Assessment of physicians’ and senior medical students’ knowledge in treatment of patients with community acquired pneumonia: Current results of the KNOCAP project

Introduction. Community-acquired pneumonia (CAP) remains one of the most acute problems of bronchopulmonary pathology being the 4th in the mortality structure (after cardiovascular, cerebrovascular diseases and malignant neoplasms) and the 1st among all fatalities from infectious diseases. Thanks to the scientific progress achieved in the antibiotic therapy and vaccine prophylaxis, the death toll has decreased four times compared to its rate during the “pre-antibiotic era“. However, nowadays there is a steadily increasing trend in the pneumonia mortality rate in Russia. The only possible way to increase efficacy of CAP treatment is timely initiated rational antibiotic therapy, considering the possible etiologies, risk factors and the severity of the patient’s condition. Materials and methods. The article represents the results of anonymous prospective surveys within the framework of the KNOCAP multi-centered research project aimed at accessing the knowledge on the fundamental issues in diagnosis and treatment of community-acquired pneumonia. The survey involved 222 students in their fifth- and sixth years in medical institute from Belgorod, Dnepr (Dnipro), Voronezh, Kiev (Kyiv) and Saratov and 110 physicians from Krasnodar, Saratov, Belgorod and Dnepr.Results and discussion. According to the results of the survey, such levels of correct answers were given by doctors and students, respectively: the inadmissibility of antimicrobial therapy (AMT) delay in CAP - 82% and 59%; the main criterion for withholding AMT - 56% and 37%; “sequential therapy” - 61% and 59%. At the same time, only 24% of the students and 23% of the physicians surveyed correctly reported typical mistakes in the treatment of a non-severe CAP with 50% or more accuracy; and in case of initial treatment, the number of correct responses was less than 28% for students and 45% for doctors. Conclusion. The survey showed that both senior medical students majoring in Medical Care and general practitioners had a low level of knowledge in CAP treatment. Hence, curricula need to be adjusted both in medical universities and in health institutions for practitioners in order to inform them and, thus, improve the quality of their knowledge in this field

Assessment of physicians’ and senior medical students’ knowledge in treatment of patients with community-acquired pneumonia: Current results of the KNOCAP project

Community-acquired pneumonia (CAP) remains one of the most acute problems of bronchopulmonary pathology being the 4th in the mortality structure (after cardiovascular, cerebrovascular diseases and malignant neoplasms) and the 1st among all fatalities from infectious diseases. Thanks to the scientific progress achieved in the antibiotic therapy and vaccine prophylaxis, the death toll has decreased four times compared to its rate during the “pre-antibiotic era“. However, nowadays there is a steadily increasing trend in the pneumonia mortality rate in Russia. The only possible way to increase efficacy of CAP treatment is timely initiated rational antibiotic therapy, considering the possible etiologies, risk factors and the severity of the patient’s condition

Comparative assessment of physicians’ and senior medical students’ basic knowledge in treatment of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is one of the most common pathologies of the respira-tory system. This disease ranks third in the group of the main causes of death in the world. The effective treatment of COPD has been developed by today. However, a significant part of physicians has an insufficient amount of education in this matter

Pharmacotherapy, etiopathogenesis, and diagnostics of bronchial asthma: Assessment of the level of senior medical students’ knowledge. comparison of the assa-i and assa-ii project results

Bronchial asthma (BA) is an incurable chronic disease that can become controlled after the appointment of rational and reasonable therapy. Due to the prevalence of this pathology, a patient with asthma can be met by a doctor of any specialty, so every clinician should have basic knowledge in the field of this nosology. We aimed to analyze the results of the first and second stages of the ASSA project and to determine the differences in the levels of senior students’ knowledge in the field of BA. Material and Methods. The article presents the results of an anonymous multicenter ASSA study (the full name of the project is “Assessment of senior medical students in the field of bronchial asthma”, “ASSA” is a partial acronym) to assess the level of senior medical students’ knowledge in the field of etiology, pathogenesis, diagnosis, and treatment of BA. The first stage of this study (2014-2016) involved 521 students from 7 cities in Russia. For the second stage (2017-2019), the results from 358 senior students from 6 cities of Russia and Ukraine were received and analyzed. The method of anonymous questioning was used in this study, for which an original questionnaire was developed based on current clinical guidelines. Results and Discussion. Over the five years of the study, the level of students’ knowledge remains above the average, without significant changes. The following questions in the two stages of the project caused the greatest difficulties in the respondents: question No.1 (the definition of BA), No.2 (a trigger of an asthma attack), No.3 (a key factor of asthma pathogenesis). Positive dynamics were observed on question No.11 (the basic treatment of moderate asthma), No.7 (the levels of BA control) and No.4 (the laboratory and instrumen-tal markers of BA)

