Samomedikacija antibioticima među studentima sesrtinstva u Srbiji: pilot studija

Healthcare professionals should serve as promoters of ra-tional antibiotic use in attempt to decrease antibiotics misuse within the process of self-medication. Current pilot study was undertaken with the aim to identify potential predictors of self-medication with antibiotics (SMA) and to describe SMA practice among nursing students in Serbia. Data have been collected dur-ing the period March-May, 2016 in Medical school of bachelor degree, in Belgrade. Self-reported questionnaire served as a data source. Descriptive statistic was used to analyse study sample characteristics. Chi-square test was used to test differences be-tween groups. Study sample have included 138 participants. Al-most half of them, 43.8%, practice SMA. Life style (smoking, al-cohol consumption, sleeping habits and physical activity) and so-cio-demographic characteristics (excepted school grade) were not shown as SMA determinants. Time & money savings were stated as the most frequent reason for SMA, while common cold, sore throat and cough were the most common conditions cured through SMA. Pharmacists’ recommendations and previous pos-itive experience were specified as the most important in the pro-cess of antibiotics selection, indicated by 50.0% and 37.5% par-ticipants, respectively. Amoxicillin was the most frequently used antibiotic in SMA, used by 50% of participants who practice SMA. High proportion of SMA and observed practice among nursing students in Serbia call for efforts with regards to relevant educa-tion about rational antibiotic use, actual clinical guidelines and potential consequences of misuse.Zdravstveni stručnjaci bi trebalo da služe kao pokretači ra-cionalne upotrebe antibiotika u pokušaju da se smanji zloupo-treba antibiotika kroz proces samomedikacije. Pilot studija je sprovedena sa ciljem da se utvrde potencijalni prediktori samomedikacije antibioticima (SMA) i da se opiše praksa SMA među studentima sestrinstva u Srbiji. Podaci su sakupljeni tokom perioda Mart-Maj 2016, u Višoj školi strukovnih studija u Be-ogradu, Srbija. Za sakupljanje podataka korišćen je upitnih za samo-popunjavanje. U analizi karakteristika ispitivanog uzorka korišćena je deskriptivna statistika. Hi-kvadrat test je korišćen za ispitivanje razlike između grupa. Ukupan broj učesnika u studiji bio je 138. Gotovo polovina, 43,8% je koristila SMA. Životni stil (pušenje, konzumiranje alkohola, navike u pogledu sna, fizička aktivnost) i socio-demografske karakteristike (izuzev godine studija) nisu pokazane kao SMA. Uštede u vremenu i novcu su navedene kao najčešći razlog za SMA, dok su prehlada, upala grla i kašalj najčešće indikacije tretirane kroz SMA. Preporuke farmaceuta i prethodno pozitivno iskustvo su navedeni kao najznačajniji faktori u odabiru antibiotika, što je tvrdilo 50,0% i 37,5% učesnika, redom. Amoksicilin je bio najčešće korišćen an-tibiotik koji je koristilo 50% učesnika kroz SMA. Visok procenat SMA i uočena praksa među studentima sestrinstva u Srbiji ukazuje na potrebe za relevantnom edukacijom u vezi sa racion-alnom upotrebom antibiotika, aktuelnim preporukama u klin-ičkim vodičima i potencijalnim posledicama nepoštovanja datih preporuka

