Investigation of factors affecting polypharmacy, rational drug use and treatment adaptation in adult patients in primary care

With the increasing population, especially chronic diseases and drug use are increasing. With the increase in drug use, the use of multiple drugs, which we call "polypharmacy", emerges. Rational drug use, on the other hand, is that with the correct diagnosis and treatment method, the patient can easily provide and use the appropriate drug for the appropriate time and dose at the lowest price. In this thesis study, patients who were followed up in Ertuğrul Education Family Health Center with number 36 in Bursa and had chronic drug use were included, and it was aimed to investigate the factors affecting polypharmacy, rational drug use and treatment compliance in adult patients in primary care. The average age of 249 patients in the study group is 51 years; 64.7% (n: 161) of them are female, 35.3% (n: 88) of them are male. It was observed that 35.2% of the patients did not have their chronic disease follow-ups regularly, 37.8% used too much medication and thought that it should be reduced, and 28.8% were exposed to drug side effects. 44.3% of patients do not know the side effects of the drugs they use, and 43.2% state that they use additional treatment other than chronic drugs. General Health Survey-12 Scale, its total score average is 2.24, and 42.6% of the participants are risky in terms of psychological illness. The overall health survey score of those who use drugs 4 and above, which we call polypharmacy, is significantly higher (p=0.039). It was shown that those who scored in the high-risk group from the general health survey were higher than other groups with 48.5% of the use of additional treatment outside of chronic drugs (p=0.014). The general health questionnaire score of individuals with drug side effects was found to be significantly higher (p <0.001). In individuals without drug side effects, those who used 1-3 drugs were significantly higher with 76.2% compared to those who used 4 or more drugs (p <0.005). Non-prescription painkiller use in women was 58.4% (p=0.01) and vitamin/mineral use was 35.4% (p<0.001) higher than in men. When the use of herbal treatment was compared with the age groups, it was observed that the use of herbal treatment increased as the age increased (p = 0.005). It is possible that the presence of polypharmacy may negatively affect the quality of life of individuals due to the fact that it brings with it risk factors such as undesirable drug reactions, drug-drug interactions, hospitalization and mortality. In primary care, it was observed that polypharmacy rates increased with aging, exposure to drug side effects increased with the increase in polypharmacy rates, and with the increase in the score obtained from the general health questionnaire, polypharmacy and exposure to drug side effects increased. In patients with elderly and chronic drug use, who make up a significant part of the patient population in primary care, rational drug use principles should be taken into account in terms of polypharmacy and exposure to drug side effects. Patients ' knowledge level should be increased in terms of disease and drug follow-up.