Potencijalno neprikladni lijekovi u osoba starije životne dobi utvrđeni implicitnim kriterijima i njihova povezanost s karakteristikama bolesnika

Cilj ovog istraživanja bio je odrediti učestalost propisivanja potencijalno neprikladnih lijekova (PNL) u hospitaliziranih osoba starije životne dobi s bolestima probavnog sustava koristeći implicitne kriterije te utvrditi povezanost PNL-ova s demografskim i kliničkim čimbenicima. Retrospektivno, presječno opservacijsko istraživanje uključilo je pacijente primljene putem hitnog ili elektivnog prijema na Odjel gastroenterologije Klinike za unutarnje bolesti Kliničke bolnice Dubrava u razdoblju od listopada 2014. do listopada 2015. godine. Uključujući kriteriji bili su životna dob od 65 ili više godina te bolest probavnog sustava ili neoplazma koja zahvaća probavni sustav. Na temelju prikupljenih podataka prikladnost svakog lijeka u terapiji pojedinog ispitanika tijekom hospitalizacije procijenjena je pomoću implicitnog Indeksa prikladnosti lijekova (MAI kriterija) te su na taj način identificirani PNL-ovi. Dodatno je istražena povezanost utvrđenih PNL-ova s demografskim i kliničkim čimbenicima. Podaci su statistički obrađeni u programu IBM SPSS v20. Istraživanje je uključilo 62 pacijenta prosječne dobi 73,84 ± 5,55 godina koji su prosječno imali 5,94 ± 2,90 dijagnoza i koristili 7,15 ± 3,45 lijekova. Identificirano je 68,6% lijekova u terapiji 96,8% ispitanika potencijalno neprikladnih barem prema jednom od deset MAI kriterija. Najčešći problem bile su neispravne ili nepotpune upute (24,8%), klinički neopravdane indikacije (19,6%) i lijek-lijek interakcije (14,9%). Lijekovi najčešće uključeni u neprikladno propisivanje bili su oni s djelovanjem na probavni (16,3%), kardiovaskularni (16,0%) i živčani (8,6%) sustav. Najpropisivaniji PNL bio je antibiotik cefuroksim (n=25). Prosječan indeks prikladnosti po lijeku iznosio je 2,23 ± 2,25, a prosječan indeks prikladnosti po pacijentu je iznosio 15,90 ± 10,93. Najviše vrijednosti indeksa imali su lijekovi s djelovanjem na osjetila (6,50 ± 0,71) i koštano-mišićni sustav (5,25 ± 3,08). Učestalost PNL-ova bila je povezana s većim brojem lijekova u terapiji (p < 0,001). Učestalost potencijalno neprikladnog propisivanja u ovom je istraživanju bila vrlo visoka. Politerapija je bila povezana sa statistički značajno većom učestalosti PNL-ova.The aim of this study was to determine the prevalence of potentially inappropriate medications (PIM) identified by implicit criteria in hospitalized elderly patients with gastrointestinal diseases, and to explore the association of PIMs with demographic and clinical factors. A retrospective, cross-sectional observational study included emergently or electively admitted patients at the Department of Gastroenterology of Clinic for Internal Medicine, University Hospital Dubrava, in the period from October 2014 to October 2015. Including criteria were the age of 65 years or older and the gastrointestinal disease or neoplasm affecting gastrointestinal system. Based on the collected data, the appropriateness of each medication in therapy of every patient during hospitalization was assessed using implicit Medication Approprateness Index (MAI criteria), and thus PIMs were identified. Additionally, the association of PIMs with demographic and clinical factors was explored. Data were analysed using IBM SPSS v20 software. The study included 62 patients, average age 73,84 ± 5,55 years, who had average 5,94 ± 2,90 diagnosis and 7,15 ± 3,45 medications. There were 68,6% of medications in therapy of 96,8% of patients identified as potentially inappropriate according to at least one of ten MAI criteria. The most common problems were inccorect directions (24,8%), clinically unindicated medications (19,6%) and drug-drug interactions (14,9%). Drugs most commonly involved in inappropriate prescribing were those with effect on gastrointestinal (16,3%), cardiovascular (16,0%) and nervous (8,6%) system. The most commonly prescribed PIM was antibiotic cefuroxime (n=25). The mean MAI score per drug was 2,23 ± 2,25, and the mean MAI score per patient was 15,90 ± 10,93. The highest MAI scores had drugs with effect on sensory organs (6,50 ± 0,71) and musculo-skeletal system (5,25 ± 3,08). The prevalence of PIMs was associated with higher number of medications (p < 0,001). The prevalence of potentially inappropriate prescribing in this study was very high. Polytherapy was associated with statistically significantly higher incidence of PIMs

Potencijalno neprikladni lijekovi u osoba starije životne dobi utvrđeni implicitnim kriterijima i njihova povezanost s karakteristikama bolesnika

