Determination of side effects and medication adherence in major depression patients utilized antidepressants
Öz
The aim of the study is to
determine side effects, and medication adherence
in patients who were diagnosed with major
depression utilized antidepressants. This study was conducted in outpatient psychiatry clinic between February
2013 and May 2013. ‘Toronto Side Effects
Scale’ and 4-item Morisky-Green- Levine
Medication Adherence Scale were evaluated. Fifty-six major depression patients (mean of age: 40.82
± 14.28 years old; male/female: 13/43)
were included in this study. Patients were
treated with escitalopram (46.4%), sertraline (26.8%), venlafaxine (10.7%), citalopram (8.9%) and
paroxetine (7.1%). The most common side
effects that patients reported were drowsiness/
daytime somnolence (57.1%), dry mouth (46.4%)
and increased sleep (46.4%), increased appetite (37.5%) and malaise or fatigue (30.4%). The most severity
side effects that patients experienced
were drowsiness/ daytime somnolence (25%),
increased sleep (19.6%) and decreased libido (14.3%). Only fifteen (26.8%) patients were found high
adherent to their medication. It was
concluded that although the frequency and
severity of side effects have been found high, the percentage of patients’ medication adherence has been
obtained low. Patient education and
monitoring regarding side effects and medication adherence providing by pharmacists would be
contributed to prevent possible drug
induced problems in these patients besides
the routine services they are taken from outpatient clinic.
Anahtar Kelimeler
Kaynakça
- Weızman S, Gonda X, Dome P, Faludı G. Pharmacogenetics of antidepressive drugs: A way towards personalized treatment of majör depressive disorder. Neuropsychopharmacol Hung, 2012; 14(2):87-101
- Serretti A, Drago A, Spina E. Pharmacogenomics of depression. In: Pharmacogenomics in Psychiatry. Eds:Schwab M, Kaschka WP, Spina E, Adv Biol Psychiatry, Basel, Karger, 2010; pp. 58-74.
- Vergouwen ACM, Bakker A, Katon WJ, Verheij TJM, Koerselman F. İmproving adherence to antidepressants: a systematic review of interventions. J Clin Psychiatry, 2003; 64: 1415-1420.
- Hunot VM, Horne R, Leese MN, Churchill RC. A cohort study of adherence to antidepressants in primary care: The influence of antidepressant concerns and treatment preferences. Prim Care Companion J Clin Psychiatry, 2007; 9(2):91-99.
- Gabrial A, Violato C. Knowledge of and attitudes towards depression and adherence to treatment: The antidepressant adherence scale (AAS). Journal of affective disorders, 2010; 126:388-394.
- Vanderkooy JD, Kennedy SH, Bagby RM. Antidepressant side effects in depression patients in a naturalistic setting: A study of bupropion, moclobemide, paroxetine, sertraline, and venlafaxine. Can J Psychiatry, 2002; 47: 174-180
- Yılmaz S. Psikiyatri hastalarında ilaç yan etkileri ve ilaç uyumu. İ.Ü. Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi, İstanbul, (Danışman: Doç. Dr. Sevim Buzlu). 2004.
- Morisky DE, Green LW, Levine DM. Concurrent and Predictive Validity of a Self-Reported Measure of Medication Adherence and Long-Term Predictive Validity of Blood Pressure Control. Med Care, 1986; 24(1): 67–74.
- Marques LAM, Galduroz JCF, Noto AR. Pharmaceutical care to patients treated with antidepressants. Rev Calid Asist, 2012; 27:55-64.
- Dewan MJ, Anand VS. Evaluating the tolerability of the newer antidepressants. J Nerv Ment Dis, 1999; 187:96-101.
- Goethe JW, Woolley SB, Cardoni AA, Woznicki BA, Piez DA. Selective serotonin reuptake inhibitor discontinuation side effects and other factors that influence medication adherence. J Clin Psychopharmacol, 2007; 27:451-458.
- Ashton A, Jamerson B, Wagoner C. Antidepressant related adverse effects impacting treatment compliance: results of a patient survey. Curr Ther Res Clin Exp, 2005; 66:96-106.
- Kostev K, Rex J, Eith T, Heilmaier C. Which adverse effects influence the dropout rate in selective serotonin reuptake inhibitor (SSRI) treatment? Results for 50,824 patients. Ger Med Sci, 2014; 12:15
- Sawada N, Uchida H, Suzuki T, Watanabe K, Kikuchi T, Handa T, Kashima H. Persistence and compliance to antidepressant treatment in patients with depression: A chart review. BMC Psychiatry, 2009; 9:38-47.
