| Abstract | Cilj: Glavni cilj ovog istraživanja bio je ispitati stavove i znanja studenata četvrte, pete i šeste godine studija Dentalne medicine u Splitu o antikoagulantnim lijekovima. Specifični ciljevi ovog istraživanja bili su ispitati poznaju li studenti dentalne medicine interakcije antikoagulantnih lijekova, koliko su informirani o mogućim štetnim posljedicama nepoznavanja antikoagulantne terapije u dentalnoj medicini te utvrditi postoji li potreba za dodatnom edukacijom studenata dentalne medicine o antikoagulantnim lijekovima.
Materijali i metode: Istraživanje je temeljeno na anonimnoj anketi koja je provedena među studentima četvrte, pete i šeste godine studija Dentalne medicine u Splitu. Istraživanje je temeljeno na online upitniku putem Google forms obrasca (Prilog), a provođenje istraživanja odobrilo je Etičko povjerenstvo Medicinskog fakulteta u Splitu. Ukupno je sudjelovalo 67 ispitanika, a upitnik se sastojao od tri dijela i 40 pitanja. U prvom dijelu upitnika ispitanici su popunjavali osobne podatke, u drugom dijelu izrazili stavove o liječenju u budućoj kliničkoj praksi, dok se u trećem ispitalo znanje o antikoagulantnim lijekovima. Podaci su obrađeni u programskom paketu STATISTICA 11.
Rezultati: Studenti svih triju godina pokazali su ispodprosječno do prosječno znanje o antikoagulantnim lijekovima, uz iznimku nekoliko pitanja s odličnim rezultatima. Samo 20,9 % ispitanika je prepoznalo sve ponuđene antikoagulanse. Ispitanici su imali odlične rezultate na pitanjima o varfarinu i INR-u za pacijente na terapiji istim, no čak 46,3 % ispitanika bi tražilo pogrešan i nepotreban test kod pacijenata na NOAK-ima. Nadalje, samo 40,3 % ispitanika je znalo točan odgovor kada nastaviti terapiju u slučaju prekidanja terapije dabigatranom što također potvrđuje slabije znanje kada se radi o NOAK-ima. Znanja o interakciji lijekova s antikoagulansima se razlikuju ovisno o pitanju. Najviše studenata (67,2 %) je prepoznalo nistatin kao antimikotik izbora kod pacijenata na terapiji varfarinom, a tek nešto više od polovice ispitanika (55,2 %) paracetamol kao analgetik izbora uz antikoagulantnu terapiju. Samo 59,7 % studenata se složilo da je korištenje antibiotika jednokratno za profilaksu sigurno kod pacijenata na antikoagulantnoj terapiji, dok čak 43,3 % studenata misli da je kod pacijenata na dualnoj antitrombocitnoj terapijji potrebno ukinuti jedan od lijekova 24 sata prije ekstrakcije. Najbolje znanje ispitanici su pokazali u zadnjoj skupini pitanja gdje su spajali ponuđene terapije s procijenjenim rizikom krvarenja te je raspon točnih odgovora za tu skupinu pitanja bio od 38,8 % do 98,5 % (66,1±22,4 %) s medijanom vrijednošću 65,7 % .
Zaključak: Temeljem rezultata ovog istraživanja pokazalo se kako većina studenata nema dovoljno znanja o antikoagulantnim lijekovima te da ne postoji značajna razlika u znanju ovisno o godini studija. Loše znanje o smjernicama, interakcijama te posljedicama prekidanja antikoagulantne terapije upućuje na potrebu za dodatnom edukacijom i ažuriranim smjernicama na ovu temu. |
| Abstract (english) | Objectives: The main aim of this study was to assess knowledge and attitudes of fourth, fifth and sixth year dental students at the University of Split School of Medicine about anticoagulants. The specific aims of this study were to determine whether dental students know the interactions of anticoagulants, possible harmful consequences of interruption of anticoagulant therapy and to assess the need for additional education of dental students about anticoagulants.
Materials and Methods: This study has been carried out using an anonymous questionnaire among students of fourth, fifth and sixth year of integrated dental study of the School of Medicine in Split. The study was based on an online questionnaire via Google forms and has been approved by the Ethics Committee of the Medical School in Split. A total of 67 students participated and the questionnaire consisted of three parts and 40 questions. In the first part, the respondents filled in personal data, in the second part they expressed their attitudes about treatment in future clinical practice, and in the third part, the knowledge about anticoagulant therapy was examined. The gathered data were processed in the software package STATISTICA 11.0.
Results: Students of all three years showed below-average to average knowledge of anticoagulant therapy, with the exception of a few questions with excellent results. Only 20.9 % of participants recognized all the anticoagulants offered. Students had excellent results on questions about warfarin and INR for patients on the same therapy, but as many as 46.3 % of students would order a wrong and unnecessary test in patients on NOACs. Furthermore, only 40.3 % of participants knew when to continue therapy in case of discontinuation of dabigatran therapy, which also confirms poorer knowledge when it comes to NOACs. Knowledge of drug interaction with anticoagulants varies depending on the issue. 67.2 % of students recognized nystatin as the antifungal of choice in patients on warfarin therapy, and just over half of the students (55.2 %) recognized paracetamol as the analgetic of choice with anticoagulant therapy. Only 59.7 % of students agreed that the use of a single antibiotic dose for prophylaxis is safe in patients on anticoagulant therapy, while as many as 43.3 % of students think that patients on dual antiplatelet therapy should discontinue one of the drugs 24 hours before extraction. Participants showed the best knowledge in the last group of questions where they combined the offered therapies with the estimated risk of bleeding and the range of correct answers for this group of questions ranged from 38.8 % to 98.5 % (66.1 ± 22.4 %) with a median worth 65.7 % .
Conclusion: Based on the results of this study, it was shown that most students do not have enough knowledge about anticoagulant therapy and that there is no significant difference in knowledge depending on the year of study. Poor knowledge of the guidelines, interactions, and the consequences of discontinuation of anticoagulant therapy, suggests the need for additional education and updated guidelines on this topic. |
