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Yıl:2018; Cilt: 19; Sayı: 3>> Özet
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Anadolu Psikiyatri Dergisi; 2018;19(3):250-255
Kırsal bölgede antidepresan ilaç kullanım alışkanlığınınirdelenmesi: Çok merkezli bir araştırma
E Dost, O Öztürk, M Ünal, H Yılmaz, G Öztürk
Ondokuz Mayıs Üniversitesi, Samsun
Amaç: Kırsal bölgelerin özgül dinamikleri vardır. Büyük sağlık merkezlerine sınırlı erişim, bu bölgelerdeki birincil bakımın önemini artırmaktadır. Antidepresanlar (AD) dünyada yaygın olarak kullanılmaktadır. AD’lerin yarısından fazlası birinci basamakta reçete edilir. Bu çalışma, kırsal alanlarda AD kullanım dinamiklerini incelemektedir. Yöntem: Üç farklı kırsal bölgede 174 hasta ile kesitsel bir araştırma çalışması yapılmıştır. Her katılımcıya 14 soru sorulmuştur (AD için 10 ve demografik veriler için dört). Veriler frekans değerleri ki-kare testi ve t-testi ile SPSS 15.0 istatistiksel paket programı kullanılarak değerlendirildi. Bulgular: Çalışmaya 131 kadın (%75.3) ve 43 erkek (%24.7) katılmıştır. Katılımcıların %35'i AD'leri 1-5 yıldır kullanıyordu. AD'leri reçete etmeye başlamanın en sık nedeni sinirlilikti (%44.3). Kadınlarda baş ağrısından ötürü AD reçete edilme oranı erkeklerden sekiz kat daha yüksekti. En yüksek gelirli meslek grubu memurlardı. En yaygın kullanılan AD ilaç essitalopram idi (%35.1). AD kullanımını en sık başlatan kurumlar devlet hastaneleridir (%43.1). Hastalar psikiyatri hastaneleri tarafından başlatılıyorsa, daha uzun süre AD kullanmaktadır. Her 10 AD kullanıcısından biri, ilacı gereksiz yere kullandığını düşünüyordu. Tartışma: Çalışmamızda saptanan AD kullanımıyla ilişkili durumlar kadın cinsiyet, evlilik, AD kullanan kadınların aile üyesi olma, kalabalık ailelerde yaşama ve yoksulluktur. İlaç raporu olan hastaların bir yıl veya daha uzun süre AD kullanmaları daha olasıydı. Hastalar arasında AD kullanımının düşük olması kırsal bölgelerdeki kişilerin ruhsal olarak daha sağlıklı olabileceğini düşündürebilir. AD'nin gereksiz olduğunu düşünen hastalar arasında ilaç almayı sürdüren temel neden, doktor önerisi idi. Sosyokültürel, ekonomik dinamikler ve birinci basamak hekimlerinin nitelikleri, kırsal alanlarda AD kullanımını etkileyebilir.
Antidepressant use habits in rural regions: a multi-center research
Objective: Rural areas have specific dynamics. Limited access to major health centers increases the importance of primary care in these regions. Antidepressants (AD) are used widely in the world. More than half of the antidepressants are prescribed in the primary care. This study examines AD use dynamics in rural areas. Methods: A cross-sectional, survey research was conducted with 174 patients in three different rural areas. Fourteen questions (10 for ADs and 4 for demographic data) were asked to each participant. The data were evaluated using the SPSS 15.0 statistical package program with frequency-values, chi-square test and t-test. Results: One hundred and thirtyone women (75.3%) and 43 men (24.7%) were participated in the study. Thirty five percent of the participants were using ADs for 1-5 years. The most frequent reason of starting ADs was nervousness (44.3%). Women were 8 times more likely to start ADs for headaches. Civil servants had the highest income. The most common AD drug was escitalopram (35.1). The most frequent institutions that AD use initiated was the state hospitals (43.1%). Patients were likely to use AD long term if they were initiated by mental hospitals. One in 10 AD user thought the drug was unnecessary. Conclusion: Conditions associated with the use of ADs in our study were female gender, being married, being a family member of women using ADs, living in crowded families and poverty. Participants who had the certificate of long term drug use (CLD) were more likely to use ADs one year or more. Low AD use among our patients may suggest people are healthier mentally in rural areas. The main reason of continuing AD was doctor advice among patients who thought the AD was unnecessary. Sociocultural, economic dynamics and the qualifications of the primary care physicians can affect AD use in rural areas

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