- Adler DA, Bungay KM, Wilson IB, Pei Y, Supran S, Peckham E,Cynn DJ, Rogers WH. The impact of a pharmacist intervention on 6 month outcomes in depressed primary care patients. Gen Hosp Psychiatry, 2004; 26: 199-209.
- Bungay KM, Adler DA, Rogers WH, McCoy C, Kaszuba M, Supran S, Pei Y, Cynn DJ, Wilson IB. Description of a clinical pharmacist intervention administered to primary care patients with depression. Gen Hosp Psychiatry, 2004; 26: 210-218.
- Cappocia KL, Boudreau DM, Blough DK, Ellsworth AJ, Clark DR, Stevens NG, Katon WJ, Sullıvan SD. Am J Health Syst Pharm, 2004; 61: 364-372.
- Al-Saffar N, Abdulkareem A, Abdulhakeem A, Salah AQ, Heba M. Depressed patients’ preferences for education about medications by pharmacists in Kuwait, Patient Educ Couns, 2008; 72: 94-101
- Rubio-Valera M, Serrano-Blnaco A, Magdalena-Belio J, Fernandez A, Garcia-Campayo J, Pujol MM, Del Hoyo YL. Effectiveness of pharmacist care in the improvement of adherence to antidepressants: A systematic review and meta-analysis. Ann Pharmacother, 2011; 45:39-48
- Murata A, Kanbayashi T, Shimizu T, Miura M. Risk factors for drug nonadherence in antidepressant-treated patients and implications of pharmacist adherence instructions for adherence improvement. Patient Preference and Adherence, 2012; 6: 863-869.
- Al-Jumah KA, Qureshi NA. Impact of pharmacist interventions on patients’ adherence to antidepressants and patient-reported outcomes: A systematic review. Patient Preference and Adherence, 2012; 6:87-100
Antidepresan Kullanan Majör Depresyon Hastalarında Yan Etkilerin ve Hasta Uyuncunun Değerlendirilmesi
Öz
Bu çalışmanın amacı, antidepresan
kullanan majör depresyon hastalarında
yan etkilerin ve hasta uyuncunun değerlendirilmesidir.
Çalışma Şubat-Mayıs 2013 tarihleri arasında
bir psikiyatri polikliniğinde yürütülmüştür. Yan etkilerin tespiti için “Toronto Yan Etki
Ölçeği”, tedaviye uyuncun belirlenmesi
için ise “Morisky Green Levine Uyunç Ölçeği”
kullanılmıştır. Çalışma 56 majör depresyon tanısı alan hasta ile (yaş ortalaması: 40,82 ± 14,28;
erkek/kadın: 13/43) tamamlanmıştır.
Hastalar depresyon tedavisi için essitalopram
(% 46,4), sertralin (% 26,8), venlafaksin (% 10,7), sitalopram (% 8,9) ve paroksetin (%7,1) kullanmaktaydı.
Hastaların en yaygın bildirdiği yan
etkilerin sersemlik/gündüz uykuya eğilim
(% 57,1), ağız kuruluğu (% 46,4), uykuda artış (% 46,4), iştah artması (% 37,5) ve halsizlik veya yorgunluk
(% 30,4) olduğu tespit edilmiştir.
Hastaların yaşadıkları bu yan etkiler şiddet
derecesine göre değerlendirildiğinde ilk sıraları sersemlik/ gündüz uykuya eğilim (% 25,0), uykuda artış
(% 19,6) ve libido azalması (% 14,3) yan
etkilerinin aldığı gözlenmiştir. Çalışmaya
katılan hastaların sadece % 26,8’inin ilaçlarına uyunç oranlarının yüksek olduğu saptanmıştır. Antidepresan
kullanan hastalarda görülen yan etki
sıklığının ve şiddetinin yüksek olduğu ve
ayrıca hastaların ilaç uyunç oranlarının düşük olduğu sonucuna varılmıştır. Bu hastaların poliklinikten
aldıkları rutin hizmetin yanısıra
eczacılar tarafından yan etkiler ve uyunç konusunda eğitilmeleri ve izlenmeleri, ilaç kaynaklı
olası sorunların önüne geçilmesine katkı
sağlayacaktır.
Anahtar Kelimeler
Kaynakça
- Weızman S, Gonda X, Dome P, Faludı G. Pharmacogenetics of antidepressive drugs: A way towards personalized treatment of majör depressive disorder. Neuropsychopharmacol Hung, 2012; 14(2):87-101
- Serretti A, Drago A, Spina E. Pharmacogenomics of depression. In: Pharmacogenomics in Psychiatry. Eds:Schwab M, Kaschka WP, Spina E, Adv Biol Psychiatry, Basel, Karger, 2010; pp. 58-74.
