Clinical and economic evaluation of pharmacotherapy of patients with tuberculosis in intensive therapy departments of antituberculosis dispensaries
Keywords:tuberculosis, co-infection with TB/HIV/AIDS, life threatening complications of TB, intensive therapy, clinical economic analysis, frequency analysis, ABC-analysis
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.
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