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HUZUREVİNDE YAŞAYAN YAŞLILARDAKİ İLAÇ PROFİLİNİN DEĞERLENDİRİLMESİ: İLAÇ-İLAÇ ETKİLEŞİMİ ANALİZİ

Year 2018, Volume: 25 Issue: 4, 361 - 369, 01.12.2018
https://doi.org/10.17343/sdutfd.403187

Abstract

Giriş: Günümüzde hastalıkların
önlenmesi ve/veya erken dönemde teşhis/tedavi edilmesi ile ortalama yaşam
süresi artmıştır. Artan yaşam süresi kronik hastalıklar nedeniyle polifarmasiyi
beraberinde getirmekte bu nedenle yaşlı bakımında kalitenin azalmasına ve yaşlı
hizmet maliyetinin artışına yol açmaktadır.

Amaç: Bu çalışma Isparta Özel Huzurevi
ve Yaşlı Bakım Merkezi’nde yaşayan yaşlılardaki polifarmasi varlığı, pDDI’ların
sıklığı ve bunların tiplerinin değerlendirilmesini amaçlamaktadır.

Materyal
- Metod:
Bu çalışma Isparta Özel Huzurevi ve Yaşlı Bakım
Merkezi’nde kesitsel tanımlayıcı nitelikte planlandı. Çalışma için Ağustos 2017
tarihinde huzurevinde yaşayan yaşlıların hasta dosyaları tarandı. Veriler
Lexi-Interact programı ile değerlendirildi.

Bulgular: Huzurevinde
yaşayan 61 yaşlının yaş ortalaması 79,16 
± 7,57 (65-94) yıl iken, yaşlıların 24’ü (% 39,3) kadın, 37’si erkek (%
60,7) idi. Huzurevi sakinlerinin huzurevinde kalma süresi ortalama 6,65  ± 8,53 (1- 35 yıl) yıl idi.

Huzurevinde kalan yaşlılarda kronik
hastalık olarak en sık hipertansiyon, gastroözefagial reflu, benign prostat
hipertrofisi ve diabetes mellitus saptandı.

Huzurevinde yaşayan 65 yaş üzeri
yaşlıların kullandıkları ilaçlar değerlendirildiğinde kişi başı ortalama ilaç
sayısı 3,14 ± 2,99 (0-12 adet) olarak bulundu. Polifarmasi ve pDDI arasında
istatistiksel olarak anlamlı bir ilişki tespit edildi (p<0.05)













Tartışma:
Yaşla birlikte artan ko-morbid hastalıklara bağlı polifarmasi ve yaşla birlikte
ortaya çıkan farmakokinetik ve farmakodinamik değişiklikler, yaşlıları advers
ilaç reaksiyonlarına yatkın hale getirir. Bu nedenle huzurevinde kalan
yaşlıların ilaç profilleri değerlendirilirken ilaçların potansiyel etkileşimler
yönünden değerlendirilmesinin uygun olacağı kanaatindeyiz.


‘Evaluation of Drug Profiles in
Elderly Living in Nursing Homes: Drug-Drug Interaction Analysis’

Summary

Introduction: Today, the average life span has
increased with the prevention of diseases and / or early diagnosis / treatment.
Increased life span brings polypharmacy due to chronic diseases, which leads to
decrease of quality in elderly care and increase of elderly service cost.

Objective: This study aims to
evaluate the prevalence of polypharmacy, pDDIs and their types in elderly
living in Isparta Private Nursing Home and Elderly Care Center.

Materials
and methods:

This study was planned as a cross-sectional descriptive feature in Isparta
Private Nursing Home and Elderly Care Center. The patient files of the elderly
living in the nursing home were screened on August 2017 for the study. The data
was evaluated using the Lexi-Interact program.

Findings: The mean age of 61 elderly
living in nursing homes was 79,16 ± 7,57 (65-94) years whereas 24 (39,3%) of
the elderly were female and 37 were male (60,7%). The average length of stay in
nursing home residents was 6.65 ± 8.53 (1- 35 years). Hypertension,
gastroesophageal reflux, benign prostatic hypertrophy and diabetes mellitus
were the most common chronic diseases. The average number of medicines per
person was 3.14 ± 2.99 (0-12). A statistically significant relationship was
found between polypharmacy and pDDI (p = 0,000)

Conclusion: Pharmacokinetic and
pharmacodynamic changes associated with polypharmacy and age associated with
increasing co-morbid diseases with age make the elderly susceptible to adverse
drug reactions. For this reason, we think that it would be appropriate to
evaluate drugs in terms of potential interactions whe
n evaluating
medication profiles of elderly
people living in nursing homes.

