Faktori povezani sa poštovanjem preporuka dobre kliničke prakse tokom bolničkog lečenja bolesnika sa prvom epizodom oboljenja iz shizofrenog spektra
Sažetak
Apstrakt
Uvod/Cilj. Poštovanje smernica datih u vodičima dobre kliničke prakse tokom lečenja specifičnih poremećaja smatra se garancijom sprovođenja uniformne, na dokazima zasnovane kliničke prakse u psihijatriji. Cilj ovog rada bio je da se analizira usklađenost obrazaca propisivanja antipsihotičkih lekova sa preporukama dobre kliničke prakse u Srbiji i da se ostvari uvid u efekte koje je na propisivačku praksu u ovoj oblasti imalo donošenje Nacionalnog vodiča dobre kliničke prakse za dijagnostikovanje i lečenje shizofrenije. Metode. Neinterventna, opservaciona studija sprovedena je na Klinici za psihijatrijske bolesti “Dr Laza Lazarević” u Beogradu. Istraživanje je obuhvatilo uzastopni uzorak od 675 prethodno netretiranih bolesnika, lečenih hospitalno u periodu od 1. januara 2012. godine do 31. decembra 2015. godine, otpuštenih sa dijagnozom nekog od poremećaja iz shizofrenog spektra. Demografski podaci i podaci o kliničkim karakteristikama bolesnika, karakteristikama propisivača i propisanim antipsihoticima sakupljeni su retrospektivno, uvidom u medicinsku dokumentaciju bolesnika. Za analizu primarnih podataka korišćene su deskriptivne statističke metode i metode za testiranje statističkih hipoteza. Metoda logističke regresije korišćena je za identifikaciju faktora povezanih sa poštovanjem preporuka dobre kliničke prakse. Rezultati. Antipsihotičnom monoterapijom tretirano je 446 (66,1%) ispitanika. Nakon donošenja Nacionalnog vodiča dobre kliničke prakse za dijagnostikovanje i lečenje shizofrenije, propisivanje antipsihotične monoterapije antipsihoticima druge generacije bilo je značajno češće u odnosu na prethodni period (78,41% prema 63,5%; p < 0.001). Faktori nezavisno povezani sa poštovanjem preporuka dobre kliničke prakse su bili: starost ordinirajućeg lekara, starost i obrazovanje bolesnika i godina hospitalizacije. Zaključak. Nakon donošenja Nacionalnog vodiča dobre kliničke prakse za dijagnostikovanje i lečenje shizofrenije došlo je do značajnih, ali nedovoljnih promena u obrascima propisivanja antipsihotičke terapije tokom tretmana prve psihotične epizode u Srbiji.
Reference
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