Determining therapeutic problems of patients with diseases of the nervous system collected during vocational training

Cilj istraživanja: Cilj ovog diplomskog rada bio je utvrditi terapijske probleme i njihove uzroke prisutne kod pacijenata koji boluju od bolesti živčanog sustava te ih usporedit s terapijskim problemima i uzrocima terapijskih problema prepoznatih od strane studenata na Stručnom osposobljavanju u javnoj ljekarni tijekom pete godine studija farmacije na Farmaceutsko-biokemijskom fakultetu Sveučilišta u Zagrebu. Ispitanici i metode: Provedena je opservacijska retrospektivna studija koja je uključivala analizu podataka prikupljenih od strane studenata u javnim ljekarnama za vrijeme Stručnog osposobljavanja u razdoblju od travnja 2019. do svibnja 2020. Prikupljeni su podaci o općim karakteristikama pacijenta, prisutnim komorbiditetima, lijekovima u terapiji, prepoznatim terapijskim problemima i njihovim uzrocima te o planu ljekarničke skrbi. Za identifikaciju terapijskih problema korišten je alat razvijen od strane Cipolle i suradnika. Nakon određivanja terapijskih problema i njihovih uzroka, procijenjena je uspješnost određivanja terapijskih problema od strane studenata. Rezultati: Ukupno je obrađeno 70 pacijenata od kojih je 47 (60,14%) žena i 23 (32,85%) muškaraca. Srednja vrijednost životne dobi iznosila je 53,84±17,2, prosječan broj komorbiditeta 4,47±2,00, a prosječan broj lijekova u terapiji 6,27±2,38. Ukupno je prepoznato 215 terapijskih problema svaki pacijent imao je barem jedan terapijski problem dok je prosječan broj terapijskih problema iznosio 3,07±1,41. Najviše terapijskih problema utvrđeno je u kategoriji indikacija (n=80, 37,21%), zatim u kategoriji sigurnost (n=76, 35,35%), slijedi kategorija učinkovitost (n=35, 16,28%) te na posljednjem mjestu nalazila se kategorija suradljivost (n=24, 11,16%). Od ukupnog broja terapijskih problema studenti su prepoznali i ispravno kategorizirali njih 16 (7,44%), 60 terapijskih problema (27,91%) ostalo je u potpunosti neprepoznato, dok su ostali terapijski problemi bili prepoznati ali netočno klasificirani. Zaključak: Iz svega navedenog možemo zaključiti da je kod pacijenata s bolestima živčanog sustava prisutan veliki broj terapijskih problema. Vrlo je važno pravovremeno prepoznati terapijske probleme i njihove uzroke te ih spriječiti kako bi se osigurali pozitivni ishodi liječenja i kako bi se smanjili troškovi u zdravstvu. S obzirom na uspješnost prepoznavanja terapijskih problema možemo zaključit da studenti nisu dovoljno upoznati s terapijskim problemima i njihovom kategorizacijom te da je potrebno dodatno se posvetiti njihovoj edukaciji s ciljem razvoja kompetentnih stručnjaka koji će nakon završetka fakulteta moći adekvatno pružati ljekarničku skrb.Research objectives: The objective of this study was to determine therapeutic problems and their causes present in patients with diseases of the nervous system and compare them with therapeutic problems and causes of therapeutic problems identified by students in vocational training in public pharmacy during the fifth year of pharmacy study on Faculty of Pharmacy and Biochemistry, University of Zagreb. Subjects and methods: An observational retrospective study was conducted that included an analysis of data collected by students in public pharmacies during the vocational training in the period from April 2019 to May 2020. Data were collected on general patient characteristics, present comorbidities, drugs in therapy, identified therapeutic problems and their causes, and a pharmacy care plan. A tool developed by Cipolla et al. was used to identify therapeutic problems. After determining the therapeutic problems and their causes, the success of the determination of therapeutic problems by students was assessed. Results: A total of 70 patients were treated, of which 47 (60.14%) were women and 23 (32.85%) were men. The mean age was 53.84 ± 17.2, the mean number of comorbidities was 4.47 ± 2.00, and the mean number of drugs in therapy was 6.27 ± 2.38. A total of 215 therapeutic problems were identified each patient had at least one therapeutic problem while the average number of therapeutic problems was 3.07 ± 1.41. Most therapeutic problems were found in the category of indications (n = 80, 37.21%), followed by the category of safety (n = 76, 35.35%), followed by the category of efficacy (n = 35, 16.28%) and the last place was the category of cooperation (n = 24, 11.16%). Of the total number of therapeutic problems, students recognized and correctly categorized 16 of them (7.44%), 60 therapeutic problems (27.91%) remained completely unrecognized, while other therapeutic problems were recognized but incorrectly classified. Conclusion: From all the above we can conclude that patients with diseases of the nervous system have a large number of therapeutic problems. It is very important to identify therapeutic problems and their causes in a timely manner and to prevent them in order to ensure positive treatment outcomes and to reduce healthcare costs. Given the success of recognizing therapeutic problems, we can conclude that students are not sufficiently familiar with therapeutic problems and their categorization and that it is necessary to further dedicate themselves to their education in order to develop competent professionals who will be able to adequately provide pharmacy care