Chronická multifaktoriální onemocnění kladou značné nároky na pacientovu spolupráci. Noncompliance – nespolupráce při léčbě – je rozšířená, například až 80 % pacientů se schizofrenií nedodržuje léčbu. Mezi příčiny nespolupráce patří některé charakteristiky nemoci samotné, problémy plynoucí z léčby a nedostatečná podpora příbuzných. Má-li být dlouhodobá spolupráce v léčbě úspěšná, musí se pacient stát informovaným partnerem lékaře. Psychoedukační intervence, jejichž cílem je pacientovi dodat informace a naučit jej zacházet s nemocí, prokazatelně zlepšují spolupráci, zdravotní stav a snižují náklady na léčbu.
Succesfull management of chronic multifactorial diseases requires highly cooperative patient. The problem of poor compliance to medical treatment is extensive. As an example, 80 % of patients with schizophrenia are noncompliant. The causes for noncompliance are complex including some disease characteristics, treatment problems and lack of support from patients' relatives. In order to achieve optimal cooperation, the patient must become an informed partner in the treatment. Psychoeducation provides a combination of education about mental illness and disease-management-skills training. Participation in psychoeducation programs results in better compliance, improves health and reduces the cost of treatments.
V řadě studií byla prokázána účinnost edukace osob s diabetem. Přesto se mnohdy nedaří přenášet poznatky o optimální léčbě diabetes mellitus do každodenní praxe. Tato kazuistika demonstruje negativní vliv nedostatečné compliance a adherence pacienta na hojení defektu končetiny. Ani opakovaná edukace nemusí vést ke zlepšení terapeutických výsledků.
A number of studies have proven the effectiveness of educating people with diabetes. Nevertheless, it is often not possible to transfer knowledge about the optimal treatment of diabetes mellitus into everyday practice. This case study demonstrates the negative impactof insufficient compliance and adherence of the patient on the healing of the limb defect.Even repeated education may not lead to improved therapeutic results.
- MeSH
- Treatment Adherence and Compliance psychology MeSH
- Diabetes Mellitus, Type 2 drug therapy complications MeSH
- Diabetic Foot * surgery nursing therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
V řadě studií byla prokázána účinnost edukace osob s diabetem. Přesto se mnohdy nedaří přenášet poznatky o optimální léčbě diabetes mellitus do každodenní praxe. Tato kazuistika demonstruje negativní vliv nedostatečné compliance a adherence pacienta na hojení defektu končetiny. Ani opakovaná edukace nemusí vést ke zlepšení terapeutických výsledků.
A number of studies have proven the effectiveness of educating people with diabetes. Nevertheless, it is often not possible to transfer knowledge about the optimal treatment ofdiabetes mellitus into everyday practice. This case study demonstrates the negative impactof insufficient compliance and adherence of the patient on the healing of the limb defect. Even repeated education may not lead to improved therapeutic results.
Compliance a adherence k léčbě je u pacientů se schizofrenií poměrně nízká. V tomto přehledovém článku je zmíněna defi nice těchto pojmů, z nichž je užíván zejména druhý termín, který je širší. Dále jsou diskutovány způsoby operacionalizace, metody měření adherence a zejména metody jejího ovlivnění. Jako nejdůležitější se jeví výběr dostatečně účinného léčiva, které má minimum nežádoucích účinků, zvláště těch pro pacienty subjektivně nepříjemných a také nebezpečných. Důležité je rovněž ovlivnění náhledu pacientů, zejména jejich postoje k léčbě.
Compliance and adherence to the treatment are quite low in patients with schizophrenia. Definitions of these terms are mentioned in this review, where we used especially the second one because of its broadness. Later are discussed methods of its operationalization, measurement and especially methods of its infl uencing. The choice of effi cient drug seems to be the most important. It must have a minimum of side-eff ects, especially those, which are for patients subjectively unpleasant and dangerous. Infl uencing of patients‘ insight, especially their attitudes to the treatment, is important too.
- MeSH
- Treatment Adherence and Compliance MeSH
- Anticholesteremic Agents therapeutic use MeSH
- Antihypertensive Agents therapeutic use MeSH
- Adult MeSH
- Dyslipidemias * diagnosis drug therapy MeSH
- Hypertension * diagnosis drug therapy MeSH
- Humans MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Medication Adherence * MeSH
- Patient Compliance * MeSH
- Medical History Taking * MeSH
- Chronic Disease * MeSH
- Long-Term Care MeSH
- Drug Therapy * MeSH
- Drug Combinations * MeSH
- Phytotherapy * MeSH
- Hospitalization * MeSH
- Inpatients * MeSH
- Comorbidity * MeSH
- Pharmacies * MeSH
- Drug Interactions * MeSH
- Drug Prescriptions * MeSH
- Nonprescription Drugs * MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions * MeSH
- Treatment Refusal * MeSH
- Polypharmacy * MeSH
- Counseling * MeSH
- Dietary Supplements * MeSH
- Medication Reconciliation * utilization MeSH
- Self Medication * MeSH
- Home Care Services * MeSH
- Age Factors * MeSH
- Nurses * utilization MeSH
- Life Style * MeSH
- Prescription Drug Misuse * MeSH
- Check Tag
- Humans MeSH
OBJECTIVES: Most patients in palliative oncology care are polymorbid and thus treated with multiple drugs. The therapeutic effect and safety of these drugs can be compromised by drug/drug interactions, but also by wider problems such as polypharmacy and compliance. The clinical pharmacist is, therefore, responsible for risk analysis and prevention. Our prospective open label non-randomised clinical study evaluated the importance of a clinical pharmacist in the palliative care team. METHODS: A total of 250 outpatients were included in the clinical study: 126 women (50.4%) and 124 men (49.6%), with a mean age of 71 years (range 21-94 years; SD 11.9). The patients had the performance status scale 0-3 [Formula: see text]. Clinical examinations were performed on a monthly basis (n=509 check-up visits). The clinical pharmacist prepared an educational chart for all medications used after each visit and evaluated any drug-related problems. Follow-up was 6 months. RESULTS: This study found a significant association between drug related-problems and polypharmacy (p<0.001). A low risk of drug-rfelated problems was observed during the initial visit, that is, 68 female (27.2%) and 25 male (10.4%) patients. A greater clinical-pharmaceutical risk was observed among the patients taking antihypertensive drugs (p=0.003) and/or beta blockers (p=0.048). CONCLUSION: This study confirms the essential role of a clinical pharmacist in oncology palliative care. The feedback obtained from the patients showed a notable improvement in their quality of life. Further, this clinical study confirmed the need for a personalised approach in palliative oncology care.
- MeSH
- Medication Adherence MeSH
- Adult MeSH
- Pharmacists MeSH
- Quality of Life MeSH
- Pharmaceutical Preparations MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Palliative Medicine * MeSH
- Prospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
