Published April 5, 2023 | Version v1
Journal article Open

Family Medicine Residents' Awareness of Rational Drug Use in Geriatric Patients and Their Need for a Web Application

Creators

  • 1. Department of Family Medicine, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Türkiye.
  • 2. Department of Family Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.
  • 3. Graduate School of Informatics, Middle East Technical University, Ankara, Türkiye.

Description

Abstract

©Copyright LMS. Licenced by Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).

The term polypharmacy is generally known as the simultaneous use of five or more medicines. An increase in polypharmacy is also observed with chronic diseases, which increases with age. The main complications of polypharmacy are medicine side effects, inappropriate medicine use, drug-drug interaction, and drug-disease interactions. Family physicians are the most effective physician group in coordinating medicine therapy, as they provide continuous, longitudinal, and comprehensive medical care to the individual. In this study, it was aimed to determine the need of an auxiliary web application regarding family medicine residents' awareness of polypharmacy side effects in geriatric population and to identify the barriers to rational drug use in their daily clinical practice. The research is a cross-sectional observational study, and all residents actively working in the Ankara City Hospital Family Medicine Clinic were planned to be included and were invited to the study. The study was conducted through survey application method under observation. It was determined that geriatric patients mostly referred to their "clinical experience" in rational drug use according to the participants. The obstacles faced by the participants in rational drug use were mostly in that of "not having enough knowledge" and "patient-centered medicine regulation to be difficult and time consuming". 75.3% of respondents (n=70) marked strongly agree and 18.3% marked agree (n=17) for the statement "I would like to have an easily accessible an artificial intelligence aided web application that I can use in my daily practice regarding polypharmacy side effects, such as drug-drug interactions, drug-chronic disease incompatibility, potentially inappropriate medicine (PIM) in the elderly" and the mean value of this proposition was determined as 4.65±0.7. This study showed that the resources used to detect polypharmacy and its complications were not used adequately and appropriately. Moreover, the study results present the need and demand for time-saving and facilitating auxiliary web applications to minimize PIM, drug-drug interaction, drug-chronic disease interaction in the elderly and to evaluate it in the light of current data to provide person-centered and comprehensive care in the clinician's practice.

Özet

Polifarmasi terimi genellikle beş veya daha fazla ilacın aynı anda kullanılması olarak bilinir. Yaşla birlikte artan kronik hastalıklarda da çoklu ilaç kullanımında artış gözlenmektedir. Polifarmasinin başlıca komplikasyonları ilaç yan etkileri, uygunsuz ilaç kullanımı, ilaç-ilaç etkileşimi ve ilaç-hastalık etkileşimleridir. Aile hekimleri, bireye sürekli, uzun süreli (boylamsal) ve kapsamlı tıbbi bakım sağladıkları için ilaç tedavisini koordine etmede en etkili hekim grubudur. Bu çalışmada, aile hekimliği asistanlarının geriatrik popülasyonda polifarmasi yan etkilerinin farkındalıkları, günlük klinik uygulamalarında akılcı ilaç kullanımının önündeki engellerin belirlenmesi ve bununla ilgili yardımcı bir web uygulamasına olan ihtiyacın belirlenmesi amaçlanmıştır. Araştırma, kesitsel gözlemsel bir çalışma olup, Ankara Bilkent Şehir Hastanesi Aile Hekimliği Kliniği'nde aktif olarak görev yapan tüm asistanlar araştırmaya dahil edilmek üzere planlanmış ve çalışmaya davet edilmiştir. Araştırma, gözlem altında anket uygulama yöntemiyle gerçekleştirilmiştir. Katılımcılara göre geriatrik hastaların akılcı ilaç kullanımın da en çok "klinik deneyimlerine" başvurdukları belirlendi. Katılımcıların akılcı ilaç kullanımında karşılaştıkları engeller en sık "yeterli bilgiye sahip olmama" ve "hasta merkezli ilaç düzenlemesinin zor ve zaman alması" şeklindedir. "Yaşlılarda ilaç-ilaç etkileşimleri, ilaç-kronik hastalık uyumsuzluğu, potansiyel olarak uygunsuz ilaç gibi polifarmasi yan etkilerine ilişkin günlük pratiğimde kullanabileceğim, kolay erişilebilir, yapay zeka destekli bir web uygulaması olmasını isterim" ifadesine yanıt verenlerin %75.3'ü (n=70) cevabı kesinlikle katılıyorum ve %18.3'ü katılıyorum (n=17) olarak işaretlemiş ve bu önermenin ortalama değeri 4.65±0.7 olarak belirlenmiştir. Bu çalışma polifarmasi ve komplikasyonlarının saptanmasında kullanılan kaynakların yeterli ve uygun şekilde kullanılmadığını göstermiştir. Çalışma sonuçları ayrıca, yaşlılarda potansiyel uygunsuz ilaç kullanımı, ilaç-ilaç etkileşimi ve ilaç-kronik hastalık etkileşimini en aza indirmek ve güncel veriler ışığında değerlendirmek için zaman kazandıran ve kolaylaştırıcı yardımcı web uygulamalarına olan ihtiyacı ve talebi ortaya koymaktadır.

Notes

Aile Hekimliği Asistanlarının Geriatrik Hastada Akılcı İlaç Kullanımı Farkındalığı ve Bir Web Uygulamasına Olan İhtiyaçları

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