Kronik Gastrointestinal Hastalıklarda Tedavi Uyumu, İzlem ve Yaşam Tarzı Eğitimi
Özet
Kronik gastrointestinal hastalıklarda inflamatuvar bağırsak hastalığı (İBH), kronik viral hepatitler, metabolik disfonksiyon ilişkili steatotik karaciğer hastalığı (MASLD), siroz, çölyak hastalığı, gastroözofageal reflü hastalığı (GÖRH), irritabl bağırsak sendromu (İBS) ve Helicobacter pylori eradikasyonu sonrası izlem dahil tedavinin uzun dönem başarısını belirleyen en kritik faktörlerden biri hastaların tedaviye uyumudur. Kronik hastalıklarda tedaviye uyum oranları ortalama %50 civarında seyreder; uyumsuzluk hastalık alevlenmelerine, hastane yatışlarına, komplikasyonlara ve sağlık harcamalarının artışına yol açar. Bu bölümde tedaviye uyumu belirleyen hasta, hekim ve sistem kaynaklı faktörler; uyum ölçüm yöntemleri; hastalığa özgü izlem parametreleri; yaşam tarzı eğitiminin kanıta dayalı bileşenleri ve etkili hasta-hekim iletişim stratejileri ele alınır. Motivasyonel görüşme, paylaşımlı karar alma, dijital sağlık araçları ve multidisipliner ekip yaklaşımı güncel kılavuzlar eşliğinde sunulur.
In chronic gastrointestinal diseases — including inflammatory bowel disease (IBD), chronic viral hepatitis, metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, coeliac disease, gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS) and post-Helicobacter pylori eradication follow-up — treatment adherence is one of the most critical determinants of long-term therapeutic success. Adherence rates in chronic diseases average around 50%; non-adherence leads to disease flares, hospital admissions, complications and increased healthcare costs. This chapter addresses patient-, physician- and system-related factors influencing adherence; adherence measurement tools; disease-specific monitoring parameters; evidence-based components of lifestyle education; and effective patient-physician communication strategies, including motivational interviewing, shared decision-making and digital health tools, in line with current ACG, AGA, ECCO, EASL, ESPEN, NICE and WHO guidelines.
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