Naslov (srp)

Ispitivanje prediktivne vrednosti kvaliteta života u proceni terapijske adherencije za metotreksat kod obolelih od reumatoidnog artritisa : doktorska disertacija

Autor

Ćeranić, Jelena Š., 1974-

Doprinosi

Maksimović, Nataša, 1974-
Kisić-Tepavčević, Darija, 1975-
Ristić, Gorica, 1968-
Šefik-Bukilica, Mirjana, 1964-
Petronijević, Milan, 1966-

Opis (eng)

Introduction.Inadequately treated and poorly controlled rheumatoid arthritis (RA) leads toserious joint damage, reduced functional capacity, and diminished quality of life. Non adherenceto methotrexate (MTX) is a significant barrier to optimal treatment of RA patients. A largenumber of variables influencing adherence to MTX have been identified, but none have beensingled out to pre cisely define the risk of non adherence.Objective. Assessment of the prevalence of nonadherence to methotrexate in patients withrheumatoid arthritis and analysis of the prognostic significance of socio demographiccharacteristics, clinical determinants of the disease and quality of life in the assessment of nonadherence to methotrexate.Methods.The study included RA patients who were treated at the Rheumatology Clinic of theMilitary Medical Academy in Belgrade. Assessment of RA activity was performed using threescales: the Clinical Disease Activity Index (CDAI) and the Disease Activity Score 28 jointcount DAS 28 (DAS28), while the HAQ Di questionnaire was used to assess functional ability(Health Assessment Questionnaire HAQ). The degree of depressio n or anxiety was measuredusing the HADS (Hospital Anxiety and Depression Scale) questionnaire. To evaluate the qualityof life, we used three questionnaires.: the general questionnaire for examining the quality of lifeSF 36 (36 Item Short Form Survey) or RAND36, RAQoL (Rheumatoid Arthritis Quality of LifeRAQoL) and the EQ 5D 3L questionnaire (EuroQol Group 5 questionnaire). Adherence wasassessed using two questionnaires and a self assessment scale: compliance questionnaire inrheumatology, CQR19 questi onnaire (Compliance Questionnaire for Rheumatology CQR),medication adherence rating scale (MARS 5) and assessment of adherence on the VAS scale(Analogue Scale VAS). Statistical data processing was done in SPSS Windows, version 26.0.The level of statisti cal significance was p < 0.05.Results.A cross section study included 111 patients with RA. Adherence to MTX was 48.6%when assessed by the CQR19 questionnaire, 70.3% by the MARS 5 questionnaire and 82.9% bythe VAS scale assessment. A highly significant positive correlation was obtained between allthree adherence assessment questionnaires. After analyzing sociodemographic and clinicalcharacteristics, as well as comorbidities, no statistically significant difference was found inquestionnaire scores forquestionnaire scores for adherence to MTX. A statistically significant independent predictive adherence to MTX. A statistically significant independent predictive value for adherence to MTX in all three measurement instruments was obtained for concomitant value for adherence to MTX in all three measurement instruments was obtained for concomitant steroid use. Patients with RA have been shown to experience a reduced quality of life, primaristeroid use...

Opis (srp)

Uvod. Neade kvatno lečen i nedovoljno kontrolisan reumatoidni artritisa (RA) dovodi doozbiljnog oštećenja zglobova i smanjenja funkcionalne sposobnosti kao i kvaliteta života.Uočeno je da nezadovoljavajuća adherencija za metotreksat (MTX) predstavlja značajnu barije ruu optimalnom lečenju pacijenata sa RA. Indentifikovan je veliki broj varijabli koji utiču naadherenciju za MTX, ali se nijedna nije izdvojila za precizno definisanje rizika za neadherenciju.CiljeviProcena prevalencije neadherencije za metotreksat k od bolesnika sa reumatoidnimartritisom i analiza prognostičnog značaja socio demografskih karakteristika, kliničkihdeterminanti bolesti i kvaliteta života u proceni neadherencije na metotreksat.Metod.Studijom su obuhvaćeni pacijenti sa RA lečeni u Kli nici za reumatologiju,Vojnomedicinske akademije u Beogradu. Procena aktivnosti RA je vršena primenom tri skale:indeksa kliničke aktivnosti bolesti (Clinical Disease Activity Index CDAI) i skora aktivnostibolesti (Disease Activity Score 28 joint count DA S 28), dok je za procena funkcionalnesposobnosti korišćen HAQ Di upitnik (Health Assessment Questionnaire HAQ). Za procenustepena depresije odnosno anksioznosti korišćen je HADS upitnik (Hospital anxiety anddepression scale). Procena kvaliteta života ra đena je pomoću tri upitnika: opšteg upitnika zaispitivanje kvaliteta života SF 36 (36 Item Short Form Survey) odnosno RAND36, RAQoL(Rheumatoid Arthritis Quality of Life RAQoL) i EQ 5D 3L upitnika (EuroQol Group 5questionnaire). Adherencija je procenjena pomoću dva upitnika i skalom samoprocene:upitnikom komplijanse u reumatologiji, CQR19 upitnikom (Compliance Questionnaire forRheumatology CQR), skalom ocene pridržavanja terapiji/leku (Medication adherence ratingscale MARS 5) i procenom adherencije na VAS skali (Analogue Scale VAS). Statistička obradapodataka je rađena u SPSS Windows, verzije 26.0. Nivo statističke značajnosti je iznosio p <0,05.Rezultati.Studijom je obuhvaćeno 111 ispitanika sa RA. Adherencija za MTX je iznosila 48,6%kada je proc enjena pomoću CQR19 upitnika, 70,3% putem MARS 5 upitnik i 82,9% procenomna VAS skali. Između sva tri upitnika za procenu adherencije dobijena je visoko značajnapozitivna korelacija . U odnosu na stepen adherencije za MTX merenom sa tri upitnika nijeuoče na razlika u sociodemografskim i kliničkim karakteristikama kao i prisustvu komorbiditeta .Statistički značajna nezavisna prediktivna vrednost za adherenciju za MTX u sva tri mernainstrumenta je dobijena za konkomitantnu upotrebu steroida...

Opis (srp)

Medicina - Epidemiologija / Medicine- Epidemiology Datum odbrane: 12.07.2024.

Jezik

srpski

Datum

2024

Licenca

© All rights reserved

Predmet

OSNO - Opšta sistematizacija naučnih oblasti, Reumatologija

Ključne reči: reumato idni artritis, adherencija, metotreksat, kvalitet života, upitnici, predikcija, konkomitantna terapija, kotikosteroidi

616.72-002.77-036.22(043.3)

OSNO - Opšta sistematizacija naučnih oblasti, Reumatologija

rheumatoid arthritis, adherence, methotrexate, quality of life, questionnaires, prediction, concomitant therapy, steroids