Vrednost telefarmacije – sadašnji troškovi i buduće uštede

Combination of information and communication technology in provision of pharmaceutical care provides possible solution in the era of health professional shortage and increased costs. Telepharmacy involves services such as medication selection, order review, dispensing, compounding, drug information services, patient counseling, and medication monitoring, offered to the patients located at the distance. Increasing evidence suggests possible clinical benefits of telepharmacy such as the easy access to healthcare services, especially in remote and rural communities, increased patient satisfaction as a result of medication access in rural areas, effective patient counseling, reduction in adverse drug events, decrease rate of dispensing errors and better documentation of pharmacist interventions (1). However, telepharmacy can be sometimes challenging to put into practice. The start-up of telepharmacy (hardware, software, technological infrastructure, internet connection, and operational cost) can be significant financial burden and time-consuming activity. The initial investment can be substantial either to the individuals or to the health system. Even in addition to this initial investment, literature shows that the development of telepharmacy services is cheaper than to open new pharmacies. Clinical benefits, mainly avoidance of adverse drug events and dispensing errors, can be translated into the possible future savings (2). Besides that, the introduction of telepharmacy can bring to a reduction of pharmacy services costs as with this technology one pharmacist can cover multiple sites and a wider area. Telepharmacy also allows patients to save money and travel time.Kombinacija informacionih i komunikacionih tehnologija u pružanju farmaceutske zdravstvene zaštite može predstavljati moguće rešenje u doba deficita zdravstvenih profesionalaca i povećanih troškova. Telefarmacija uključuje usluge poput izbora leka, naručivanja, izdavanja, izrade, informacije o leku, savetovanje pacijenata i monitoring terapije, koje se pružaju pacijentima koji se nalaze na drugoj lokaciji. Brojne studije ukazuju na moguće kliničke efekte telefarmacije poput lake dostupnosti zdravstvenim uslugama pogotovo u udaljenim i ruralnim sredinama, porast zadovoljstva pacijenata kao rezultat dostupnosti u ruralnim sredinama, efektivno savetovanje pacijenata, smanjenje broja neželjenih reakcija na lek, smanjenje grešaka prilikom izdavanja leka i bolje dokumentovanje izvršenih intervencija farmaceuta (1). Međutim, telefarmacija ponekad može biti zahtevna za implementaciju. Započinjanje pružanja usluga putem telefarmacije (hardwere, software, tehnološka infrastruktura, pokrivenost internetom i operativni troškovi) može predstavljati značajno finansijsko opterećenje bilo za pojedinca bilo za zdravstveni sistem u celini. I pored potrebe za inicijalnim ulaganjem, dokazi iz literature pokazuju da je razvoj telefarmacije jeftiniji u odnosu na otvaranje klasične apoteke. Kliničke prednosti, pre svega prevencija neželjenih reakcija i grešaka prilikom izdavanja leka, mogu biti prevedene u moguće buduće uštede (2). Pored toga, uvođenje telefarmacije doprinosi redukciji troškova i time što primenom ovakve tehnologije jedan farmaceut može obezbediti dostupnost na različitim mestima i veću geografsku pokrivenost. Telefarmacija doprinosi i uštedama novca i vremena i kod samih pacijenata.VIII Kongres farmaceuta Srbije sa međunarodnim učešćem, 12-15.10.2022. Beogra

Assessment of the Suitability of the Delphi Method for Assessing the Needs of Pharmacoeconomic Studies in the Decision-Making Process

Background: Increasing need for control in healthcare spendings and for publicly available services, opens new areas and topics that needs to be discussed. The aim of this paper is assessment of the technic adequacy for evaluation of knowledge level in the subject territory. Materials and Methods: Systematic review has been performed with electronic database PubMed and MEDLINE. The SPIDER model (Sample, Phenomenon of Interest, Design, Evaluation, Research Type) was used to create the search strategy, which is more suitable for qualitative research. Results: After the initial check by title and the introductory part of the abstract, 1,282 published articles were eliminated due to inadequate study design. 249 articles that were checked by abstract with a focus on methodology and sample went for additional checking. During this step, 50 articles were selected for checking the complete research, i.e., the published content. Given results has enabled us insight in Delphi method with assessment of advantages and disadvantages

Analysis of the Professional Aspects of Medical Drugs Industry in the Republic of Serbia in Times of COVID-19 Pandemic

The research subject of this paper is the analysis of the attitudes of employees in pharmaceutical companies towards the business aspects of the pharmaceutical industry during and after the end of the pandemic in the Republic of Serbia. The aim is to examine the differences in the attitudes of employees, as well as to determine which variables predict the situations of endangering the professional reputation of pharmaceutical companies during the COVID-19 pandemic. The research was conducted by means of a survey during 2021 on a sample of 27 innovative and generic pharmaceutical companies. We used the SPSS program for descriptive statistics analysis, chi square test and binary logistic regression models. The findings show that there is a statistically significant difference in the expressed attitudes of employees in innovative and generic pharmaceutical companies in terms of coming to the office during the pandemic; the lack of medicines and medical devices used in the treatment of COVID-19 infections; the patient access to a chosen doctor; the expectations of the employees to continue working from home after the outbreak of the COVID-19 pandemic. The findings of the binary regression models show the slowdown in the supply chain, the access to doctors and working from the home office have not been perceived as creating situations of endangering professional reputations, that is, they contribute to the sustainable economic success. On the other hand, the introduction of digital technologies decreases the occurrence of conditions in which their professional reputation has been threatened

