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Paper presented at a conference

Paper presented at a conference

Paper presented at a conference

Uvod rada Padovi i prijelomi značajni su uzroci morbiditeta i mortaliteta u osoba starije životne dobi. Otprilike svaka četvrta starija osoba padne svake godine, pri čemu 20 – 30% pretrpi umjerene do teške ozljede. Pad je definiran kao neočekivan događaj u kojemu osoba ostane nepokretno ležati na tlu ili nekoj drugoj čvrstoj podlozi. Značajan razlog bolničkog prijema svih dobnih skupina predstavljaju padovi i ozljede uzrokovane padovima i snažni su prediktivni čimbenik smještaja u starački dom bolesnika starije životne dobi. Mogućnosti za potpuni oporavak nakon teške ozljede uzrokovane padom su niske. Uočeno je preko 400 rizičnih čimbenika koji mogu dovesti do pada, pri čemu su najvažniji problemi mobilnosti i korištenje lijekova koji povećavaju rizik od pada (engl. fall-risk increasing drugs, FRIDs). Identifikacija čimbenika rizika za padove mogla bi dovesti do razvoja preventivnih strategija s ciljem poboljšanja kvalitete života, smanjenja prijevremene smrtnosti i zdravstvenih troškova. Svrha rada Svrha rada bila je utvrditi učestalost padova u osoba starije životne dobi, te istražiti čimbenike koji su povezani s padovima u ispitivanoj populaciji. Metode Opservacijsko istraživanje obuhvatilo je 164 starije osobe u dobi od 65 godina i više, koje imaju u kroničnoj terapiji propisan barem jedan lijek. Ispitivanje je provedeno u javnim ljekarnama na području grada Zagreba, Zagrebačke i Varaždinske županije, u razdoblju od lipnja 2019. do svibnja 2021. godine. Provedbu istraživanja odobrilo je Povjerenstvo za etičnost eksperimentalnog rada (PEER) Farmaceutsko-biokemijskog fakulteta Sveučilišta u Zagrebu. Podatci o ispitanicima prikupljeni su ispunjavanjem upitnika, razvijenog za potrebe istraživanja EuroAgeism. Upitnik je preveden na hrvatski jezik metodom dvostrukog prijevoda te prilagođen nakon pilotiranja na manjem uzorku ispitanika. Dijelovi upitnika korišteni u ovom istraživanju su: sociodemografske karakteristike (dob i spol), procjena sindroma krhkosti (eng. frailty), klinički podaci (simptomi, dijagnoze i terapija) i padovi (jesu li bili prisutni i kada). Analiza FRID ova učinjena je upotrebom STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk) alata. Skupine lijekova uključene u ovo istraživanje su: antikolinergici, diuretici, alfa-blokatori (korišteni kao antihipertenzivi), opioidi, antidepresivi, antipsihotici, antiepileptici, benzodiazepini i benzodiazepinima-slični lijekovi. Za svakog ispitanika određen je ukupan broj FRID-ova koji čini zbroj svih propisanih lijekova iz gore navedenih skupina. Za prikaz rezultata i statističku obradu podataka korišteni su računalni programi Microsoft Excel, Microsoft office (Microsoft, SAD), Canva (Canva Pty Ltd, Australija) i IBM SPSS verzija 20.0 (Armonk, NY: IBM Corp., 2011). Statističko testiranje provedeno je na razini značajnosti od 95% odnosno razlika se smatrala statistički značajnom ukoliko je p- vrijednost bila manja od 0, 05 (α =0, 05). Rezultati Od ukupno 164 ispitanika, veći udio čini ženski spol (63%). Prosječna dob ispitanika iznosila je 74, 8 ± 7, 0 godine, raspon dobi 65-92 godine. U svrhu analiza ispitanici su bili podijeljeni u tri dobne skupine: rana starost (65 –74), srednja starost (75 – 84) i duboka starost (85 i više godina). Ispitanici su najčešće bolovali od hipertenzije (71, 7%), oštećenog vida (51, 2%) i dislipidemije (48, 2%), a najčešće su imali simptome nikturije (34, 3%), žgaravice (31, 9%) i nestabilnog hoda (30, 1%). Pri procjeni krhkosti, 109 (66, 5%) ispitanika procijenjeno je da nije krhko, 54 (32, 9%) kao krhko te jedan ispitanik (0, 6%) kao ozbiljno krhak. Padovi su bili zabilježeni kod 102 (62, 2%) ispitanika, a 48 (29, 3%) ispitanika prošle godine palo je jedan ili više puta. Padovi su uočeni kod 71 (68, 3%) žene i 31 (51, 7%) muškarca, a pad u posljednjih 12 mjeseci navelo je 34 (32, 7%) žena i 14 (23, 3%) muškaraca. Kao uzroke padova ispitanici su naveli poskliznuće (22 ispitanika), spotaknuće (11 ispitanika), nesmotrenost (10 ispitanika) i gubitak ravnoteže (8 ispitanika), dok 18 ispitanika nije znalo navesti uzrok pada. Primjena FRIDova bila je zabilježena kod 115 (70, 1%) ispitanika pri čemu je jedan FRID u terapiji imalo 58 (35, 4%) ispitanika. Istražena je povezanost između padova u posljednjih 12 mjeseci i pojedinih karakteristika ispitanika (spol, dob, prisutnost FRID-ova u terapiji i prisutnosti sindroma krhkosti). Nađena je statistički značajna povezanost između padova i FRID ova u terapiji (p=0, 047) te sindroma krhkosti (p=0, 004), dok povezanost s dobi (p=0, 289) i spolom (p=0, 205) nije uočena. Ispitanici koji su imali FRID-ove u terapiji i kod kojih je bio prisutan sindrom krhkosti češće su iskusili pad u posljednjih 12 mjeseci. Zaključak Dobiveni rezultati ukazuju da su osobe koje su u posljednjih 12 mjeseci iskusile pad imale veći broj FRID-ova u terapiji, kao i da je broj padova bio veći u krhkijih bolesnika. Istraživanje ukazuje na potrebu praćenja i utjecaja na čimbenike koji mogu dovesti do padova osoba starije životne dobi. Uočena je potreba za racionalnijom primjenom FRID-ova u starijih osoba te provođenje daljnjih istraživanja usmjerenih na praćenje čimbenika rizika koji mogu dovesti do padova u osoba starije životne dobi. U buduća istraživanja trebalo bi uključiti različite alate i veći broj ispitanika u različitim okruženjima

