Clinical and economic evaluation of pharmacotherapy of patients with tuberculosis in intensive therapy departments of antituberculosis dispensaries

Abstract

Aim. To conduct the clinical and economic evaluation of the prescription leaflets of patients with complicated forms of tuberculosis and co-infection with TB / HIV.

Materials and methods. In the study 70 medical cards of inpatients with life-threatening complications of TB and TB/HIV/AIDS treated in six departments of anesthesiology and intensive therapy of regional anti-TB dispensaries of Ukraine were considered; such methods as retrospective clinical and economic: frequency / ABC analysis; analytical-synthetic; and graphic were used.

Results. In intensive therapy departments there were patients with TB (34 %) and TB/HIV/AIDS (66 %) with pulmonary insufficiency (37 %) and polyorganic insufficiency syndrome (simultaneously progressive disorders of hemostasis, acute respiratory distress syndrome, hepato-renal insufficiency – 19 %) with a chance to survive or die 51 % to 49 %. Most often the cause of death was cerebral edema (53 %) and multiple organ failure (23 %). On average, patients stayed 12 ± 11 bed-days in the departments; they had 1701 prescriptions with 223 medicines. The leaders in the frequency of prescriptions were: Analgin sol. for inj. 500 mg/ml, amp. 2 ml, No. 10, Yuria-Pharm; Dimedrol sol. For inj. 10 mg/ml, amp. 1 ml, No. 10, Darnitsa; Furosemide sol. for inj. 10 mg / ml, amp. 2 ml, No. 10, Zdorovia. The total cost of the pharmacotherapy consumed by patients was 3 574.95 UAH/for 1 patient.

Conclusions. The qualitative composition of pharmacotherapy taken by patients in the antituberculosis dispensaries needs to be improved on the model of the world standards: development of the Unified Protocol for providing medical care to patients with TB, co-infection of TB/HIV/AIDS with urgent states in intensive therapy departments is necessary.