13 research outputs found
Monitoring cardiovascular medicine prices as a tool for analyzing the effectiveness of government intervetions to ensure access to medicines at the regional level
Aim. The aim of our study was to continue a comparative analysis of availability and access to cardiovascular medicines in 2017 and 2018 in the city of Kazan according to the original WHO/HAI methodology to assess the effectiveness of government interventions to ensure access to medicines. Material and methods. We performed a comparative analysis of prices of cardiovascular medicines in 2017 and 2018 in Kazan using the World Health Organization and Health Action International (WHO/HAI) methodology, to assess medicinesβ availability and affordability to ensure their rational use. We studied availability and prices of 71 cardiovascular medicines in public and private pharmacies in the city of Kazan and analyzed procurement prices of these medicines in hospitals. Also we studied the affordability of medicines, as well as performed pharmacoeconomic cost-minimization analysis for arterial hypertension pharmacotherapy in 2018. For each name, we studied the prices for the original brand and its lowest-priced generic. We compared medicine prices with international reference, delivered by the Management Sciences for Health and by expressing them as median price ratio (MPR). Results. In the public sector, prices of generic medicines were at the level of reference prices with the indicators of MPR 1.14 [0.41-1.84] and 1.17 [0.49-2.21], in 2017 and 2018 respectively. In the private sector, prices of generics reduced 2 times in 2018 compared to 2017, with the decrease in MPR from 2.22 [1.12-3.91] to 1.25 [0.44-2.32], (p0.05). In 2018, depending on the choice of the medicine the annual course of therapy of hypertension varied from 149 to 28835 rubles. Conclusions. In 2018, the prices of generic cardiovascular medicines, but not of originator brands, reached the level of reference prices in both the public and private sectors of Kazan. According to the WHO/HAI methodology, generic cardiovascular medicines became affordable. In the private sector, there was a reduction in the prices of generic medicines, but not of originator brands, with an improvement of affordability of generics in 2018 compared to 2017
Cerebrolysin for acute ischaemic stroke
Copyright Β© 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Background: Cerebrolysin is a mixture of low-molecular-weight peptides and amino acids derived from porcine brain that has potential neuroprotective properties. It is widely used in the treatment of acute ischaemic stroke in Russia, Eastern Europe, China, and other Asian and post-Soviet countries. This is an update of a review first published in 2010 and last updated in 2017. Objectives: To assess the benefits and harms of Cerebrolysin for treating acute ischaemic stroke. Search methods: We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, Web of Science Core Collection, with Science Citation Index, LILACS, OpenGrey, and a number of Russian databases in October 2019. We also searched reference lists, ongoing trials registers, and conference proceedings. Selection criteria: Randomised controlled trials (RCTs) comparing Cerebrolysin, started within 48 hours of stroke onset and continued for any length of time, with placebo or no treatment in people with acute ischaemic stroke. Data collection and analysis: Two review authors independently applied the inclusion criteria, assessed trial quality and risk of bias, extracted data, and applied GRADE criteria to the evidence. Main results: Seven RCTs (1601 participants) met the inclusion criteria of the review. In this update we re-evaluated risk of bias through identification, examination, and evaluation of study protocols and judged it to be low, unclear, or high across studies: unclear for all domains in one study, and unclear for selective outcome reporting across all studies; low for blinding of participants and personnel in four studies and unclear in the remaining three; low for blinding of outcome assessors in three studies and unclear in four studies. We judged risk of bias to be low in two studies and unclear in the remaining five studies for generation of allocation