{"id":29583,"date":"2017-11-23T09:24:40","date_gmt":"2017-11-23T08:24:40","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=29583"},"modified":"2017-11-23T09:24:40","modified_gmt":"2017-11-23T08:24:40","slug":"seniori-v-domovech-jsou-casto-ohrozeni-nevhodnymi-leky-vyplyva-to-ze-setreni-ustavu-lekoveho-pruvodce","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=29583","title":{"rendered":"Senio\u0159i v domovech jsou \u010dasto ohro\u017eeni nevhodn\u00fdmi l\u00e9ky. Vypl\u00fdv\u00e1 to ze \u0161et\u0159en\u00ed \u00dastavu l\u00e9kov\u00e9ho pr\u016fvodce"},"content":{"rendered":"

Star\u0161\u00ed lid\u00e9 v za\u0159\u00edzen\u00edch soci\u00e1ln\u00ed p\u00e9\u010de jsou ohro\u017eeni u\u017e\u00edv\u00e1n\u00edm vysok\u00e9ho po\u010dtu l\u00e9k\u016f, l\u00e9k\u016f nevhodn\u00fdch k jejich v\u011bku \u010di zdravotn\u00edmu stavu, nevhodn\u00fdmi kombinacemi l\u00e9k\u016f nebo jejich vysok\u00fdmi d\u00e1vkami.<\/strong>
\n
\nDomovy senior\u016f se dlouhodob\u011b pot\u00fdkaj\u00ed s nedostatkem praktick\u00fdch l\u00e9ka\u0159\u016f i specialist\u016f, kte\u0159\u00ed mohou zdravotn\u00ed stav klient\u016f pravideln\u011b sledovat. Stejn\u011b tak se jim nedost\u00e1v\u00e1 zku\u0161en\u00fdch zdravotn\u00edch sester a o\u0161et\u0159ovatel\u016f. Segment zdravotn\u011b soci\u00e1ln\u00edch slu\u017eeb je chronicky podfinancov\u00e1n. Potvrzuj\u00ed to v\u00fdsledky ze t\u0159\u00edlet\u00e9ho \u0161et\u0159en\u00ed neziskov\u00e9 organizace \u00dastav l\u00e9kov\u00e9ho pr\u016fvodce a klinick\u00fdch farmaceut\u016f. Partnery projektu jsou Nemocnice Na Homolce a jej\u00ed t\u00fdm zku\u0161en\u00fdch klinick\u00fdch farmaceut\u016f pod veden\u00edm PharmDr. Milady Hala\u010dov\u00e9, Ph.D., a St\u00e1tn\u00ed \u00fastav pro kontrolu l\u00e9\u010div.<\/p>\n

Detailn\u00edmi rozbory farmakoterapie na z\u00e1klad\u011b posouzen\u00ed l\u00e9ka\u0159sk\u00e9 a o\u0161et\u0159ovatelsk\u00e9 dokumentace pro\u0161lo dosud 13 domov\u016f pro seniory po cel\u00e9 \u010cR. Nejv\u00edc domov\u016f se \u00fa\u010dastnilo v Praze a na Vyso\u010din\u011b, kde \u201eaudity\u201c prob\u00edhaly ve spolupr\u00e1ci s kraji. Do projektu je nyn\u00ed zapojeno 17 klinick\u00fdch farmaceut\u016f, kte\u0159\u00ed v\u017edy na m\u00edst\u011b ov\u011b\u0159ili medikaci u celkem 846 klient\u016f. V pr\u016fm\u011bru vydali v\u00edce jak dv\u011b doporu\u010den\u00ed na jednoho klienta a posoudili t\u00e9m\u011b\u0159 7 tis\u00edc l\u00e9k\u016f.<\/p>\n

