Oral Antikoagülan Kullanan Bireylerde Güvenli İlaç Yönetiminin Değerlendirilmesi

Amaç: Bu araştırma oral antikoagülan (OAK) tedavi uygulanan bireylerde güvenli ilaç yönetimini belirlemek amacıyla tanımlayıcı olarak planlandı. Yöntem: Araştırmanın evreni, Şubat 2011 -Şubat 2012 tarihleri arasında bir üniversitenin, eğitim ve araştırma hastanesinin kardiyoloji poliklinikleri, servisleri ve koroner yoğun bakım ünitelerinde takip edilen ve OAK ilaç kullanan bireylerden, örneklemi ise araştırmanın amacı açıklandıktan sonra bilgilendirilmiş izin alınan ve araştırmanın kriterlerini karşılayan 145 hastadan oluştu. Veriler bireylerin sosyo-demografik, sağlık öyküleri ve tedavi ile ilgili özellikleri, OAK tedaviye yönelik bilgi ve davranışlarını değerlendiren sorulardan oluşan anket formu ile toplandı. Verilerin analizi bilgisayar ortamında SPSS 15.0 paket programı ile analiz edildi. Bulgular: Araştırma sonucunda, bireylerin yaş ortalamasının 53.14±13.83 yıl, %64,1'inin günde 5 mg OAK ilaç kullandığı ve %40'ının ilaç konusunda herhangi bir eğitim almadığı, %75.9 'unun kanama yan etkisi deneyimlediği görüldü. OAK ilaç kullanan bireylerin bilgi ve davranış puan ortalamaları 3.55?2.01 (düşük) ve 7.42?2.03 (yüksek) idi. Bilgi puan ortalaması ile yaş, cinsiyet, öğrenim durumu, eğitim alma ve yan etki yaşama arasında anlamlı ilişki olduğu (p

EVALUATION OF MEDICATION MANAGEMENT SAFETY IN PATIENTS USING ORAL ANTICOAGULANTS

Objective: This study is planned as a descriptive study in order to identify the safe medication for the individuals who are given oral anti-coagulator treatment. Methods: The population of this research involves the patients who take OAC under observation in the outpatient departments and cardiology policlinics, inpatients in cardiology and coronary intensive care of a university hospital between February 2011-February 2012. The sample involves 145 patients having the criteria who had an informed consent after being explained the aim of the research. The data is collected by a questionnaire of questions on socio-demographic features, the treatment they take, and their knowledge, attitudes towards OAC The analysis of data is performed on the computer with SPSS 15 package. Results: As a result of this research, the mean age of the individuals is seen as 53.14±13.83 years. It is also found out that about 64.1% of the patients use 5 mg./day of OAC medication, about 40 % have had no training about the medication, about 75.9% have experienced side effects of bleeding. The mean score of knowledge and attitude of the patients having OAC medication is 3.55?2.01(low) ve 7.42?2.03 (high). It is detected that there is a significant relationship between the mean score of knowledge and age, sex, education level, training and side effect experience (p