sequence; low in one study and unclear in six studies for allocation concealment; and low in one study, unclear in one study, and high in the remaining five studies for incomplete outcome data. The manufacturer of Cerebrolysin supported four multicentre studies, either totally, or by providing Cerebrolysin and placebo, randomisation codes, research grants, or statisticians. We judged three studies to be at high risk of other bias and the remaining four studies to be at unclear risk of other bias. All-cause death: we extracted data from six trials (1517 participants). Cerebrolysin probably results in little to no difference in all-cause death: risk ratio (RR) 0.90, 95% confidence interval (CI) 0.61 to 1.32 (6Β trials, 1517 participants, moderate-quality evidence). None of the included trials reported on poor functional outcome defined as death or dependence at the end of the follow-up period or early death (within two weeks of stroke onset), or time to restoration of capacity for work and quality of life. Only one trial clearly reported on the cause of death: cerebral infarct (four in the Cerebrolysin and two in the placebo group), heart failure (two in the Cerebrolysin and one in the placebo group), pulmonary embolism (two in the placebo group), and pneumonia (one in the placebo group). Serious adverse events (SAEs): Cerebrolysin probably results in little to no difference in the total number of people with SAEs (RR 1.15, 95% CI 0.81 to 1.65, 4 RCTs, 1435 participants, moderate-quality evidence). This comprised fatal SAEs (RR 0.90, 95% CI 0.59 to 1.38) and an increase in the total number of people with non-fatal SAEs (RR 2.15, 95% CI 1.01 to 4.55, P = 0.047, 4 trials, 1435 participants, moderate-quality evidence). In the subgroup of dosing schedule 30 mL for 10 days (cumulative dose 300 mL), the increase was more prominent: RR 2.86, 95% CI 1.23 to 6.66, P = 0.01 (2 trials, 1189 participants). Total number of people with adverse events: four trials reported on this outcome. Cerebrolysin may result in little to no difference in the total number of people with adverse events: RR 0.97, 95% CI 0.85 to 1.10, P = 0.90, 4 trials, 1435 participants, low-quality evidence. Non-death attrition: evidence from six trials involving 1517 participants suggests that Cerebrolysin results in little to no difference in non-death attrition, with 96 out of 764 Cerebrolysin-treated participants and 117 out of 753 placebo-treated participants being lost to follow-up for reasons other than death (very low-quality evidence). Authors' conclusions: Moderate-quality evidence indicates that Cerebrolysin probably has little or no beneficial effect on preventing all-cause death in acute ischaemic stroke, or on the total number of people with serious adverse events. Moderate-quality evidence also indicates a potential increase in non-fatal serious adverse events with Cerebrolysin use
ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ ΠΏΠΎ ΡΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΌΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² Π² Ρ ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡΡ ΠΌΠ½ΠΎΠ³ΠΎΠΏΡΠΎΡΠΈΠ»ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°: ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ 7-Π»Π΅ΡΠ½Π΅Π³ΠΎ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ.
Background. Irrational medicine use including excessive use and abuse of antibiotics remains a crucial problem for the healthcare systems. In this regard, studies examining approaches to improving the clinical use of medicines are highly important.Β Aim: to assess the efficacy rate of management for the rational use of antibiotics in surgical departments of a multi-disciplinary hospital.