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The Importance of Self-Reported Medication Adherence in the Evaluation of the Effectiveness of Pharmacotherapy
Ládová, Kateřina ; Matoulková, Petra (advisor) ; Červený, Petr (referee) ; Lukáš, Milan (referee) ; Kolář, Jozef (referee)
Charles University in Prague, Faculty of Pharmacy in Hradec Králové Department of Social and Clinical Pharmacy Candidate: Mgr. Kateřina Ládová Supervisor: PharmDr. Petra Matoulková, Ph.D.; PharmDr. Magda Vytřísalová, Ph.D. (Consultant) Title of Doctoral Thesis: The Importance of Self-Reported Medication Adherence in the Evaluation of the Effectiveness of Pharmacotherapy Introduction and Objective: Medication adherence (MA) is a highly variable factor affecting the response to the therapy. Especially in chronic disease, non-adherence presents a problem that may have health, social, and even economic consequences. Measuring MA is the most often performed by self-reported surveys which enables, among others, their simple application in research as well as in every day clinical practices. Self-reported MA monitoring may contribute to maximizing the effectiveness of pharmacotherapy and minimizing the risk of therapy failure, however, standardization of measuring process is needed. Moreover, some factors such as healthy adherer effect (HAE), which reflect patient health seeking behaviour but cannot be easily monitored, can favourably affect health outcomes. Acquired results may then be incorrectly attributed to drug therapy examined in the study. Hence, the main aims of this doctoral thesis were: 1) to...
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Beliefs about medicines, Complementary and Alternative Medicine Use and Medication Adherence
Drapáková, Tereza ; Matoulková, Petra (advisor) ; Malý, Josef (referee)
1 ABSTRACT BELIEFS ABOUT MEDICINES, COMPLEMENTARY AND ALTERNATIVE MEDICINE USE AND MEDICATION ADHERENCE Student: Drapáková Tereza Tutor: PharmDr. Matoulková Petra, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic Introduction: Medication non-adherence is a very complex problem across different diseases leading to failure of treatment and increasing costs for medical care. Medication adherence is influenced by various factors and is also connected with different patients' attitudes to classical pharmacotherapy and complementary and alternative medicine (CAM). CAM is nowadays quite often used option for chronically treated patients. Aim of the study: The aim of the study was to analyse medication adherence at chronically treated patients visiting pharmacies in the Czech Republic, their attitudes to CAM including percentage of using CAM, the most common reasons using CAM and which types of CAM are the most spread among asked patients. Methods: Questionnaires were distributed in pharmacies in the Czech Republic among patients 18 years old and older who were chronically treated for at least 3 months. Selected patients were asked to complete a questionnaire containing questions about CAM, Czech version of Medication Adherence...
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Analysis of drug-related problems in a health facility I.
Bahnerová, Michaela ; Malý, Josef (advisor) ; Matoulková, Petra (referee)
Analysis of drug-related problems in a health facility I. Author: Michaela Bahnerová1 Tutor: Josef Malý1 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové Intoduction: Drug-related problems (DRPs) lower the quality of health care and present a risk factor in patient's safety. Objectives: The aim of this thesis is identification, classification and further analysis of DRPs in health care facility. Methods: Revision of pharmacotherapy was performed in health care facility in term 6. 8. - 10. 8. 2012. The pharmaceutical team which contained two pharmacists and diplomant examined health documentation of patients hospitalized in the facility. We collected information from personal, allergic, family, and labor-social anamnesis of patients. This data were noted into electronical database and after revision were DRPs classified and evaluated. The results of DRPs identification were evaluated by frequency analysis. In ten randomly selected patients was described DRPs resolution. Results: In total we noticed medical therapy in 175 patients (61 % women). Average patient's age was 58 years. 482 DRPs were identified. Of the patients, 84 % had DRPs and an average of 2,75 DRPs were recorded per patient. Conclusion: Appearance of DRPs is very frequent and...
