scholarly journals Problems of rational medicines use: the situation in Kyrgyzstan

2018 ◽  
Vol 16 (2) ◽  
pp. 57-61
Author(s):  
Aida A Zurdinova

The article discusses the problems of irrational medicines use at the hospital level of the health care system from the perspective of evidence-based medicine and assessment of the adherence of doctors to follow the recommendations from the developed clinical guidelines and protocols of the Kyrgyz Republic. The study purpose was to analyze the use of medicines and assess the problems of irrational use in hospital-based health facilities in the Kyrgyz Republic. The material of the study was the sheets of prescriptions from the case histories and the questionnaire on the study of the determinants for using and prescription of medicines by methods of excavation, questionnaires and the analysis of the prescriptions to clinical guidelines and protocols. The results of our study showed that doctors admit inefficient use of medicines - polypharmacy, prescription of drugs with unproven efficacy and safety, do not follow recommendations from clinical guidelines and protocols under different pretexts. Data from the questionnaires of doctors revealed an inverse correlation between the prescriptions of medicines in accordance with approved national clinical guidelines and protocols and work experience, i.e. the longer the work of the doctor, the less they are guided by the clinical guidelines and protocols (p < 0.05). The results indicate a low level of adherence of doctors to the use of clinical guidelines and protocols, gaps in the awareness of the population on the use of drugs, the lack of a single information system in the sphere of drug circulation. (For citation: Zurdinova AA. Problems of rational medicines use: the situation in Kyrgyzstan. Reviews on Clinical Pharmacology and Drug Therapy. 2018;16(2):57-61. doi: 10.17816/RCF16257-61).

2018 ◽  
Vol 15 (5) ◽  
pp. 365-375
Author(s):  
Igor A. Kovalev ◽  
Yuri M. Belozerov ◽  
Dinara I. Sadykova ◽  
Dina R. Sabirova ◽  
Lyudmila V. Yakovleva ◽  
...  

Rhythm and conduction disorders of the heart occupy one of the leading places in the structure of cardiovascular pathology in children. Atrioventricular block is the slowing down or loss of impulses from the atria to the ventricles. The team of authors presents clinical guidelines based on the principles of evidence-based medicine, including all stages of diagnosis and treatment of children with atrioventricular block. The use of guidelines in clinical practice will allow to choose the best strategy for the diagnosis and treatment of atrioventricular block for each individual patient.


2021 ◽  
Vol 67 (5) ◽  
pp. 67-83
Author(s):  
V. A. Peterkova ◽  
O. B. Bezlepkina ◽  
N. V. Bolotova ◽  
E. A. Bogova ◽  
O. V. Vasyukova ◽  
...  

Childhood obesity is an urgent problem of pediatric endocrinology due to the widespread occurrence, the development of metabolic complications and their steady tracking into adulthood. The developed clinical guidelines are the main working tool of the practitioner. They briefly and structurally present the main information about the epidemiology and modern classification of obesity, methods of its diagnosis and treatment based on the principles of evidence-based medicine.


Vestnik ◽  
2021 ◽  
pp. 62-67
Author(s):  
Н.Е. Айдаргалиева ◽  
А.О. Доскулова ◽  
Ж.C. Шерияздан ◽  
М.Е. Рамазанов

Применение антикоагулянтов у пациентов с фибрилляцией предсердий (ФП) - краеугольный камень профилактики инсульта. Обзор включает современные данные доказательной медицины по эффективности и безопасности применения Эдоксабана - ингибитора Xa фактора - для предупреждения инсульта при ФП, включая больных с чрескожными коронарными вмешательствами. The use of anticoagulants in patients with atrial fibrillation (AF) is the cornerstone of stroke prevention. The review includes modern evidence-based medicine data on the efficacy and safety of the use of Edoxaban, a factor Xa inhibitor, for the prevention of stroke in AF, including in patients with percutaneous coronary interventions.


