Bertrand M, Alperovitch A, et al. Frequency and risk factors of potentially inappropriate med- ication use in a community-dwelling elderly population: results from the 3C Study. Eur J Clin Pharmacol 2005;60(11):813-9. (PMID:15599504).
  • Rajska-Neumann A, Wieczorowska-Tobis K. Polypharmacy and potential inappropriateness of pharmaco-logical treatment among community-dwelling elderly patients. Arch Gerontol Geriatr 2007;44(1):303-9. (PMID:17317466).
  • Blalock SJ, Byrd JE, Hansen RA, et al. Factors associated with potentially inappropriate drug utilization in a sample of rural community-dwelling older adults. Am J Geriatr Pharmacother 2005;3(3):168-79. (PMID:16257819).
  • Solmaz T, Akin B. Medication use and ability of self-medica- tion use in elderly living at home. Turkish Journal of Geriatrics 2009;12(2):72-81. (in Turkish).
APA SÖNMEZ Y, AŞCI H, OLGUN İZMİRLİ G, GÜNDOAR D, CANKARA F, YESILOT S (2014). EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. , 125 - 133.
Chicago SÖNMEZ Yonca,AŞCI Halil,OLGUN İZMİRLİ Gülşen,GÜNDOAR Duru,CANKARA Fatma Nihan,YESILOT SÜKRIYE EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. (2014): 125 - 133.
MLA SÖNMEZ Yonca,AŞCI Halil,OLGUN İZMİRLİ Gülşen,GÜNDOAR Duru,CANKARA Fatma Nihan,YESILOT SÜKRIYE EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. , 2014, ss.125 - 133.
AMA SÖNMEZ Y,AŞCI H,OLGUN İZMİRLİ G,GÜNDOAR D,CANKARA F,YESILOT S EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. . 2014; 125 - 133.
Vancouver SÖNMEZ Y,AŞCI H,OLGUN İZMİRLİ G,GÜNDOAR D,CANKARA F,YESILOT S EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. . 2014; 125 - 133.
IEEE SÖNMEZ Y,AŞCI H,OLGUN İZMİRLİ G,GÜNDOAR D,CANKARA F,YESILOT S "EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY." , ss.125 - 133, 2014.
ISNAD SÖNMEZ, Yonca vd. "EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY". (2014), 125-133.
APA SÖNMEZ Y, AŞCI H, OLGUN İZMİRLİ G, GÜNDOAR D, CANKARA F, YESILOT S (2014). EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. Türk Geriatri Dergisi, 17(2), 125 - 133.
Chicago SÖNMEZ Yonca,AŞCI Halil,OLGUN İZMİRLİ Gülşen,GÜNDOAR Duru,CANKARA Fatma Nihan,YESILOT SÜKRIYE EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. Türk Geriatri Dergisi 17, no.2 (2014): 125 - 133.
MLA SÖNMEZ Yonca,AŞCI Halil,OLGUN İZMİRLİ Gülşen,GÜNDOAR Duru,CANKARA Fatma Nihan,YESILOT SÜKRIYE EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. Türk Geriatri Dergisi, vol.17, no.2, 2014, ss.125 - 133.
AMA SÖNMEZ Y,AŞCI H,OLGUN İZMİRLİ G,GÜNDOAR D,CANKARA F,YESILOT S EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. Türk Geriatri Dergisi. 2014; 17(2): 125 - 133.
Vancouver SÖNMEZ Y,AŞCI H,OLGUN İZMİRLİ G,GÜNDOAR D,CANKARA F,YESILOT S EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY. Türk Geriatri Dergisi. 2014; 17(2): 125 - 133.
IEEE SÖNMEZ Y,AŞCI H,OLGUN İZMİRLİ G,GÜNDOAR D,CANKARA F,YESILOT S "EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY." Türk Geriatri Dergisi, 17, ss.125 - 133, 2014.
ISNAD SÖNMEZ, Yonca vd. "EVALUATION OF POTENTIALLY INAPPROPRIATE DRUG USE AND MEDICAL NON-ADHERENCE IN A COMMUNITY-DWELLING ELDERLY POPULATION: A CROSS-SECTIONAL STUDY". Türk Geriatri Dergisi 17/2 (2014), 125-133.