Social Pharmacy in Health Care

The study of the composition of the medical first-aid kit that road patrol police vehicles are equipped with

R. V. Sahaidak-Nikitiuk — 2024-12-19

Aim. To study the composition of the medical first-aid kit that road patrol police vehicles are equipped with.

Materials and methods. In the course of the research, the methods of analysis, synthesis, logical, generalization, and content analysis were used to study the composition of medical first-aid kits and expert survey. The expert method was used to determine the relevance of the problem under study and the opinions of the police officers regarding the composition of medical first-aid kits intended for police officers. Respondents were police officers from Kharkiv, Poltava and Kyiv regions. The total number of respondents was 51 people. The minimum number of experts who participated in the survey was determined taking into account the maximum permissible relative error. The reliability of the data obtained was substantiated by the representativeness of the samples, their required volume was determined with a permissible error of 5 %. According to the calculated concordance coefficient and the χ²-criterion determined, there was a consensus in the opinion of experts.

Results. The study of the opinions of the respondents indicates the need for a medical first-aid kit for police officers (92.7 % of responses) and the state of staffing patrol policemen with first-aid kits (70 % of responses). According to 93.8 % of the surveyed policemen, the available medical first-aid kits do not meet the requirements of both domestic and international standards. The types of medical first-aid kits that police officers are equipped with in accordance with the Order of the Ministry of Internal Affairs of Ukraine No. 396 of 20.05.2016 – Individual medical first-aid kit and Medical first-aid kit for patrol police units – have been studied. A comparative analysis of the composition of medical first-aid kits of police officers of Great Britain, the USA and Ukraine has been performed, and significant differences in their composition have been determined.

Conclusions. The dynamics of traffic accidents with injured and dead people on the highways of Ukraine has been studied. The survey of police officers conducted has allowed us to conclude that medical first-aid kits for police officers need to be improved, taking into account modern requirements and trends in first aid provision. The types of medical first-aid kits for units of the National Police of Ukraine and their composition have been studied. The composition of medical first-aid kits of police officers of different countries has been compared.

Prospects for digital transformation of the “Affordable Medicines” program in Ukraine and opportunities for its integration into the EU healthcare system

G. V. Smirnova — 2024-12-19

The “Affordable Medicines” program introduced in Ukraine is an important element of the state policy in the field of healthcare. Its implementation is significantly influenced by many factors, in particular, socio-economic conditions and features of the organization of the healthcare system (namely, the absence of mandatory social health insurance), war and related crisis processes in the economy, population migration, etc. Under such conditions, it is important to study the features of pharmaceutical provision for vulnerable categories of the population in the EU countries, in particular, Ukrainians who are forced to stay abroad and need the appropriate treatment.

Aim. To analyze the problems of ensuring the availability of medical and pharmaceutical care for Ukrainians abroad and possible prospects for developing cooperation in providing cross-border healthcare.

Materials and methods. A sociological survey (questionnaire) was conducted on access to medical services, medicines, problems of bureaucracy, the language barrier, as well as assessment of the effectiveness of the “Affordable Medicines” program in Ukraine and its adaptation opportunities for refugees.

Results. Respondents pointed to significant problems with access to health services and medicines in EU countries. The main difficulties are high prices, lack of medicines in pharmacies, difficulties in obtaining prescriptions and bureaucratic obstacles. The “Affordable Medicines” program in Ukraine was rated as effective, in particular due to simplified access to medicines and reimbursement of the cost of medicines. Most respondents believe that its adaptation to the needs of refugees in the EU can significantly improve the situation.

Conclusions. The “Affordable Medicines” program has significant potential for adaptation in EU countries, which will improve access to medical services and medicines for refugees, in particular Ukrainians. It is proposed to create a mobile application “Affordable Medicines Abroad”, which will allow issuing prescriptions in several languages, providing discounts on medicines and integrating the system into a single database of medical services between Ukraine and the EU. These measures will contribute to more effective assistance to refugees and optimization of medical care in Europe.