Level of senior medical students’ knowledge on antimicrobial therapy: the results of the «KANT» project

Objective. To determine the level of basic knowledge of senior students of medical universities in the rational use of AMP. Materials and Methods. Analysis of an anonymous multicenter survey in the framework of the “KANT” project (the full name of the project is “Physicians’ (Students ’) knowledge in antimicrobials usage”), conducted in 2018–2019 in 6 cities of Russia and Kyrgyzstan. Results. The study revealed a low level of knowledge of senior students in the field of antibiotic therapy and the empirical use of AMP. The best results are shown by students when answering questions “time interval for evaluating the effectiveness of starting antimicrobial therapy”, “rationality and the period of changing AMP with a positive clinical effect”, and “choice of tactics for treating acute tonsillitis/pharyngitis”; the worst – for questions “choice of first-line AMP in the treatment of various infections”, “choice of adjuvant drugs for bacterial infections of the respiratory tract”, and “determination of irrational combinations of AMP”. Conclusions. According to the results of this study, senior students showed a low level of knowledge in the basic issues of the rational use of AMP and the principles of antibiotic therapy in general, which indicates the urgent need for additional educational activities among this category of respondents and an increase in the number of academic hours in the disciplines “Pharmacology” and “Clinical” pharmacology in universities

THE CHOICE OF ANTIMICROBIAL THERAPY AMONG PHYSICIANS IN THE TREATMENT OF GESTATIONAL PYELONEPHRITIS

From 1 to 10% of the physiological pregnancy complicated by acute pyelonephritis. The purpose work- analyze the choice of antimicrobial therapy among physicians in the treatment of gestational pyelonephritis. Materials and methods-analysis of the anonymous survey in the framework of the second stage of the All-Russian pharmacoepidemiological study, "Epidemiology of the use of drugs in pregnant women", which was conducted from February to April 2015. On the basis of this was carried out to compare the results with the results of the survey of doctors of the Belgorod region. Results and discussion. Approximately half of the doctors choose the treatment of pyelonephritis in pregnant cephalosporins of generations II and III, as well as amoxicillin / clavulanate. Up to 30% of physicians prescribe ineffective in this case macrolides. A third of doctors sent patients for treatment to other specialists. Conclusion. An analysis of the responses of doctors tactics purpose of antimicrobial therapy in gestational pyelonephritis showed that only half of practitioners prescribed therapy based on the rational use of antimicrobials

THE ANALYSIS OF PREFERENCES OF OBSTETRICIANSGYNECOLOGISTS AND THERAPISTS OF BELGOROD REGION IN HEARTBURN AND CONSTIPATION TREATMENT IN PREGNANT WOMEN IN COMPARISON WITH ALL-RUSSIAN DATA

Summary. One of the most frequent accompanying pathologies during pregnancy – digestive tract diseases. The work purpose - to analyse the choice of medicinal therapy among doctors at heartburn and constipation treatment during pregnancy. Materials and methods - the analysis of anonymous questioning within carrying out the second stage of the All-Russian pharmacoepidemiological research "Epidemiology of medicines use in pregnant women" which was carried out from February to April, 2015 The comparison of the received results with results of questioning of doctors of Belgorod region was executed on the basis of received data. Results and discussion. About a half of doctors chooses for heartburn treatment in pregnant women antacids medicines, and also inhibitors of a proton pomp (omeprazole). To 10% of doctors prescribe insufficiently studied blockers of H2-histamine receptors. In constipation therapy more than 60% of doctors voted for salt laxative a lactulose. Less than 11% of doctors prescribed to patients unsafe medicines of senna and macrogol. Conclusion. The analysis of doctors’ answers on tactics of medicinal therapy purpose at heartburn and constipation during pregnancy has shown that more than 68% of the practicing experts appoint the therapy, based on rational use of medicines

