Social Pharmacy in Health Care

The assessment of the state of prescription dispensing by pharmacists in the context of the electronic prescription introduction in Ukraine

L. V. Tereschenko — 2024-07-16

Aim. To assess the current state of prescription dispensing of medicines and the effectiveness of introducing electronic prescriptions (EP) based on the results of a survey of pharmacists.

Materials and methods. The study materials included regulatory legal acts, scientific publications, data from the State Register of Medicines of Ukraine, and the results of a sociological survey. The general scientific (analysis, generalization, synthesis), theoretical (structural, systemic analysis) and practical (sociological analysis) methods of analysis were used in the study.

Results. It has been determined that in accordance with the provisions of the current regulatory legal acts, currently there is a list of OTC medicines in Ukraine. In 2023, it included 3191 medicines. And it is only 21.6 % of all medicines registered in Ukraine as of 18.11.2023. The results of the survey of 262 pharmaceutical employees of pharmacies in different regions have shown that among the main advantages of the introduction of the drug dispensing by EP, 77.5 % of respondents point out a significant reduction in the number of errors due to doctor’s unclear handwriting, 59.9 % note reliable control over dispensing of medicines. It has been determined that 231 pharmacists (89.2 % of respondents) believe that the functioning of EP will enable pharmacies to comply with the requirements of the legislation on prescription medicines. It has been found that more than half – 201 respondents (76.7 %) believe that the introduction of EP in the national healthcare system will prevent the irrational use of antibacterial drugs. The main difficulties that pharmacists most often encounter when dispensing medicines by EP have been identified, in particular technical failures (54 %), the patient’s misunderstanding of how EP works (40.5 %), and the lack of Internet access (30.5 %). It has been found that 94.7 % of pharmacists are familiar with the latest changes in the legislation on dispensing of medicines from pharmacies.

Conclusions. Based on the analysis, the main directions of solving current problems related to dispensing of prescription medicines in Ukraine have been identified. It has been determined that the introduction of EP for all finished medicines will contribute to the protection of the patient’s health, the rational use of prescription medicines and reliable control over their dispensing.

The study of modern professional competences for pharmaceutical positions that determine the effective activities based on the analysis of opinions of pharmacy professionals

M. V. Zarichkova — 2024-07-16

Aim. To study modern professional competencies – hard skills (including knowledge, abilities, skills) and soft skills (personal skills) that determine the effective activity of pharmacy professionals (PP) in certain pharmaceutical positions (pharmacy manager, pharmacist, pharmacist’s assistant) and determine the most important of them for pharmacy retail in today’s conditions.

Materials and methods. To collect and process data, such scientific methods as the analysis of literary sources, the method of questionnaire survey, the method of comparison, comparison, and generalization, were used. The results of the analysis were processed using licensed software products of Microsoft Office Excel. The methods of descriptive statistics and statistical analysis, such as the Epitools service (Ausvet Ltd., Australia), a STATISTICA 13 statistical package (TIBCO Software Inc., USA) were used to process the questionnaire data.

Results. As part of our study, a survey, in which 200 PP took part, was conducted. The questionnaire contained open-ended questions, in which it was necessary to specify 3-5 hard skills (professional skills) or soft skills (personal skills) that are necessary for the effective performance of the professional duties of PP in the relevant position, as well as select one of the most important ones from this list. At the same time, three positions were differentiated: pharmacist, pharmacist’s assistant, and pharmacy manager. According to the survey results, hard skills and soft skills, which, according to the majority of PP, were the most necessary for each position. were identified.

Conclusions. Based on the results of the study conducted, it has been found that the actualization of professional competences and soft skills is an important step for effective work by position in pharmacy institutions in today’s conditions. It has been determined that such soft skills as sociability, responsibility, stress resistance, honesty, intelligence, purposefulness, hard work, love for the profession, experience, energy and reliability are equally important for the positions of a pharmacist, pharmacist’s assistant and pharmacy manager. At the same time, specific hard and soft skills are distinguished for each of the positions: empathy and attentiveness are more important for pharmacists and pharmacist’s assistants, while organizational skills, managerial qualities, desire for professional development and knowledge of legislation are important for pharmacy managers. Responsibility is a key quality for pharmacy managers, professionalism and knowledge – for pharmacists, and attentiveness – for pharmacist’s assistants. Differences in the perception of the importance of these hard and soft skills are also related to the age, qualification and type of pharmacy institutions where respondents work.

Organization of reviews of a pharmaceutical enterprise quality management system functioning

V. O. Lebedynets — 2024-07-16

Aim. To determine the state of organizing the process of analyzing the quality management system of a typical pharmaceutical enterprise in accordance with the current industry requirements of Good Manufacturing Practice and the ISO 9001:2015 standard, as well as substantiating effective approaches to improving this activity.

Materials and methods. We used analysis, comparison, questionnaires, surveys and direct observations. The results were processed and verified using licensed Microsoft Office Excel software products.