\u201eV\u00fdsledky zji\u0161t\u011bn\u00ed ukazuj\u00ed, \u017ee senio\u0159i v domovech u\u017e\u00edvaj\u00ed v pr\u016fm\u011bru 8 r\u016fzn\u00fdch druh\u016f l\u00e9k\u016f na p\u0159edpis denn\u011b. U \u0159ady klient\u016f nen\u00ed dohledateln\u00e9 z dokumentace, pro\u010d konkr\u00e9tn\u00ed l\u00e9k u\u017e\u00edvaj\u00ed. Jde o kritickou hranici, kdy by m\u011bli b\u00fdt klienti pravideln\u011b sledov\u00e1ni l\u00e9ka\u0159em z d\u016fvodu p\u0159ehodnocen\u00ed \u00fa\u010delnosti a bezpe\u010dnosti pod\u00e1van\u00e9 medikace. Praxe v\u0161ak ukazuje, \u017ee v\u011bt\u0161ina klient\u016f se dost\u00e1v\u00e1 ke konzultaci s praktick\u00fdm l\u00e9ka\u0159em a\u017e v okam\u017eiku, kdy se objev\u00ed probl\u00e9m. Proaktivn\u00ed p\u0159\u00edstup a pravideln\u00e1 revize medikace nen\u00ed v podstat\u011b z kapacitn\u00edch d\u016fvod\u016f mo\u017en\u00e1,\u201c shrnuje vedouc\u00ed Odd\u011blen\u00ed klinick\u00e9 farmacie Nemocnice Na Homolce, PharmDr. Milada Hala\u010dov\u00e1.<\/p>\n

Klienty za\u0159\u00edzen\u00ed soci\u00e1ln\u00ed p\u00e9\u010de jsou v drtiv\u00e9 v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f lid\u00e9 star\u0161\u00ed 80 let. \u010casto jde o nemohouc\u00ed seniory, kte\u0159\u00ed trp\u00ed v\u00edce nemocemi a pot\u0159ebuj\u00ed p\u00e9\u010di r\u016fzn\u00fdch specialist\u016f jako je kardiolog, urolog, diabetolog nebo psychiatr. A\u017e 80 procent z nich je p\u0159i u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f zcela z\u00e1visl\u00e1 na o\u0161et\u0159uj\u00edc\u00edm person\u00e1lu, a to vlivem sn\u00ed\u017een\u00fdch rozhodovac\u00edch schopnost\u00ed nebo demence.<\/p>\n

\u201eNej\u010dast\u011bji jsme p\u0159i studiu zdravotnick\u00e9 dokumentace klient\u016f zjistili, \u017ee lid\u00e9 u\u017e\u00edvaj\u00ed l\u00e9ky nevhodn\u00e9 vzhledem k jejich v\u011bku \u010di diagn\u00f3ze, naopak chyb\u011bla l\u00e9\u010diva s jasn\u011b prok\u00e1zan\u00fdm pozitivn\u00edm vlivem na v\u00fdvoj jejich nemoci \u010di d\u00e9lku p\u0159e\u017eit\u00ed nebo byly voleny nevhodn\u00e9 d\u00e1vky l\u00e9k\u016f, kter\u00e9 n\u00e1sledn\u011b vedly k rozvoji ne\u017e\u00e1douc\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f,\u201c doplnila Hala\u010dov\u00e1.<\/p>\n

