scholarly journals Chronic pain in older and senile patients. Clinical guidelines

2021 ◽  
pp. 275-320
Author(s):  
O. N. Tkacheva ◽  
A. V. Naumov ◽  
Yu. V. Kotovskaya ◽  
N. K. Runikhina ◽  
A. S. Mil'to ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Medical Care ◽  
Clinical Guidelines ◽  
Older Patients ◽  
Care Organization ◽  
Quality Control Criteria ◽  
The Russian Federation ◽  
Control Criteria ◽  
Russian Association ◽  
Screening And Diagnosis

The present document developed by the Russian Association of Gerontologists and Geriatricians represents the Clinical guidelines on chronic pain in older and senile patients. The Clinical guidelines were endorsed by Scientific Council of the Ministry of Health of the Russian Federation in December 2020.Clinical guidelines are focused on geriatricians providing medical care in outpatient and hospital settings, general practitioners, and physiotherapists.The document sets out the pain syndrom screening and diagnosis principles in older patients, management and treatment approaches in patients with chronic pain, as well as the prevention, rehabilitation, medical care organization issues and quality control criteria for its provision in this category of persons.

scholarly journals Clinical guidelines on frailty

2020 ◽  
pp. 11-46 ◽  
Author(s):  
O. N. Tkacheva ◽  
Yu. V. Kotovskaya ◽  
N. K. Runikhina ◽  
E. V. Frolova ◽  
A. V. Naumov ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Medical Care ◽  
General Practitioners ◽  
Clinical Guidelines ◽  
Treatment Options ◽  
Adult Patients ◽  
Diagnostic Tools ◽  
Care Organization ◽  
Family Doctors ◽  
Russian Association

The paper represents clinical guidelines on frailty, developed by Russian Association of gerontologists and geriatricians. The guidelines are dedicated to geriatricians, internal medicine specialists, general practitioners, family doctors and other specialists, dealing with adult patients. The paper includes screening and diagnostic tools and treatment options for patients with frailty, along with prevention, rehabilitation and medical care organization in this cohort of patients.

Legislation regulating medical care for children with rheumatic diseases in the Russian Federation

2020 ◽  
Vol 15 (5) ◽  
pp. 126-133
Author(s):  
V.K. Sevostyanov ◽  
◽  
Yu.Yu. Razumov ◽  
I.A. Petrova ◽  
E.P. Kakorina ◽  
...  
Keyword(s):  
Medical Care ◽  
Rheumatic Diseases ◽  
Russian Federation ◽  
Systemic Vasculitis ◽  
Health Care Organization ◽  
Legal Framework ◽  
Care Organization ◽  
Legal Documents ◽  
Regulatory Documents ◽  
The Russian Federation

Objective. To analyze legislation regulating medical care for children with rheumatic diseases in the Russian Federation. Materials and methods. We analyzed regulatory documents of the Ministry of Health of Russia, including the rules of medical care for children with rheumatic diseases, the resolution regulating the distribution of medicines at a discount or for free, and regional legal acts regulating routing of children with rheumatic diseases. Results. The legislation regulating medical care for children with rheumatic diseases is imperfect and needs to be updated. We identified shortcomings in the system regulating preferential provision of certain groups of patients with medicines. The results of our analysis can be used as a rationale for changes and amendments to existing regulatory legal acts and for the development of new regulatory documents. Conclusion. This analysis of legal documents allows us to suggest amendments to the existing legal framework in order to reduce tensions (including legal tensions) associated with distribution of preferential medicines, reconsider establishment of disability in patients with juvenile idiopathic arthritis, expand opportunities to prescribe biologicals for non-disabled patients with systemic scleroderma, juvenile dermatomyositis, and systemic vasculitis in regions. We justified detailed description of regional legal documents regulating distribution of preferential medicines among patients with rheumatic diseases. Key words: rheumatic diseases in children, regulatory framework, health care organization, drug provision

scholarly journals Аnaphylactic shock. Сlinical guidelines

2021 ◽  
Vol 18 (1) ◽  
pp. 56-72
Author(s):  
Natalya G. Astafieva ◽  
Ainagul Zh. Bayalieva ◽  
Igor B. Zabolotskikh ◽  
Natalya I. Ilyina ◽  
Alexander V. Kulikov ◽  
...  
Keyword(s):  
Clinical Guidelines ◽  
Anaphylactic Shock ◽  
Treatment And Prevention ◽  
Classification Of Diseases ◽  
Threatening Condition ◽  
International Statistical Classification ◽  
Life Threatening ◽  
The Russian Federation ◽  
Russian Association