Results. The relevance of the development of quality management systems (QMS) of domestic pharmaceutical organizations in the period of martial law has been proven. The requirements of the DSTU ISO 9001:2015 standard, as well as the requirements of the guidelines on Good Manufacturing Practice (GMP) of medicines for reviewing and analyzing QMS of pharmaceutical enterprises (PhE) have been analyzed. Approaches to the organization of QMS review at a number of domestic PhE have been studied; as a result, typical inconsistencies of these procedures have been determined. Based on the results of the study and the experience analyzed in supporting the QMS functioning of PhE, effective organizational approaches have been identified, and recommendations are given for the effective analysis of QMS of PhE.

Conclusions. In the study conducted, a review of the practice of analyzing QMS at a number of domestic and foreign PhE has been carried out, and typical inconsistencies of this process have been identified and systematized. The requirements of the DSTU ISO 9001:2015 standard, as well as the industry requirements of the GMP guidelines for reviewing and analyzing the quality system of PhE have been analyzed. Based on the results of the research and the authors’ own experience in implementing and supporting the QMS functioning of PhE, the main organizational approaches and recommendations for analyzing QMS of PhE have been determined.

Development of management and its impact on medicine and pharmacy

I. V. Pestun — 2024-07-16

Aim. To study and generalize the main current trends in the theory and practice of management and their impact on the activities of healthcare institutions.

Materials and methods. Scientific literature, legislative and regulatory acts, informational websites on the Internet were used. Such methods as the content analysis, comprehensive and systemic approach, structural-logical analysis, generalization, comparison, and grouping were applied.

Results. The current trends in management have been systematized and grouped. The role of the development of organizational management theory and practice in changing approaches to management, leadership in forming new requirements for the skills of employees, increasing attention to the human factor, digitalization of management processes, socialization of management, etc., in general and in the healthcare system in particular has been demonstrated. Areas of use of artificial intelligence (AI) in medical, clinical, pharmaceutical, and biotechnological practice have been identified. The impact of innovative processes on the functioning of pharmaceutical market entities has been characterized.

Conclusions. Modern management trends have been analyzed; changes in management concepts and company transformation have been described; the characteristics of contemporary leadership, the implementation of a value-oriented approach, directions for the development of mechanisms for intellectual management and digitalization, and innovative approaches to management have been determined. The impact of existing management trends and achievements on the medical and pharmaceutical system has been demonstrated.

The substantiation of the feasibility of implementing stress management in pharmacies

T. V. Krutskikh — 2024-07-16

The stress level of pharmaceutical workers in Kharkiv was studied. The results of pharmacists' own assessment of their mental health and the level of satisfaction with work in a pharmacy were obtained. An assessment of the frequency of stressful situations among specialists while working in a pharmacy was carried out, and the factors influencing the development of stress among pharmaceutical workers were determined.

The peculiarities of setting goals in geriatric rehabilitation

N. V. Zhabotynska — 2024-07-05

Aim. To determine the peculiarities of setting SMART goals in geriatric rehabilitation.

Materials and methods. Materials of scientific publications and international guidelines on the organization of rehabilitation; methods of data analysis, systematization and generalization were used.

Results. Age-related physiological changes in the body of older people combined with their own life experience and individual personality qualities require special approaches to setting goals in geriatric rehabilitation. When setting goals in geriatric rehabilitation, certain problems may arise: patients may feel that their opinion is not sufficiently taken into account, and difficulties in understanding what exactly they expect from the rehabilitation process; specialists may have doubts about the ability of older patients to formulate realistic goals; not all patients seek an active role in the goal-setting process. To solve these problems, members of the multidisciplinary team can use certain tools: the use of language that is understandable for the patient in discussions; determination of the patient’s role in setting goals; achievement of a balance between the patient’s wishes and capabilities; demarcation of goals to better achieve them. Directly, the process of setting goals can be presented as a process consisting of three stages: introduction, goal setting, summary and clarification of goals. The authors consider in detail the actions that must be performed by members of the multidisciplinary team at each stage. The use of a three-step algorithm for forming goals can help specialists better interact with the patient and better form the goals of the rehabilitation cycle.

Conclusions. The article highlights the problems that arise when setting goals in geriatric rehabilitation; tools for solving these problems and a three-stage goal formation algorithm, which allows increasing the efficiency of interaction with the patient to achieve the SMART goals set have been proposed.

The study of the range, availability and affordability of vitamin B1 medicines combined with vitamin B6 and/or B12 in the pharmaceutical market of Ukraine

I. V. Vyshnytska — 2024-07-16

Aim. To conduct a study of the range of combined neurotropic vitamins B in the pharmaceutical market, to analyze their availability and affordability for patients with neurological diseases.

Materials and methods. The study was conducted using data from the State Register of Medicines of Ukraine, ATC classification, and information on statistical retail prices from the online service www.tabletki.ua. Such research methods as systematization, generalization, comparative, marketing, content analysis, pharmacoeconomic analysis by the “cost of illness” method were used.

