Çocuk Onkoloji Hastalarında Oral İlaç Uyumu
DOI:
https://doi.org/10.5281/zenodo.17240337Anahtar Kelimeler:
İlaç uyumu,, Pediatrik onkoloji,, Oral kemoterapi,, Akut lenfoblastik lösemi,Özet
Özet
Çocukluk çağı kanser tedavilerinde son yıllarda sağkalım oranları belirgin şekilde artmıştır ve günümüzde bazı pediatrik kanserlerde 5 yıllık yaşam oranı %95’in üzerine çıkmıştır. Ancak, tedavinin başarısı büyük ölçüde hastaların oral yoldan alınan ilaçları hekim önerisine uygun şekilde kullanmasına bağlıdır. Bu derleme, pediatrik onkoloji hastalarında oral ilaç uyumunu (tedaviye bağlılığı) etkileyen faktörleri, uyumsuzluğun sonuçlarını ve uyumu artırmaya yönelik stratejileri incelemeyi amaçlamaktadır. Literatürde özellikle akut lenfoblastik lösemi (ALL) idame tedavisi sırasında oral kemoterapi (6-merkaptopürin gibi) kullanımının aksamasının hastalık nüks riskini anlamlı ölçüde yükselttiği gösterilmiştir. Çeşitli çalışmalarda çocukluk çağı kanser hastalarının yaklaşık dörtte birinde oral kemoterapi dozlarının tam alınmadığı, yani ilaç uyumunun yetersiz olduğu saptanmıştır. Uyum sorunları, ergenlik dönemi, düşük sosyoekonomik düzey, aile desteğinin yetersizliği ve unutkanlık gibi çok boyutlu nedenlere dayanır. Oral tedaviye uyumu artırmak için hasta-aile eğitimi, davranışsal stratejiler ve teknoloji destekli hatırlatıcı uygulamalar gibi çeşitli müdahaleler önerilmektedir. Sonuç olarak, çocukluk çağı kanser hastalarında ilaç uyumu tedavi başarısı için kritik önemdedir; bu konuda sağlık ekibinin aileleri kapsamlı şekilde eğitmesi ve düzenli takiple uyumu izlemesi, ayrıca uyumu kolaylaştırıcı yeni yöntemlerin geliştirilmesi gerekmektedir.
Anahtar Kelimeler: İlaç uyumu; Pediatrik onkoloji; Oral kemoterapi; Akut lenfoblastik lösemi;
Referanslar
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