Β Material and methods. The intervention complex combined the research, educational, and methodological activities: local protocols for perioperative antibiotic prophylaxis (PABP) for various surgical departments were developed; local PABP protocols were discussed with the physicians of specialized surgical departments; official order on implementation of PABP was issued; the list of drug prescriptions for registration of the first pre-operative antibiotic dose was changed; audit and feedback processes were introduced as well as consultations of a clinical pharmacologist were implemented. We assessed the efficacy rate of the interventions basing on the changes in consumption of antibiotics (both quantitatively and qualitatively) at surgical departments of a hospital using ATC/DDD methodology. Comparison of the studied outcomes was performed before and after the intervention implementation and between the departments (vascular and abdominal surgery). The consumption of antibacterial agents (ATCJ01) was measured as a number of defined daily doses (DDD) per 100 bed-days (DDD/100 bed-days, indicator recommended by the World Health Organization, WHO) and DDD per 100 treated patients (DDD/100 treated patients).Β Results. From 2006 to 2012, a decrease in antibacterial consumption in surgical departments by 188 DDD/100 treated patients was observed. We obtained the opposite results when using an indicator of DDD/100 bed-days (increase by 2.5 DDD/100 bed-days) which could be explained by the dependence on indices of overall hospital work and its changes during the examined period. Observed changes in antibacterial consumption varied in different surgical departments. The most pronounced positive changes were noted in the department of vascular surgery: decrease in total antibacterial consumption by 298 DDD/100 treated patients, decrease in the use of cephalosporins of the III generation from 141 to 38Β DDD/100 treated patients. These positive changes were accompanied by the same (low) level of consumption/use of reserve antibiotics. In the department of abdominal surgery, there was no decrease in total antibiotic consumption, as well as in consumption of broad-spectrum cephalosporins of the III generation and fluoroquinolones, and we observed an increase in the use of reserve antibiotics (carbapenems) during the study period. Positive changes in antibiotic consumption were associated with the positive attitude of the manager/head of the department towards interventions: we observed the most pronounced decrease in antibiotic consumption straight after the publication of the administrative order on perioperative antibacterial prophylaxis.Β Conclusion. The combination of scientific, educational, and methodological interventions is effective for improving antibiotic application. The study results provide the rationale for analyzing the drug consumption using the DDD/100 treated patients measure in addition to the WHO-recommended indicator of DDD/100 bed-days which depends on overall hospital performance.ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅. ΠΠ΅ΡΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ Π»Π΅ΠΊΠ°ΡΡΡΠ², Π²ΠΊΠ»ΡΡΠ°Ρ ΡΡΠ΅Π·ΠΌΠ΅ΡΠ½ΠΎΠ΅Β ΠΈΒ Π½Π΅ΠΏΡΠ°Π²ΠΈΠ»ΡΠ½ΠΎΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ², ΠΎΡΡΠ°Π΅ΡΡΡ ΡΠ΅ΡΡΠ΅Π·Π½ΠΎΠΉ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠΎΠΉ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ. ΠΠΎΡΡΠΎΠΌΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π½ΡΠ΅ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²Β Π²Β ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅, ΡΠΎΡ
ΡΠ°Π½ΡΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ.Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ, Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΡΡ
Π½Π° ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ²Β Π²Β Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡΡ
ΠΌΠ½ΠΎΠ³ΠΎΠΏΡΠΎΡΠΈΠ»ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°.Β ΠΠ΅ΡΠΎΠ΄Ρ. ΠΠΎΠΌΠΏΠ»Π΅ΠΊΡ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ Π²ΠΊΠ»ΡΡΠ°Π» ΡΠΎΠ·Π΄Π°Π½ΠΈΠ΅ Π»ΠΎΠΊΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠΎΡΠΎΠΊΠΎΠ»ΠΎΠ² ΠΏΠΎ ΠΏΠ΅ΡΠΈΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅, ΠΈΡ
ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅Β ΡΒ Π²ΡΠ°ΡΠ°ΠΌΠΈ ΠΏΡΠΎΡΠΈΠ»ΡΠ½ΡΡ
ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΉ, ΠΈΠ·Π΄Π°Π½ΠΈΠ΅ ΠΏΡΠΈΠΊΠ°Π·Π°Β ΠΎΒ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΠΈ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½ΡΡ