- Vergouwen ACM, Bakker A, Katon WJ, Verheij TJM, Koerselman F. İmproving adherence to antidepressants: a systematic review of interventions. J Clin Psychiatry, 2003; 64: 1415-1420.
- Hunot VM, Horne R, Leese MN, Churchill RC. A cohort study of adherence to antidepressants in primary care: The influence of antidepressant concerns and treatment preferences. Prim Care Companion J Clin Psychiatry, 2007; 9(2):91-99.
- Gabrial A, Violato C. Knowledge of and attitudes towards depression and adherence to treatment: The antidepressant adherence scale (AAS). Journal of affective disorders, 2010; 126:388-394.
- Vanderkooy JD, Kennedy SH, Bagby RM. Antidepressant side effects in depression patients in a naturalistic setting: A study of bupropion, moclobemide, paroxetine, sertraline, and venlafaxine. Can J Psychiatry, 2002; 47: 174-180
- Yılmaz S. Psikiyatri hastalarında ilaç yan etkileri ve ilaç uyumu. İ.Ü. Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi, İstanbul, (Danışman: Doç. Dr. Sevim Buzlu). 2004.
- Morisky DE, Green LW, Levine DM. Concurrent and Predictive Validity of a Self-Reported Measure of Medication Adherence and Long-Term Predictive Validity of Blood Pressure Control. Med Care, 1986; 24(1): 67–74.
- Marques LAM, Galduroz JCF, Noto AR. Pharmaceutical care to patients treated with antidepressants. Rev Calid Asist, 2012; 27:55-64.
- Dewan MJ, Anand VS. Evaluating the tolerability of the newer antidepressants. J Nerv Ment Dis, 1999; 187:96-101.
- Goethe JW, Woolley SB, Cardoni AA, Woznicki BA, Piez DA. Selective serotonin reuptake inhibitor discontinuation side effects and other factors that influence medication adherence. J Clin Psychopharmacol, 2007; 27:451-458.
- Ashton A, Jamerson B, Wagoner C. Antidepressant related adverse effects impacting treatment compliance: results of a patient survey. Curr Ther Res Clin Exp, 2005; 66:96-106.
- Kostev K, Rex J, Eith T, Heilmaier C. Which adverse effects influence the dropout rate in selective serotonin reuptake inhibitor (SSRI) treatment? Results for 50,824 patients. Ger Med Sci, 2014; 12:15
- Sawada N, Uchida H, Suzuki T, Watanabe K, Kikuchi T, Handa T, Kashima H. Persistence and compliance to antidepressant treatment in patients with depression: A chart review. BMC Psychiatry, 2009; 9:38-47.
- Adler DA, Bungay KM, Wilson IB, Pei Y, Supran S, Peckham E,Cynn DJ, Rogers WH. The impact of a pharmacist intervention on 6 month outcomes in depressed primary care patients. Gen Hosp Psychiatry, 2004; 26: 199-209.
- Bungay KM, Adler DA, Rogers WH, McCoy C, Kaszuba M, Supran S, Pei Y, Cynn DJ, Wilson IB. Description of a clinical pharmacist intervention administered to primary care patients with depression. Gen Hosp Psychiatry, 2004; 26: 210-218.
- Cappocia KL, Boudreau DM, Blough DK, Ellsworth AJ, Clark DR, Stevens NG, Katon WJ, Sullıvan SD. Am J Health Syst Pharm, 2004; 61: 364-372.
- Al-Saffar N, Abdulkareem A, Abdulhakeem A, Salah AQ, Heba M. Depressed patients’ preferences for education about medications by pharmacists in Kuwait, Patient Educ Couns, 2008; 72: 94-101
- Rubio-Valera M, Serrano-Blnaco A, Magdalena-Belio J, Fernandez A, Garcia-Campayo J, Pujol MM, Del Hoyo YL. Effectiveness of pharmacist care in the improvement of adherence to antidepressants: A systematic review and meta-analysis. Ann Pharmacother, 2011; 45:39-48
- Murata A, Kanbayashi T, Shimizu T, Miura M. Risk factors for drug nonadherence in antidepressant-treated patients and implications of pharmacist adherence instructions for adherence improvement. Patient Preference and Adherence, 2012; 6: 863-869.
- Al-Jumah KA, Qureshi NA. Impact of pharmacist interventions on patients’ adherence to antidepressants and patient-reported outcomes: A systematic review. Patient Preference and Adherence, 2012; 6:87-100
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Eylül 2016 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 21 Sayı: 1 |