scholarly journals ASSESSMENT OF THE FREQUENCY AND RATIONALITY OF PRESCRIBED MEDICINES IN PATIENTS WITH LIVER CIRRHOSIS

2021 ◽  
pp. 86-93
Author(s):  
Iryna Fediak ◽  
Oleksandra Maksymenko
Keyword(s):  
Liver Cirrhosis ◽  
Clinical Practice ◽  
Digestive System ◽  
Causes Of Death ◽  
Cirrhosis Of The Liver ◽  
Class V ◽  
Group A ◽  
Formal Basis ◽  
Prescribed Medicines ◽  
Real Clinical Practice

The aim. Assessment of the dynamics of prescribing drugs to patients with liver cirrhosis (LC, K 74), in terms of real clinical practice by methods of clinical and economic analysis. Materials and methods. 355 medical cards of inpatients with cirrhosis of the liver, which were divided into 4 groups depending on the period of stay of patients in the hospital. Methods: compatible retrospective ABC-frequency analysis, which ranked drugs consumed by patients in real clinical practice, according to the frequency of appointment using ABC-segmentation according to the Pareto principle (A – 80 % of drugs appointments: B – 15 %: C – 5 %); VEN-analysis, which divides the consumed drugs on a formal basis depending on the presence / absence of a particular drug in the regulations: vital (Vital or V), necessary (Essential or E) and secondary (Non-essential or N). Results. Cirrhosis of the liver in recent years has been on the 10th - 11th place among the causes of death in the world. The analysis of prescribed drugs to patients with LC in real clinical practice in Ivano-Frankivsk region of Ukraine revealed that over the years doctors prescribed fewer drugs on average per patient (11.4 drugs → 8.8 drugs), which can be considered a positive fact. Among the prescribed drugs, drugs of group A – “Drugs that affect the digestive system and metabolism” prevailed, the share of which increased and was the highest in 2019 – 2020 (2007–2009 – 44.6 %; 2012–2013 – 46.6 %; 2015–2016 – 48.1 %; 2019–2020 – 48.55 %); the share of dietary supplements also increased from 1.65 % to 6.52 %. Conclusions. Combined ABC-frequency and VEN-analyzes showed that the leaders in the years of hospital stay were the following drugs: Sodium chloride, Ademetionine, Pantoprazole, Spironolactone, Thioctic acid, Ornithine, Asparaginate K-Mg, Torasemide, Furosemide. However, the vital class V included only 9–11 % of drugs from the whole set of prescribed drugs, which requires systemic correction in accordance with European recommendations.

scholarly journals КОМОРБІДНІСТЬ ТА ЇЇ ВПЛИВ НА ПРИХИЛЬНІСТЬ ДО ПОДАЛЬШОГО ЛІКУВАННЯ У ПАЦІЄНТІВ З ІНФАРКТОМ МІОКАРДА

2018 ◽  
Author(s):  
O. I. Levchyk
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Digestive System ◽  
Causes Of Death ◽  
Associated Diseases ◽  
The World ◽  
Group A ◽  
Adherence To Therapy

In modern clinical practice, the doctor is increasingly faced with a combination of two or more diseases in one patient. Such states are called comorbid, concomitant pathologies, or associated diseases [1–3]. This is especially true for patients with myocardial infarction (MI), since cardiovascular disease (CVD ) remains one of the main causes of death in Ukraine and in the world (World Heart Federation, WH F, 2017).The aim of the study – to set the frequency and the structure of comorbidity in patients with myocardial infarction (IM) and its effect on adherence to further treatment.Materials and Methods. We examined 152 patients with MI, aged 38 to 89 years, on average (60.66±0.86) years (52 women and 100 men) who were divided according to the Morisky-Green questionnaire by two groups: the first – adherent to treatment (n=77), the second group – not adherent to treatment (n=75). The Charlson and CIRS comorbidity indices were determined.Results and Discussion. Both groups identified risk factors and 84% of the concomitant pathology, with the Charleston index – (5.81±1.78), and CIRS (9.32±2.79) points, the largest proportion of diseases of the digestive system. When comparing between groups for the same amount of comorbid pathology (5.66±0.19) and (5.96±0.24) points of Charlson, p<0.05) in patients in the second group a heavier course with deeper damage to organs and systems (CIRS – (8.23±0.25) versus (10.43±0.34) points, p<0.001), which reduces the level of adherence to the prescribed therapy.Conclusions. Patients with myocardial infarction often have a comorbidity, but with the same number of concomitant diseases in different patients, the severity and depth of damage to organs and systems are different. The present combined pathology has an effect on adherence to therapy. Determining the Charlson and CIRS indices allows you to predict the level of compliance individually for each patient and take measures to increase its level.

In real clinical practice osteoporosis drugs are taken for a very short period: analysis of persistence in the campania region

2013 ◽  
Author(s):  
Giovanni Iolascon ◽  
Annarita Capaldo ◽  
Valentina Orlando ◽  
Enrica Menditto ◽  
Francesca Gimigliano
Keyword(s):  
Clinical Practice ◽  
Campania Region ◽  
Period Analysis ◽  
Short Period ◽  
Real Clinical Practice

PCSK9 inhibitors as an add on for the treatment of dislipemia in real clinical practice

2018 ◽  
Author(s):  
Carmen Hernandez Garcia ◽  
Cristina Maria Diaz Perdigones ◽  
Miguel Damas Fuentes ◽  
Clara Estaun Martinez ◽  
Andrea Sanchez Ramos ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pcsk9 Inhibitors ◽  
Real Clinical Practice

Comprehensive assessment of drug consumption as a basis for pharmacotherapy optimization