ΠΏΡΠΎΡΠΎΠΊΠΎΠ»ΠΎΠ², Π²Π½Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉΒ Π²Π»ΠΈΡΡ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ Π΄Π»Ρ ΡΠ΅Π³ΠΈΡΡΡΠ°ΡΠΈΠΈ ΠΏΠ΅ΡΠ²ΠΎΠΉ Π΄ΠΎΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π΄ΠΎΠ·Ρ, ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡ Π°ΡΠ΄ΠΈΡΠ° ΠΏΠΎ Π²ΠΎΠΏΡΠΎΡΠ°ΠΌ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ²Β ΠΈΠΏΡΠ΅Π΄ΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ Β«ΠΎΠ±ΡΠ°ΡΠ½ΠΎΠΉ ΡΠ²ΡΠ·ΠΈΒ», ΠΊΠΎΠ½ΡΡΠ»ΡΡΠ°ΡΠΈΠΈ Π²ΡΠ°ΡΠ° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠ»ΠΎΠ³Π°. ΠΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ² ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ Π°Π½Π°Π»ΠΈΠ·Π° ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΎΠ±ΡΠ΅ΠΌΠΎΠ²Β ΠΈΒ ΡΡΡΡΠΊΡΡΡΡ ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ²Β Π²Β Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡΡ
ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Β ΡΒ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΠ’C/DDD-ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΠΈ. Π‘ΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ ΠΈΠ·ΡΡΠ°Π΅ΠΌΡΡ
ΠΈΡΡ
ΠΎΠ΄ΠΎΠ² ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΈ Π΄ΠΎΒ ΠΈΠΏΠΎΡΠ»Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉΒ ΠΈΒ ΠΌΠ΅ΠΆΠ΄Ρ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡΠΌΠΈ. ΠΠ±ΡΠ΅ΠΌ ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ² (ΠΠ’Π‘J01) ΠΈΠ·ΠΌΠ΅ΡΡΠ»ΠΈ ΠΊΠ°ΠΊ ΡΠΈΡΠ»ΠΎ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π½ΡΡ
Π΄Π½Π΅Π²Π½ΡΡ
Π΄ΠΎΠ· Π½Π° 100Β ΠΊΠΎΠΉΠΊΠΎ-Π΄Π½Π΅ΠΉ (DDD/100Β ΠΊΠΎΠΉΠΊΠΎ-Π΄Π½Π΅ΠΉ) (ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ, ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΠΎΠ²Π°Π½Π½ΡΠΉ ΠΠΠ)Β ΠΈΒ Π½Π° 100Β ΠΏΡΠΎΠ»Π΅ΡΠ΅Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (DDD/100Β ΠΏΡΠΎΠ»Π΅ΡΠ΅Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²).Β Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ.Β Π‘Β 2006 ΠΏΠΎ 2012Β Π³. ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ²Β Π²Β Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡΡ
Π½Π° 188Β DDD/100Β ΠΏΡΠΎΠ»Π΅ΡΠ΅Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΡΠΎΡΠΈΠ²ΠΎΠΏΠΎΠ»ΠΎΠΆΠ½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΒ DDD/100Β ΠΊΠΎΠΉΠΊΠΎ-Π΄Π½Π΅ΠΉ (ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ Π½Π° 2,5Β DDD/100Β ΠΊΠΎΠΉΠΊΠΎ-Π΄Π½Π΅ΠΉ), ΡΡΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΡΡΡ Π΅Π³ΠΎ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡΡ ΠΎΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠ°Π±ΠΎΡΡ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Β ΠΈΒ ΠΈΡ
ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΡΠΌΠΈ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡΠΌΠΈΒ Π²Β ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΈΠ·ΡΡΠ°Π΅ΠΌΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄Π°. ΠΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΎΠ±ΡΠ΅ΠΌΠ°Β ΠΈΡΡΡΡΠΊΡΡΡΡ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠ°Π·Π»ΠΈΡΠ°Π»ΠΈΡΡΒ Π²Β ΡΠ°Π·Π½ΡΡ
ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡΡ
. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΡΒ Π²Β ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ Ρ
ΠΈΡΡΡΠ³ΠΈΠΈ: ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ²Β Π²Β ΡΠ΅Π»ΠΎΠΌ Π½Π° 298Β DDD/100Β ΠΏΡΠΎΠ»Π΅ΡΠ΅Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅ΡΠ°Π»ΠΎΡΠΏΠΎΡΠΈΠ½ΠΎΠ²Β IIIΒ ΠΏΠΎΠΊΠΎΠ»Π΅Π½ΠΈΡ ΡΠΎ 141 Π΄ΠΎ 38Β DDD/100Β ΠΏΡΠΎΠ»Π΅ΡΠ΅Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΡΠΎ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π»ΠΎΡΡ ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠ΅ΠΌ Π½Π° ΠΏΡΠ΅ΠΆΠ½Π΅ΠΌ (Π½ΠΈΠ·ΠΊΠΎΠΌ) ΡΡΠΎΠ²Π½Π΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² ΡΠ΅Π·Π΅ΡΠ²Π°. ΠΡΡΡΡΡΡΠ²ΠΈΠ΅ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ ΠΎΠ±ΡΠ΅ΠΌΠ° ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ²Β Π²Β ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΠΎΠΉ Ρ
ΠΈΡΡΡΠ³ΠΈΠΈ,Β Π°Β ΡΠ°ΠΊΠΆΠ΅ Π°ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² ΡΠΈΡΠΎΠΊΠΎΠ³ΠΎ ΡΠΏΠ΅ΠΊΡΡΠ° (ΡΠ΅ΡΠ°Π»ΠΎΡΠΏΠΎΡΠΈΠ½ΡIIIΒ ΠΏΠΎΠΊΠΎΠ»Π΅Π½ΠΈΡ, ΡΡΠΎΡΡ
