Quality assessment of pharmaceutical care to patients with headaches using the simulated patient method: interaction practice

Relevance. WHO assesses headaches as a global world problem. Russia occupies a leading position in the prevalence of primary headaches. Headaches are one of the most common reasons for visiting a pharmacy for self-medication. The interaction of the pharmacist and the visitor with the headache problem in general determines the quality of pharmaceutical care.Aim. To assess the practice of the interaction between a patient with a headache and a pharmacist using the simulated patient method.Materials and methods. Trained simulated patients (women aged 20, 40 and 58 years) visited a total of 101 pharmacies. The dialogue was recorded on a voice recorder, all the features of the interaction were additionally recorded aſter the visit. Special forms were filled out based on the information received. The data was processed using Microsoſt Excel 2010 and STATISTIKA 10.0.Results. The average interaction time was 98.2±3.8 seconds. There was a high frequency of spontaneous recommendations without preliminary questions (66.3%), a small number of questions asked (0.84±0.1). These indicators practically did not depend on various factors (type of pharmacy organization, age of the pharmacist, age of the simulated patient, the presence of a queue, and others).Conclusion. The results of the study demonstrate a low level of interaction between pharmacists and visitors with a headache, as well as a practical absence of involvement in the process of providing pharmaceutical care, which negatively affects its quality: frequent spontaneous recommendations, short consultations and rare questions. The approach to the interaction of pharmacists with visitors with headaches is formal and requires standardization

The rationality of recommendations of drugs for patients with cephalgia in simulated situations in the pharmacy

Relevance. According to statistics of the World Health Organization, at least half of the world’s adult population experienced headaches at least once a year. Patients suffering from headaches do not always have the opportunity to visit a doctor, therefore, an important role in helping these patients is assigned to pharmacists. Purpose. Based on the pharmacoepidemiological study to identify the features of providing pharmaceutical care to patients with headache in pharmacies in the issue of rationality of recommendations of pharmaceutical workers. Materials and methods. A pharmacoepidemiological study was conducted based on a survey of 153 pharmaceutical workers (Saratov) using a specially developed questionnaire that includes free-form questions with a simulated situation. The data was processed using Microsoft Excel 2010 and STATISTIKA 6.0. Results Of the groups recommended to visitors, INNs in the group «Nonsteroidal anti-inflammatory and antirheumatic drugs [M01A]» account for 45.0 % of all INNs, and the group «Analgesics [N02]» - 55.0 %. Ibuprofen (62.8 %) and the combination of drotaverine + caffeine + naproxen + paracetamol + phenylephrine (41.2 %) were noted as the most frequently recommended. A visit to a doctor was recommended by the majority of respondents (52.3 %, n=153) in the case of a patient with a headache accompanied by nausea and vomiting. Ibuprofen (90.8 %) or paracetamol (45.8 %), moreover in the form of suspension or suppositories, are the preferred recommendations for headache in children under 3 years of age (n=131). Paracetamol in combinations (69.2 %) prevails as the first recommendation for headache associated with acute respiratory viral infections (n??=146). Non-selective NSAIDs for a patient with gastrointestinal complications could be recommended by 43.4 % of specialists (n=113). The NSAID recommendation is the most frequent (51.8 %, n=110) in the case of an 80-year-old patient without concomitant diseases. Paracetamol (50.0 %) or ibuprofen (34.7 %) would be more often recommended by pharmaceutical workers for a pregnant woman with headache (n=98). In case of headache after trauma, 47.1 % recommend a visit to a doctor (n=153). Conclusion. The frequent recommendation of combined analgesics and their association with the development of drug-induced headaches indicates the need for careful recommendation of these drugs. Not always correct recommendations indicate the need to increase the level of professional knowledge, study clinical recommendations for the therapy and diagnosis of cephalgia, which can make it possible to make a rational choice of the drug, initially assume that the visitor has conditions that require a visit to a doctor, and ultimately improve the quality of pharmaceutical care

POSTERIOR INTEROSSEOUS FLAP IN PEDIATRIC HAND RECONSTRUCTIONS

Purpose: to assess early and long-term results of the pediatric hand reconstructions with posterior interosseous flap, including those in children younger than 3 years old. Materials and methods: results of the hand reconstructions with posterior interosseous artery reverse flap were studied in 10 children (4 males and 6 females) aged from 1 year and 1 month to 13 years old. In 4 cases flap coverage were performed due to acquired posttraumatic hand deformity, in 6 cases reconstruction was assumed for congenital hand deformities. Combined procedures consisted of posterior interosseous artery flap coverage and other types of microsurgical reconstructions were suggested in 4 patients. Preoperative color doppler visualization of the posterior interosseous vessels were mandatory. All flaps were risen under 3.5x-4.5x magnification. Results: all flaps survived completely in 3 weeks postoperatively. There were no postoperative complications such as flap’s arterial or venous insufficiency, deep infection, or posterior interosseous nerve palsy. Nearly whole group (9 of 10) of patients and/or their parents were satisfied with the esthetic view of the reconstructed hand and donor site of the forearm 1 year postoperatively. Conclusion: posterior interosseous flap is a reliable and versatile option in pediatric hand reconstructions, providing excellent skin coverage with good color match and texture. Preservation of major vascular bundles of the forearm (radial and ulnar arteries) during flap harvest gives a possibility to perform a simultaneous microsurgical reconstructions of the hand (e.g. free toe transfer)

Innovative drugs for the treatment of primary headaches: migraine

The article presents information about innovative drugs for the treatment of primary headaches (in particular, migraine), which are at the stages of clinical or preclinical studies, or were recently introduced to the foreign pharmaceutical market. The classes of these drugs, their mechanism of action, as well as the results of past studies are presents in article

Российско-китайские отношения: некоторые векторы и перспективы развития

The article analyzes the Russian-Chinese relations at the present stage of their development. Considered grounds for mutually beneficial relations between China and Russia. These vectors of their formation in the short term, as well as some marked differences. Some results on the important areas of Russian-Chinese cooperation. The recommendations for its strengthening.В статье анализируются российско-китайские отношения на современном этапе их развития. Рассмотрены основания для взаимовыгодных связей между КНР и РФ. Указаны векторы их формирования в ближайшей перспективе, а также обозначены некоторые противоречия. Приведены некоторые результаты на важных направлениях российско-китайского сотрудничества. Предложены рекомендации по его усилению

ELECTROCHEMICAL OXIDATIVE C-C COUPLING

This work was supported by the Russian Science Foundation, project # 21-13-00205