SURADLJIVOST BOLESNIKA U REDOVITOM UZIMANJU PROPISANE TERAPIJE KOD BOLESNIKA NA HEMODIJALIZI OPĆE ŽUPANIJSKE BOLNICE POŽEGA ; PATIENT COMPLIANCE DURING THE REGULAR TAKING OF PRESCRIBED THERAPY IN PATIENTS ON HAEMODIALYSIS IN GENERAL COUNTRY HOSPITAL POŽEGA

Abstract

Kada govorimo o suradljivosti bolesnika (engl. compliance), razlikujemo dva pojma koje hrvatski možemo nazvati ustrajnost (engl. persistence), te adherencija odnosno pridržavanje (engl. adherence). Iako se navedeni izrazi rabe kao sinonimi, obično se za njih rabi izraz suradljivost. Posebno je problem kod kroničnih bolesnika koji moraju godinama uzimati više lijekova, a istraživanja su pokazala da bolesnici na kroničnoj hemodijalizi (HD) uzimaju i do 19 raznih tableta na dan, te je njihova suradljivost vrlo loša. Ciljevi rada su: utvrditi postoji li povezanost dobi i spola s redovitim uzimanjem propisane terapije, utvrditi postoji li povezanost redovitog uzimanja propisane terapije s dobro reguliranim krvnim tlakom. Kao instrument istraživanja uporabljen je anketni upitnik koji je sadržavao demografske podatke o dobi, spolu, te standardizirani upitnik od 8 pitanja vezana za redovito uzimanje terapije, Morisky Medication Adherence Scale (MMAS-8), preveden na hrvatski kao Upitnik o pridržavanju terapiji (UOPT). Istraživanje je provedeno na 61 ispitaniku, od kojih je 28 (45,9 %) žena i 33 (54,1 %) muškaraca. Medijan dobi bio je 67 godina (interkvartilni raspon 58–74), a značajno su bile starije žene (Mann-Whitneyev test, P=0,004). Nije nađena statistički značajna razlika između žena i muškaraca u pridržavanju redovitog uzimanja propisane terapije prema MMAS-8 testu. Prema upitniku o pridržavanju uzimanja propisane terapije, njih 14 (23 %) ima nisko pridržavanje uzimanja terapije, njih 31 (50,8 %) ima srednje pridržavanje, a 16 (26,2 %) ima visoko pridržavanje uzimanja propisane terapije. Također, ovo istraživanje nije utvrdilo da postoji značajna razlika u regulaciji krvog tlaka prema spolu i pridržavanju uzimanja propisane terapije. Istraživanjem je utvrđeno da postoji statistička značajnost u broju bodova dobivenih MMAS-8 upitnikom i pridržavanja uzimanja propisane terapije (P=0,001, Kruskal-Wallisov test). Kod bolesnika koji se liječe HD-om kao jednim od oblika nadomjesne bubrežne funkcije osobito je nužno redovito uzimanje propisane im terapije. ; When we talk about patient compliance, we distinguish between two concepts which may be called persistence and adherence, i.e. compliance. Although the said terms are used interchangeably as synonyms, usually for their use of the term compliance. It is especially a problem in chronic patients who have to take several drugs for years, and studies have shown that patients on chronic haemodialysis (HD) take up to 19 different tablets a day, and their compliance is very bad. The objectives of this paper are: to determine whether there is a correlation between age and sex with a regular taking of prescribed therapy, to determine whether there is a connection between regular taking of prescribed therapy with well-controlled blood pressure. The survey instrument used was a questionnaire containing demographic information on age, sex, education, and the standardized questionnaire containing eight questions related to the regular use of therapy, Morisky Medication Adherence Scale (MMAS-8), translated into Croatian. The study was conducted on 61 subjects, of whom 28 (45.9%) women and 33 (54.1%) men. The median age was 67 years (interquartile range 58-74), and women were significantly older (Mann-Whitney test, P = 0.004). There was no statistically significant difference between women and men in compliance with the regular intake of prescribed therapy according to MMAS-8 test. According to the questionnaire on compliance of taking the prescribed therapy, 14 of them (23%) showed a low adherence to treatment, 31 (50.8%) sowed moderate adherence, and 16 (26.2%) showed a high compliance to taking the prescribed therapy. Furthermore, this study did not find that there is a significant difference in blood pressure regulation by sex and compliance with taking the prescribed therapy. During the research it has been found that there is statistical significance in a number of points obtained by the MMAS-8 questionnaire and compliance with taking prescribed therapy (P = 0.001, Kruskal-Wallis test). In patients treated with HD as a form of replacement of renal function, regular taking of prescribed treatment is especially important.