2019 ◽  
pp. 22-31
Author(s):  
Olga Vyacheslavovna Zhukova
Keyword(s):  
Clinical Practice ◽  
Treatment Options ◽  
Comprehensive Assessment ◽  
Drug Consumption ◽  
Treatment Standards ◽  
Disease Epidemiology ◽  
Efficacy Analysis ◽  
Epidemiological Monitoring ◽  
Guidelines Development ◽  
Real Clinical Practice

This article describes the rationale for methodology of comprehensive assessment of drug consumption in real clinical practice. The proposed methodology includes three stages: 1) epidemiological monitoring – disease epidemiology assessment; assessment of the role of factors leading to the disease; 2) pharmacoepidemiological monitoring – assessment of pharmacotherapy in real clinical practice; clinical efficacy analysis of drugs; cost-effectiveness analysis; 3) long-term clinical and economical evaluation of various treatment options. Comprehensive assessment of drug consumption should result in optimal pharmacotherapy regimens, decrease of the drug load, increasing of the therapy effectiveness and cost reduction. The scheme of comprehensive assessment of drug consumption is universal and can be used for clinical guidelines development, treatment standards, for the optimal formation of drugs lists at the federal level. Separate stages and sub-steps of an integrated assessment also can be used at the territorial and local levels, medical institution, to optimize pharmacotherapy.

Pharmacoepidemiological Analysis of Pharmacotherapy for Burn Injuries in Real Clinical Practice

2020 ◽  
pp. 70-79
Author(s):  
Olga Vyacheslavovna Zhukova ◽  
Ekaterina Sergeevna Nekaeva ◽  
Elena Sergeevna Khoroshavina ◽  
Ekaterina Alexeevna Kozlova ◽  
Yulia Alexandrovna Dudukina ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Average Cost ◽  
Burn Injury ◽  
General Structure ◽  
Burn Injuries ◽  
Antimicrobial Drugs ◽  
Positive Tendency ◽  
Defined Daily Doses ◽  
Duration Of Hospitalization ◽  
Real Clinical Practice

Objective: to conduct pharmacoepidemiological analysis and analysis of the costs of pharmacotherapy, taking into account the actual consumption of drugs in the real inpatient clinical practice at the federal center in Russia. Materials and methods. Data from the medical records of 14 patients with burn injury, who were hospitalized in 2018, was analyzed. Patients’ age was from 23 to 67 years (44,93 ± 14,66). Duration of hospitalization was from 17 to 62 days (35,93 ± 14,17). We calculated rate of prescription foe each drug and its share in general structure of all utilized drug courses (n = 460). We performed frequency analysis of prescription structure, DDD (defined daily doses) analysis, DU90% (Drug Utilization 90%) analysis, ABC-analysis and analysis of average cost of pharmacotherapy. Results. Most frequently used drugs, prescribed in 75-100% of all hospital cases, included 15 names, e.g. 2 antimicrobial drugs (vancomycin and amikacin), 19 were used commonly, including 4 antimicrobial drugs (co-trimoxazole, cefoperazone/sulbactam, tigecyclin and cefepime). Other drugs were used in less than 25% of cases. 33 drugs made 90% of all consumed NDDD, including 5 antimicrobial drugs (vancomycin, amikacin, co-trimoxazole, cefoperazone/sulbactam and tigecyclin). These drugs comprised 70,24% in the prescription structure. The cost of one DDD in DU90% segments (512,33 rubles) is 1,4 higher than in DU10% segment (649,34 rubles). Average cost of drugs included in DU90% group was 4735,89 rubles vs 4966,80 rubles for drugs from DU10% group. This finding shows positive tendency of burn injuries pharmacological treatment. Conclusion. We obtained the data, which can be used for comparison of real clinical practice costs with a current payment rates for medical care.

scholarly journals Insulin doses requirements in patients with type 1 diabetes using glargine U300 or degludec in routine clinical practice

2021 ◽  
pp. jim-2020-001633
Author(s):  
Florentino Carral San Laureano ◽  
Mariana Tomé Fernández-Ladreda ◽  
Ana Isabel Jiménez Millán ◽  
Concepción García Calzado ◽  
María del Carmen Ayala Ortega
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Practice ◽  
Retrospective Study ◽  
Real World ◽  
Glycosylated Hemoglobin ◽  
Routine Clinical Practice ◽  
Insulin Analogs ◽  
Total P ◽  
Real Clinical Practice

There are not many real-world studies evaluating daily insulin doses requirements (DIDR) in patients with type 1 diabetes (T1D) using second-generation basal insulin analogs, and such comparison is necessary. The aim of this study was to compare DIDR in individuals with T1D using glargine 300 UI/mL (IGlar-300) or degludec (IDeg) in real clinical practice. An observational, retrospective study was designed in 412 patients with T1D (males: 52%; median age 37.0±13.4 years, diabetes duration: 18.7±12.3 years) using IDeg and IGla-300 ≥6 months to compare DIDR between groups. Patients using IGla-300 (n=187) were more frequently males (59% vs 45.8%; p=0.004) and had lower glycosylated hemoglobin (HbA1c) (7.6±1.2 vs 8.1%±1.5%; p<0.001) than patients using IDeg (n=225). Total (0.77±0.36 unit/kg/day), basal (0.43±0.20 unit/kg/day) and prandial (0.33±0.23 unit/kg/day) DIDR were similar in IGla-300 and IDeg groups. Patients with HbA1c ≤7% (n=113) used significantly lower basal (p=0.045) and total (p=0.024) DIDR, but not prandial insulin (p=0.241), than patients with HbA1c between 7.1% and 8% and >8%. Patients using IGla-300 and IDeg used similar basal, prandial and total DIDR regardless of metabolic control subgroup. No difference in basal, prandial and total DIDR was observed between patients with T1D using IGla-300 or IDeg during at least 6 months in routine clinical practice.

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