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Osteoporosis management at general practitioners level
Karaščák, Roman ; Vytřísalová, Magda (advisor) ; Kostřiba, Jan (referee)
CHARLES UNIVERSITY IN PRAGUE Faculty of Pharmacy in Hradec Králové Department of Social and Clinical Pharmacy Candidate: Mgr. Roman Karaščák Title of thesis: Osteoporosis management at general practitioners level Director of studies: PharmDr. Magda Vytřísalová, Ph.D. Consultant of studies: PharmDr. Leoš Fuksa, Ph.D. Osteoporosis, the most prevalent human skeletal metabolism-based disease, is manifested by the weakened bone micro-structure and its lowered endurance against mechanical impacts which results to the higher fracture incidence. Nowadays it is considered to be a lifestyle disease. Contnuous rise of osteoporosis incidence and prevalence may become even more rapid in the future and could overwhelm the public healthcare system. Post-menopausal women and elderly people are threatened by an involutional osteoporosis. In Czech Republic, the principal provider is general practitioner, who ensures comprehensive healthcare for his patients. In order to do so, because of the present limitations, he has an obligation to cooperate with and to adress his patients to certain specialists - osteologists, endocrinologists, internists, orthopedists and gynecologists. We conducted a cross-sectional questionnairy study. Questionnaires were sent to 1 500 random-selected general practitioners in the two-round...
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Adherence to pharmacotherapy of osteoporosis
Santariová, Martina ; Vytřísalová, Magda (advisor) ; Doseděl, Martin (referee)
ADHERENCE TO PHARMACOTHERAPY OF OSTEOPOROSIS Author: Martina Santariová Supervisor: PharmDr. Magda Vytřísalová, Ph.D. Charles University in Prague, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy INTRODUCTION: Adherence is the extent to which the patient's behavior (using of medication, following recommended regimen) is in accordance with the advice of the health care provider. Adherence to pharmacotherapy of osteoporosis, including compliance and persistence, is still suboptimal. OBJECTIVE: The objective of the study was assessing of subjectively evaluated adherence with peroral bisphosphonates used to treat osteoporosis within Czech women. METHODS: A cross-sectional multicentre survey. Data collecting was carried out using anonymous questionnaire in five osteocenters in the Czech Republic. The research was performed between November 2012 and March 2013. Adherence was evaluated using a standardized questionnaire OS- MMAS (Osteoporosis-specific Morisky Medication Adherence Scale). RESULTS: A total of 363 postmenopausal women aged 55 years and older with osteoporosis or osteopenia were participated in the study. 133 (36,6 %) women used weekly dosage forms of BIS (alendronate, alendronate and vitamine D in a fixed combination, risedronate) and 230 (63,4 %) women used...
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Qualitative aspects of adherence to antiresorptive treatment in women with postmenopausal osteoporosis
Ravingerová, Aneta ; Vytřísalová, Magda (advisor) ; Doseděl, Martin (referee)
QUALITATIVE ASPECTS OF ADHERENCE TO ANTIRESORPTIVE TREATMENT IN WOMEN WITH POSTMENOPAUSAL OSTEOPOROSIS Author: Aneta Ravingerová Supervisor: Magda Vytřísalová Charles University in Prague, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy INTRODUCTION: Compliance is using of medication in accordance with a prescription drug regimen. Qualitative aspect of compliance represents use of drugs in correct way. significantly affects treatment outcomes.Suboptimal compliance The study aim was to assess qualitative compliance with bisphosphonates (BIS)AIMS: among Czech women with osteoporosis in common clinical practice. METHODS: Data collection was performed using anonymous questionnaire in five outpatient Compliance with fivecentres in the Czech Republic from November 2012 to March 2013. dosing instructions for safe use and adequate absorption of BIS was evaluated. : A total of 363 patients were involved in the analysisRESULTS (mean age 68.9 years). once a week dosing forms ofPatients were treated with BIS - alendronate, alendronate + once a month dosing formvitamine D in a fixed combination, risedronate (N = 36.6 %) or - Only 46.6 % of respondents from weekly subgroup were compliantibandronate (N = 63.4 %). with all five dosing recommendations in monthly subgroup....