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Acaroğlu R ve Şendir M. The importance of patient education in the use of anticoagulants. IU Florence Nightingale Hemsirelik Dergisi. 2001; 12 (47): 69-77.
Ansell EJ, Hirsh J, Hylek E, Jacobson A, Crowther M. and Palareti G. Pharmacology and management of the vitamin K antagonists. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest. 2008; 133: 160-98.
Ansell EJ, Hirsh J, Dalen J, Anderson D, Deykin D. Managing oral anticoagulant therapy. Chest 2001; 119(1): 22-38.
Bajorek BV, Ogle SJ, Duguid MJ, Shenfield GM, Krass I. Management of warfarin in atrial fibrillation: views of health professionals, older patients and their carers. Med J Australia. 2007; 186(4): 175-80.
Barcellona D, Contu P, Marongiu F. Patient education and oral anticoagulant therapy. Haematologica. 2002; 87: 1081-6.
Beyth RJ. Hemorrhagic complications of oral anticoagulant therapy. Clin Geriatr Med. 2001; 17(1): 49-56.
Bhavnani M, Shiach CR. Patient self-management of oral anticoagulation. Clin Lab Haem. 2002; 24: 253-7.
Budnitz DS, Shehab N, Kegle SR, Richards CL. Medication use leading to emergency department visits for adverse drug events in older adults. Ann Inter Med. 2007; 147(11): 755-65.
Campbell JC and Sefton M. Discharge teaching about warfarin: patient retention of knowledge. Home Healthc Nurse. 2010; 28(6): 366-74.
Estrada CA, Hryniewicz MM, Higgs VB, Collins C, Byrd JC. Anticoagulant patient information material is written at high readability levels. Stroke 2000; 31: 2966-70.
Gadisseur APA, Breukink-Engbers WGM, van der Meer FJM, van den Basselaar AMH, Sturk A, Rosendaal FR. Comparison of the quality of oral anticoagulant therapy through patient selfmanagement and management by specialized anticoagulation clinics in the Netherlands. Arch Intern Med. 2003; 163(21): 2639-46.
Hirsh J, Fuster V, Ansell J, Halperin JL. American Heart Association/American College of Cardiology foundation guide to warfarin therapy. Circulation. 2003; 107: 1692-711.
Jaff MR, McMurtry MS, Archer SL. Cushman M, Goldenberg N, Goldhaber SZ, Jenkins JS, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thrombo embolic pulmonary hypertension. Circulation. 2011; 123(16):1788-830.
Jeffree RL, Gordon DH, Sivasubramaniam R, Chapman A. Warfarin related intracranial haemorrhage: A case-controlled study of anticoagulation monitoring prior to spontaneous subdural or intracerebral haemorrhage. J Clin Neurosci. 2009; 16(7): 882-5.
Jones M, McEwan P, Morgan CL, Peters JR, Goodfellow J, and Currie CJ. Evaluation of the pattern of treatment, level of anticoagulation control, and outcome of treatment with warfarin in patients with non-valvar atrial fibrillation: a record linkage study in a large British population. Heart. 2005; 91: 472-7.
Khudair IF, Hanssens YI. Evaluation of patients' knowledge on warfarin in outpatient anticoagulantion clinics in a teaching hospital in Qatar. Saudi Med J. 2012; 31(6): 672-7.
Kuhn MM. Pharmacotherapeutics: A Nursing Process Approach. 3rd ed. USA: F.A. Davis Company Philadelphia, 1994; 742-64.
Mercan S, Enç N. Educational needs of patients with warfarin. J Card Nurs. 2010; 1: 12-7.
Mitchell P. Warfarin and paracetamol do not always mix. The Lancet. 1998. 351, 729.
Moore T, Cohen, M. and Furberg C. (2007). Serious Adverse Drug Events Reported to the Food and Drug Administration, 1998-2005. Arch Intern Med. 167(16): 1752-9
Ouirke W, Cahill M, Perera K and Conway J. Warfarin prevalence, indication for use and haemorrhagic events. Irish Med J. 2007; 100(3),402- 4.
Palareti G, Legnani C, Guazzaloca G, Lelia V, Cosmi B, Lunghi B, Marchetti G, Poli D, and Pengo V. Risks factors for highly unstable response to oral anticoagulation: a case-control study. Br J Haematol. 2005; 129(1): 72-8.
Porter B. The Role of the Advanced Practice Nurse in Anticoagulation. AACN Clin Issues. 2002; 13(2): 221-3.
Rubboli A, Becattini C, Verheugt FWA. Incidence, clinical impact and risk of bleeding during oral anticoagulation therapy. World J Cardiol 2011; 3(11): 351-8.
Sharifi M, Vajo Z, Freeman W, Bay C, Sharifi M, Schwartz F. Transforming and Simplifying the Treatment of Pulmonary Embolism: "Safe Dose" Thrombolysis Plus New Oral Anticoagulants. Lung.2015;193(3): 369-77-.
Uzun S, Arslan F. Nurses' role in education of patients using warfarin. Aylık Bilimsel Dergiler Grubu-Kardiyoloji. 2007; 13(5): 352-4.
Wysowski DK, Nourjah P, Swartz L. Bleeding complications with Warfarin use. Arch Intern Med. 2007; 167(13): 1414-9.
Yaka E, Pekdemir M, Yilmaz S, Akalın E. Assessment of emergency department patients' knowledge on oral anticoagulant therapy. Tr J Emerg Med. 2011; 11(4): 155-60.