Results. The pharmaceutical market of vitamin A11DB group Vitamin B₁ in combination with vitamin B₆ and/or B₁₂ registered in Ukraine as 43 trade names (TN) of medicines has been analyzed taking into account all dosage forms; among them, 53.5 % are medicines of domestic manufacturers. Among dosage forms, the vast majority are solutions for injection (65.1 %). Only 56 % of the registered medicines are accessible, i.e. available for sale in regional pharmacies, with an equal proportion of domestic and foreign manufacturers. In 63 % of the drugs studied, the price liquidity ratio indicator shows fluctuations from 0.51 to 1.0, which indicates a significant range of drug prices, a relatively low level of competition in the market, and negatively characterizes the availability of these drugs for the population. It has been found that for injectable dosage forms of the drugs studied, the coefficient of adequacy of solvency ranges from 1.41 % to 3.30 %, and for oral medicines – from 0.67 % to 6.20 %, i.e., the cost of purchasing one package of a complex vitamin B medicine does not exceed 6.20 % of the average monthly salary on the example of the Odesa region, which is not included in the List of territories where military operations are (were) conducted or temporarily occupied. A pharmacoeconomic analysis has been conducted using the “cost of illness” method; and the drugs of choice have been selected taking into account the information on their equivalence provided by the manufacturer. According to the results of this analysis, it has been found that the cost of treating polyneuropathy with complex vitamin B medicines produced in Ukraine is 1.4-6 times more affordable than in the case of imported analogues.

Conclusions. The results presented indicate the need to introduce additional mechanisms for compensating the cost of vitamin B medicines in order to increase the level of socio-economic affordability of pharmaceutical care provided in pharmacies. In addition, they can be used in the formation of the range of medicines to ensure the availability of medicines of choice, taking into account the most affordable cost of the treatment course.

Analysis of legal regulation and results of the assessment of public and professional awareness on rehabilitation care packages

A. A. Kotvitska — 2024-07-16

Aim. To determine the peculiarities of legal regulation of rehabilitation care packages, as well as present the results of assessing the awareness of the population and professionals on rehabilitation care packages.

Materials and methods. The legislation of Ukraine, scientific publications, results of a sociological survey; content analysis, system analysis, sociological analysis, generalization, synthesis, graphic methods were used.

Results. It has been determined that the active development of legislation of Ukraine on the provision of rehabilitation care begins with the adoption of the Law “On Rehabilitation in the Field of Healthcare” in 2020. Today, these relations are already regulated by a number of legal acts. The Law “On State Financial Guarantees of Medical Care for the Population” adopted in 2017 defined the provision of medical services necessary for patients at the expense of the state budget. Since 2023, two packages of rehabilitation services have been provided in Ukraine; they are subject to payment under the medical guarantee program – rehabilitation care for adults and children in inpatient and outpatient settings. The study has shown that 55 % of the Ukrainians surveyed feel the need for rehabilitation, but they consider the lack of financial resources to be a barrier to obtaining it, and they also note that they do not know where and whom to turn to. Rehabilitation professionals have demonstrated an average level of awareness of their rights and opportunities within these programs.

Conclusions. The article highlights the active development of legislation of Ukraine on rehabilitation in the healthcare sector at the present stage. According to the results of the survey, it has been found that the population of Ukraine has an insufficient level of awareness of medical guarantee packages for rehabilitation care. The necessity for a more active information campaign and the creation of social advertising on this topic has been substantiated.

Priority areas for the development of the health technology assessment system in Ukraine: survey results

M. M. Babenko — 2024-07-16

The purpose of the study is to analyze the expert opinion on the priority areas of development of the HTA in Ukraine, taking into account the existing condition, problems and possible prospects for effective development.

Materials and methods. The expert survey (online questionnaire) included the preparation of a special questionnaire, targeted selection of experts based on their competence in the field of HTA. Three groups of respondents took part in the survey, including 13 HTA developers, 32 users, and 31 informed persons to ensure the representativeness of the survey results. The following methods were used to process and interpret the results: scientific generalization, mathematical and statistical, analytical, and graphical.

Results of the study. Based on the results of the expert survey, the role and place of the HTA in the health care system was determined. Experts see the main purpose of the HTA as preparing the necessary information of the relevant level of evidence for decision-making on the selection of optimal MTs (in particular, for budget procurement, inclusion in regulatory lists for price regulation and reimbursement).

The respondents' opinions on the participation of different socio-professional groups in the implementation of the HTA and the use of its results were studied. Thus, according to the results of the survey, HTA experts and scientists can carry out the assessment, and in some cases (mini-HTA, hospital HTA for the formation of local formularies and protocols) – specialists of medical institutions. According to the respondents, it is advisable to expand the use of HTA results for decision-making at the national, regional and local levels.

According to the survey, the priority areas for the development of HTA are the creation of a professional environment, adequate logistical and informational support, improvement of legislation, creation of an optimal institutional structure, harmonization of HTA methodology and development of international cooperation.

Conclusions. The expert survey allowed us to determine the most likely scenario for the further development of HTA in Ukraine. According to the majority of respondents, the main efforts are currently focused on capacity building, formation of a professional environment, active use of evidence, and infrastructure development.