Farmakoekonomska evaluacija fakoemulzifikacije i ekstrakapsularne ekstrakcije u operaciji katarakte

Background/Aim. Cataract surgery is one of the most often performed surgical interventions. The predominant method in Western countries is phacoemulsification, while in developing countries, the extracapsular cataract extraction (ECCE) method remains popular. The aim of the study was to evaluate the cost- effectiveness of these two cataract surgery techniques from the provider’s perspective if operation complications were the out- come of the interest. Methods. The data were obtained from the Department of Ophthalmology of the General Hospital Kruševac during a one-year period. A total of 1,179 surgeries by five surgeons were performed. The cost-effectiveness was evaluated using the decision tree. All probabilities were calcu- lated based on the likelihood of the occurrence during the study period. Only direct costs were considered, and values were taken from the documentation at the hospital and the of- ficial price list of health services. One- and two-way sensitivity analyses were performed. Results. The total cost per patient in the phacoemulsification group was 71,008.70 Serbian dinars (RSD), while the total cost in the ECCE group was 74,340.36 RSD. At the same time, phacoemulsification shows higher ef- fectiveness than the ECCE method, with 87% and 57% of pa- tients without complications, respectively. With these results, phacoemulsification was the dominant strategy compared to ECCE. The sensitivity analysis revealed that the results are sen- sitive to the number of performed operations per year. Con- clusion. The phacoemulsification technique seems to be the preferred technique for cataract surgery. All the investment in phacoemulsification equipment and consumables is justified if the number of surgeries per year exceeds 350.Uvod/Cilj. Operacija katarakte predstavlja jednu od najčešće primenjivanih hirurških intervencija. U zapadnim zemljama, dominantna tehnika je fakoemulzifikacija, dok je u zemljama u razvoju najzastupljenija tehnika ekstrakapsularne ekstrakcije (ECCE). Cilj rada bio je da se proceni ekonomska isplativost te dve tehnike operacije katarakte iz perspektive pružaoca usluge, ukoliko se kao ishod posmatraju komplikacije. Metode. Podaci su dobijeni sa Očnog odeljenja Opšte bolnice Kruševac tokom jednogodišnjeg perioda. Ukupno je izvedeno 1 179 operacija od strane pet hirurga. Ekonomska isplativost je procenjena primenom „drveta odlučivanja“. Verovatnoće za događaje su izračunate na osnovu verovatnoće pojavljivanja tokom navedenog perioda. U analizi su razmatrani samo direktni troškovi, a vrednosti su preuzete iz prateće dokumentacije i zvaničnog cenovnika zdravstvenih usluga. Sprovedena je jednosmerna i dvosmerna analiza osetljivosti. Rezultati.Ukupni troškovi u grupi koja je bila podvrgnuta fakoemulzifikaciji iznosili su 71 008.70 srpskih dinara (RSD), dok su u ECC E grupi oni iznosili 74 340.36 RSD. Istovremeno, fakoemulzifikacija je pokazala višu efikasnost u odnosu na ECCE, 87% i 57% bolesnika bez komplikacija, redom. Na osnovu dobijenih rezultata, fakoemulzifikacija je bila dominantna strategija u poređenju sa ECCE. Analiza osetljivosti pokazala je da su rezultati osetljivi na broj izvršenih intervencija na godišnjem nivou. Zaključak. Fakoemulzifikacija je ekonomski isplativija tehnika operacije katarakte u odnosu na ECCE. Sva ulaganje u opremu i potrošni materijal za fakoemulzifikaciju opravdani su ukoliko je broj izvedenih operacija na godišnjem nivou preko 350

Cost-effectiveness of velmanase alfa vs. bone marrow transplantation or no causal therapy in patients with mild to moderate alpha-mannosidosis

