Moguće neodgovarajuće propisivanje lekova starijim bolesnicima sa kardiovaskularnim bolestima
Sažetak
Uvod/Cilj. Sve veći broj starijih osoba koristi lekove. Cilj rada bio je da se utvrdi učestalost i prepoznaju faktori rizika od mogućeg neodgovarajućeg propisivanja lekova (MNPL) starijoj populaciji sa kardiovaskularnim bolestima. Metode. Retrospektivnom studijom preseka, sprovedenom tokom 2018. godine, prikupljeni su bitni podaci za period od januara 2016. do decembra 2017. godine. Studijski uzorak obuhvatao je 1 500 bolesnika starijih od 65 godina sa kardiovaskularnim oboljenjima koji su bili korisnici zdravstvenih usluga i imali dostupnu medicinsku dokumentaciju na Institutu za gerontologiju i palijativnu zaštitu, Beograd. Procena MNPL obavljena je upotrebom standardnih međunarodnih kriterijuma poput American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. Rezultati. Učestalost MNPL u starijoj populaciji iznosila je 70,3%. U odnosu na pol, veća učestalost MNPL primećena je kod ispitanika ženskog pola. Prosečan broj propisanih lekova bio je sličan za 2016. i 2017. i iznosio je 7,2 i 7,3 lekova, redom. Najviše su propisivani: benzodiazepini sa srednjim vremenom delovanja (70,9%) centralni α blokatori (23,98%) i antipsihotici (tipični i atipični) (20,94%). Najviše komorbiditeta bilo je u grupi bolesti sa međunarodnom klasifikacijom I00-I99 koja obuhvata bolesti srca i krvnih sudova [n = 2 658 (36,9%)]. Najčešće dijagnoze bile su iz podgrupa: I10-I15 [hipertenzivne bolesti, n = 1 298 (18%)],
I20-I25 [ishemijske bolesti srca, n = 542 (7,5%)], I30-I52 [ostale oblika bolesti srca, n = 705 (9,8%)], I60-I69 [cerebrovaskularne bolesti n = 94 (1,3%)], i I80-I89 [bolesti vena, limfnih sudova i limfnih čvorova n = 12 (0.17%)]. Faktori rizika od MNPL bili su: polifarmacija, pol, upotreba nikotina, kognitivni status, uhranjenost, kao i broj oboljenja zabeležen kod ispitanika. Zaključak. Kardiovaskularne bolesti u starijoj populaciji povezane su sa visokom prevalencijom MNPL. Kreiranje zdravstvenih preporuka za propisivanje lekova starijim osobama koje bi naglasile navedene faktore moglo bi uticati na smanjenje prevalencije MNPL u navedenoj popilaciji.
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