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Adherence to calcium and vitamin D supplementation in women with postmenopausal osteoporosis
Holcová, Radka ; Vytřísalová, Magda (advisor) ; Fuksa, Leoš (referee)
Adherence to calcium and vitamin D supplementation in women with postmenopausal osteoporosis Author: Radka Holcová Supervisor: Magda Vytřísalová Charles University in Prague, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy Introduction: The insufficient medication adherence is a very frequent problem with chronic asymptomatic diseases as osteoporosis which significantly influences the treatment outcome. The successful osteoporosis therapy is based on adequate supply of calcium and vitamin D. A lot of studies are focused on the adherence to antiresorptive treatment but the adherence to supplementation therapy is rarely evaluated. Aims: The aim of the study was to evaluate the adherence to calcium and vitamin D supplementation in women with postmenopausal osteoporosis. Methods: The adherence was evaluated using two different methods: self-reported questionnaire and the electronic monitoring by bottles type Medication Event Monitoring System (MEMS). This partial analysis of a multicentre study includes and assesses data from Osteocentre in Pardubice Regional Hospital. Results: The analysis was performed with 15 women (the average age of 73). The patients were treated with Caltrate 600 mg/400 IU D3 once a day for three months. The adherence during the entire period...
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Analysis of blood pressure measurement in Czech pharmacies II.
Bajer, Richard ; Doseděl, Martin (advisor) ; Vytřísalová, Magda (referee)
Background Arterial hypertension is a worldwide issue. This disease is underdiagnosed dispite of frequent media publication. Intervention of the pharmacist can significantly influence the hypertension detection, improve the adherence to treatment and control of the blood pressure value at already treated patients. Aim The main task of this project is evaluation of the way the pharmacists in the district Karviná provide the blood pressure monitoring and how they provide the pharmaceutic care to the patients with hypertension or high risk of cardiovascular disease. This submitted work is part of extensive study dealing with this issue in nationwide scope. Methods Data for this work were collected with two questionnaires in the period of August to September 2011 in district Karviná. The questionnaires included thirty open, semi-open and closed questions. The first questionnaire included questions focused on the pharmacy. The second questionnaire included questions focused on the workers operating the blood pressure monitoring and the way how the exercise the measurements (age, sex, job in the pharmacy, description of the measurement method, model situations). Results 54 (98 %) of the pharmacies were evaluated in this work from the total number of 55 pharmacies. Only one pharmacy refused the...
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2Adherence to Osteoporosis Treatment
Vytřísalová, Magda ; Vlček, Jiří (advisor) ; Horák, Pavel (referee) ; Macek, Karel (referee)
Literature search Introduction: Osteoporosis (OP) is an important non-communicable disease, the incidence of which is increasing. It is a systemic metabolic skeletal disease characterized by reduced bone mass and changes in bone tissue quality. These disorders increase the risk of fracture and consequently have a considerable impact on public health. OP affects primarily postmenopausal women, but has recently become a great concern in men as well. Among the most important preventive (and non-drug therapeutic) interventions are a diverse diet high in calcium, adequate physical activity, avoidance of exposure to toxic substances and fall prevention. Multiple therapeutic strategies are used in attempts to restore balance between the bone resorption and the bone formation. A first-line intervention is calcium and vitamin D supplementation. Specific drug therapies (anti-osteoporosis drugs) are classified according to the predominant mechanism of action into anticatabolic or antiresorptive drugs (bisphosponates, raloxifene, calcitonin) and formation stimulating, anabolic drugs (parathormones), and drugs with a dual mechanism of action (strontium-ranelate). The current treatment strategies reduce the risk of fracture by about half and have proved cost effective. As in other chronic asymptomatic diseases,...
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Secondary prevention and pharmacotherapy after fragility hip fracture.
Bechyňová, Štěpánka ; Vlček, Jiří (advisor) ; Vytřísalová, Magda (referee)
Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Social and Clinical pharmacy Candidate: Štěpánka Bechyňová Supervisor: Prof. RNDr. Vlček CSc., MUDr. Tomáš Hála Title of diploma thesis: Secondary prevention and pharmacotherapy after fragility hip fracture. Osteoporosis is a global healthy problem. The incidence of fractures increases with increasing age. In particular, hip fractures are the most serious of all osteoporotic fractures. It is not only due to healthy problems, but also because of social isolation. Hip fractures are also associated with high mortality. The secondary prevention tries to prevent further fractures. This includes pharmacological and non-pharmacological approaches. The non-pharmacological approach includes prevention of falls, hip protectors, nutrition and lifestyle. The Ground of pharmacological treatment is calcium and vitamin D. At present we are able to treat osteoporosis with calcitonin, selective estrogen receptor modulators (for women), bisphosphonates, parathyroid hormone and strontium ranelate. In order to prevent further fractures, the patient should be sent to the bone mineral density, and according to it the patient should be treated. Our study includes patients who are over 50 years old, who have suffered a fractured neck of femur...
