Clinical pharmacology-real basis of effi cient and inoff ensive pharmacotherapy

Clinical pharmacology play an important role in ensuring effective and inofensive pharmacotherapy. The administration of a adjusted treatment according to the pharmacokinetic and pharmacodynamic peculiarities of the drug, as well as the patient’s condition is indispensable. The rational use of medicines would increase the patient’s quality of life, as well as has important financial and public health benefits. Excessive, unreasonable prescription of drugs, polypharmacy, misuse of drugs, including expensive and unnecessary are the most common problems of irrational drug use. Many efforts have been made to improve drug use, but few evaluations have been carried out in this area. Identifying the problems that lead to irrational drug use and awareness of the importance of clinical pharmacology could ensure safe and effective pharmacotherapy.

“PerConcept” study: provider opinions about integrating preconception care into family planning services

The importance of preconception care for the mother and child health has long been demonstrated, but the practical realization of this prophylactic activity remains insignificant. Th e article presents the “PerConcept” study results – a survey on “Family Planning” concept perceptions among physicians, whose activity is related to reproductive health. Th e study was conducted based on a unified questionnaire in three cities from three countries: Chisinau (Republic of Moldova), Irkutsk (the Russian Federation) and Ciudad de Mexico (Mexico). Th e survey involved 1.012 family physicians, obstetricians gynecologists, urologists, andrologists, but also doctors of other specialties. A number of 991 questionnaires were validated and analyzed. About 79.5% of all respondents (788) reported that the term of “family” is associated with the birth of children. About 96.0% of respondents (951) believed that pregnancy should be planned by the couple/woman. From a professional perspective, 862 physicians (94.5%), consider that the concept of family planning should also really include a component of preconception care, simultaneous with contraception. Th e majority of participants – 91.1%, (831) had the opinion that strategies and programs in the field of family planning should be revised, in order to include preconception health services. Although the “PerConcept” study had some limitations, the authors consider that the results are interesting because doctors from 3 regions of the world: Europe, Asia, and North America had a similar opinion about the need to expand the family planning concept, which should really include the preconception care, with an equal approach as another component – contraception.

Trends in the transformation of primary health care in the WHO European Region during the pandemic

During the COVID-19 pandemic in the WHO European Region, primary care underwent continuous transformation that proved the important role of this medical fi eld. In diff erent countries, the transformation process has gone diff erently and diff erent goals and objectives were determned. Th e narrative review was conducted using a number of 15 publications, pragmatic and action-oriented, describing the policy instruments that countries have implemented to strengthen the role of primary health care during the pandemic response, as well as to maintain essential health. Th e case studies, published in series by WHO, were analyzed and evaluated in terms of common and country-specifi c trends in the WHO European region. Interventions described in WHO publications focused on the following areas: Strengthening governance and legislative frameworks; Strengthening the workforce, multidisciplinary team; Community and distance services; E-health and digital solutions; and Prevention, health promotion and education programs. Regardless of the results obtained, the continuous transformation of primary health care in different countries in the WHO European Region during the COVID-19 pandemic has allowed the adjustment of medical services provided to the situation created and contextual to the health system. Th is transition period allowed the learning of a number of lessons, both general and specifi c to specifi c countries. By presenting the crucial role of primary health care during the pandemic and beyond, the cases described by WHO have enabled the exchange of experience between countries to inspire policy action and accelerate long-term reforms in primary health care

Medical rehabilitation strategies in complex assistance of people with COVID-19. Literature review