Cilj ovog istraživanja bio je odrediti učestalost propisivanja potencijalno neprikladnih lijekova (PNL) u hospitaliziranih osoba starije životne dobi s bolestima probavnog sustava koristeći implicitne kriterije te utvrditi povezanost PNL-ova s demografskim i kliničkim čimbenicima. Retrospektivno, presječno opservacijsko istraživanje uključilo je pacijente primljene putem hitnog ili elektivnog prijema na Odjel gastroenterologije Klinike za unutarnje bolesti Kliničke bolnice Dubrava u razdoblju od listopada 2014. do listopada 2015. godine. Uključujući kriteriji bili su životna dob od 65 ili više godina te bolest probavnog sustava ili neoplazma koja zahvaća probavni sustav. Na temelju prikupljenih podataka prikladnost svakog lijeka u terapiji pojedinog ispitanika tijekom hospitalizacije procijenjena je pomoću implicitnog Indeksa prikladnosti lijekova (MAI kriterija) te su na taj način identificirani PNL-ovi. Dodatno je istražena povezanost utvrđenih PNL-ova s demografskim i kliničkim čimbenicima. Podaci su statistički obrađeni u programu IBM SPSS v20. Istraživanje je uključilo 62 pacijenta prosječne dobi 73,84 ± 5,55 godina koji su prosječno imali 5,94 ± 2,90 dijagnoza i koristili 7,15 ± 3,45 lijekova. Identificirano je 68,6% lijekova u terapiji 96,8% ispitanika potencijalno neprikladnih barem prema jednom od deset MAI kriterija. Najčešći problem bile su neispravne ili nepotpune upute (24,8%), klinički neopravdane indikacije (19,6%) i lijek-lijek interakcije (14,9%). Lijekovi najčešće uključeni u neprikladno propisivanje bili su oni s djelovanjem na probavni (16,3%), kardiovaskularni (16,0%) i živčani (8,6%) sustav. Najpropisivaniji PNL bio je antibiotik cefuroksim (n=25). Prosječan indeks prikladnosti po lijeku iznosio je 2,23 ± 2,25, a prosječan indeks prikladnosti po pacijentu je iznosio 15,90 ± 10,93. Najviše vrijednosti indeksa imali su lijekovi s djelovanjem na osjetila (6,50 ± 0,71) i koštano-mišićni sustav (5,25 ± 3,08). Učestalost PNL-ova bila je povezana s većim brojem lijekova u terapiji (p < 0,001). Učestalost potencijalno neprikladnog propisivanja u ovom je istraživanju bila vrlo visoka. Politerapija je bila povezana sa statistički značajno većom učestalosti PNL-ova.The aim of this study was to determine the prevalence of potentially inappropriate medications (PIM) identified by implicit criteria in hospitalized elderly patients with gastrointestinal diseases, and to explore the association of PIMs with demographic and clinical factors. A retrospective, cross-sectional observational study included emergently or electively admitted patients at the Department of Gastroenterology of Clinic for Internal Medicine, University Hospital Dubrava, in the period from October 2014 to October 2015. Including criteria were the age of 65 years or older and the gastrointestinal disease or neoplasm affecting gastrointestinal system. Based on the collected data, the appropriateness of each medication in therapy of every patient during hospitalization was assessed using implicit Medication Approprateness Index (MAI criteria), and thus PIMs were identified. Additionally, the association of PIMs with demographic and clinical factors was explored. Data were analysed using IBM SPSS v20 software. The study included 62 patients, average age 73,84 ± 5,55 years, who had average 5,94 ± 2,90 diagnosis and 7,15 ± 3,45 medications. There were 68,6% of medications in therapy of 96,8% of patients identified as potentially inappropriate according to at least one of ten MAI criteria. The most common problems were inccorect directions (24,8%), clinically unindicated medications (19,6%) and drug-drug interactions (14,9%). Drugs most commonly involved in inappropriate prescribing were those with effect on gastrointestinal (16,3%), cardiovascular (16,0%) and nervous (8,6%) system. The most commonly prescribed PIM was antibiotic cefuroxime (n=25). The mean MAI score per drug was 2,23 ± 2,25, and the mean MAI score per patient was 15,90 ± 10,93. The highest MAI scores had drugs with effect on sensory organs (6,50 ± 0,71) and musculo-skeletal system (5,25 ± 3,08). The prevalence of PIMs was associated with higher number of medications (p < 0,001). The prevalence of potentially inappropriate prescribing in this study was very high. Polytherapy was associated with statistically significantly higher incidence of PIMs

APPLICATION OF GEOGRAPHIC INFORMATION SYSTEM FOR THE POSTAL NETWORK ANALYSIS

The postal network is a comprehensive set of several subsets, namely, postal infrastructure (consisted of objects and means), transportation networks, and human resources. It is organized by specific considerations of every country, following practices outlined by national and international regulation. Geographic Information System is a tool specialized for spatial data and network analysis. It can help identify shortcomings in a network environment, conditioned by a specific set of criteria and provisions. Spatial data and characteristics of the postal network are taken into consideration. The research area’s transportation infrastructure and administrative data are also needed for quality analysis of the postal network. The application of GIS in this paper is made following one County’s example in the Republic of Croatia