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Patients' attitudes to pharmacotherapy of osteoporosis
Theimerová, Hana ; Vytřísalová, Magda (advisor) ; Hendrychová, Tereza (referee)
1 ABSTRACT PATIENTS' ATTITUDES TO PHARMACOTHERAPY OF OSTEOPOROSIS Author: Hana Theimerová Supervisor: Magda Vytřísalová Charles University in Prague, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy INTRODUCTION: Patients' attitudes to treatment might be affected by various factors. These may vary in different generations as well as in different populations. The patients' attitudes to the treatment along with the illness may affect decision concerning the beginning, interruption or end of the treatment. That implies that the interaction between these factors and attitudes to the treatment is comprehensive. AIMS: The study aim was to evaluate the patients' attitudes to the treatment of osteoporosis based on the perception of necessity and concerns of treatment with oral bisphosphonates (BIS). METHODS: Data for the analysis were obtained using an anonymous questionnaire in five outpatient centres in the Czech Republic from November 2012 to March 2013. The patients' opinions concerning the BIS treatment were identified (necessity vs. concerns) using the Czech version of the "Beliefs about Medicines Questionnaire Specific" (BMQ-CZ). RESULTS: A total of 363 patients were involved in the analysis (mean age 68.9 years). Patients were treated with once a week dosing forms of BIS -...
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Qualitative and Quantitative Aspects of Adherence to Osteoporosis Treatment
Toušková, Tereza ; Vytřísalová, Magda (advisor) ; Mareš, Jiří (referee) ; Tesař, Tomáš (referee)
Charles University, Faculty of Pharmacy in Hradec Králové Department of Department of Social and Clinical Pharmacy Candidate Mgr. Tereza Toušková Supervisor PharmDr. Magda Vytřísalová, PhD. Title of Doctoral Thesis QUALITATIVE AND QUANTITATIVE ASPECTS OF ADHERENCE TO OSTEOPOROSIS TREATMENT Následuje překlad abstraktu práce do anglického jazyka. Introduction: Non-adherence in the field of osteoporosis (OP) is considerable and it is necessary to deal with it because adequate adherence to the therapy leads to a reduction in the risk of fractures, the number of hospitalizations, and the cost of health care. Monitoring of the adherence is therefore an essential and integral part of patient care. The problem in osteoporotic patients is that 30-50% don't follow the recommendations for proper use of the drugs, which is f.e. for the treatment of oral bisphosphonates (p.o. BIS) essential. Despite the availability of effective pharmacotherapy, approximately half of patients with OP aren't adherent to the treatment regimen and / or discontinue treatment during the first year of use. Many different methods are used for adherence measurement, making the results difficult to compare. There still isn't a "gold standard" in the measurement of adherence, which would be widely used, which would allow relevant data on...
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Qualitative and Quantitative Aspects of Adherence to Osteoporosis Treatment
Toušková, Tereza ; Vytřísalová, Magda (advisor) ; Mareš, Jiří (referee) ; Tesař, Tomáš (referee)
Charles University, Faculty of Pharmacy in Hradec Králové Department of Department of Social and Clinical Pharmacy Candidate Mgr. Tereza Toušková Supervisor PharmDr. Magda Vytřísalová, PhD. Title of Doctoral Thesis QUALITATIVE AND QUANTITATIVE ASPECTS OF ADHERENCE TO OSTEOPOROSIS TREATMENT Následuje překlad abstraktu práce do anglického jazyka. Introduction: Non-adherence in the field of osteoporosis (OP) is considerable and it is necessary to deal with it because adequate adherence to the therapy leads to a reduction in the risk of fractures, the number of hospitalizations, and the cost of health care. Monitoring of the adherence is therefore an essential and integral part of patient care. The problem in osteoporotic patients is that 30-50% don't follow the recommendations for proper use of the drugs, which is f.e. for the treatment of oral bisphosphonates (p.o. BIS) essential. Despite the availability of effective pharmacotherapy, approximately half of patients with OP aren't adherent to the treatment regimen and / or discontinue treatment during the first year of use. Many different methods are used for adherence measurement, making the results difficult to compare. There still isn't a "gold standard" in the measurement of adherence, which would be widely used, which would allow relevant data on...
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