Publication: Estudio del cumplimiento terapéutico del tratamiento oncológico dispensado en oficina de farmacia en pacientes con cáncer de mama y cáncer de próstata
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2018-02-22
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Universidad Complutense de Madrid
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Abstract
El cáncer es, actualmente, uno de los problemas de salud más importantes en la mayoría de los países occidentales, no solo porque se ha convertido en una de las principales causas de muerte en todo el mundo, sino también por el impacto psicosocial de los pacientes, por la incidencia en la calidad de vida de los mismos y su entorno, y por los recursos sanitarios implicados en su asistencia y tratamiento. Pero, además, el paciente oncológico presenta muchas veces síntomas que requieren tratamiento tales como dolor, astenia, complicaciones orales, alteraciones de la piel, alteraciones nutricionales, deshidratación, trastornos gastrointestinales, trastornos cardiopulmonares, trastornos cognitivos y delirio, y trastornos del sueño. Es importante, además, tener en cuenta que un 60% de los pacientes con cáncer tienen más de 65 años, por lo que habrá que considerar la disfunción de órganos relacionada con la edad y que más del 80% presentan otras enfermedades que también requieren medicación. Todos ellos son factores que contribuyen a que este grupo de pacientes estén polimedicados. La falta de adherencia al tratamiento constituye un problema prevalente y de importante relevancia en la práctica clínica. En general, se estima que aproximadamente uno de cada dos pacientes no toma la medicación según las indicaciones de prescripción realizadas por el médico, aunque esta proporción varía mucho en función de la patología analizada. Aunque todavía no se ha cuantificado el coste económico por la falta de cumplimiento terapéutico en enfermedades oncológicas, se puede intuir que son costes muy elevados porque el incumplimiento terapéutico lleva consigo un aumento de visitas a urgencias hospitalarias, aumento de pruebas complementarias y aumento de ingresos hospitalarios. Además, la OMS considera la falta de adherencia un tema prioritario de salud pública. Existen múltiples evidencias sobre la relación existente entre la falta de adherencia terapéutica y el aumento de la morbimortalidad debido a la pérdida de eficacia del medicamento. Médicos, enfermeros y farmacéuticos son conscientes de este problema y, desde las oficinas de farmacia, se puede ayudar de forma muy importante a solventar este problema, siempre en comunicación directa con todo el personal sanitario de Atención Primaria...
Cancer is currently one of the most important health problems in most Western countries. Not only because it has become one of the leading causes of death in the world, but also because of the psychosocial impact on patients, the impact on the quality of life of the same and their environment, and by the health resources involved in patient care and treatment. In addition, the cancer patient often exhibits symptoms requiring treatment such as pain, asthenia, oral complications, skin disorders, nutritional disorders, dehydration, gastrointestinal disorders, cardiopulmonary disorders, cognitive disorders and delirium, and sleep disorders. It is also important to take into account that 60% of patients with cancer are over 65 years old. Therefore, age-related organ dysfunction has to be considered as well as the fact that more than 80% of these patients have other diseases that also require medication. All of these are factors that contribute to this group of patients being polymedicated. The lack of adherence to treatment is a prevalent problem and of great relevance in clinical practice. In general, it is estimated that approximately one in two patients does not take the medication as prescribed by the physician, although this proportion varies greatly depending on the pathology analyzed. Although the economic cost due to the lack of therapeutic compliance in oncological diseases has not yet been quantified, one can guess that the cost are very high as therapeutic noncompliance leads to an increase of visits to hospital emergencies, increase of complementary tests and increase of hospitalizations. In addition, the WHO considers the lack of adherence a priority public health issue. There is multiple evidence of a relationship between lack of therapeutic adherence and increased morbidity and mortality due to the loss of efficacy of the drug. Doctors, nurses and pharmacists are aware of this problem. The pharmacies, in direct communication with all the primary health care staff, can help in a very important way to solve this problem...
Cancer is currently one of the most important health problems in most Western countries. Not only because it has become one of the leading causes of death in the world, but also because of the psychosocial impact on patients, the impact on the quality of life of the same and their environment, and by the health resources involved in patient care and treatment. In addition, the cancer patient often exhibits symptoms requiring treatment such as pain, asthenia, oral complications, skin disorders, nutritional disorders, dehydration, gastrointestinal disorders, cardiopulmonary disorders, cognitive disorders and delirium, and sleep disorders. It is also important to take into account that 60% of patients with cancer are over 65 years old. Therefore, age-related organ dysfunction has to be considered as well as the fact that more than 80% of these patients have other diseases that also require medication. All of these are factors that contribute to this group of patients being polymedicated. The lack of adherence to treatment is a prevalent problem and of great relevance in clinical practice. In general, it is estimated that approximately one in two patients does not take the medication as prescribed by the physician, although this proportion varies greatly depending on the pathology analyzed. Although the economic cost due to the lack of therapeutic compliance in oncological diseases has not yet been quantified, one can guess that the cost are very high as therapeutic noncompliance leads to an increase of visits to hospital emergencies, increase of complementary tests and increase of hospitalizations. In addition, the WHO considers the lack of adherence a priority public health issue. There is multiple evidence of a relationship between lack of therapeutic adherence and increased morbidity and mortality due to the loss of efficacy of the drug. Doctors, nurses and pharmacists are aware of this problem. The pharmacies, in direct communication with all the primary health care staff, can help in a very important way to solve this problem...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, Departamento de Farmacología, leída el 26-06-2017