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Medicinski časopis
2012, vol. 46, br. 4, str. 205-213
jezik rada: srpski
vrsta rada: pregledni članak
doi:10.5937/mckg46-1467


Komplijansa, adherenca, konkordanca i perzistenca u savremenoj farmakoterapiji
aUniverzitet u Kragujevcu, Medicinski fakultet
bAlvogen Pharma, Beograd
cFakultet medicinskih nauka, Klinički centar 'Kragujevac', Centar za anesteziju i reanimaciju, Kragujevac
dOpšta bolnica, Šabac
eApotekarska ustanova, Kragujevac
fActavis d. o. o., Novi Beograd
gUniverzitet Union, Beograd

e-adresa: duca1duca@gmail.com

Sažetak

Kvalitet zdravstvene zaštite, propisivanje recepata i uzimanje lekova na odgovarajući način može se donekle definisati terminima kao što su komplijansa, adherenca, perzistenca i konkordanca. Komplijansa je mera do koje se ponašanje osobe koja uzima lek, poklapa sa preporukom zdravstvenog radnika koji lek izdaje/propisuje. Adherenca je pojam koji se često poistovećuje s pojmom komplijansa, a podrazumeva veće angažovanje pacijenta pri donošenju odluka vezanih za njegovu terapiju. Neuspeh u merenju adherence delom se može pripisati fenomenu 'adherence belog mantila'. Zato se istraživači trude da pronađu novu meru, kao što je perzistenca. Neadherenca se može razvrstati u dve kategorije: primarnu i sekundarnu; namernu i nenamernu. Za merenje adherence koriste se razne metode. U zavisnosti od istraživačkih ciljeva bira se jedna od metoda za praćenje adherence iz grupe direktnih (merenje nivoa leka ili metabolita u krvi, biološkog markera u krvi) ili indirektnih metoda (brojanje pilula, dnevnici pacijenata, stopa ponovnih popunjavanja recepata, upitnici za pacijente, samoizveštaji pacijenata). Brojni dokazi pokazuju da je slaba adherenca u terapijskim procedurama izuzetno skupa i da predstavlja veliki problem koji utiče na sve uzraste, oba pola i ljude svih društvenoekonomskih slojeva. Za poboljšanje komplijanse, adherence, konkordance i perzistence treba primenjivati celovitije strategije, s komplementarnim intervencijama, kako bi ukupni rezultati bili bolji iz aspekta javnog zdravlja. Pred donosiocima odluka u zdravstvu i ekspertima angažovanim u redovnom, kliničkom radu i upravljanju zdravstvenim sistemom je važan zadatak implementacije validnih strategija jer već sada postoji obilje jakih dokaza za mnoge od njih. Smernice translacione medicine su, u tom smislu, posebno korisne.

Ključne reči

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