Gözde IŞIK, Meltem ÖZDEN YÜCE, Banu ÖZVERİ KOYUNCU, Aliye MANDIRACIOĞLU

İlaç kullanımına bağlı gelişen çene osteonekrozu: bir grup tıp doktorunun farkındalığı ve bilgi düzeyleri

Amaç: Bu çalışma, bifosfonatların (BPs) yan etkilerine karşı tıp hekimlerinin bilgisi ve farkındalık seviyesini değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Bu kesitsel çalışma Tıp Fakültesi Hastanesinde gerçekleştirilmiştir. Veriler, BPs reçete eden iç hastalıkları (onkolog, endokrinolog ve romatolog) ortopedi, fizik tedavi, kadın doğum ve hastalıkları ve üroloji araştırma görevlilerine uygulanan anket sorularıyla toplanmıştır. Sorular mesleki yıl, ilaçla ilgili bilgi verme, ilacı reçete etmeden önce ve reçete ettikten sonra diş hekimine yönlendirme, ilaç kullanımına bağlı gelişen çene osteonekrozu (MRONJ) deneyimi ve BPs alım şekli ile kesilmesi gibi tedavi modifikasyonlarından oluşmaktadır. Bulgular: 106 araştırma görevlisinin 91’i hastalarını bifosfonat ile tedavi etmektedir. Bunların %89’u hastalara ilacın yan etkilerinden bahsetmesine rağmen, sadece %16,5’u bifosfonat reçete etmeden önce hastalarını diş hekimine konsülte etmektedir. Dental yönlendirme fizik tedavi, iç hastalıkları, kadın doğum ve hastalıkları, üroloji ve ortopedi olacak şekilde azalarak devam etmektedir. İstatistiksel olarak bilgi düzeyi ve çalışma yılı arasında belirgin bir farklılık olmamakla birlikte (p=0.3) uzmanlık dalına göre ortopedistlerin bilgi düzeyi ve farkındalığı daha düşük bulunmuştur (p=0.02). Sonuç: BPs reçete eden araştırma görevlileri MRONJ riskinin çoğunlukla farkında değildir. Bu yüzden eğitim programlarının devamlılığı ve hekimler arası iş birliği, farkındalığın arttırılması için gereklidir.

Anahtar Kelimeler:

ilaç kullanımına bağlı gelişen çene osteonekrozu, ilaç yan etkileri, bilgi düzeyi, farkındalık

Medication-related osteonecrosis of the jaw: awareness and level of knowledge of a group of Turkish physicians

Background: The aim of this study was to evaluate physicians’ level of knowledge and awareness regarding the side effects of bisphosphonates (BPs). Methods: A cross-sectional descriptive study was conducted at University Hospital. Data were collected through a self-administered questionnaire given to a group of research assistants all of whom were required to prescribe BPs, including internists (oncologists, endocrinologists and rheumatologists), orthopaedic specialists, physiotherapists, obstetricians and gynaecologists, and urologists. The questionnaire consisted of a range of questions covering such matters as length of time in occupation, how information is given out, whether a dentist is consulted before or in the course of prescribing the medicine, and previous experience of medication-related osteonecrosis of the jaw (MRONJ) and any treatment modifications. Results: Ninety-one out of 106 physicians included in our sample were found to be treating patients with BPs. Although 89% of the physicians informed their patients about the side effects of BPs, only 16.5% advised their patients to consult a dentist for dental treatment before prescribing BPs. When the different specialist groups were ranked in terms of their rate of dental referrals, from highest to lowest, the order was as follows: physiotherapists, internists, obstetricians and gynaecologists, urologists and orthopaedists. A statistically significant correlation was found between knowledge and specialty (p=0.02), but no significant correlation was observed between knowledge and years of experience (p=0.3). Conclusion: There is a lack of awareness among research assistants about the risk of MRONJ when prescribing BPs. Therefore, continuous education programmes and multiple interventions are needed to increase awareness.

Keywords:

medication-related osteonecrosis of the jaw, drug related side-effects, knowledge, awareness,

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