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Cilj istraživanja: Cilj je ovog istraživanja procijeniti racionalnost korištenja inhibitora protonske pumpe (IPP) kod bolesnika starije životne dobi i pomoću kriterija sastavljenih prema smjernicama Depreskripcija inhibitora protonske pumpe (Canadian family physician), odrediti udio bolesnika kojima bi depreskripcija IPP-a donijela korist. Ispitanici i metode: Istraživanje je provedeno na uzorku 391 bolesnika starije životne dobi u sklopu EuroAgeism Horizon 2020 projekta. Podaci su prikupljeni u javnim ljekarnama pomoću upitnika razvijenog za potrebe ovog istraživanja. Na temelju smjernica za depreskripciju IPP-a (Depreskripcija inhibitora protonske pumpe, Canadian family physician) definirano je pet kriterija prema kojima se odlučivalo o potrebi za depreskripcijom IPP-a kod bolesnika koji su ih imali u terapiji. Rezultati: U ispitivanju je sudjelovao 391 ispitanik (248 žena i 143 muškarca). Prosječna je dob ispitanika 74,33 (SD=10,65) godine, a u terapiji su imali prosječno šest lijekova. IPP je koristilo 122 (32,0%) ispitanika, a najčešće korišteni bio je pantoprazol. Pomoću kriterija za depreskripciju dobiveni su rezultati da bi 25 (20,5%) ispitanika moglo imati korist od depreskripcije IPP-a. Najviše ispitanika kandidati su za depreskripciju prema kriteriju C: Navedena indikacija za IPP je gastroprotekcija, ali ne postoji jasna potreba za njom, a iza njega slijedi kriterij B: indikacija je prisutna u bolesnikovoj anamnezi, ali ne uključuje dugotrajno korištenje IPP-a, te je trenutno trajanje terapije predugo. Zaključak: Rezultati ovog istraživanja ukazali su na potrebu za racionalnijim korištenjem IPP-a u bolesnika starije životne dobi te su pokazali u kojim bi situacijama bolesnici od depreskripcije mogli imati koristi. Smjernice i kriteriji koji definiraju potrebu za depreskripcijom mogli bi biti vrijedan alat i pridonijeti racionalizaciji uporabe IPP-a. Potencijalna korist depreskripcije bila bi povećanje racionalizacije farmakoterapije IPP-ovima; manji broj lijekova u terapiji, smanjenje mogućnosti pojave interakcija s drugim lijekovima ili nuspojava do kojih može doći zbog dugotrajne primjene te financijska ušteda za zdravstveni sustav i bolesnike. Objectives: The objective of this study was to determine rationality of proton pump inhibitor (PPI) use among older adults and to identify patients who would benefit from PPI deprescription based on deprescribing guidelines (Deprescribing proton pump inhibitors, Canadian Family Physician). Patients and Methods: 391 older adult patients participated in the study which is part of EuroAgeism Horizon 2020 research. Data was collected in community pharmacies using a standardized questionnaire. Based on the deprescribing guidelines for PPI (Deprescribing proton pump inhibitors) five criteria for deprescribing were defined and used to determine the need for deprescribing PPI among the patients that use them. Results: 391 patients participated in this study (248 women and 143 men). On average, they were 74,33 (SD=10,65) years old, and were prescribed on average 6 different medications. 122 patients had PPI in their therapy, and the most commonly used was pantoprazole. Based on deprescription criteria, 25 (20,5%) patients could benefit from deprescription of PPI. The majority of patients are candidates for deprescription primarily according to the criteria C: the indication for PPI use is gastroprotection, but there is no clear need for it, and secondarily criteria B: the indication is present in patient's history, but it doesn't include long-term use of PPI and it is used for too long. Conclusion: The results of this research indicate the need for a more rational use of PPI in older patients and situations where deprescription is recommended and beneficial. Guidelines and criteria which define the need for deprescription could provide a valuable tool for the rationalisation of PPI use. A potential benefit of deprescription would be an increase in rational use of PPI; fewer medications in therapy, reduced risk of interactions with other drugs or side effects that may occur due to long-term use, as well as financial benefits for the healthcare system and the patients. |
