Znanja i stavovi bolesnika o primjeni antidepresiva - iskustva iz javne ljekarne

Uvod: Depresija je javnozdravstveni psihički poremećaj koji pogađa više od 264 milijuna ljudi u svijetu. Depresivni se poremećaji pojavljuju u bilo kojoj životnoj dobi, vrlo često u osoba mlađe životne dobi i češće ženskog spola. Liječenje se provodi farmakoterapijom, psihoterapijom ili kombinacijom obje, a ponekad i drugim metodama, kao što je elektrokonvulzivna terapija. Usprkos brojnim terapijskim opcijama, u velikog broja oboljelih ne postižu se terapijski ciljevi, a bolest se smatra rezistentnom na terapiju. S obzirom na složenu patofiziologiju bolesti i neizvjesne ishode liječenja, važan je multidiscipliniran pristup i uključenje svih dionika koji skrbe o bolesniku, pri čemu je uloga farmaceuta kao najdostupnijeg zdravstvenog djelatnika od velike važnosti. Cilj istraživanja: Cilj rada je dobiti uvid u indikacije za koje se propisuju antidepresivi, te koji su stavovi pacijenata o propisanoj terapiji. Opservacijsko istraživanje provedeno je na uzorku bolesnika koji podižu svoju terapiju u Ljekarnama PRIMA PHARME. Na osnovu prikupljenih podataka pomoću posebno kreiranog upitnika dobit će se uvid za koje se indikacije propisuju antidepresivi te procijeniti odgovor, uspješnost, adherentnost i zadovoljstvo pacijenata propisanom terapijom. Ispitanici i metode: Opservacijsko istraživanje u ovom radu provedeno je na 22 pacijenta koji su u razdoblju u kojem se istraživanje provodilo (kolovoz – listopad 2020.) podizali svoju terapiju u ljekarni te su pristali sudjelovati u istraživanju. U istraživanju je korišten upitnik kreiran za potrebe rada kojim su se bilježili i ispitivali: medicinska anamneza, propisani lijekovi na recept, bezreceptni pripravci koje pacijent koristi, primijećene nuspojave i zadovoljstvo propisanom terapijom. Od pacijenata je zatražen informirani pristanak za sudjelovanje u istraživanju. Istraživanje je odobreno od Povjerenstva za etičnost eksperimentalnog rada Farmaceutsko – biokemijskog fakulteta Sveučilišta u Zagrebu. Rezultati: Na uzorku od 22 ispitanika njih 69% ima dijagnosticiranu depresiju, dok se kod 31% ispitanika antidepresivi propisuju zbog drugih indikacija. Najčešće propisivani antidepresivi su escitalopram i sertralin, dok je venlafaksin nešto rjeđe propisivan lijek. Osim antidepresiva, ispitanici imaju lijekove za liječenje drugih bolesti. Hipertenzija i hipotireoza su najčešće zabilježene kronične bolesti, dok se gastritis javlja kao posljedica uzimanja veće količine lijekova. Dio pacijenata koristi hipnotike i anksiolitike za primjenu po potrebi, najčešće zbog problema sa spavanjem. Pregledom bezreceptnih pripravaka, manji dio ispitanika koristi dodatke prehrani sa magnezijem i vitaminima B skupine. Odgovori na pitanja koja obuhvaćaju životni stil ispitanika, ukazuju da većina redovito puši cigarete (1 – 2 kutije dnevno), dok se alkohol konzumira prigodno. Nuspojave navodi samo jedan ispitanik, a odnose se na porast apetita. Zaključak: Premda se ovo istraživanje temelji na malom broju pacijenata, rezultati pokazuju da depresija i drugi psihički poremećaji sa sobom nose niz simptoma koje treba liječiti, ali je i praćena različitim komorbiditetima, što traži multidiscipliniran i individualiziran pristup svakom pacijentu. Uloga ljekarnika je od iznimne važnosti kod praćenja ishoda liječenja budući da su ljekarnici zdravstveni djelatnici koji izdaju propisanu terapiju, savjetuju pacijenta, te prate ishode liječenja. Preduvjet za kvalitetnu ljekarničku skrb je stalna edukacija i osobni razvoj, kao i prilagodba pacijentima s kojima smo svakodnevno u kontaktu.Introduction: Depression is a public health mental disorder that affects more than 264 million people worldwide. Depressive disorders occur at any age, very often in people of younger age and more often females. Treatment is carried out with pharmacotherapy, psychotherapy, or a combination of both, and sometimes by other methods, such as electroconvulsive therapy. Despite numerous therapeutic options, a large number of patients do not achive therapeutic goals, and the disease is considered resistant to therapy. Given the complex pathophysiology of the disease and the uncertain outcome of treatment, a multidisciplinary approach and involvement of all stakeholders caring for the patient is important, with the role of the pharmacist as the most accessible health professional being of great importance. Objectives: The aim of this paper is to gain insight into the indications for which antidepressants are prescribed, and what are the attitudes of patients about the prescribed therapy. The observational study was conducted on a sample of patients who raise their therapy in PRIMA PHARMA Pharmacies. Based on the collected data, a specially created questionare will provide insight into the indications for which antidepressants are prescribed and assess the response, success, cooperation and satisfaction of patients with the prescribed therapy. Respondents and methods: Observational research in this study was conducted on 22 patients who in the period in which the study was conducted (August - October 2020) raised their therapy in the pharmacy and agreed to participate in the study. The research used a questionnaire created for the purposes of work that was recorded and examined: medical history, prescribed prescription drugs, over-the-counter preparations used by the patient, observed side effects and satisfaction with the prescribed therapy. Patients were asked for informed consent to participate in the study. The research was approved by Ethics Committee for Experimental Work of the Faculty of Pharmacy and Biochemistry, University of Zagreb. Results: In a sample of 22 subjects, 69% of them were diagnosed with depression, while 31% of subjects were prescribed antidepressants due to other indications. The most commonly prescribed antidepressants are escitalopram and sertraline, while venlafaxine is a somewhat less commonly prescribed drug. In addition to antidepressants, subjects have medications to treat other illnesses. Hypertension and hypothyroidism are the most commonly reported chronic diseases, while gastritis occurs as a result of taking larger amounts of medication. Some patients use hypnotics and anxiolytics for use as needed, most often due to sleep problems. By reviewing over-the-counter preparations, a smaller proportion of respondents use dietary supplements with magnesium and B vitamins. The answers to the questions covering the lifestyle of the respondents indicate that most people smoke cigarettes regularly (1-2 boxes a day), while alcohol is consumed occasionally. Side effects are reported by one respondent and relate to an increase in appetite. Conclusion: Although this research is based on a small number of patients, the results show that depression and other mental disorders carry with them a number of symptoms that need to be treated, but is also accompanied by different comorbidities, which requires a multidisciplinary and individual approach to each patient. The role of the pharmacist is extremely important in monitoring the outcomes of treatment since pharmacists are health professionals who prescribe the prescribed therapy, advise the patient, and monitor the outcomes of treatment. A prerequisite for quality patient care is constant education and personal development, as well as adaptation to patients with whom we are in daily contac