Uvod rada Demografsko starenje stanovništva spada među najznačajnije trendove posljednjih nekoliko desetljeća i čini veliki javnozdravstveni izazov. U svrhu poboljšanja kvalitete života starijih osoba, važno je istražiti njihove poglede na zdravlje i doživljaj vlastitog zdravlja uključujući i čimbenike koji mogu utjecati na njega, posebice one povezane s terapijom lijekovima. Svrha rada Svrha rada bila je utvrditi čimbenike rizika (sociodemografske čimbenike, čimbenike povezane s bolestima i korištenjem lijekova) koji utječu na doživljaj vlastitog zdravlja kod funkcionalno nezavisnih starijih pacijenata. PS-15 Klinička farmacija u sustavu zdravstva: MOGUĆNOSTI I IZAZOVI 126 Metode Istraživanje je provedeno u javnim ljekarnama na području Grada Zagreba, Slavonije i Istre u sklopu projekta Horizon 2020 EuroAgeism. U istraživanje su uključeni ispitanici koju su zadovoljili uključne kriterije (dob ≥ 65 godina te propisan barem jedan lijek na recept). Ispitanici su dobrovoljno potpisali informirani pristanak prije početka istraživanja. Podaci su prikupljani korištenjem strukturiranog, standardiziranog upitnika koji je razvijen za potrebe projekta EuroAgeism. U analizi dobivenih rezultata korištene su deskriptivne i interferencijalne statističke metode, p

Conference paper

Background and Objective: The aim of this study was to explore the association between number of prescribed medications and their impact on frequency of falls and hospitalizations in community-re siding older adults. Method: This observational, cross-sectional study was conducted as part of the EUROAGEISM H2020 ESR 7 project. Presented data are preliminary and include 84 adults aged C 65 years who attended three community pharmacies in the City of Zagreb. Data were collected using structured, standardized questionnaire developed for the purpose of the EUROAGEISM H2020 project. Descriptive and inferential statistical methods were applied to analyse data using IBM SPSS v 20. Main outcome measures: Association between number of prescribed medications and the incidence of falls and hospitalizations in the last 12 months. Results: Final analysis included 84 participants (67.9% female ; median age 73 (IQR 68–80)). Every participant used on average 5, 62±2, 916 prescribed medications, while polypharmacy (5+medi cations) was identified in 51 (60, 7%) of them. Use of at least one medication from the benzodiazepine drug class was observed in 32 (38, 1%) of the participants, with females using them statistically significantly more often than males (V2 (1) = 4, 251, p\0, 05). Of the total number of participants, 57 (67, 9%) experienced a fall in the past, of which 17 (20, 2%) in the last 12 months. Female participants have fallen statistically significantly more often in the past than males (V2 (1) = 4, 673, p\ 0, 05). Only 12 (14.3%) participants were hospi talized in the last 12 months, while men were statistically significantly more often hospitalized than women (V2 (1) = 4, 403, p\ 0, 05). A positive trend was observed showing that higher number of medica tions were prescribed in participants who fell (6.00 ± 2.716 vs. 5.52 ± 2.976 ; p[ 0.05) or were hospitalized (6.58 ± 2.937 vs. 5.46 ± 2, 902 ; p[ 0.05) in the last 12 months, however, the statistical sig nificance was not confirmed. Conclusion: This study provides preliminary results regarding asso ciation between number of medications prescribed and frequency of falls and hospitalizations in community-residing older adults in the City of Zagreb and indicates the importance of pharmacotherapy optimisation in this vulnerable age group. Grant support: EuroAgeism H2020 MSCF-ITN-764632, Inomed NO.CZ.02.1.01/0.0/0.0/18_069/0010046, Progress Q42- Faculty of Pharmacy, Charles University, START/MED/093 CZ.02.2.69/0.0/0.0/ 19_073/0016935, SVV 260551 and ICARE4OLD H2020 -96534.

