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

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

Quality assessment of pharmaceutical care to patients with headaches using the simulated patient method: drug recommendations and pharmaceutical counseling

Relevance. Headaches are one of the most important health problems both in Russia and around the world, as well as one of the most common reasons for self-treatment in a pharmacy due to the availability of over-the-counter drugs. Pharmaceutical workers play an important role in the control of self-medication, and the rationality of drug recommendations determines the quality of pharmaceutical care.Aim. To assess the rationality of drug recommendations for a patient with a headache and pharmaceutical drug counseling 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. There was a high frequency of spontaneous recommendations without preliminary questions (66.3%), recommendations (14.9%) and dispensing of prescription drugs (5.0%), frequent recommendations of combined drugs (91.0%). Trade name Pentalgin (46.5%) and trade name Nurofen (42.6%), INN Ibuprofen (47.5%) were the most recommended. Combination analgesics were purchased in most of the visits (72.0%), information on the duration of use of the drug and the need to visit a doctor was never provided.Conclusion. Pharmacists' recommendations are in most cases irrational, focused on the drug as a product and sometimes unsafe, and counseling is practically non-existent. Improving the quality of pharmaceutical care at this stage should include the development of standards for drug recommendations and adequate counseling

Modern aspects of epidemiology of congenital anomalies of development: methodological issues and the translation of research fndings into clinical practice

Progress achieved in the identifcation and characterization of the risk factors for congenital anomalies occur mainly from epidemiological studies, which gave many associations between risk factors and groups of birth defects. However, in clinical practice the transmission of these associations as the actual reasons remains very difcult. Characteristics and epidemiological analysis of possible factors, including drugs, associated with the occurrence of congenital anomalies, are crucial for the development of prevention activities that have an impact on the incidence of defects. To further reduce the global burden of birth defects can help the integration of studies in epidemiology, genetics and epigenetics through personalized and population oriented preventive strategies

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

Evaluation of adherence of patients with atrial fibrillation to anticoagulant therapy at the outpatient stage of treatment

Despite clinical guidelines for the treatment of atrial fibrillation (AF) patient adherence to oral anticoagulants (OACs) in routine clinical practice remains low. Assessing the factors affecting adherence to the OACs regimen and developing strategies for its improvement is important. Aim. To assess the adherence of patients with AF to the prescribed anticoagulant therapy at the outpatient stage of treatment. Methodology. The object of the study was 165 patients with nonvalvular AF undergoing treatment in a specialized cardiology department or receiving outpatient treatment in a specialized cardiological dispensary in Saratov from February 2018 to December 2019. After 3, 6, 12 months, a telephone contact with the patients was carried out, a specially designed questionnaire was filled out, in which the anticoagulant therapy received by AF patients was reflected, the Morisky-Green questionnaire was filled out, the answers of patients about the reasons for skipping or stopping the administration of the OACs were recorded. Results. After 3 months. 16.6 % of AF patients replaced the OACs intake with antiplatelet agents, 16 % refused antithrombotic therapy; 43.1 % of AF patients were adherent to OACs. After 6 months. antiplatelet agents were taken by 24.5 % patients (p<0.05), 11.9 % completely stopped taking antithrombotic drugs; 30.8 % of patients were adherent to OACs (p<0.05). After 12 29,5 % patients replaced OACs treatment with antiplatelet agents, 7.6 % patients did not take any antithrombotic drugs; 31.8 % of AF patients were adherent to OACs. The most common reasons for a decrease in the adherence to OACs therapy were the cost of drugs, lack of understanding of the value of OACs administration in AF, and the lack of appreciable effect of OACs administration. Conclusion. At the outpatient stage of treatment, there was an insufficient level of adherence of AFpatients to OACs treatment

Analysis of antithrombotic therapy of atrial fibrillation in international and Russian registries

In the article the features of the organization of international and Russian registers of patients with atrial fibrillation (AF), the clinical and demographic characteristics of patients included in the registers, as well as the features of antithrombotic therapy of AF and its compliance with current clinical guidelines were observed. In a number of large randomized controlled trials (RCTs), not less effectiveness, and in some cases, the superiority of direct oral anticoagulants (DOACs) over warfarin, were proved in the prevention of ischemic insulin stroke patients with non-valvular AF with better safety profile and ease of use. However, the problem of the use of data obtained during RCTs in real clinical practice, for the solution of which medical registers are gaining much popularity, remains relevant. The article provides an analysis of 16 prospective multicenter international and Russian registers of patients with AF. For convenience of comparison, registers were divided into three groups in accordance with the features of the organization and inclusion criteria. Unambiguous conclusions were drawn about the incompatibility of the real clinical practice of antithrombotic therapy of AF with current clinical recommendations. Differences in the population of patients with AF in Russia compared with European countries were found, which led to the conclusion that insufficient detection of AF at the outpatient stage of diagnosis and the resulting inappropriate anticoagulant therapy aiming the prevention of stroke and ischemic complications take place, which may be due to the differences in the socioeconomic status of the regions and the characteristics of the organization of medical treatment and preventive care to the population