References

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  • 2. Kirchmayer U, Mayer F, Basso M, De Cristofaro R, Mores N, Cappai G, et al. Polypharmacy in the elderly: A population based cross-sectional study in Lazio, Italy. Eur Geriatr Med, 2016; 7(5): 484–7.
  • 3. Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf, 2014;13(1): 57-65.
  • 4. Kerry Z. Yaşlılarda doğru ilaç kullanımı Rational drug use in elderly. 2015;62–73.
  • 5. Taşkın Şayir Ç, Aslan Karaoğlu S, Evcik Toprak D. Evaluation of polypharmacy and complementary therapy use in patients >=65 years, attending to Family Medicine Outpatient Clinic of Şişli Etfal Training and Research Hospital. Turkiye Aile Hekim Derg, 2014; 18(1): 35–41. 6. Hovstadius B, Petersson G. Factors Leading to Excessive Polypharmacy. Clin Geriatr Med, 2012; 28(2): 159–72.
  • 7. Olumuyiwa JF, Akinwumi AA, Ademola OA, Oluwole BA, Ibiene E. Prevalence and Pattern of Potential Drug-Drug Interactions among Chronic Kidney Disease patients in South-Western Niger. Niger Postgrad Med J, 2017; 24(2): 88–92.
  • 8. Borges TL, Vedana KGG, Castilho ECD, Miasso AI. Factors Associated with Potential Drug-Drug Interactions in Patients Attended in Primary Health Care: A Focus on Mental Health. Issues Ment Health Nurs, 2017; 0(0): 1–6.
  • 9. Mallet L, Spinewine A, Huang A. Prescribing In Elderly People 2 The challenge of managing drug interactions in elderly people. Lancet, 2007; 370: 185–91.
  • 10. Jazbar J, Locatelli I, Horvat N, Kos M. Clinically relevant potential drug–drug interactions among outpatients: A nationwide database study. Res Soc Adm Pharm , 2017; Available from: http://linkinghub.elsevier.com/retrieve/pii/S1551741117300414
  • 11. van Leeuwen RWF, Brundel DHS, Neef C, van Gelder T, Mathijssen RHJ, Burger DM, et al. Prevalence of potential drug-drug interactions in cancer patients treated with oral anticancer drugs. Br J Cancer, 2013; 108(5): 1071–8.
  • 12. Bjerrum, L Rosholm, JU Hallas, J Kragstrup J. Methods for estimating the occurence of polypharmacy by means of prescrition database. Eur J Clin Pharmacol, 1997; 53(1): 7–11.
  • 13. Özdemir L, Koçoğlu G, Sümer H, Nur N, Polat H, Aker A, et al. Sivas İl Merkezinde Yaşlı Nüfusta Bazı Kronik Hastalıkların Prevalansı ve Risk Faktörleri. C. Ü. Tıp Fakültesi Dergisi, 2005; 27 (3): 89 – 94,
  • 14. Dökmeci D. Yaşlıda Polifarmasi ve Toksisite. Türkiye Klin J Surg Med Sci, 2006; 2(46): 53-8
  • 15. Arslan Ş, Atalay A, Kutsal GY. Yaşlılarda i̇laç tüketi̇mi̇. Turkish J Geriatr, 2000; 3(2): 56–60.
  • 16. Husson N, Watfa G, Laurain M, Perret-Guillaume C, Niemier J, Miger P, et al. Characteristics of polimedicated (>4) elderly: a survey in a community-dwellin population aged 60 years and over. J Nutr Heal Aging, 2014;18(1): 87–91.
  • 17. Niclós G, Olivar T, Rodilla V. A cross-sectional evaluation of the prevalence and detection of predictors of polypharmacy amongst adult in Spain. Int J Pharm Pract, 2017;9–11.
  • 18. Feng X, Tan X, Riley B, Zheng T, T B, U S. Polypharmacy and Multimorbidity Among Medicaid Enrollees: A Multistate Analysis. Popul Heal Manag, 2017; Epub ahead.
  • 19. Goldberg RM, Mabee J, Chan L, Wong S. Drug-drug and drug-disease interactions in the ED: Analysis of a high- risk population. Am J Emerg Med, 1996; 14(5): 447–50.
  • 20. Dookeeram D, Bidaisee S, Paul JF, Nunes P, Robertson P, Maharaj VR, et al. Polypharmacy and potential drug–drug interactions in emergency department patients in the Caribbean. Int J Clin Pharm, 2017 Aug 9. doi: 10.1007/s11096-017-0520-9.
  • 21. Marusic S, Bacic-Vrca V, Obreli Neto PR, Franic M, Erdeljic V, Gojo-Tomic N. Actual drug-drug interactions in elderly patients discharged from internal medicine clinic: A prospective observational study. Eur J Clin Pharmacol, 2013; 69(9): 1717–24.
  • 22. Secoli S-R, Figueras A, Lebrao ML, Dias de Lima F, Santos LF. Risk of Potential Drug-Drug Interactions among brazilian eldery. Drugs Aging, 2010; 27(9): 759–70.
  • 23. Ascı H, Sönmez Y, Cankara Fatma N, Yeşilot Ş, Yıldırım MK. Investigation of the presence of potential drug-drug interactions in the adult intensive care unit : a retrospective study. Med J SDU, 2016; 23(3): 87–96.
  • 24. Johnell K, Klarin I. The relationship between number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register. Drug Saf, 2007; 30(10): 911–8.
  • 25. Gülçebi İM, Küçükibrahimoğlu E, Karaalp A, Sarıkaya Ö, Demirkapu M, Onat F, et al. Potential drug-drug interactions in a medical intensive care unit of a university hospital. Turk J Med Sci, 2016; 46(3): 812–9.
  • 26. Egger S, Drewe J, Schlienger R. Potential drug–drug interactions in the medication of medical patients at hospital dis- charge. Eur J Clin Pharmacol, 2003; 58: 773–8.
  • 27. Luxembourg: Menarini International O.L.S.A. Keral (dexketoprofen) [summary of product characteristics]. [Internet]. 2012. Available from: https://myhealthbox.eu/en/view/1552144/c0fcf0d101a3aeb3ad4ab135c37392ce/leaflet
  • 28. Luxembourg: Menarini International O.L.S.A. Enantyum (dexketoprofen) [summary of product characteristics] [Internet]. 2012. Available from: http://www.shijiebiaopin.net/upload/product/201462920485230.pdf
  • 29. Luxembourg: Menarini International Operation Luxembourg S.A. Ketesse (dexketoprofen) [summary of product characteristics] [Internet]. 2013. Available from: http://www.meppo.com/pdf/drugs/966-KETESSE-1331886339.pdf
Year 2018, Volume: 25 Issue: 4, 361 - 369, 01.12.2018
https://doi.org/10.17343/sdutfd.403187