\u201eV\u00fdznamn\u00e1 \u010d\u00e1st zvl\u00e1\u0161t\u011b velmi star\u00fdch senior\u016f se vyzna\u010duje n\u00edzkou \u00farovn\u00ed potenci\u00e1lu zdrav\u00ed, ozna\u010dovanou jako k\u0159ehkost (frailty). Pr\u00e1v\u011b u t\u011bchto senior\u016f s klesaj\u00edc\u00ed sob\u011bsta\u010dnost\u00ed se zv\u00fdraz\u0148uje pot\u0159eba \u00fa\u010deln\u00e9, bezpe\u010dn\u00e9, dostupn\u00e9 a personalizovan\u00e9 farmakoterapie. Mezin\u00e1rodn\u00ed studie p\u0159ed n\u011bkolika lety zjistila, \u017ee v tomto ohledu pat\u0159\u00ed \u010cR k nejhor\u0161\u00edm v r\u00e1mci EU ji\u017e p\u0159i hodnocen\u00ed l\u00e9\u010dby zdatn\u011bj\u0161\u00edch senior\u016f \u017eij\u00edc\u00edch v dom\u00e1c\u00edm prost\u0159ed\u00ed. Nyn\u011bj\u0161\u00ed projekt L\u00e9kov\u00e9ho pr\u016fvodce potvrdil syst\u00e9mov\u011b neut\u011b\u0161enou situaci u nejk\u0159eh\u010d\u00edch ob\u010dan\u016f v domovech pro seniory, kter\u00e9 se rychle m\u011bn\u00ed ze soci\u00e1ln\u011b pobytov\u00fdch v o\u0161et\u0159ovatelsk\u00e1 za\u0159\u00edzen\u00ed sv\u00e9ho druhu s nedostate\u010dnou m\u00edrou zdravotn\u00ed podpory, v\u010detn\u011b sledov\u00e1n\u00ed \u00fa\u010delnosti a bezpe\u010dnosti pod\u00e1van\u00fdch l\u00e9k\u016f. Sou\u010dasn\u011b nab\u00eddnul modern\u00ed formu podpory: farmaceutick\u00e9 audity a konzultace pro registruj\u00edc\u00ed praktick\u00e9 l\u00e9ka\u0159e. Zat\u00edm \u0159ada kasuistik sv\u011bd\u010d\u00ed o ot\u0159esen\u00e9 dostupnosti prim\u00e1rn\u00ed zdravotn\u00ed (zdravotn\u011b soci\u00e1ln\u00ed) p\u00e9\u010de, o z\u00e1va\u017en\u00e9m po\u010dtu medic\u00ednsky nepochopen\u00fdch, problematicky l\u00e9\u010den\u00fdch k\u0159ehk\u00fdch lid\u00ed, na n\u011b\u017e nen\u00ed \u010das, kte\u0159\u00ed jsou ztraceni mezi nespolupracuj\u00edc\u00edmi specialisty, kte\u0159\u00ed n\u011bkdy trp\u00ed v\u00edce l\u00e9\u010dbou ne\u017e nemoc\u00ed a jindy z\u016fst\u00e1vaj\u00ed zbyte\u010dn\u011b bez \u00fa\u010dinn\u00e9 podpory.\u201c Poznamen\u00e1v\u00e1 k t\u00e9matice odborn\u00fd garant projektu, MUDr. Z. Kalvach, CSc., geriatr, internista.<\/p>\n

Prakti\u010dt\u00ed l\u00e9ka\u0159i maj\u00ed v domovech pro seniory velmi slo\u017eitou pozici, pokud cht\u011bj\u00ed dohl\u00ed\u017eet na \u00fa\u010delnost farmakoterapie. \u201eA\u010dkoli se obvykle dozv\u00edm, jak\u00e9 l\u00e9ky klientovi p\u0159edepisuj\u00ed moji kolegov\u00e9 ambulantn\u00ed specialist\u00e9, \u010di l\u00e9ka\u0159i v r\u00e1mci hospitalizace, m\u00e1m jen velmi omezen\u00e9 mo\u017enosti tuto l\u00e9\u010dbu racionalizovat, pokud si na \u201esv\u00e9\u201c l\u00e9\u010db\u011b kolegov\u00e9 trvaj\u00ed. Tak\u00e9 rodiny \u010dasto z\u00e1sobuj\u00ed sv\u00e9ho bl\u00edzk\u00e9ho \u0159adou voln\u011b prodejn\u00fdch l\u00e9k\u016f a r\u016fzn\u00fdch dopl\u0148k\u016f stravy, kter\u00e9 mohou ne\u017e\u00e1douc\u00edm zp\u016fsobem ovlivnit terapii, ale o t\u011bch se obvykle ani nedozv\u00edm.\u201c upozor\u0148uje MUDr. Petr Bouzek, PL v domov\u011b pro seniory a p\u0159edseda Spole\u010dnosti l\u00e9ka\u0159\u016f a zdravotn\u00edk\u016f v soci\u00e1ln\u00edch slu\u017eb\u00e1ch \u010cLS JEP.<\/p>\n