Anaphylactic shock is a severe life-threatening condition caused by medicines, food, hymenoptera, animal poisons, etc. Therefore, anaphylactic shock (anaphylaxis) can develop both in medical institution and outside it, and physicians of any specialties should be ready to treat this condition. In this regard, clinical guidelines for anaphylactic shock have been developed. These recommendations were approved by the Russian Association of Allergy and Clinical Immunology (Protocol No. 743/12 dated December 30, 2020) and the Federation of Anesthesiologists and Resuscitators (Protocol No. 1 dated January 13, 2021), approved at a meeting of the Scientific and Practical Council of the Ministry of Health of the Russian Federation (Protocol No. 743/12 dated December 10, 2020). Guidelines covered a number of nosologies corresponding to codes of the International Statistical Classification of Diseases and Related Health Problems: T 78.0; T 78.2; T 80.5; T 88.6. The clinical guidelines systematize modern data on etiology, epidemiology, classification, clinical picture, diagnosis, treatment, and prevention of anaphylactic shock. In addition, an algorithm for managing a patient with anaphylactic shock has been developed. Clinical guidelines for anaphylactic shock are intended for practitioners of all specialties, students, and teachers of medical universities, residents, and graduate students.

scholarly journals Regulatory framework of the oncological medical care provision

2020 ◽  
Vol 13 (3) ◽  
pp. 304-315
Author(s):  
S. N. Tishkina ◽  
V. E. Matskevich ◽  
Yu. A. Ledovskikh ◽  
E. V. Semakova ◽  
V. V. Omelyanovskiy
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
Financial Support ◽  
Legal Framework ◽  
Regulatory Documents ◽  
Analytical Review ◽  
The Russian Federation ◽  
The Government ◽  
Guidelines And Standards

Aim. To conduct an analytical review of the regulatory legal framework on the resources provision required in medical organizations for the provision of oncological medical care based on clinical guidelines.Materials and methods. Using Russian normative legal and regulative documents on the oncological medical care, the authors studied the normative regulation of the issues of both resources’ provision for medical organizations and resources’ demand assessment, including the need for financial support from various sources of the budgetary system of the Russian Federation. The analysis was carried out in two regulatory areas: financing and organization of the provision of medical care. The authors examined the main legislation acts relating to oncological medical care, including documents of the compulsory medical insurance, the annual decrees of the Government of the Russian Federation on the program of state guarantees of free provision of medical care to citizens for the coming year and the planned period, the decree of the Government of the Russian Federation regulating the provision of medicines and medical products, provisions on the organization of medical care by type of medical care, procedures for the provision of oncological medical care, regulatory documents on clinical guidelines and standards of medical care.Results. The content analysis of the studied materials showed that certain components of the resources’ provision, including the financial provision of oncological medical care, are regulated by various regulatory documents, and there is no methodology for assessing the resources’ demand based on clinical guidelines.Conclusion. New approaches to assessing the resources’ demand for the provision of medical care and the required financial support based on clinical guidelines need to be developed.

Review of clinical guidelines “Cystic fibrosis”, 2020

2021 ◽  
Vol 31 (2) ◽  
pp. 135-146
Author(s):  
E. I. Kondratyeva ◽  
E. L. Amelina ◽  
M. Yu. Chernukha ◽  
V. D. Sherman ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
Health Care Services ◽  
Diagnostic Tools ◽  
Federal State ◽  
Diagnostic Strategy ◽  
The Russian Federation