Анализ объемов потребления психотропных лекарственных средств, применяемых для лечения шизофрении, в стационарах различного типа

the goal of our research was to carry out an analysis of psychotropic drug utilization used for patients with schizophrenia in two (state and municipal) in-patient clinics during 2000 and 2010, using the DDD methodology. As the result, we found out that psychotropic drug utilization increased from 2000 to 2010 in both types of in-patient clinics. Consumption of second-generation antipsychotics increase in state clinic in 2010. And in the state clinic we can observe a favorable trend in the decrease of antidepressants and tranquilizers consumption.открытое фармакоэпидемиологическое ретроспективное исследование потребления психотропных лекарственных средств, применяемых для лечения шизофрении, проводилось в 2000-2010 гг. Цель: целью данного исследования было проведение анализа объемов потребления психотропных лекарственных средств (ЛС), применявшихся для лечения параноидной шизофрении в двух стационарах разного типа в 2000 и 2010 гг. с помощью методики «определенных дневных доз». Материалы и методы: оценивались демографические данные пациентов, диагноз, синдром, тип течения заболевания, длительность госпитализации, возраст начала заболевания; названия нейролептиков (НЛ) и препаратов сопутствующей терапии с указанием режима их применения (доза, кратность, путь введения), с использованием методики «определенных дневных доз» (Defined Daily Doses – DDD). Также оценивались побочные эффекты психофармакотерапии и исход лечения. Результаты: обнаружено, что объемы потребления психотропных ЛС при стационарном лечении шизофрении выросли с 2000 по 2010 г., независимо от типа стационара. Объемы использования атипичных НЛ в 2010 г. выросли при снижении объемов потребления антидепрессантов и транквилизаторов

Фармакоэпидемиология лекарственных средств, применяемых для лечения инфаркта мозга, в стационарах различного типа

cerebral infarction – is serious medical and social problem. Results of pharmacoepidemiological studies provide an objective assessment of the quality of pharmacotherapy of brain infarction, and find out the rational use of drugs and to identify ways to optimize the consumption of drugs. The results of pharmacoepidemiological analysis of drugs used for the treatment of cerebral infarction in hospitals of various types, are presented. An assessment of compliance with national and international recommendations «is carried out».инфаркт головного мозга – серьезная медицинская и социальная проблема. Результаты фармакоэпидемиологических исследований позволяют объективно оценить качество фармакотерапии инфаркта мозга, выяснить рациональность использования лекарственных средств и наметить пути оптимизации потребления медикаментов. Представлены результаты фармакоэпидемиологического анализа лекарственных средств, применяемых для лечения инфаркта мозга в стационарах различного типа. Проведена оценка их соответствия национальным и международным рекомендациям

Анализ структуры затрат на фармакотерапию инфаркта мозга в стационаре в 2009-2011 гг

Pharmacoeconomic analysis includes the assessment of direct cost structure in pharmacotherapy of cerebral infarction for the period of 2009-2011 in healthcare institutions in Saratov (762 patients) based on ABC analysis and frequency analysis. The results of the mentioned analysis showed the presence of drugs without proven efficacy and a very high associated cost component (75.67%) of purchasing budget in drug group «A». It was revealed, that the drugs of scientifically substantiated efficacy and safety are not used sufficiently in treatment of cerebral infarction. On the other hand the drugs without proven efficacy are widely used, which leads to an increase in financial losses of the state and population. The results of clinical and economic analysis showed the need for changing the cost structure for drug therapy of the mentioned disease in hospitals.Фармакоэкономический анализ включал оценку структуры прямых затрат на фармакотерапию инфаркта мозга в 2009-2011 годах в стационарных лечебных учреждениях г. Саратова (762 пациента) с использованием АВС- и частотного анализа. По результатам этого анализа было выявлено наличие в группе «А» лекарственных препаратов без доказанной эффективности и очень высокая доля затрат на них (75,67%) от бюджета закупок. Отмечено недостаточное применение лекарственных средств, применяемых при лечении инфаркта мозга и имеющих научно обоснованные доказательства эффективности и безопасности. Напротив, широкое распространение получило применение препаратов без доказанной эффективности, что приводит к увеличению финансовых потерь государства и населения. Результаты проведенного клинико-экономического анализа показали необходимость изменения структуры затрат на фармакотерапию данного заболевания в стационарах города