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Advertising on complementary, alternative medicines and over the counter medicines (OTC) published in the printed journals for lay people from the view of Evidence Based Medicine
Schirlová, Zuzana ; Matoulková, Petra (advisor) ; Malý, Josef (referee)
Advertising on complementary, alternative medicines and over the counter medicines (OTC) published in the printed journals for lay people from the view of Evidence Based Medicine Student: Schirlová. Z Tutor: Matoulková, P. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic INTRODUCTION: Advertisements are important means of communicating information to public. The quality of the pharmaceutical advertising has been continuously discused. METHODS: The objective of the study was to assess availability of supporting scientific information for health claims stated in the food supplements and OTC (Over-the- Counter) medicines ads that were published during period September 2012 and June 2013 in the mostly read life style journals for women. For each advertisement, the emphasized claim/-s was compared to available scientific unbiased evidence. The literature search was conducted by using Pubmed database (mainly meta-analysis and randomized clinical trials). Further information was searched in the Scholar Google, Natural Medicines Comprehensive Database (Consumer version) and Micromedex. Different keywords and their appropriate combinations were used to identify relevant information. Frequency analysis was used to assess frequency...
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Drug interactions of cardiovascular drugs and their analysis in the patients of community pharmacy
Vávrová, Zuzana ; Malý, Josef (advisor) ; Matoulková, Petra (referee)
Drug interactions of cardiovascular drugs and their analysis in the patients of community pharmacy Author: Zuzana Vávrová1 Tutor: PharmDr. Josef Malý, Ph.D.1 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové Introduction: Drug interactions represent a serious health problem and they cause many hospitalizations. Although their identification and documentation received a considerable attention, they remain unrecognized for many patients. Objectives: The goal of the thesis was to analyze serious drug interactions between cardiovascular drugs, to describe their management in clinical practice, which is useful during dispensation, and to evaluate occurrence of these drug interaction in a community pharmacy. Methodology: The information was gained from several databases and compared, and afterwards management of major drug interactions of betablockers and calcium channel blockers was created. Patients of a community pharmacy were screened for these drug interactions. The data were processed by frequency analysis. Results: In the theoretical part, 94 drug interactions were analysed. The total number of patients who received betablockers or calcium channel blockers in the community pharmacy was 525. Serious drug interactions described in this...
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The analysis of eating habits of diabetics in the USA
Vaňkátová, Helena ; Vlček, Jiří (advisor) ; Matoulková, Petra (referee)
Besides the good drug compliance, appropriate nutrition plays important role in successful management of the metabolic aspects of type 2 diabetes mellitus (DM2), and in the prevention of diabetes-related conditions. The goal of this study was to analyze eating habits among DM2 patients in the United States. The Fat- and Fiber-Related Diet Habits Questionnaire (A.Shattuck, 1998) was used in this study to obtain identical data for comparison. The original version was slightly adjusted according to the local habits. The study took place at the El Rio Community Health Center clinics in Tucson, Arizona, USA; during the time period of three months (September to December 2011). Patients with DM2 patients visiting the clinic were recruited for participation. Once patients were given the questionnaire, answers were put into the database created in an Excel application (Microsoft Office 2010) and analyzed using the frequency analysis. 207 patients filled out the questionnaire. The mean age was 56,8 ± 12,6 years, the mean age when diagnosed with DM2 was 45,3 ± 12,7 years, BMI 33,2 ± 7,8 kg/m2, the mean waist circumference 109,7 ± 19,7 cm and the mean A1C was 8,1± 1,7% (ad DCCT). 10% of participants were treated only by the diet, 49% with peroral antidiabetics (PAD), 14% with insulin, and 28% with combination...
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The Pharmacotherapy of Chronic Non-maligant Pain Among Geriatric Patients
Bártová, Barbora ; Fialová, Daniela (advisor) ; Matoulková, Petra (referee)
Charles University in Prague, Faculty of Pharmacy in Hradec Králové Department of Social and Clinical Pharmacy Candidate: Mgr. Barbora Bartova Consultant: PharmDr. Daniela Fialova, PhD. Title of Thesis: The Pharmacotherapy of Chronic Non-malignant Pain among Geriatric Patients Introduction: Epidemiological studies demonstrate that prevalence of chronic pain increases with higher age. Furthermore, pain among older patients is often underrecognized and/or undertreated. Although rational treatment of geriatric pain has been extensively studied during the past decade, many older people still suffer from uncontrolled or insufficiently treated pain. The aim of this study is to evaluate the treatment of non-malignant chronic pain by general practitioners (GPs) in geriatric patients. Further, we discuss the role of pharmacist in rational pain pharmacotherapy as well as complex pharmacotherapy management in these patients. Methods: Data were obtained by prospective assessment of 80 geriatric patients 65+ (mean age 75,0 years (range 65-94 yrs), 80 % females) suffering from chronic nonmalignant pain. Evaluation of pain management and complex drug regimens was provided by specifically trained pharmacist in two general practices in Brno, Czech Republic (between March 2010 and December 2011). To assess the...
