Didem KAFADAR, Ertuğrul OKUYAN, Sercan BULUT, Elvan YAKUPOĞLU

KORONER ARTER HASTALIĞI TANILI HASTALARDATEDAVİYE UYUMUN POLİFARMASİ VEMULTİMORBİDİTE İLE İLİŞKİSİNİNDEĞERLENDİRİLMESİ

Amaç: Koroner arter hastalığı (KAH) tanısı alan hastaların sıklıkla eşlik eden hastalıklarının da olması nedeniyle tedavide birçok ilacın birlikte kullanılmasıyla hastalığın yönetiminde tedaviye uyum önem kazanmaktadır. Tedaviye uyumsuzluk ilaçların doz ve kullanım saatlerine uyulmaması nedeniyle ortaya çıkabilir. Bu çalışmada KAH tanılı hastalarda polifarmasi ve multimorbiditenin tedaviye uyum ile ilişkisinin araştırılması amaçlanmıştır.Materyal ve Metot: Kesitsel bir araştırma olan bu çalışma; polikliniğe başvuran KAH tanısı almış ≥ 40 yaşhastalarla gerçekleştirilmiştir. Araştırmacılar tarafından hazırlanan sosyodemografik özelliklerin, hastalık öykülerinin, ilaç kullanımlarının sorulduğu soru formu yüz yüze görüşmelerde doldurulmuştur. Günlük kullanılan ilaç sayıları

EVALUATION OF THE ASSOCIATION OF MEDICATION ADHERENCE WITH POLYPHARMACY AND MULTIMORBIDITY IN PATIENTS WITH CORONARY ARTERY DISEASE

Objectives: Patients diagnosed with coronary artery disease (CAD) often have comorbidities and many drugsare used together in treatment, so medication adherence becomes important in disease management. Non adherence to treatment may be caused by failure to comply with the dosage and hours of use of the medications. The aim of this study was to investigate the association of polypharmacy and multimorbidity with medicationadherence in patients with CAD. Materials and Methods: This cross-sectional study was conducted with patients≥ 40 years of age who werediagnosed with CAD and admitted to the outpatient clinics. A questionnaire prepared by the researchers aboutsociodemographic characteristics, history of the disease, and medications that were used, during face-to-faceinterviews. Daily medications were evaluated as

PDF

___

1. Milton J, Jackson S. Inappropriate polypharmacy: reducing the burden of multiple medication. Clin Med 2007;7:514–7.
2. Tjia J, Velten SJ, Parsons C, Valluri S, Briesacher BA. Studies to reduce unnecessary medication use in frail older adults: a systematic review. Drugs Aging. 2013;30(5):285-307. (doi: 10.1007/s40266-013- 0064-1).
3. Stefanacci RG, Khan T. Can Managed Care Manage Polypharmacy? Clin Geriatr Med. 2017;33(2):241- 55. (doi: 10.1016/j.cger.2017.01.005).
4. Kronish IM, Ye S. Adherence to cardiovascular medications: lessons learned and future directions. Prog Cardiovasc Dis. 2013;55(6):590–600. (doi:10.1016/j.pcad.2013.02.001).
5. Muszbek N, Brixner D, Benedict A, Keskinaslan A, Khan ZM. The economic consequences of noncompliance in cardiovascular disease and related conditions: a literature review. Int J Clin Pract. 2008;62:338–51.
6. Kumar K, Greenfield S, Raza K, Gill P, Stack R. Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis. BMC Endocr Disord. 2016;16(1):24. (doi: 10.1186/s12902-016-0103-0).
7. Wong MC, Liu J, Zhou S, et al. The association between multimorbidity and poor adherence with cardiovascular medications. Int J Cardiol. 2014;177(2):477-82. (doi: 10.1016/j.ijcard.2014.09.103).
8. Miyazaki M, Nakashima A, Nakamura Y, et al. Association between medication adherence and illness perceptions in atrial fibrillation patients treated with direct oral anticoagulants: An observational cross-sectional pilot study. PLoS One. 2018;13(9):e0204814. (doi:10.1371/journal.pone.0204814).
9. Lee GK, Wang HH, Liu KQ, Cheung Y, Morisky DE, Wong MC. Determinants of medication adherence to antihypertensive medications among a Chinese population using Morisky Medication Adherence Scale. PLoS One.2013;8(4):e62775. (doi:10.1371/journal.pone.0062775).
10. Marcum ZA, Amuan ME, Hanlon JT, et al. Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans. J Am Geriatric Soc. 2012;60:34–41.
11. Martínez-Arroyo JL, Gómez-García A, Sauceda-Martínez D.[Polypharmacy prevalence and potentially inappropriate drug prescription in the elderly hospitalized for cardiovascular disease]. Gac Med Mex. 2014 Dec;150 Suppl 1:29-38.
12. Appleton SC, Abel GA, Payne RA. Cardiovascular polypharmacy is not associated with unplanned hospitalisation: evidence from a retrospective cohort study. BMC Fam Pract. 2014;15:58. (doi: 10.1186/1471-2296-15-58).
13. Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: metaanalysis on 376,162 patients. Am J Med. 2012;125(9):882-7.e1. (doi: 10.1016/j.amjmed.2011.12.013).
14. Benner JS, Glynn RJ, Mogun H, Neumann PJ, Weinstein MC, Avorn J. Long-term persistence in use of statin therapy in elderly patients. JAMA. 2002;288(4):455-61.
15. Newby LK, LaPointe NM, Chen AY, et al. Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease. Circulation. 2006 ;113(2):203-12.
16. Rai M, Kishore J. Myths about diabetes and its treatment in North Indian population. Int J Diabetes Dev Ctries. 2009;29(3):129-32. (doi: 10.4103/0973-3930.54290).
17. Özkan B, Örsçelik Ö, Uyar H, et al. Awareness of Pleiotropic and Cardioprotective Effect of Statins in Patients with Coronary Artery Disease. Biomed Res Int. 2018;2018:8961690. (doi:10.1155/2018/8961690).
18. Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V. Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PLoS One. 2013;8(12):e80633. (doi:10.1371/journal.pone.0080633).
19. Simpson SH, Eurich DT, Majumdar SR, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006 ;333(7557):15. (doi: 10.1136/bmj.38875.675486.55).
20. Yıldırım AB, Kılınç AY. Yaşlı hastalarda polifarmasi ve ilaç etkileşimi. (Polypharmacy and drug interactions in elderly patients). Turk Kardiyol Dern Ars 2017;45 Suppl 5:17–21 (doi: 10.5543/tkda.2017.92770).
21. Shah BM, Hajjar ER. Polypharmacy, adverse drug reactions, and geriatric syndromes. Clin Geriatr Med. 2012;28(2):173-86. (doi: 10.1016/j.cger.2012.01.002).
22. Divchev D, Stöckl G; study investigators. Effectiveness and Impact on Adherence of a New Fixed-Dose Combination of Ivabradine and Metoprolol in a Wide Range of Stable Angina Patients in Real-Life Practice. Cardiol Ther. 2019;8(2):317-28.(doi: 10.1007/s40119-019-00145-7)