Identifikacija terapijskih problema tokom uvođenja usluga farmaceuta na Odeljenju gerijatrije Kliničko-bolnickog centra
Sažetak
Uvod: Višestruki komorbiditeti i polifarmacija dovode gerijatrijske pacijente u povećan rizik od terapijskih problema, što može dovesti do povećanog morbiditeta, mortaliteta i troškova zdravstvene zaštite ovih pacijenata.
Cilj rada: Cilj studije je da identifikuje učestalost i uzroke terapijskih problema kod starijih pacijenata i faktore koji na njih utiču, kao i da proceni implementaciju usluga farmaceuta na gerijatrijskom odeljenju.
Metod: Farmaceut je analizirao terapiju hospitalizovanih pacijenata na odeljenju za gerijatriju, identifikovao terapijske probleme i formulisao preporuke za promenu terapije. Terapijski problemi su kategorizovani prema PCNE-DRP klasifikaciji, verzija 9. U studiju je uključeno ukupno 100 pacijenata, od kojih su 52% bili muškarci, prosečne starosti 79,7±7,88 godina.
Rezultati: Prosečan broj identifikovanih terapijskih problema je bio 2,36 po pacijentu. Najčešće uočen problem je bezbednost terapije (44,9%), zatim efikasnost terapije (33,1%) i nepotreban lek u terapiji (22%). Za većinu terapijskih problema uzrok je bio neadekvatan izbor leka (61%) i neadekvatan izbor doze (38,1%). Pacijenti sa atrijalnom fibrilacijom i hroničnom bubrežnom insuficijencijom imali su značajno veći broj terapijskih problema u poređenju sa pacijentima bez ovih komorbiditeta. Analizirana terapija za 100 hospitalizovanih gerijatrijskih pacijenata zahtevala je ukupno 229 intervencija. Međutim, stopa prihvatanja preporučenih intervencija bila je niska (25,9%).
Zaključak: Prevalencija terapijskih problema kod gerijatrijskih pacijenata je visoka, dok je stepen prihvatanja preporuka farmaceuta za promenu terapije nizak. Da bi se unapredila implementacija farmaceutskih usluga i poboljšala zdravstvena zaštita starijih pacijenata, veoma je važno unaprediti saradnju između lekara i farmaceuta. Razumevanje veština farmaceuta može omogućiti prihvatanje farmaceuta kao dela multidisciplinarnog tima i uspešnu implementaciju farmaceutskih usluga.
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