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Analysis of care in patients at risk for arterial hypertension in pharmacy I.
Gregor, Stanislav ; Malý, Josef (advisor) ; Matoulková, Petra (referee)
Analysis of care in patiens at risk for arterial hypertension in pharmacy I. Author: Stanislav Gregor1 Tutor: Josef Malý1 Consultant: Stanislav Havlíček2 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové 2 Czech Chamber of Pharmacists, Prague Introduction: Arterial hypertension represents a serious health problem. Despite of the fact that great attention is paid to an early diagnosis and therapy of arterial hypertension, it remains compensated insufficiently in a number of patients. Objectives: The aim of the thesis was to analyse the possibilities of pharmaceutical care provided to patients who are at risk of arterial hypertension. Methodology: Blood pressure was measured from the beginning of October till December 2012 in a public pharmacy in Moravská Třebová. The blood pressure was measured by a pharmacist by means of a validated and calibrated tonometer. Other data were collected from a directed interview with the pharmacy client. The data were evaluated in Microsoft Excel 2007 and processed by means of the frequency analysis. A retrospective analysis of drug problems was further performed in patients who have been using pharmacotherapy or food supplements. Results: The data were obtained from 196 pharmacy clients (31 % of men and...
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Analysis of Pharmacotherapy by patients with diagnosis of COPD
Kartali Kaouni, Marilena ; Vlček, Jiří (advisor) ; Matoulková, Petra (referee)
Title: Analysis of Pharmacotherapy by patients with diagnosis of COPD Student: Marilena Kartali-Kaouni Tutor: Prof. RNDr. Jiri Vlcek, CSc Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Kralove Background: " Chronic Obstructive Pulmonary Disease (COPD) is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases". Tobacco smoking is the major risk factor in the development of COPD. COPD is a leading cause of morbidity and mortality worldwide. Aim: 1st from the current literature to understand the nature of COPD and obtain information about the aetiopathogenesis of the disease, diagnosis options and summarize the current view of strategies for achieving the goals of treatment. 2nd in a pilot study to analyze drug therapy in COPD patients visiting a pharmacy in Greece. Methods: 56 prescriptions with the diagnosis of COPD were collected during a period of 8 months from a Greek pharmacy. Information from the prescriptions with regard to COPD medications prescribed (active substances, trade names, strength, dosage scheme, pack size), patients characteristics (age and gender) and prescribing...
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Prescription of Antibiotics and Antibacterial Chemotherapeutics of Selected Doctors in the Vysocina Region
Barochová, Jana ; Vlček, Jiří (advisor) ; Matoulková, Petra (referee)
Charles University in Prague, Faculty of Pharmacy in Hradec Králové Department of Department of Social and Clinical Pharmacy Candidate Mgr. Jana Barochová Consultant Prof. RNDr. Jiří Vlček, CSc. Title of Thesis Prescription of antibiotics and antibacterial chemotherapeutics of selected doctors in the Vysocina Region This work concerns the problems of prescription of antibiotics in the out-patient care. It analyzes the possibility to use pharmaceutical database for monitoring and evaluation of medical prescription at regional level. It is well known that the portion of antibiotics in the total prescription in Czech Republic is higher than would be optimal and therefore methods for minimization of excessive prescription of antibiotics are now intensively being searched. In this work we focused on the evaluation of prescription of antibiotics during years 1995 to 2008 for 35 general practitioners for adults and for 20 general practitioners for children. The data for prescription analysis was taken from the pharmaceutical database Medico, from 15 pharmacies in Vysocina region. For evaluation of the prescription patterns we used so called prescribing indicators. We have found out that during years 1995 to 2008 the drugs of the first choice in the treatment was gradually substituted by the alternative...
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