Alpha-mannosidosis is an inherited rare disorder of mannose-containing oligosaccharides metabolism that is currently treated by enzyme replacement therapy (ERT), bone marrow transplantation (BMT), or supportive therapy (ST). However, the relative cost-effectiveness of these treatment options is yet unknown. Our study aimed to compare the cost-effectiveness of the treatment options for mild to moderate alpha-mannosidosis. The study is based on a modeling approach using a Discrete-Event Simulation model to generate and simulate the course of the disease under the influence of each of the treatment options: ERT, BMT, and ST. The model had a lifetime horizon and was made from the perspective of the Serbian Health Insurance Fund. Currently, available causal therapy of mild to moderate alpha-mannosidosis with velmanase alpha enzyme replacement is not cost-effective compared with supportive therapy (ICER = 941,587,152 RSD) or bone marrow transplantation (ICER = −398,412,755 RSD). Bone marrow transplantation can be cost-effective compared to supportive therapy (ICER = 6,032,689 RSD), but only if the willingness-to-pay threshold is increased to 9 gross domestic products (GDP) per capita per QALY gained. According to the current threshold, velmanase-alfa is not cost-effective compared to BMT or ST. To make alfa-mannosidosis therapy widely accessible to patients, criteria for assessing the cost-effectiveness of orphan drugs must include not only the absolute value of ICER but other aspects like equity weightings of QALYs, risk-sharing, reimbursement of severe forms of a disease only, or availability of dedicated funding

Predictors of Inadequate Health Literacy among Patients with Type 2 Diabetes Mellitus: Assessment with Different Self-Reported Instruments

INTRODUCTION: Obtaining, understanding, interpreting, and acting on health information enables people with diabetes to engage and make health decisions in various contexts. Hence, inadequate health literacy (HL) could pose a problem in making self-care decisions and in self-management for diabetes. By applying multidimensional instruments to assess HL, it is possible to differentiate domains of functional, communicative, and critical HL. OBJECTIVES: Primarily, this study aimed to measure the prevalence of inadequate HL among type 2 diabetes mellitus patients and to analyze the predictors influencing health literacy levels. Secondly, we analyzed if different self-reported measures, unidimensional instruments (Brief Health Literacy instruments (BRIEF-4 and abbreviated version BRIEF-3), and multidimensional instruments (Functional, Communicative and Critical health literacy instrument (FCCHL)) have the same findings. METHODS: The cross-sectional study was conducted within one primary care institution in Serbia between March and September 2021. Data were collected through Serbian versions of BRIEF-4, BRIEF-3, and FCCHL-SR12. A chi-square test, Fisher's exact test, and simple logistic regression were used to measure the association between the associated factors and health literacy level. Multivariate analyses were performed with significant predictors from univariate analyses. RESULTS: Overall, 350 patients participated in the study. They were primarily males (55.4%) and had a mean age of 61.5 years (SD = 10.5), ranging from 31 to 82 years. The prevalence of inadequate HL was estimated to be 42.2% (FCCHL-SR12), 36.9% (BRIEF-3) and 33.8% (BRIEF-4). There are variations in the assessment of marginal and adequate HL by different instruments. The highest association was shown between BRIEF-3 and total FCCHL-SR12 score (0.204, p < 0.01). The total FCCHL-SR12 score correlates better with the abbreviated BRIEF instrument (BRIEF-3) than with BRIEF-4 (0.190, p < 0.01). All instruments indicated the highest levels for the communicative HL domain and the lowest for the functional HL domain with significant difference in functional HL between the functional HL of FCCHL-SR12 and both BRIEF-3 and BRIEF-4 (p = 0.006 and 0.008, respectively). Depending on applied instruments, we identified several variables (sociodemographic, access to health-related information, empowerment-related indicators, type of therapy, and frequency of drug administration) that could significantly predict inadequate HL. Probability of inadequate HL increased with older age, fewer children, lower education level, and higher consumption of alcohol. Only high education was associated with a lower probability of inadequate HL for all three instruments. CONCLUSIONS: The results we obtained indicate that patients in our study may have been more functionally illiterate, but differences between functional level could be observed if assessed by unidimensional and multidimensional instruments. The proportion of patients with inadequate HL is approximately similar as assessed by all three instruments. According to the association between HL and educational level in DMT2 patients we should investigate methods of further improvement

Farmakoterapija arterijske hipertenzije u ambulantnim uslovima - troškovi na godišnjem nivou na teret sredstava zdravstvenog osiguranja