ΠΈΠ½ΠΎΠ»ΠΎΠ½Ρ) ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π»ΠΎΡΡ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² ΡΠ΅Π·Π΅ΡΠ²Π° (ΠΊΠ°ΡΠ±Π°ΠΏΠ΅Π½Π΅ΠΌΡ)Β Π²Β ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ΅ΡΠΈΠΎΠ΄Π° ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡΒ Π²Β ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΠΈ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² ΡΠΎΠΎΡΠ½ΠΎΡΠΈΠ»ΠΈΡΡΒ ΡΒ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΠΌ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ΠΌ Π·Π°Π²Π΅Π΄ΡΡΡΠ΅Π³ΠΎ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ΠΌΒ ΠΊΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠΌΡΠΌ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°ΠΌ; Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² ΠΌΡ Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ ΡΡΠ°Π·Ρ ΠΏΠΎΡΠ»Π΅ ΠΈΠ·Π΄Π°Π½ΠΈΡ ΠΏΡΠΈΠΊΠ°Π·Π°Β ΠΎΠΏΠ΅ΡΠΈΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅.Β ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΠΌΠΏΠ»Π΅ΠΊΡ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π΅Π½ Π΄Π»Ρ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ². Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²ΡΠ²Π°ΡΡ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ DDD/100Β ΠΏΡΠΎΠ»Π΅ΡΠ΅Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²Β Π²Β Π΄ΠΎΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅Β ΠΊΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΠΎΠ²Π°Π½Π½ΠΎΠΌΡ ΠΠΠ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ DDD/100Β ΠΊΠΎΠΉΠΊΠΎ-Π΄Π½Π΅ΠΉ, Π·Π°Π²ΠΈΡΡΡΠ΅ΠΌΡ ΠΎΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠ°Π±ΠΎΡΡ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°, Π΄Π»Ρ Π°Π½Π°Π»ΠΈΠ·Π° ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²
Perioperative antibiotic prophylaxis for abdominal delivery at the regional perinatal center
Aim. To conduct a comparative pharmacoepidemiological study and assess the rational use of antibiotics in women undergoing caesarean section. Methods. A retrospective analysis of 1,025 birth histories of women after planned and emergency cesarean section was carried out with a detailed assessment of the use of antibiotics in 2007-2009 (523) and 2016-2017 (502) - with an interval of 10 years for which new clinical guidelines, principles of rational pharmacotherapy and evidence-based medicine were introduced. The time of administration of the first dose, duration of administration, consumption of antibiotics were assessed. The significance of differences in relative indicators was assessed according to Pearson (Ο2). Results. Antibiotics were prescribed to women with planned and emergency caesarean section in 100% of cases in the first period of the study (2007-2009) and prescribed in 98% of women with planned caesarean section and 96% with emergency caesarean section in the second period (2016-2017). In the first period, the first dose of antibiotic was administered: in 110 (44%) cases during surgery and 139 (56%) cases after surgery in planned caesarean section; in 139 (51%) cases during surgery and 135 (49%) cases after surgery in emergency caesarean section. In the second period, antibiotics were administered 30-60 minutes before the operation in 263 (96%) cases in the planned caesarean section and 218 (95%) cases in the emergency; postoperative antibiotics were administered in 7 (2%) women in the planned caesarean section and 2 (1%) women in the emergency (p <0.05). Greater than 5-6 days of antibiotics were used: in 166 (67%) women in the planned operation and 166 (61%) in the emergency for the first period; in 43 (16%) women with the planned operation, and 38 (17%, p <0.05) women with an emergency for the second period. In the first period, 13 antibiotics from 8 pharmacotherapeutic groups were used and in the second period, 7 out of 5 were used. Conclusion. From 2007 to 2017, the use of antibiotics has become to comply with the implemented clinical guidelines for abdominal delivery: the duration of antibiotic use has decreased, the time of administration of the first dose and the range of antibiotics used changed
CLINICAL PHARMACOLOGICAL SERVICE IN OPTIMIZATION OF THE PHARMACOLOGICAL SUPPORT AT THE INITIAL STAGE OF THE PEDIATRIC CARE
Assisted by ΠΠΠ‘/VEN analysis, the article evaluates the efficiency of the medication consumption in the day patient facility of the children's health center for 4 years, while providing the beneficial categories of the children's population with the necessary medications. Having analyzed the efficiency of the acute respiratory viral infection pharmacotherapy by the indices of the who medication prescription, the authors identified the leading role of the clinical pharmacological service in the optimization of the pharmacological support at the initial stage of the pediatric care pertaining to the reasonable prescription of medications and impact on the inefficient variants of their application.Key words: clinical pharmacology, children, children's health center, day patient facility, medication, pharma-cotherapy