Conference paper

Journal Article

Paper presented at a conference

Paper presented at a conference

Patient factor such as older age is one of the key factors that influence medication adherence. The number of people over 65 years of age is increasing in Serbia and thus the number of patients with chronic conditions which leads to increased number of medication used. The study about the medication use in Serbian patients over 65 years was a part of the European Union’s Horizon 2020 EuroAgeism project. The questionnaire used for this study was designed by the main research institution Charles University, Faculty of Pharmacy in Hradec Kralove. The study included 450 patients over 65 years. Patients were recruited by pharmacists and data were collected in community pharmacies in three cities located in geographically different regions in Serbia (150 patients from each city). The self-reported medication adherence was estimated as a percentage value, from 0% as non-adherent to 100% as total adherent patient. Most of the patients were female (59.1%) and was old in average 73.0 years (SD=6.9, Range: 65-93). The average number of prescribed medications was 5.0 (SD=2.7, Range:1-14, Med=5) and the most prevalent was cardiovascular disease (89.1%). The average value of self-reported medication adherence was 92.4% (SD=13.4). The most common reasons for non–adherence were forgetfulness (55.8%), fear of side effects/addiction because of taking too many medications (11.0%), high price (8.7%), and complexity of medication regimen (8.7%). Correlation between number of drugs and adherence value was positive, but not statistically significant (ρ=0.06, p>0.05). This study has confirmed that older patients tend to take multiple medications in a day. Even though our expectation was that more drugs would affect medication adherence, the correlation was not statistically significant. Since forgetfulness is the most common cause of non-adherence, community pharmacists should remind patients more about the proper medication use.

Paper presented at a conference

Paper presented at a conference

Paper presented at a conference

Paper presented at a conference

Background and Objective: Self-reported health status is shown to be a potent indicator of patients’ overall health prognosis and some health-related outcomes. The aim of our study was to explore various risk factors (sociodemographic, clinical and medication-related) that significantly correlate with self-reported poor health status in com munity-residing older patients in Croatia. Method: 210 patients aged 65 years and older attending community pharmacies in 3 different regions of Croatia (Zagreb, Istria and Slavonia) were prospectively assessed using method of comprehen sive geriatric assessment with the EUROAGEISM H2020 ESR7 study protocols (Jun2019– Jan2020). Descriptive and inferential statistical methods were applied to analyse data by the SPSS statistical program vers. 20. Main outcome measures: Correlation between older patients’ self reported poor health and sociodemographic, clinical and medication related risk factors was tested. Results: The mean age of study participants was 74.7±6.6 years and the majority were female (64.8%). 50.5% patients reported their health status to be good or very good, 39.0% as moderate and 10.5% as poor or very poor. Male patients and patients 80 years and older perceived their health to be poorer (r= - 0.231, p=0.001 ; r=- 0.182, p=0.009), as well as patients using polypharmacy (C 5 medications, 61.0%) (r=- 0.162, p=0.019). Statistically significant correlation was found also between self-reported poorer health and nonadherence to medication therapy (r=0.149, p=0.031). Conclusion: Self-reported poorer health in community-residing older adults in our study correlated with some unaffected risk factors as male gender and higher age, but also with modifiable correlates as polypharmacy and nonadherence to medication therapy. The last two risk factors might be positively influenced by early clinical pharmacy interventions and pharmacotherapy optimisation. Grants: EuroAgeism Horizon 2020 MSCF-ITN-764632, Inomed NO.CZ.02.1.01/0.0/0.0/18_069/0010046, Progress Q42- Faculty of Pharmacy, Charles University, START/MED/093 CZ.02.2.69/0.0/0.0/ 19_073/0016935, SVV260 551 and I-CARE4OLD H2020 -965341

Paper presented at a conference

Paper presented at a conference

Paper presented at a conference

Paper presented at a conference