THE ANALYSIS OF PREFERENCES OF OBSTETRICIANSGYNECOLOGISTS AND THERAPISTS OF BELGOROD REGION IN HEARTBURN AND CONSTIPATION TREATMENT IN PREGNANT WOMEN IN COMPARISON WITH ALL-RUSSIAN DATA

Summary. One of the most frequent accompanying pathologies during pregnancy – digestive tract diseases. The work purpose - to analyse the choice of medicinal therapy among doctors at heartburn and constipation treatment during pregnancy. Materials and methods - the analysis of anonymous questioning within carrying out the second stage of the All-Russian pharmacoepidemiological research "Epidemiology of medicines use in pregnant women" which was carried out from February to April, 2015 The comparison of the received results with results of questioning of doctors of Belgorod region was executed on the basis of received data. Results and discussion. About a half of doctors chooses for heartburn treatment in pregnant women antacids medicines, and also inhibitors of a proton pomp (omeprazole). To 10% of doctors prescribe insufficiently studied blockers of H2-histamine receptors. In constipation therapy more than 60% of doctors voted for salt laxative a lactulose. Less than 11% of doctors prescribed to patients unsafe medicines of senna and macrogol. Conclusion. The analysis of doctors’ answers on tactics of medicinal therapy purpose at heartburn and constipation during pregnancy has shown that more than 68% of the practicing experts appoint the therapy, based on rational use of medicines

Assessment of senior medical care majors’ knowledge in antimicrobial chemotherapy

Introduction: The resistance of microorganisms to antimicrobials has been gradually increasing since 2011 and is now recognized by the World Health Organization as a global biological threat. Causes of antimicrobial resistance must be actively addressed. Healthcare workers’ awareness of rational antimicrobial prescribing practices is of great importance. The increasing relevance of this issue is considered within this study, which started in 2014. Materials and methods: The article represents the results of anonymous prospective surveys within the framework of the KANT multi-centered research project aimed at assessing students’ knowledge of rational antimicrobial prescribing practices also known as “antimicrobial stewardship”. The survey involved 309 Medical Care majors in their fifth- and sixth- years in two Russian regional centers: Belgorod and Voronezh. The answers to four main questions of the survey were analyzed in this work. Results and discussion: According to the survey, 51.5% of the respondents properly identified a pharmacological group of an antimicrobial; 79.3% of the students would change an antibiotic if the desired therapeutic outcome was not achieved within two or three days of treatment; 29.8% of the students believed that an antimicrobial substitution was required even when a positive therapeutic outcome was achieved; and nobody could correctly identify all the proposed pharmacologically irrational combinations of antimicrobials. Conclusions: The survey showed that senior medical students have insufficient knowledge in antimicrobial stewardship. Appropriate use of antibiotics and antimicrobial prescribing practices need to be considered more thoroughly in Pharmacology, Clinical Pharmacology and Medical Care curricula. Likewise, educational activities on antimicrobial stewardship and best prescribing practices are of great importance for students as they will help with improving the knowledge of future doctors

Physicians’ knowledge and preferences in tactics of management and rational pharmacotherapy of arterial hypertension in pregnant women (PHYGEST study)

Introduction: The issues of rational antihypertensive therapy in pregnant women are always extremely relevant, since high blood pressure in a pregnant woman is associated with serious risks for a mother and a fetus. The aim of the study: To determine the knowledge and preferences of physicians in the management of pregnant women with arterial hypertension. Materials and methods: A multicenter study was conducted in 2018–2021 using an anonymous questionnaire among 411 doctors from 8 regions of Russia. Results and discussion: The levels of knowledge and preferences of specialists in the issues of diagnosing and formulating a diagnosis of arterial hypertension and preeclampsia in pregnant women, prescribing basic and additional drugs for the treatment and prevention of hypertension were revealed, and the degree of compliance with the current clinical guidelines was assessed. Conclusion: Due to the insufficient level of knowledge of specialists, it is required to pay increased and special attention to this problem, strengthen control over compliance with clinical guidelines, and introduce it into postgraduate recommendations and continuing education programs