Motivaci, pro\u010d se domov pro zrakov\u011b posti\u017een\u00e9 Palata zapojil do projektu Senior, vysv\u011btluje jeho \u0159editel Ing. J. Proch\u00e1zka: \u201eOb\u010dan\u00e9 vyhled\u00e1vaj\u00ed pobytovou soci\u00e1ln\u00ed slu\u017ebu na Palat\u011b, proto\u017ee u n\u00e1s z\u00edskaj\u00ed pocit jistoty a bezpe\u010d\u00ed, kter\u00fd v dom\u00e1c\u00edm prost\u0159ed\u00ed s p\u0159ib\u00fdvaj\u00edc\u00edm v\u011bkem a zhor\u0161uj\u00edc\u00edm se zrakem ztr\u00e1c\u00ed. Do sledov\u00e1n\u00ed farmakologie jsme se zapojili, abychom p\u0159edch\u00e1zeli mo\u017en\u00fdm zdravotn\u00edm komplikac\u00edm a s nimi spojenou vy\u0161\u0161\u00ed n\u00e1ro\u010dnost\u00ed p\u0159i zaji\u0161t\u011bn\u00ed slu\u017eeb klient\u016fm domova. I klienti maj\u00ed o tuto neobvyklou slu\u017ebu velk\u00fd z\u00e1jem. Klinick\u00e9ho farmaceuta vn\u00edm\u00e1me jako d\u016fle\u017eit\u00e9ho partnera v propojen\u00ed pr\u00e1ce ambulantn\u00edch l\u00e9ka\u0159\u016f a dal\u0161\u00edch zdravotn\u00edk\u016f p\u0159i poskytov\u00e1n\u00ed komplexn\u00edch slu\u017eeb. O\u010dek\u00e1v\u00e1me, \u017ee tato aktivita zv\u00fd\u0161\u00ed d\u016fv\u011bru klient\u016f a rodinn\u00fdch p\u0159\u00edslu\u0161n\u00edk\u016f a podpo\u0159\u00ed kvalitu na\u0161ich slu\u017eeb.\u201c<\/p>\n

\u00dastav l\u00e9kov\u00e9ho pr\u016fvodce se chce tomuto v\u00e1\u017en\u00e9mu t\u00e9matu kontinu\u00e1ln\u011b v\u011bnovat. \u201eJe velmi pot\u011b\u0161uj\u00edc\u00ed, \u017ee se domovy samy hl\u00e1s\u00ed a \u017e\u00e1daj\u00ed o konzultace a ov\u011b\u0159en\u00ed medikace u sv\u00fdch klient\u016f. O konzultace \u017e\u00e1daj\u00ed i prakti\u010dt\u00ed l\u00e9ka\u0159i v domovech. Abychom v projektu mohli pokra\u010dovat, pot\u0159ebujeme finan\u010dn\u00ed podporu. Letos se n\u00e1m j\u00ed dostalo od spole\u010dnosti Lesy \u010cR a S\u00daKL. V\u011b\u0159\u00edme, \u017ee i v roce 2018 se najde d\u00e1rce, kter\u00fd umo\u017en\u00ed, aby st\u00e1le v\u00edce senior\u016f v domovech u\u017e\u00edvalo l\u00e9ky \u00fa\u010deln\u011b a bezpe\u010dn\u011b,\u201c \u0159ekla \u0159editelka \u00dastavu l\u00e9kov\u00e9ho pr\u016fvodce, PhDr. Ivana Plechat\u00e1.<\/p>\n

\u00dastav l\u00e9kov\u00e9ho pr\u016fvodce<\/p>\n

\u00dastav l\u00e9kov\u00e9ho pr\u016fvodce je nez\u00e1visl\u00e1 neziskov\u00e1 organizace, jej\u00edm posl\u00e1n\u00edm je komunikovat probl\u00e9my spojen\u00e9 s dostupnost\u00ed l\u00e9\u010dby, s bezpe\u010dn\u00fdm u\u017e\u00edv\u00e1n\u00edm l\u00e9k\u016f a l\u00e9kovou politikou obecn\u011b. Na sv\u00fdch str\u00e1nk\u00e1ch provozuje zdarma tak\u00e9 on-line Poradnu bezpe\u010dn\u00e9ho u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f. V\u00edce na www.lekovypruvodce.cz<\/a><\/p>\n

Tiskov\u00e1 zpr\u00e1va<\/p>\n","protected":false},"excerpt":{"rendered":"

Star\u0161\u00ed lid\u00e9 v za\u0159\u00edzen\u00edch soci\u00e1ln\u00ed p\u00e9\u010de jsou ohro\u017eeni u\u017e\u00edv\u00e1n\u00edm vysok\u00e9ho po\u010dtu l\u00e9k\u016f, l\u00e9k\u016f nevhodn\u00fdch k jejich v\u011bku \u010di zdravotn\u00edmu stavu, nevhodn\u00fdmi kombinacemi l\u00e9k\u016f nebo jejich […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14131,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,9],"tags":[],"class_list":["post-29583","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29583","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29583"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29583\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14131"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29583"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29583"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29583"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}