Analiza uticaja životnog stila, socio-ekonomskih faktora i zdravstvenog stanja ispitanica na upotrebu lekova u trudnoći
Analysis of impact of life style, socio-economic factorsand health status on the use of medicines in pregnancy
Doktorand
Odalović, Marina M.Mentor
Tasić, LjiljanaČlanovi komisije
Vezmar-Kovačević, SandraIlić, Katarina
Krajnović, Dušanka
Sabo, Ana
Metapodaci
Prikaz svih podataka o disertacijiSažetak
Uvod i ciljevi. Upotreba lekova u trudnoći čest je razlog brige lekara koji ih
propisuju i trudnica koje ih koriste. Iako bi bilo veoma korisno poznavati rizične
populacije trudnica koje imaju veću verovatnoću upotrebe lekova u toku trudnoće,
mali je broj studija koje su se bavile istraživanjima u ovoj oblasti. Uloga i doprinos
farmaceuta u procesu izdavanja ili prodaje lekova trudnicama mogu biti ključni za
bezbednu primenu lekova u trudnoći. Cilj disertacije bio je da se istraži upotreba
lekova u periodu od šest meseci pre i tokom trudnoće, da se izvrši evaluacija
upotrebljenih lekova prema anatomsko-terapijsko-hemijskoj (ATC) klasifikaciji,
prema riziku za plod i režimu izdavanja (na recept i bez recepta (samomedikacija)),
zatim, da se ispita da li postoji povezanost između faktora životnog
stila, socio-ekonomskih faktora i zdravstvenog stanja ispitanica i upotrebe lekova
pre i tokom trudnoće, kao i da se ispita na koji način pomenuti faktori utiču na
upotrebu navedenih klasa lekova.... Cilj je bio i da se ispita potencijalni doprinos
farmaceuta kod upotrebe lekova u trudnoći.
Metode istraživanja. Radi postizanja postavljenih ciljeva sprovedene su dve
studije. Prva studija bila je multi-centrična i sprovedena je u šest domova zdravlja i
pet apoteka na teritoriji opština Vračar, Voždovac, Lazarevac, Loznica, Čačak i
Subotica, u periodu mart 2009 – mart 2010. Prikupljanje podataka sprovedeno je
upitnikom specijalno dizajniranim za potrebe studije. Trudnice su upitnik
popunjavale samostalno, bez pomoći zdravstvenih radnika, anonimno, dobrovoljno
i volonterski. Prikupljeni su podaci o socio-ekonomskim karakteristikama,
životnom stilu i zdravstvenom statusu ispitanica, kao i o upotrebi lekova u periodu
od šest meseci pre i tokom trudnoće. Radi klasifikovanja lekova prema riziku za
plod korišćena je klasifikacija američke Agencije za hranu i lekove (Food and Drug
Administration - FDA). Upotreba lekova izražavana je kao proporcija žena izložena
leku ili ATC grupi ili podgrupi lekova. Razlike u upotrebi lekova između različitih
grupa analizirane su upotrebom McNemar-ovog testa. Univarijantna i
multivarijantna logistička regresija korišćene su da bi se odredili faktori značajno
povezani sa upotrebom lekova. Kao mere povezanosti između faktora i upotrebe
lekova korišćeni su direktni odnos šansi (odds ratio – OR) i korigovan odnos šansi
(adjusted odds ratio – aOR) uz prikazivanje 95% intervala pouzdanosti (confidence
intervals - CI)...
Background and Aims. Drug use in pregnancy is often a reason of concern
for mothers and their physicians. However, only few studies investigated
predictors of drug use in pregnancy. The role and contribution of pharmacists in
the process of drug dispensing could be very important for improvement of safe
drug use in pregnancy. The aim of dissertation was to investigate prescription and
over the counter drug use among Serbian women in the 6 months before
pregnancy and in the first 6 months of pregnancy, and to evaluate the drugs used
according to anatomical-therapeutic-chemical classification, according to the risk
for the fetus and according to dispensing status (proscription (Rx) or over-thecounter
(OTC)). The aim was also to examine if a significant association between
socio-economic factors, life style and health status of women and drug use exist, as
well as to investigate how much these factors impact drug use before and during
pregnancy. Finally, the aim was to investigate a poten...tial contribution of
pharmacist in safe drug use in pregnancy.
Methodology. Two studies were carried out in order to gain all the aims. The
first study was multi-center and performed in the six maternity care units and five
community pharmacies (municipalities: Vračar, Voždovac, Lazarevac, Loznica,
Čačak i Subotica) during the period from March 2009–March 2010. A selfreporting
questionnaire was used as a data source. Participation in the study was
voluntarily and anonymous. Data according to socio-economic characteristics, life
style, health status and drug use six months before and during pregnancy were
collected. Food and Drug Administration (FDA) risk classification system was used
to determine the risk of used drugs for the fetus. Proportion of women exposed to
drugs or class of drugs. Differences between subgroups were assessed using
McNemar’s test on paired proportions. Logistic regression was used to identify
factors associated with medication use. Adjusted odds ratios (aOR) and 95 %
confidence intervals (CI) were used as association measures. Data analysis was
performed using SPSS software package (SPSS 18.0 for Windows, SPSS Inc.,
Chicago, IL, USA). The study was performed after obtaining approval from The
Board of Management and The Human Research Ethics Committee...
Fakultet:
Универзитет у Београду, Фармацеутски факултетDatum odbrane:
21-11-2013Projekti:
- Interakcije ksenobiotika i uticaj na sisteme u biomedicini (RS-MESTD-Integrated and Interdisciplinary Research (IIR or III)-41012)