Expenditures for the treatment of hypertension and its complication differ among countries and represent huge burden for National Health Funds. The aim of this study is to determine the expenditures charged off obligated health insurance funds and also the prescribing practice of ambulatory treatment of arterial hypertension (AH) in 2006. Retrospective study included 2764 patients with diagnosis AH (I10-I15) and its complications (I20, I21, I25, I50 and I69). Therapy was analyzed according to complexity (number of diagnosis) and frequency of the prescribed medications. The annual expenditures for antihypertensive drugs were compared with total expenditures from National Health Insurance Fund (NHIF) for prescribed medicines. Uncomplicated AH was diagnosed in 1856 (67,15%), while complicated AH in 908 (32,85%) patients. ACE inhibitors were the most frequently prescribed medications (37,01%). NHIF participated with 86,47% in total expenditures for the treatment of AH. More then 55% of total NHIF expenditures for prescribed medications gone on therapy AH. High percentage of patients with complications show late beginning of therapy, irregular visits to general practitioner and inadequate compliance. The expenditures of ambulatory treatment of AH demonstrate that NHIF participate in therapy expenditures with great amount, making the therapy available to patients.Troškovi terapije arterijske hipertenzije (AH) i njenih komplikacija razlikuju se od zemlje do zemlje i istovremeno predstavljaju veliko opterećenje za nacionalne zdravstvene fondove. Cilj ove studije je određivanje troška farmakoterapije AH u ambulantnim uslovima za 2006.godinu na teret sredstava obaveznog zdravstvenog osiguranja, kao i propisivačke prakse. Retrospektivna studija je uključila 2764 pacijenta sa dijagnozom AH (I10-I15) i njenim komplikacijama (I20, I21, I25, I50 i I69). Terapija je analizirana po kompleksnosti (br. dijagnoza) i učestalosti propisivanja farmakoloških grupa lekova. Godišnji troškovi terapije AH su poređeni sa ukupnim izdvajanjem Republičkog zavoda za zdravstveno osiguranje (RZZO) za lekove na recept. Pacijenata bez komplikacija AH bilo je 1856 (67,15%), a pacijenata sa komplikacijama 908 (32,85%). Najpropisivanija grupa AH lekova su ACE inhibitori (37,01%). RZZO učestvuje sa 86,47% u ukupnim troškovima terapije AH. Preko 55% svih sredstava RZZO utrošeno je na medikamentoznu terapiju obolelih od AH. Visok procenat obolelih od komplikacija AH u Srbiji ukazuje na kasno započinjanje lečenja AH, neredovno javljanje lekaru, kao i nedovoljnu komplijansu. Analizom troška terapije pacijenata sa AH u ambulantnim uslovima pokazano je da RZZO u trošku terapije učestvuje sa visokim procentom, čineći terapiju AH dostupnu pacijentima