Abstract

References

  • 1. Bahar A, Parlar S. Yaşlılık ve evde bakım. Fırat Sağlık Hizmetleri Derg, 2007; 2(4): 33–9.
  • 2. Kirchmayer U, Mayer F, Basso M, De Cristofaro R, Mores N, Cappai G, et al. Polypharmacy in the elderly: A population based cross-sectional study in Lazio, Italy. Eur Geriatr Med, 2016; 7(5): 484–7.
  • 3. Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf, 2014;13(1): 57-65.
  • 4. Kerry Z. Yaşlılarda doğru ilaç kullanımı Rational drug use in elderly. 2015;62–73.
  • 5. Taşkın Şayir Ç, Aslan Karaoğlu S, Evcik Toprak D. Evaluation of polypharmacy and complementary therapy use in patients >=65 years, attending to Family Medicine Outpatient Clinic of Şişli Etfal Training and Research Hospital. Turkiye Aile Hekim Derg, 2014; 18(1): 35–41. 6. Hovstadius B, Petersson G. Factors Leading to Excessive Polypharmacy. Clin Geriatr Med, 2012; 28(2): 159–72.
  • 7. Olumuyiwa JF, Akinwumi AA, Ademola OA, Oluwole BA, Ibiene E. Prevalence and Pattern of Potential Drug-Drug Interactions among Chronic Kidney Disease patients in South-Western Niger. Niger Postgrad Med J, 2017; 24(2): 88–92.
  • 8. Borges TL, Vedana KGG, Castilho ECD, Miasso AI. Factors Associated with Potential Drug-Drug Interactions in Patients Attended in Primary Health Care: A Focus on Mental Health. Issues Ment Health Nurs, 2017; 0(0): 1–6.
  • 9. Mallet L, Spinewine A, Huang A. Prescribing In Elderly People 2 The challenge of managing drug interactions in elderly people. Lancet, 2007; 370: 185–91.
  • 10. Jazbar J, Locatelli I, Horvat N, Kos M. Clinically relevant potential drug–drug interactions among outpatients: A nationwide database study. Res Soc Adm Pharm , 2017; Available from: http://linkinghub.elsevier.com/retrieve/pii/S1551741117300414
  • 11. van Leeuwen RWF, Brundel DHS, Neef C, van Gelder T, Mathijssen RHJ, Burger DM, et al. Prevalence of potential drug-drug interactions in cancer patients treated with oral anticancer drugs. Br J Cancer, 2013; 108(5): 1071–8.
  • 12. Bjerrum, L Rosholm, JU Hallas, J Kragstrup J. Methods for estimating the occurence of polypharmacy by means of prescrition database. Eur J Clin Pharmacol, 1997; 53(1): 7–11.
  • 13. Özdemir L, Koçoğlu G, Sümer H, Nur N, Polat H, Aker A, et al. Sivas İl Merkezinde Yaşlı Nüfusta Bazı Kronik Hastalıkların Prevalansı ve Risk Faktörleri. C. Ü. Tıp Fakültesi Dergisi, 2005; 27 (3): 89 – 94,
  • 14. Dökmeci D. Yaşlıda Polifarmasi ve Toksisite. Türkiye Klin J Surg Med Sci, 2006; 2(46): 53-8
  • 15. Arslan Ş, Atalay A, Kutsal GY. Yaşlılarda i̇laç tüketi̇mi̇. Turkish J Geriatr, 2000; 3(2): 56–60.
  • 16. Husson N, Watfa G, Laurain M, Perret-Guillaume C, Niemier J, Miger P, et al. Characteristics of polimedicated (>4) elderly: a survey in a community-dwellin population aged 60 years and over. J Nutr Heal Aging, 2014;18(1): 87–91.
  • 17. Niclós G, Olivar T, Rodilla V. A cross-sectional evaluation of the prevalence and detection of predictors of polypharmacy amongst adult in Spain. Int J Pharm Pract, 2017;9–11.