Access to medicines: Case studies from Russia and Kyrgyzstan
Β© The Author(s) 2020. We report medicine prices, availability and affordability in Russia and Kyrgyzstan using the WHO/HAI methodology. In Kyrgyzstan, median prices of cardiovascular medicines were 6 times higher than in Russia, whilst their affordability was 9 times lower than in Russia for lowest-priced generics and 11 times lower for originator brands. Antihypertensive pharmacotherapy was affordable in Russia, but not in Kyrgyzstan (2015). We monitored patient and procurement prices in Russia (2010-2017) and documented success of government interventions in reduction of essential and cardiovascular patient prices from 2010 onwards to recommended values for generics in public sector and the need for continued price monitoring
Assessing human post-editing efforts to compare the performance of three machine translation engines for english to Russian translation of cochrane plain language health information: Results of a randomised comparison
Cochrane produces independent research to improve healthcare decisions. It translates its research summaries into different languages to enable wider access, relying largely on volunteers. Machine translation (MT) could facilitate efficiency in Cochraneβs low-resource environment. We compared three off-the-shelf machine translation engines (MTEs)-DeepL, Google Translate and Microsoft Translator-for Russian translations of Cochrane plain language summaries (PLSs) by assessing the quantitative human post-editing effort within an established translation workflow and quality assurance process. 30 PLSs each were pre-translated with one of the three MTEs. Ten volunteer translators post-edited nine randomly assigned PLSs each-three per MTE-in their usual translation system, Memsource. Two editors performed a second editing step. Memsourceβs Machine Translation Quality Estimation (MTQE) feature provided an artificial intelligence (AI)-powered estimate of how much editing would be required for each PLS, and the analysis feature calculated the amount of human editing after each editing step. Google Translate performed the best with highest average quality estimates for its initial MT output, and the lowest amount of human post-editing. DeepL performed slightly worse, and Microsoft Translator worst. Future developments in MT research and the associated industry may change our results
Improving the Russian-language Wikipedia articles on medicines using new knowledge Cochrane
To evaluate the effectiveness of the Cochrane Russia Initiative to improve the articles of the Russianlanguage Wikipedia by including information from Cochrane Systematic Reviews (CSR) to ensure the accuracy and impartiality of their content as an information basis for the quality use of medicines by doctors and the public. Methods. Wikipedia articles on selected drugs were improved by introducing evidence from Cochrane Systematic Reviews - "Cochrenized". A parallel open-label non-randomized controlled intervention study was conducted. We assigned 2 groups of drugs and Wikipedia articles about them: the intervention group ("Cochrenization") and the control group (36 articles each). Control group articles were not edited. The change in the number of visits to Wikipedia pages for the year (2018-2019) was measured, the statistical significance of the differences was assessed by using the Wilcoxon signed-rank test. Results. We edited 36 Wikipedia articles, including 13 articles on migraine treatment, 9 diabetes mellitus, 14 pain and inflammation articles. These articles constituted the intervention group. The control group consisted of articles on cardiovascular (11), gastrointestinal (14) and dermatological agents (11). We used the Cochrane Russia Initiative dashboard on Wikipedia to compare the number of article views before and after the intervention and Cochrane analytics on demand for translations of Cochrane systematic reviews