(magistrsko delo)
Metka Škofič (Avtor), Tanja Hojs-Fabjan (Mentor), Mateja Lorber (Komentor)

Povzetek

Multipla skleroza (MS) je kronično vnetno avtoimunsko obolenje osrednjega živčnega sistema in je najpogostejši vzrok invalidnosti pri mladih. Ženske zbolevajo pogosteje od moških. Vzrok za bolezen ni poznan, prav tako nimamo zdravila s katerim bi bolezen pozdravili. Imamo pa zdravila s katerimi lahko vplivamo na potek bolezni, z zmanjšanjem števila zagonov, upočasnitvijo napredovanja invalidnosti ter izboljšanja kakovosti življenja. Za slednje je pomembna tudi dobra adherenca jemanja zdravil. Namen raziskave je ugotoviti adherenco zdravljenja, vzroke za izpustitev odmerka zdravila in morebitno potrebo po predčasnem obisku pri zdravniku. Prav tako nas je zanimalo ali sta oblika bolezni ter način jemanja zdravila povezani z adherenco. Metodologija raziskovanja. Raziskovalne metode: V raziskavo smo vključili 90 bolnikov zdravljenih na Oddelku za nevrološke bolezni UKC Maribor Glede na vrsto učinkovine smo bolnike razvrstili v tri skupine po 30 bolnikov. Za ugotavljanje vzrokov in razlogov izpuščenih odmerkov zdravila smo uporabili prirejen anketni vprašalnik (MSTEQ Multiple Sclerosis Experience Questionnare). Vsi bolniki so bili seznanjeni z namenom in vsebino raziskave. Za raziskavo smo pridobili soglasje Komisije za medicinsko etiko UKC Maribor. Rezultati raziskave. V obeh naših skupinah bolnikov zdravljenih s peroralno terapijo smo ugotovili, da jih je 25 % izpustilo odmerek zdravila. Prav tako je v skupini 3, ki je bila na injekcijski terapiji, odstotek bolnikov z izpuščenim odmerkom podoben in znaša 26,7 %. Če upoštevamo kriterij izpuščen ≥1 odmerek, je bila pri naših bolnikih adherenca zdravljenja prisotna kar pri 74,4 % bolnikov z MS. Pri upoštevanju kriterija izpuščenega odmerka ≥ 25 % pa je adherenca 97,4 %. Na podlagi slednjega kriterija smo v vseh treh skupinah dobili visoko adherenco, saj je v skupini 1 bila 99,2 %, v skupini 2 95,2 % in v skupini 3 97,8 %. Ko smo primerjali adherenco posameznih skupin med seboj ter ko smo primerjali skupini na peroralni terapiji z injekcijsko terapijo ni bilo statistično značilnih razlik. Le enemu bolniku (6,7 %) od 15 na peroralni terapiji, ki so izpustili odmerek zdravila, se je zdravstveno stanje spremenilo iv in je potreboval predčasen obisk pri zdravniku. Nobenemu bolniku od osmih, ki so prejemali injekcijsko terapijo in so izpustili odmerek zdravila, se zdravstveno stanje ni spremenilo in nihče ni potreboval zdravniške pomoči. Največ težav so imeli bolniki zaradi občutka pekoče bolečine med injiciranjem (80 %), ter krvavenja na mestu injiciranja (80 %). Najpogostejši vzrok za izpustitev odmerka zdravila pri injekcijski terapiji je bila odsotnost z doma s posledično nedostopnostjo do zdravila. Najpogostejša vzroka izpustitve odmerka peroralne terapije sta bila prezaposlenost (60 %) ter pozabljivost (40 %). Diskusija in zaključek: Pri doseganju adherence smo ugotovili, da je izobraževanje bistvenega pomena. Dobra adherenca je povezana z dobro podporo bolnikov s strani tima za multiplo sklerozo.

Ključne besede

multipla skleroza;adherenca jemanja zdravil;oblike in načini zdravljenja;MSTEQ vprašalnik;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.09 - Magistrsko delo
Organizacija: UM - Univerza v Mariboru
Založnik: [M. Škofič]
UDK: 616.832-004:615.2(043.2)
COBISS: 2411428 Povezava se bo odprla v novem oknu
Št. ogledov: 1109
Št. prenosov: 160
Ocena: 0 (0 glasov)
Metapodatki: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Ostali podatki

Sekundarni jezik: Angleški jezik
Sekundarni naslov: Impact of adherence in the treatment of multiple sclerosis with immunomodulatory agents
Sekundarni povzetek: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of central nervous system and is the most common cause of disability with the youth. Women get sick more often than men do. The reasons for the disease are not know and there is no cure available. However, there are treatments available that can control the progression of the disease, reduce the number of onsets, slow the progression of disability and improve the quality of life. The latter is also influenced by the patients’ adherence. The purpose of the research is to determine adherence, reasons for medication non-compliance and eventual need for preliminary doctor’s visits. We were also interested in whether the type of disease and type of medication are related with adherence. Methods of research Ninety patients from the Department of neurological disease of UKC Maribor were included in the research. Depending on the active substance, the patients were separated in the three groups of 30. To determine the reasons for medication noncompliance we used the modified questionnaire MSTEQ -Multiple Sclerosis Experience Questionnaire. All patients were acquainted with the purpose of the research. The research was approved by Medical Ethics Commission of UKC Maribor. Results We found out that in both our groups of patients, treated with peroral therapy 25 % missed their medication. In the third group which was treated with injections, the noncompliant patients constituted a similar 26,7 %. When the criteria of ≥1 missed medication of medication is taken into consideration, we determined that 74,4 % of patients with MS were adherent. If we apply the criteria of ≥25 % of missed medication we determine the adherence of 97,4 %. Based on the latter criteria we determined the high level of adherence in all three group, resulting in 99,2 % in first group, 95,2 % in second group and 97,8 % in the third group. When we compared the adherence between different groups and between patients on peroral and injection therapies we found no statistical differences. Only one patient of fifteen (6,7 %), receiving peroral therapy that missed the medication experienced the decline in health condition and had to make a preliminary doctor’s appointment. No patients of total eight, receiving vi injection therapy that missed on their medication experienced changes in their health condition and none needed medical aid. The patients had most problems due to the burning sensation when injecting (80 %) and bleeding on the place of injection (80 %). The most common reason for missing the medication with the patients on the injection therapy was being away from home, meaning the unavailability of medication. The most common reason for missing the medication on peroral therapy was being overworked or too busy (60 %) and forgetfulness (40 %). Conclusion We ascertained that the education is essential to achieving adherence. Good adherence is related with good patients support from the medical staff.
Sekundarne ključne besede: multiple sclerosis;adherence;disease modifying treatment;Multiple Sclerosis Treatment Experience Questionnaire;Multiple sclerosis;Medication adherence;Multipla skleroza;Adherenca pri jemanju zdravil;
URN: URN:SI:UM:
Vrsta dela (COBISS): Magistrsko delo/naloga
Komentar na gradivo: Univ. v Mariboru, Fak. za zdravstvene vede
Strani: VII, 45 f., 17 f. pril.
ID: 10922537