Veysel Ozgur BARIŞ, Fatma Tamara KOROĞLU, Kamile SİLAY

BİRİNCİ BASAMAKTA GERİATRİK YAKLAŞIM: KIRSAL BİR BÖLGEDEN OLGULAR

Geriatrik hastalar çok sayıda hastalığa sahip olmaya ve yüksek ilaç yükü altında kalmaya yatkındır. Aile sağlığı merkezleri, yaşlıların muayene ve reçete ihtiyaçları için hastanelere kıyasla daha ulaşılabilir yerlerdir. Kırsal bölgelerde, aile sağlığı merkezlerinin bu uygunluğu daha da önemli hale gelir. Bu durumda, aile hekimleri kırsal bölgede yaşayan yaşlıların yaşadıkları problemleri tespit edecek ve ilaçlarını düzeltip doğru ilaç kullanımını sağlayacak tek doktorlar olmaktadır. Bu makalede, kırsal bir bölge olan Bala’da, aile hekimini ziyaret eden üç geriatrik hasta olası uygunsuz ilaç kullanımı yönünden ele alınmıştır.

GERIATRIC APPROACH IN PRIMARY CARE: CASE REPORTS FROM A RURAL TOWN

Geriatric patients tend to have multiple diseases and a high burden of medication. Primary care centers are more accessible for the elderly to meet their examination and prescription needs compared to hospitals. In rural places, the convenience of primary care centers is far more important. Therefore, family physicians may be the only doctors in rural places to correct and/or supply proper medications as well as detecting ongoing problems of the elderly. In this article, three geriatric patients who visited their family physician in a rural town, Bala, were evaluated in terms of potentially inappropriate drug use.

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1. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019 Apr;67(4):674-94.
2. Bhattacharjee S, Lee JK, Patanwala AE et al. Extent and Predictors of Potentially Inappropriate Antidepressant Use Among Older Adults with Dementia and Major Depressive Disorder. Am J Geriatr Psychiatry. 2019 Aug;27(8):794-805.
3. Kollhorst B, Jobski K, Krappweis J, Schink T, Garbe E, Schmedt N. Antidepressants and the risk of death in older patients with depression: A population-based cohort study. PLoS One. 2019 Apr 15;14(4):e0215289.
4. Anand S, Tamura MK. Combining Angiotensin Receptor Blockers with ACE Inhibitors in Elderly Patients. Am J Kidney Dis. 2012 Jan; 59(1):11–4.
5. Misra S, Stevermer JJ. ACE inhibitors and ARBs: One or the other—not both—for high-risk patients. J Fam Pract. 2009 Jan; 58(1):24–7.
6. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-20.
7. Yakaryılmaz FD, Öztürk Za. Treatment of type 2 diabetes mellitus in the elderly. World J Diabetes. 2017 Jun 15; 8(6): 278–85.
8. Older Adults: Standards of Medical Care in Diabetes—2019 American Diabetes Association Diabetes Care Jan 2019, 42 (Supplement 1) S139-47.
9. Canadian Agency for Drugs and Technologies in Health. Glyburide, Gliclazide or Glimepiride for Elderly Patients with Type 2 Diabetes: A Review of the Clinical Effectiveness and Safety – An Update. CADTH Rapid Response Service. 2015 Aug 18 [Internet] https://www.ncbi.nlm.nih.gov/books/NBK315876/ (Accessed: 01.02.2021)
10. Perissinotto CM, Ritchie C. Atypical Presentations of Illness in Older Adults. In: Williams BA, Chang A, Ahalt C et al. editors. Current Diagnosis & Treatment: Geriatrics 2nd ed. New York: McGraw-Hill; 2014. p. 101-8