Covid-19 infection is a challenge for the medical system. The development of programs and strategies for the rehabilitation of people in different stages of the disease is relevant and current. The study is a bibliographic synthesis that aimed to analyze the methods and strategies of medical rehabilitation of patients with the new “coronavirus infection”. Data were collected from the academic databases PubMed, PubMed Central, Google, collecting relevant articles from 2019-2021, using the keywords: [“Covid-19” or “Covid 19” or “2019- CoV” or “SARS- CoV” or“ new coronavirus” or “SARS-CoV-2”] and [“rehabilitation ”or“ physical medicine”]. Th e aim of the study was to estimate the consequences of COVID-19 and to identify methods of recovery treatment. Because Covid-19 severely affects the respiratory system, pulmonary rehabilitation interventions with respiratory techniques and postural drainage combined with other physiotherapeutic methods may be used for a patient with COVID-19. The wide range of clinical manifestations in COVID-19 reveals the importance of adapting the rehabilitation program to functional deficits and patient needs. Multifactorial programs combined with active and supportive methods (physical therapy, exercise, occupational therapy, reflex therapy) are effective and can be used in the complex care of patients with COVID-19 at all stages of treatment.

Headaches in the context of the COVID-19 pandemic: preliminary results of a national survey

Headache in the context of the COVID-19 pandemic is a current topic, being divided into pre-infection headache, headache attributed to COVID-19 infection and post-COVID-19 headaches. The aim of the research was to analyze the peculiarities of the evolution and treatment of headache during the COVID-19 pandemic in the cohort of patients from the Republic of Moldova. The study was an online survey. People with COVID-19 infection and headaches were asked to complete a structured, validated and approved questionnaire, which included questions on: demographics, comorbidities, clinical signs of COVID-19 infection, headache before, during and after COVID-19 infection, screening for anxiety, depression and sleep disorders. The data collected for 3 months from the launch are presented (January - March 2021). The study showed that half (58.3%) of the respondents had different forms of headache before COVID-19 infection. During the infection period - 91% of the respondents had bouts of headache attributed to COVID-19, which were of high intensity, holocranial localization, being associated with such signs as vertigo, nausea, peripheral vegetative signs, pronounced asthenia (80%) and pain with another location (85.5%). Persistent headache after COVID-19 was reported by 62.7% of respondents, it being severe for 16.7% of them. Preliminary results show that headache during COVID-19 is prevalent and persists after COVID-19 causing disability and increased costs. Further studies are needed to validate these results.

Organization of the therapeutic education process in hypertension at the level of primary health care

High blood pressure is a major public health problem, with indicators of morbidity and mortality being alarming. Therapeutic education in hypertension increases the level of awareness, blood pressure control and prevents complications. The aim of the study is to evaluate the process of organizing the therapeutic education of patients with hypertension at the level of primary health care in the Republic of Moldova. Study design: descriptive, transversal, by applying the questionnaire developed in the interest of the study. Study methods: statistical, synthetic, comparative, graphical. Th e study involved 371 respondents, of which 65% family physicians, 35% nurses. The majority of medical staff (98.1%) consider therapeutic education important, 87.3% recognized the definition of therapeutic education and its benefits: blood pressure control (90.6%); decrease in mortality caused by complications (81.7%); increasing treatment compliance (72.5%); disease awareness (65.5%). The surveyed medical staff demonstrated a disproportionate involvement in the 4 stages of the organization process: 42.3% are involved in the planning stage, 93.0% - implementation 29.1% - evaluation and 54.2% - organization. The process of organizing therapeutic education is incomplete, due to the lack or insufficiency of planning and evaluation of therapeutic education of patients with hypertension.

Development of biosimilaries and biosimilar growth hormone

In this article, an informative presentation was made about the development of biosimilar and biosimilar growth hormone in Europe and the Republic of Moldova following the selection and analysis of 37 bibliographic sources from the PubMed database and from specialized journals. Human growth hormone was approved by the EMA in 2006 as the world’s first biosimilar drug. Recombinant growth hormone therapy is currently approved for growth hormone deficiency, Turner syndrome, chronic kidney failure, in children/adolescents born young for gestational age and Prader-Willi syndrome. At the same time, biosimulation therapy is very expensive. In the Republic of Moldova but also in Eastern Europe, the accessibility of biological medicines is extremely low due to the lack of local or regional producers. Th e development of the biosimilar production branch, including the biosimilar growth hormone in the Republic of Moldova, will be an attractive and pharmacoeconomically advantageous option for the therapeutic arsenal.