  • 18. Feng X, Tan X, Riley B, Zheng T, T B, U S. Polypharmacy and Multimorbidity Among Medicaid Enrollees: A Multistate Analysis. Popul Heal Manag, 2017; Epub ahead.
  • 19. Goldberg RM, Mabee J, Chan L, Wong S. Drug-drug and drug-disease interactions in the ED: Analysis of a high- risk population. Am J Emerg Med, 1996; 14(5): 447–50.
  • 20. Dookeeram D, Bidaisee S, Paul JF, Nunes P, Robertson P, Maharaj VR, et al. Polypharmacy and potential drug–drug interactions in emergency department patients in the Caribbean. Int J Clin Pharm, 2017 Aug 9. doi: 10.1007/s11096-017-0520-9.
  • 21. Marusic S, Bacic-Vrca V, Obreli Neto PR, Franic M, Erdeljic V, Gojo-Tomic N. Actual drug-drug interactions in elderly patients discharged from internal medicine clinic: A prospective observational study. Eur J Clin Pharmacol, 2013; 69(9): 1717–24.
  • 22. Secoli S-R, Figueras A, Lebrao ML, Dias de Lima F, Santos LF. Risk of Potential Drug-Drug Interactions among brazilian eldery. Drugs Aging, 2010; 27(9): 759–70.
  • 23. Ascı H, Sönmez Y, Cankara Fatma N, Yeşilot Ş, Yıldırım MK. Investigation of the presence of potential drug-drug interactions in the adult intensive care unit : a retrospective study. Med J SDU, 2016; 23(3): 87–96.
  • 24. Johnell K, Klarin I. The relationship between number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register. Drug Saf, 2007; 30(10): 911–8.
  • 25. Gülçebi İM, Küçükibrahimoğlu E, Karaalp A, Sarıkaya Ö, Demirkapu M, Onat F, et al. Potential drug-drug interactions in a medical intensive care unit of a university hospital. Turk J Med Sci, 2016; 46(3): 812–9.
  • 26. Egger S, Drewe J, Schlienger R. Potential drug–drug interactions in the medication of medical patients at hospital dis- charge. Eur J Clin Pharmacol, 2003; 58: 773–8.
  • 27. Luxembourg: Menarini International O.L.S.A. Keral (dexketoprofen) [summary of product characteristics]. [Internet]. 2012. Available from: https://myhealthbox.eu/en/view/1552144/c0fcf0d101a3aeb3ad4ab135c37392ce/leaflet
  • 28. Luxembourg: Menarini International O.L.S.A. Enantyum (dexketoprofen) [summary of product characteristics] [Internet]. 2012. Available from: http://www.shijiebiaopin.net/upload/product/201462920485230.pdf
  • 29. Luxembourg: Menarini International Operation Luxembourg S.A. Ketesse (dexketoprofen) [summary of product characteristics] [Internet]. 2013. Available from: http://www.meppo.com/pdf/drugs/966-KETESSE-1331886339.pdf
There are 28 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Mehtap Savran 0000-0002-7933-0453

Halil Aşcı

Publication Date December 1, 2018
Submission Date March 8, 2018
Acceptance Date April 12, 2018
Published in Issue Year 2018 Volume: 25 Issue: 4

Cite

Vancouver Savran M, Aşcı H. HUZUREVİNDE YAŞAYAN YAŞLILARDAKİ İLAÇ PROFİLİNİN DEĞERLENDİRİLMESİ: İLAÇ-İLAÇ ETKİLEŞİMİ ANALİZİ. Med J SDU. 2018;25(4):361-9.

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