„Zelena” farmacija - preporuke za unapređenje farmaceutske prakse

Drug residues isolated from environment, such as soil and water, pose a direct threat to human and animal health, and appropriate regulations have been adopted at the European Union level to reduce and control pollution caused by drugs (1, 2). Accordingly, numerous professional debates have been initiated related to pharmacists’ professional responsibility. As a result, international professional associations of pharmacists have made recommendations for taking specific professional activities to protect the environment from the harmful effects of drugs, which will directly contribute to the implementation of adopted regulations (2, 3). Among the most important recommendations for improving pharmaceutical practice to contribute to green pharmacy are as follows: (i) taking actions to increase the public awareness on the prudent use of medicines and pharmaceutical waste collection, (ii) developing guidelines and information materials for healthcare professionals on the prudent use of pharmaceuticals, (iii) exploring the inclusion of environmental aspects for pharmaceuticals posing a risk to or via the environment in the pharmacy education and continuous professional development programs, (iv) developing and ensuring compliance with environmental quality standards for pharmaceuticals as a measure to promote greener manufacturing, (v) ensuring appropriate funding of pharmacy-led disposal and collection schemes for medicines, (vi) reducing pharmaceutical waste caused by leftover medicines by ensuring that systems are in place that encourage the prescription and dispensing of quantities of certain risk medicines in package sizes matching the duration of treatment, (vii) supporting the development of environmentally friendly practices and sustainability policies in pharmacies. There are numerous examples of good practices in European countries in pharmaceutical waste management. Among them are numerous examples of programs to improve citizens' awareness of the importance of returning unused or expired drugs to pharmacies, i.e. on dangers to the environment and public health if medicines are disposed with communal waste. In addition, there are many examples of good organization of pharmaceutical waste management, which emphasize the importance of cooperation between different stakeholders (i.e. pharmacies, pharmaceutical industries, distributors) and support of municipalities and national government. Adherence to adopted regulations for pharmaceutical waste management, and the recommendations of professional associations to improve pharmaceutical practice in the light of green pharmacy, with examples of good practice from developed countries, represents the basis of the pharmacists’ professional responsibility in the context of environmental protection from drug pollution.Ostaci lekova izolovani iz životne sredine, kao što su zemljište i voda, predstavljaju direktnu pretnju zdravlju ljudi i životinja, te su na nivou Evropske unije doneti odgovarajući propisi radi smanjenja i kontrole zagađenja uzrokovanog lekovima (1, 2). U skladu sa navedenom situacijom pokrenute su brojne debate na temu profesionalne odgovornosti farmaceuta, a kao rezultat stručnih diskusija, međunarodna strukovna udruženja farmaceuta donela su preporuke za preduzimanje konkretnih profesionalnih aktivnosti sa ciljem zaštite životne sredine od zagađenja lekovima, koje će direktno doprineti implementaciji usvojenih propisa (2, 3). Među najznačajnim preporukama za unapređenje farmaceutske prakse radi doprinosa „zelenoj” farmaciji navodi se sledeće: (i) sprovođenje aktivnosti sa ciljem povećanja svesti javnosti o značaju upotrebe lekova sa oprezom, kao i o prikupljanju i vraćaju u apoteku lekova sa isteklim rokom i neupotrebljenih lekova, (ii) izrada smernica i promotivnih materijala za zdravstvene radnike o racionalnoj upotrebi lekova, (iii) izučavanje nastavnih sadržaja sa temama iz oblasti rizika od upotrebe lekova za životnu sredinu u toku studija i programa kontinuirane edukacije, (iv) obezbeđenje odgovarajućih finansijskih sredstava za prikupljanje i odlaganje lekova na nivou apoteke, (v) usklađenost sa propisima za zaštitu životne sredine, kao mera za promovisanje „zelenije” proizvodnje lekova, (vi) smanjenje nastanka farmaceutskog otpada uzrokovano neupotrebljenim lekovima kroz podsticanje mera za propisivanja i izdavanje lekova u količini ograničenoj na period trajanja lečenja, (vii) podrška razvoju ekološki prihvatljivih praksi i pratećih propisa u apotekama (3). U zemljama Evropske unije danas postoje brojni primeri dobrih praksi u prikupljanju i pravilnom rukovanju farmaceutskim otpadom Među njima su brojni primeri programa za unapređenje svesti građana o značaju vraćanja lekovima sa isteklim rokom ili neupotrebljenih lekova u apoteke, tj. o opasnostima po životnu sredinu i javno zdravlje ukoliko se lekovi odlažu sa komunalnim otpadom. Pored toga, dosta je primera dobre organizacije procesa rukovanja farmaceutskim otpadom gde se ističe značaj saradnje različitih interesnih strana, tj. apoteka, farmaceutske industrije, distributera, kao i podrška lokalne samouprave i državne uprave. Poštovanje nacionalnih propisa za rukovanje farmaceutskim otpadom i preporuka profesionalnih udruženja za unapređenje farmaceutske prakse u svetlu „zelene” farmacije, imajući u vidu primere dobrih praksi iz razvijenih zemalja, predstavlja okosnicu profesionalne odgovornosti farmaceuta u kontekstu zaštite životne sredine od zagađenja lekovima.Drugi naučni simpozijum Saveza farmaceutskih udruženja Srbije sa međunarodnim učešćem, 28. 10. 2021. Beogra

Economic analysis of wheat production and applied marketing management

Wheat is, in quantity, the third largest crop produced in the world and therefore contributes greatly to the world economy both globally and in Serbia and Bosnia and Herzegovina-B &amp; H. With wheat, worldwide it is sowing about 2.20 million ha annually and in Republic of Serbia wheat cultivated in 588.820 ha. The present trial was carried out to study the growth rates of yield, production and market of wheat in B &amp; H. During the period 2010-2016, wheat was sown of Bosnia and Herzegovina on 63606.30 ha. There is trend in increasing of areas under wheat with a rate of 0.99% per year and, it varies. Average yield of wheat during the monitored period was 3.58 t ha-1. Average export of wheat in the tested period was 41750 t and had a tendency to increase with a rate of 25.67% and variation (CV = 104.41%) while average import of wheat was 398750 t and had a tendency to increase with a rate of 0.82% and variation (CV = 10.37%). The highest import was achieved in 2016 (398750 t) and the lowest in 2013. External trade of agro-industrial products and trade liberalization implies the necessity of raising the technological level of production, productivity, efficiency and application of marketing management