Öz
Amaç
Bu çalışmada toplum eczanelerinde yaşlılarda uygunsuz reçete kalıplarının belirlenmesine olanak sağlayan bir klinik karar destek sistemi (KKDS) tasarlanması ve değerlendirilmesi amaçlanmıştır.
Yöntemler
Çalışma, 6 aylık bir süre boyunca 20 toplum eczanesinde 65 yaş ve üstü hastalarda yürütülmüştür. Yaşlı hastaların reçetelerinin potansiyel uygunsuz ilaçlar (PUİ) varlığı açısından otomatik olarak kontrol edilmesine olanak sağlayan bir KKDS geliştirilmiş ve eczane otomasyon sistemlerine entegre edilmiştir. Eczacının tercihine bağlı olarak öneriler reçeteyi yazan doktora iletilmiş ya da iletilmemiştir. PUİ’lerin sayısı ve özellikleri, reçete yazan doktorların önerileri kabul etme durumu ve KKDS’nin kullanılabilirliği kaydedilmiştir.
Bulgular
Altı aylık dönem boyunca her biri ayrı bir hastaya ait 1250 reçete değerlendirilmiştir. Hastaların medyan (çeyrekler arası aralık) yaşı 73 (63-81) idi. Hastaların %59’unun en az bir PUİ’ye sahip olduğu ve toplam PUİ sayısının 1359 olduğu tespit edilmiştir. En sık karşılaşılan PUİ’ler proton pompası inhibitörleri (%16) ve selektif beta-blokerlerdir (%11,9). Eczacılar, PUİ içeren reçetelerin %24,4’ü ile ilgili olarak reçeteyi yazan doktorla iletişim kurmuş ve önerilerin %85,8’i doktorlar tarafından kabul etmiştir. KKDS’nin kullanılabilirliği iyi olarak bulunmuştur.
Sonuç
Bu ürünün yaygın kullanımının ilaca bağlı advers olayları, hastaneye yatışları, morbiditeleri ve mortaliteleri önleyeceği; böylece hem hastaların sağlık ve yaşam kalitesinde, hem de sağlık çıktılarının klinik, insani ve ekonomik düzeylerinde iyileşmelere yol açacağı öngörülmektedir.
Anahtar Kelimeler: Klinik karar destek sistemi, toplum eczanesi, yaşlı, geriatrik, potansiyel uygunsuz ilaç
Kaynakça
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