2019 ◽  
Vol 56 (3) ◽  
pp. 186-201
Author(s):  
Sergei Yu. Shevchenko ◽  

Semantic framework of the discussion about the equivalence and interchangeability of the original drugs and generics is considered in the article. Generics are identical to the original drugs in terms of chemical structure, nevertheless some patients and doctors consider that generics are less effective and have more severe side effects than original drugs. These discussions are considered as an example of a public deliberation concerning the achievements of technoscience. The conflicting parties determined the identity either from the chemical structure of the drug (according to D. Chalmers – secondary intensional) or from the phenomenal characteristics of the situation of its application (primary intensional). In this regard, the method of resolving the conflict is the alignment of the hierarchy of methods for determining equivalence in biomedicine. The methodology of evidence-based medicine already has such a hierarchy, which makes it possible to determine the validity of outcomes of clinical trial. According to this hierarchy, the phenomenal characteristics of the outcome of treatment (quality and life expectancy of patients) are more important than instrumentally established indicators. Thus, new clinical data on the efficacy and safety of a generic should give the opportunity to cancel the recognition of drug equivalence. More generally, this means that technoscience achievement which directly affects a person can only be assessed by him/her. The recognition of such priority is the basis of the ‘division of linguistic labor’ during public deliberation concerning the achievements of technoscience.


2016 ◽  
Vol 22 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Roland Bal

The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine – clinical trials, and the production and use of clinical guidelines – I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively. In the conclusion, I discuss the prospects of such a practice for evidence-based policy.


2020 ◽  
pp. 62-69
Author(s):  
I.L. Vysochyna ◽  
◽  
V.V. Kramarchuk ◽  

Numerous publications, meta-analyzes and systematic reviews suggest different approaches to the treatment and prevention of ARI, therefore, in the practice of a doctor both in Ukraine and in other countries, there is a variety of schemes, protocols, regulations and professional recommendations for the management of these patients. Therefore, for competent, effective and safe treatment and prevention of ARI among national and world standards, a doctor needs to find the most optimal and effective algorithm for the management and treatment of viral infections of the respiratory tract, which ideally has a high level of evidence-based medicine and can be used in specific practice with the point of view of patient management and routing. Purpose — to analyze the knowledge of the existing in Ukraine and the world of the regulatory framework and national protocols for the management of patients with ARI by general practitioners — family medicine, as well as to study the opinion of family doctors about the efficacy and safety of using flavonoids in the treatment and prevention of ARI. Materials and methods. Anonymous survey of 149 family doctors in the city of Dnipro and the region was conducted in the current 2020. Among the respondents there were 55 doctors with a primary specialization in Pediatrics (37%), 37 doctors with a primary specialization in Internal Medicine (25%) and 57 with a primary specialization in Family Medicine (38%). The distribution normality was checked using the Kolmogorov+Smirnov test. Considering that 90% of the data were normally distributed, we used parametric statistics methods. To assess relationships between binary features, the ϕ-coefficient of mutual conjugation was used. The critical level of statistical significance was accepted as <5% (p<0.05). Results. Family physicians are aware of current trends in the strategy of therapy and prevention of ARI. According to family doctors, drugs with the active substance Proteflazid, when prescribed for the treatment and prevention of acute respiratory viral infections, are safe (no toxic effect) and effective (according to our own observations) by reducing the duration and severity of the disease, the severity of fever and manifestations of intoxication syndrome, reducing the frequency of acute respiratory diseases (frequency rate per year), and that the above effects obtained in their own practice are associated with direct antiviral action, suppression of viral reproduction and multiple mechanisms of action of Proteflazid bioflavonoids. In addition to the professional opinion of family doctors, the opinion of parents about the effectiveness of drugs with the active substance Proteflazid for the treatment and prevention of ARI (feedback from a doctor) in the form of their positive feedback and a note that they are often used for self+treatment, and their choice is associated with the fact that Proteflazid preparations shorten the period of illness and, according to parents, children are less ill with ARI. Conclusions. The presence of the proven antiviral action of flavonoids, as a class of polyphenolic compounds, and the fact that the flavonoids that make up Flavovir have a proven mechanism of antiviral activity, which is confirmed in clinical outpatient practice by the positive experience of primary care physicians (pronounced clinical efficacy) allows you to recommend Flavovir syrup for the treatment and prevention of influenza and seasonal ARI to children from birth. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the doctors was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: ARI, flavonoids, treatment, outpatient practice, evidence-based medicine.


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