The aim of the experts who provide health care for patients with cystic fibrosis (CF) has been to develop clinical guidelines on cystic fibrosis for children and adults.Methods. The 2020 Clinical Guidelines were based on the European consensus documents on cystic fibrosis and the national consensus “Cystic fibrosis: definition, diagnostic criteria, therapy” (2016, 2019). When creating clinical guidelines, the experts were guided by Article 2 of the Federal Law No.323-FL “On the basics of health care in the Russian Federation” as of November 21st, 2011, and the regulatory legal documents governing the development and approval of clinical guidelines (https://rosmedex.ru/kr/).Results. The clinical guidelines were approved by the Federal State Budgetary Institution “Centre for Expertise and Quality Control of Medical Care” of the Russian Ministry of Health in August 2020. Standards of medical care for children and adults with cystic fibrosis were prepared based on these guidelines. The diagnostic algorithms have been expanded with a three-stage DNA diagnostic strategy, functional assays of CFTR channel, laboratory and instrumental diagnostic tools for assessing disorders of respiratory and other systems, diagnosis of the microbial inflammatory process, microbiological monitoring, and therapeutic approaches. The antibiotic therapy with dosages and courses is described in detail. The updated document should describe a unified tactic for the management of Russian CF patients.Conclusion. Unified clinical guidelines for children and adults should develop unified tactics for the diagnosis, therapy, and follow-up of CF patients in the Russian Federation and ensure continuity between health care services for children and adults.

scholarly journals Oncology calculator as a tool for optimizing drug provision for patients with malignant neoplasms in the subjects of the Russian Federation

2021 ◽  
Vol 65 (5) ◽  
pp. 418-424
Author(s):  
Sergey A. Linnik ◽  
Elena E. Tumenko
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
Federal Budget ◽  
Federal State ◽  
Malignant Neoplasms ◽  
Constituent Entity ◽  
Patients With Cancer ◽  
Number Of Patients ◽  
The Russian Federation

Introduction. The increase in financial resources on the part of the state for the procurement of medicines for treating patients with malignant neoplasms makes the issue of calculation the need in medicinal preparations (MP) actual. The aim of the work is to develop a special tool (oncology calculator) that standardizes the method for determining the need for drugs and can calculate the need for medications for the treatment of malignant neoplasms in a particular constituent entity of the Russian Federation. Material and methods. To develop an oncology calculator, we analyzed the need for the drugs for the treatment of patients with the most common malignant neoplasms was analyzed based on current clinical guidelines approved and published on the Ministry of the Russian Federation website. The number of patients at each stage of a specific cancer was calculated. The frequency of application of a particular treatment regimen was calculated based on the approved standards of medical care for patients with cancer or from a project. The number of patients was calculated on the official statistics presented in the P.A. Hertsen Moscow Oncological Research Institute - branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” by the Ministry of Health of Russia. Results. We have developed a tool called the “Oncology calculator” that standardizes the methodology for determining the need of a constituent entity of the Russian Federation or a medical institution for drugs based on clinical guidelines, as well as facilitating the planning of the volume of medical care in the conditions of round-the-clock and day hospitals, and in the provision of medical care to patients with malignant neoplasms in outpatient settings. Conclusion. The existing approaches to calculating the need for drugs for the treatment of patients with cancer in the constituent entities of the Russian Federation are scattered, which leads to the ineffective use of funds from the federal budget, compulsory medical insurance funds, budgets of the constituent entities of the Russian Federation. A uniform approach to calculating the need for drugs to treat malignant neoplasms should be based on clinical guidelines containing drug regimens for treating patients.

scholarly journals Evaluating of the system of institutional medical care organization for road accident injured in the subject of the Russian Federation

2019 ◽  
Vol 21 (2) ◽  
pp. 184-187
Author(s):  
D A Bugaev ◽  
V Ya Gorbunkov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Premature Mortality ◽  
Road Accident ◽  
Economic Damage ◽  
Care Organization ◽  
Care Organisation ◽  
Stavropol Region ◽  
The Subject ◽  
The Russian Federation

