Efikasnost procjene adherence i komplijanse u hroničnih pacijenata

Feka Pepić; Sabina Čongo; Edina Gafić; Vladimir Biočanin; Dušan Djurić

doi:10.5937/pomc16-17888

Feka Pepić Faculty of medical scinces,University of Kragujevac, Department of Oral surgery
Sabina Čongo Magistar farmacije, Doktorske studije – farmacija. Zdravstvena ustanova, apoteka GAMES, Travnik, Bosna i Hercegovina
Edina Gafić Magistar farmacije, Doktorske studije – farmacija. Zdravstvena ustanova, apoteka GAMES, Travnik, Bosna i Hercegovina
Vladimir Biočanin Docent, Stomatološki fakultet, Pančevo Docent, Farmaceutsko-zdravstveni fakultet, Travnik
Dušan Djurić Profesor, Integrisane akademske studije farmacije, Fakultet medicinskih nauka u Kragujevcu, Univerzitet u Kragujevcu, Institut za rehabilitaciju, Beograd, Srbija

DOI: https://doi.org/10.5937/pomc16-17888

Abstract

Kvalitet zdravstvene zaštite, propisivanje recepata i uzimanje lijekova na odgovarajući način može se donekle definisati terminima kao što su komplijansa, adherenca, perzistenca i konkordanca. Komplijansa je mijera do koje se ponašanje osobe koja uzima lijek, poklapa sa preporukom zdravstvenog radnika koji lijek izdaje/propisuje. Adherenca je pojam koji se često poistovjećuje s pojmom komplijansa, a podrazumijeva veće angažovanje pacijenta pri donošenju odluka vezanih za njegovu terapiju. Neadherenca se može razvrstati u dvije kategorije: primarnu i sekundarnu; namjernu i nenamjernu. Postoji niz načina kojima se utvrđuje ustrajnost pacijenata prema terapiji. Naročito su pogodna ispitivanja koja se svode na iskazivanje samih pacijenata s obzirom da su jeftina i neposredna, a ujedno dolazimo do stavova pacijenata o uzimanju lijekova. Ograničenja takvih istraživanja su moguća nedovoljna razumljivost pitanja od strane pacijenata te nepovjerenje i strah pacijenata vezanih uz objavljivanja podataka o uzimanju lijekova. Pretraživanjem PubMeda uz ključne riječi adherence, compliance i persistence (ustrajnost) te self-report questionnaire došlo se do svih do sada poznatih skala za mjerenje ustrajnosti. Večina skala je dizajnirana u zadnjih nekoliko godina (2005–2012). Pregledano je oko stotinjak članaka i 20 je uključeno u ovaj prikaz. Iako postoji niz različitih skala, još uvijek se ne može govoriti o zlatnom standardu, iako je tome najbliža medication Adherence Questionnaire (MAQ) skala nazvana još i, prema svom autoru, Morisky skala. Ova sinteza literature je izvedena sa željom da približi farmakoekonomsku dimenziju problema komplijanse i utiče na intenziviranje napora na njenom unapređenju u lokalnim uslovima.

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