Pereira de Paula Bianca Augusta, da Silva Alves Geisa Cristina, PercÍnio Álvaro, Pereira Mariana Linhares, Moraes Juliano Teixeira, Sanches Cristina
Federal University of São João Del Rei, Bairro Chanadour, Divinópolis, Brazil.
Ostomy Wound Manage. 2017 Sep;63(9):24-31. doi: 10.25270/owm.2017.09.2431.
Research on the use of medications in people with intestinal stomas is lacking, creating gaps in knowledge of pharmacoepidemiology in these patients. A cross-sectional, descriptive study was conducted over a period of 4 months in Divinópolis, Brazil to describe the profile of medication use among people enrolled in the Health Support Service for People with Stoma - Level II (SSPS II) of a municipality in the state of Minas Gerais, Brazil. All patients from SSPS II with a colostomy or ileostomy were invited by phone to participate; those with incomplete registration data and/or who were <18 years old, hospitalized for any reason, or had their stoma reversed were excluded from participation. During home interviews, researchers obtained sociodemographic profiles (age, gender, education, occupation, and family income) and information on comorbidities, medication use, adherence to medication protocols (per the Morisky Green Levine test), polypharmacy, and adult/pharmaceutical care (medication description and indication, expiration date, self-medication). Drug storage was assessed by visual evaluation. The information was entered onto individual data sheets, numbered to ensure patient anonymity. The data then were entered into and analyzed using SSPS II statistical software using frequency measurements, measures of central tendency, and dispersion of demographic variables, health conditions, and medicine use. The study population included 59 persons (average age 66.9 ± 13.27 years), 36 (61.0%) women, 38 (64.4%) with an incomplete/primary level education, and 44 (74.5%) retired. Forty-nine (49) patients had a colostomy and 10 had an ileostomy; cancer was the main reason for stoma creation (61.1%). Half of the survey participants reported having 1 or 2 comorbidities (average 2.3); the most prevalent (52) was circulatory system disease among which hypertension (38, 64.4%) was most common. Analysis of the pharmacotherapeutic profile (prescribed and used) showed 89.8% of the study population used medication, and 52.8% were prescribed >5 medications (polypharmacy). Low and medium level adherence with prescriptions was noted (37.7%); 39.6% reported receiving no guidance on the use of the medication associated with their condition. Improper storage was observed in 33.9% of participants. In this population, persons with a stoma had complex pharmacotherapy, a high rate of polypharmacy, and deficiency in guidance on the use of medication. Further research into determining whether investments in both inclusion of a pharmacist on the team and more pharmacoepidemiological studies would improve patient care and medication safety in patients with a stoma is warranted.
关于肠造口患者用药的研究尚缺,导致这些患者在药物流行病学知识方面存在空白。在巴西迪维诺波利斯进行了一项为期4个月的横断面描述性研究,以描述巴西米纳斯吉拉斯州一个城市的造口患者二级健康支持服务(SSPS II)登记人员的用药情况。通过电话邀请SSPS II所有有结肠造口或回肠造口的患者参与;排除登记数据不完整和/或年龄<18岁、因任何原因住院或造口已回纳的患者。在家庭访谈中,研究人员获取了社会人口学资料(年龄、性别、教育程度、职业和家庭收入)以及合并症、用药情况、用药方案依从性(根据Morisky Green Levine测试)、多重用药和成人/药物治疗(药物描述和适应证、有效期、自我用药)等信息。通过视觉评估对药物储存情况进行评估。信息录入个人数据表,并进行编号以确保患者匿名。然后使用SSPS II统计软件输入并分析数据,采用频率测量、集中趋势测量以及人口统计学变量、健康状况和用药情况的离散度分析。研究人群包括59人(平均年龄66.9±13.27岁),36名(61.0%)女性,38名(64.4%)接受不完全/小学教育,44名(74.5%)退休。49名患者有结肠造口,10名有回肠造口;癌症是造口形成的主要原因(61.1%)。一半的调查参与者报告有1种或2种合并症(平均2.3种);最常见的(52例)是循环系统疾病,其中高血压(38例,64.4%)最为常见。对药物治疗情况(处方和用药)的分析显示,89.8%的研究人群使用药物,52.8%的人被处方>5种药物(多重用药)。注意到对处方的依从性处于低和中等水平(37.7%);39.6%的人报告未得到与其病情相关用药的指导。33.9%的参与者存在储存不当情况。在这个人群中,造口患者有复杂的药物治疗、较高的多重用药率以及用药指导不足的问题。有必要进一步研究确定在团队中纳入药剂师以及开展更多药物流行病学研究是否会改善造口患者的护理和用药安全。