HUZUREVİNDE YAŞAYAN YAŞLILARDAKİ İLAÇ PROFİLİNİN DEĞERLENDİRİLMESİ: İLAÇ-İLAÇ ETKİLEŞİMİ ANALİZİ

Giriş: Günümüzde hastalıkların önlenmesi ve/veya erken dönemde teşhis/tedavi edilmesi ile ortalama yaşam süresi artmıştır. Artan yaşam süresi kronik hastalıklar nedeniyle polifarmasiyi beraberinde getirmekte bu nedenle yaşlı bakımında kalitenin azalmasına ve yaşlı hizmet maliyetinin artışına yol açmaktadır.Amaç: Bu çalışma Isparta Özel Huzurevi ve Yaşlı Bakım Merkezi’nde yaşayan yaşlılardaki polifarmasi varlığı, pDDI’ların sıklığı ve bunların tiplerinin değerlendirilmesini amaçlamaktadır.Materyal - Metod: Bu çalışma Isparta Özel Huzurevi ve Yaşlı Bakım Merkezi’nde kesitsel tanımlayıcı nitelikte planlandı. Çalışma için Ağustos 2017 tarihinde huzurevinde yaşayan yaşlıların hasta dosyaları tarandı. Veriler Lexi-Interact programı ile değerlendirildi.Bulgular: Huzurevinde yaşayan 61 yaşlının yaş ortalaması 79,16 ± 7,57 (65-94) yıl iken, yaşlıların 24’ü (% 39,3) kadın, 37’si erkek (% 60,7) idi. Huzurevi sakinlerinin huzurevinde kalma süresi ortalama 6,65 ± 8,53 (1- 35 yıl) yıl idi.Huzurevinde kalan yaşlılarda kronik hastalık olarak en sık hipertansiyon, gastroözefagial reflu, benign prostat hipertrofisi ve diabetes mellitus saptandı.Huzurevinde yaşayan 65 yaş üzeri yaşlıların kullandıkları ilaçlar değerlendirildiğinde kişi başı ortalama ilaç sayısı 3,14 ± 2,99 (0-12 adet) olarak bulundu. Polifarmasi ve pDDI arasında istatistiksel olarak anlamlı bir ilişki tespit edildi (p<0.05) Tartışma: Yaşla birlikte artan ko-morbid hastalıklara bağlı polifarmasi ve yaşla birlikte ortaya çıkan farmakokinetik ve farmakodinamik değişiklikler, yaşlıları advers ilaç reaksiyonlarına yatkın hale getirir. Bu nedenle huzurevinde kalan yaşlıların ilaç profilleri değerlendirilirken ilaçların potansiyel etkileşimler yönünden değerlendirilmesinin uygun olacağı kanaatindeyiz.‘Evaluation of Drug Profiles in Elderly Living in Nursing Homes: Drug-Drug Interaction Analysis’SummaryIntroduction: Today, the average life span has increased with the prevention of diseases and / or early diagnosis / treatment. Increased life span brings polypharmacy due to chronic diseases, which leads to decrease of quality in elderly care and increase of elderly service cost.Objective: This study aims to evaluate the prevalence of polypharmacy, pDDIs and their types in elderly living in Isparta Private Nursing Home and Elderly Care Center.Materials and methods: This study was planned as a cross-sectional descriptive feature in Isparta Private Nursing Home and Elderly Care Center. The patient files of the elderly living in the nursing home were screened on August 2017 for the study. The data was evaluated using the Lexi-Interact program.Findings: The mean age of 61 elderly living in nursing homes was 79,16 ± 7,57 (65-94) years whereas 24 (39,3%) of the elderly were female and 37 were male (60,7%). The average length of stay in nursing home residents was 6.65 ± 8.53 (1- 35 years). Hypertension, gastroesophageal reflux, benign prostatic hypertrophy and diabetes mellitus were the most common chronic diseases. The average number of medicines per person was 3.14 ± 2.99 (0-12). A statistically significant relationship was found between polypharmacy and pDDI (p = 0,000)Conclusion: Pharmacokinetic and pharmacodynamic changes associated with polypharmacy and age associated with increasing co-morbid diseases with age make the elderly susceptible to adverse drug reactions. For this reason, we think that it would be appropriate to evaluate drugs in terms of potential interactions when evaluating medication profiles of elderly people living in nursing homes.

Anahtar Kelimeler:

Yaşlı, Huzurevi, Polifarmasi

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