summaries. After "Cochrenization", the number of Wikipedia article views (2018-2019) increased in total/average article views for treatments: migraines by 18%/47%, pain and inflammation - 16%/43%, diabetes mellitus - 18%/0%. Analysis of Cochrane reports showed an increase in the number of views of Cochrane systematic reviews summaries on the Cochrane.org website in general by 9 times and from Russian-speaking browsers by 11 times. Improvement of medicine-related articles of the Russian-language Wikipedia by the introduction of information from Cochrane systematic reviews was accompanied by an increase in their demand in terms of the number of views in general by 34%, with a similar increase in control (without intervention) (p-value of the experimental group - 0.002, control - 0.000). The Wikipedia articles on medicines, which belonged to the Russian Vital and Essential Drugs List or the World Health Organization Model List of Essential Medicines, got more views. Conclusion. The role of confounding factors justifies the feasibility of developing a methodology for studying the usefulness of improving Wikipedia articles, different from controlled trial research methodology; further inclusion of Cochrane knowledge into Wikipedia is needed
CLINICAL PHARMACOLOGICAL SERVICE IN OPTIMIZATION OF THE PHARMACOLOGICAL SUPPORT AT THE INITIAL STAGE OF THE PEDIATRIC CARE
Assisted by ΠΠΠ‘/VEN analysis, the article evaluates the efficiency of the medication consumption in the day patient facility of the children's health center for 4 years, while providing the beneficial categories of the children's population with the necessary medications. Having analyzed the efficiency of the acute respiratory viral infection pharmacotherapy by the indices of the who medication prescription, the authors identified the leading role of the clinical pharmacological service in the optimization of the pharmacological support at the initial stage of the pediatric care pertaining to the reasonable prescription of medications and impact on the inefficient variants of their application.Key words: clinical pharmacology, children, children's health center, day patient facility, medication, pharma-cotherapy
Smart and age-friendly cities in russia: An exploratory study of attitudes, perceptions, quality of life and health information needs
Β© 2020 by the authors. Licensee MDPI, Basel, Switzerland. In Russia, initiatives for healthy ageing have been growing over the last two decades; however, none use an evidence-based (EB) approach. It is proposed that Kazan, a city with a population of over a million in the European part of Russia, has good chances of moving towards age-friendliness and contributing to raising awareness about healthy ageing through Cochrane evidence. One of the eight essential features of age-friendly cities by the World Health Organisation (WHO) directly points to health services. This exploratory study assesses the health information needs of the ageing population of Kazan and the challenges people face in improving their health and longevity. Survey data were used from 134 participants, patients, caregivers and healthcare providers of the Interregional Clinical Diagnostic Centre (ICDC), aged from 30 to over 80 years, and potential associations of the studied parameters with age, gender, quality of life and other characteristics were analysed. Older people (60+) were less positive about their quality of life, took medicines more often on a daily basis (10/16 compared to 29/117 of people under 60), encountered problems with ageing (9/16 compared to 21/117 of people under 60) and rated their quality of life as unsatisfactory (4/14 compared to 9/107 of people under 60). Awareness of EB approaches and Cochrane was higher within health professions (evidence-based medicine: 42/86 vs. 13/48; Cochrane: 32/86 vs. 2/48), and health information needs did not differ between age or gender groups or people with a satisfactory and unsatisfactory quality of life. The minority (10%β13/134) were aware of ageism without age or gender differences. The low awareness calls for the need of Cochrane intervention both for consumers and those in the health profession to raise awareness to contribute to Kazan moving towards an age-friendly city