We examine organization of institutional medical care for road accident injured and validate strategies of improvement in the subject of the Russian Federation. Road accidents are one of the crucial reasons of premature mortality, which cause great demographic and social-economic damage. The leading way in global best practices is making traumatologic systems, which also proceeds in the Russian Federation. The research is done in Stavropol region, which possess more than20,1 thousand kilometres of roads. Institutional medical care for road accident injured is provided by 2 traumatologic centres of I level, 3 of II level, 15 of III level. In 2014 the number of injured taken into centres was 3595, in 2017 - 3185. Hospital lethality rate decreased from 4,9% (n=179) in 2014 to 3,7% (n=117) in 2017. However, in 2014 the rate of injured taken into centres of I and II levels was about 37,1%, in 2017 - 46,7% (aimed rate 82%). Complex approach, which includes analyses of location, resource supply, rate of medical centres work and results of the expertise of the provided medical care revealed great shortages in medical care organisation for road accident injured not only in certain centres, but also in the subject in general. Strategies of improvement of institutional medical care for road accident injured are validated in the subject of the Russian Federation (Stavropol region). That includes expanding traumatologic centres network, accreditation of existing traumatologic centres, creating a supplementary sheet for injured in road accident.

scholarly journals Nutritional insufficiency (malnutrition) in older adults. Clinical recommendations

2021 ◽  
pp. 15-34
Author(s):  
O. N. Tkacheva ◽  
V. A. Tutelyan ◽  
A. E. Shestopalov ◽  
Yu. V. Kotovskaya ◽  
A. V. Starodubova ◽  
...  
Keyword(s):  
Older Adults ◽  
Quality Control ◽  
Medical Care ◽  
General Practitioners ◽  
Russian Federation ◽  
Food Industry ◽  
Clinical Guideline ◽  
Clinical Recommendations ◽  
The Russian Federation ◽  
Russian Association

This document is a clinical guideline on malnutrition in elderly and senile patients, developed by experts from the Russian Association of Gerontologists and Geriatricians, the National Association of Clinical Nutrition and Metabolism, the Union of Nutritionists, Nutritionists, and Food Industry Specialists. The Scientific and Practical Council of the Ministry of Health of the Russian Federation approved the document in December 2020. Clinical recommendations are aimed at geriatricians who provide assistance in outpatient and inpatient conditions, general practitioners, general practitioners, nutritionists, anesthesiologists-resuscitators, clinical pharmacologists, and rehabilitologists.The document outlines the principles of screening, diagnosis of malnutrition syndrome, approaches to managing, preventing, and rehabilitating patients with malnutrition, and organizing medical care for this category of persons and criteria for quality control of its provision.

The Quality of Medical Care Provided to Vulnerable Older Patients with Chronic Pain

2004 ◽  
Vol 52 (5) ◽  
pp. 756-761 ◽  
Author(s):  
Joshua Chodosh ◽  
David H. Solomon ◽  
Carol P. Roth ◽  
John T. Chang ◽  
Catherine H. MacLean ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Medical Care ◽  
Older Patients ◽  
Quality Of Medical Care

scholarly journals Developing clinical guidelines and assessing the quality of medical care using the RAND/UCLA method

2020 ◽  
Vol 12 (4) ◽  
pp. 327-332
Author(s):  
O. O. Buzuverova ◽  
V. K. Fedyaeva ◽  
O. A. Sukhorukikh
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
International Experience ◽  
Scientific Data ◽  
Rand Corporation ◽  
National Medical ◽  
Quality Of Medical Care ◽  
The Russian Federation

Introduction. The RAND/UCLA system is commonly used in healthcare economics as it allows one to consider both the relevant scientific data and the opinion of leading experts for deciding on the specifics of medical care.Objective. To analyze the recommendations and practical aspects of the RAND/UCLA and the international experience in using this method; to analyze the feasibility of its application in the Russian Federation, including the basic documents regulating the national medical care.Materials and methods. We analyzed the information available in the RAND corporation website and the PubMed bibliographic database.Results. An analysis of the original information provided by the developers of the RAND/UCLA method showed that using this method involves several stages: selecting a subject to be further studied, reviewing the scientific literature on this subject, choosing the expert commission, and preparing documents for its work; the voting stage is followed by a voting results analysis. The international experience on the applications of the RAND/UCLA method in healthcare demonstrates the successful use of this method in different countries. The use of the RAND/UCLA method in the healthcare system of the Russian Federation can contribute to improving the quality of medical care and the rational use of healthcare resources.Discussion. Currently, the RAND/UCLA method is internationally used to develop clinical guidelines, criteria for assessing the quality of medical care, and feasibility of medical interventions.Concusion. In the Russian Federation, the application of the RAND/UCLA method can prove useful for developing clinical guidelines and related documentation.

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