The study of key aspects of the professional activity of a clinical pharmacist to create a job description on a competency-based approach

M. V. Zarichkova — 2024-12-19

description on a competency-based approach

Aim. To study the attitude of experts to various aspects of the professional activity of a clinical pharmacist (CP) and determine the current requirements for professional competencies necessary for the effective performance of duties in modern conditions, with further consideration of the results when developing a job description on a competence-based approach.

Materials and methods. The survey methods, analysis and synthesis, as well as formal-logical, semantic, comparative, and systematic methods were used in the study. The data was analyzed using Microsoft Office Excel, Epitools (Ausvet Ltd., Australia), and STATISTICA 13 (TIBCO Software Inc., USA).

Results. The significance of CP job functions, workplace requirements, documentation and reporting has been assessed. The study has confirmed the need to update professional competencies in accordance with changes in legislation and current challenges, especially under martial law conditions. Regulatory documents governing CP activities have been identified, and attention has been focused on professional development, rights, duties, and responsibilities. The key documents for the Infection Control Department (ICD) have been highlighted, and the importance of standard operating procedures (SOP) has been evaluated. The issues related to the medical staff consulting, performing duties outside the hospital, communication barriers with the healthcare personnel, and the assessment of key performance indicators (KPI) have been studied.

Conclusions. The study has confirmed the expansion of CP’s professional responsibilities, in particular in the field of the rational use of antimicrobial agents (AMA), drug monitoring, and the medical staff consulting. The key professional competencies have been defined, including AMA therapy management, compliance with SOP, and maintenance of relevant documentation. The main professional development activities identified are continuous professional development (CPD) initiatives, such as simulation training and practical skills training, as well as advanced training courses in thematic improvement and specialization. Based on the study, a job description for CP has been developed, and it meets modern standards and contributes to improving the CP efficiency in healthcare institutions.

Analysis of legal regulation and modern applied aspects of social advertising in healthcare

G. E. Boldar — 2024-12-19

Aim. To determine the features of normative and legal regulation of social advertising, as well as to clarify the specificity of the content, forms, and methods of social advertising placement in the healthcare (HC) sector in Ukraine at the present stage.

Materials and methods. Normative legal acts of Ukraine, scientific works, specific creative products of social advertising, the content of which reflects the thematic direction of HC.

Results. Scientific and legislative approaches to determining the purpose and functions of social advertising have been analyzed, and its essential characteristics have been studied. It has been determined that social advertising in the field of HC relates to non-commercial communication and, according to the method of placement, it refers to direct advertising. Based on the analysis of specific examples of social advertising in the field of HC, the specificity of its content, forms, and methods of placement have been clarified. It has been proven that by content, social advertising in the field of HC can contain socially useful information aimed at promoting a healthy lifestyle (raising awareness of the harm of smoking, drug use, and sedentary lifestyle); vaccination; donation; timely visits to healthcare institutions; an inclusive society (tolerant attitudes towards persons with disabilities and other mobility-impaired groups of the population, towards people suffering from tuberculosis, HIV, etc.); changes in the HC system (e-prescription, new packages of medical guarantee programs for the population, the state program ”Affordable Medicines”, etc.); volunteer activities.

Conclusions. The classification of social advertising has been proposed, taking into account the requirements of legislation and scientific and practical approaches. It is emphasized that social advertising is subject to all general permissive norms regarding the methods, forms and places of distribution, as well as prohibitions on discriminatory, hidden, illegal comparative and unfair advertising. The study of legal and organizational aspects of non-commercial communication in the field of HC and improvement of legislation on drug advertising, as well as the study of factors that will affect the effectiveness of social advertising, is a promising area for further research.

The analysis of regulatory decisions on drug safety in the context of harmonisation with international standards

A.A. Kotvitska — 2024-12-19

Aim. To analyze regulatory decisions of national authorities on the drug safety.

Materials and methods. The study materials were reports of the State Expert Centre of the Ministry of Health of Ukraine (SEC) and the State Service of Ukraine on Medicines and Drugs Control (SSMDC), regulatory acts of the SSMDC, and scientific publications. General scientific and special methods, including content analysis, synthesis, generalization, graphic methods, were used in the study.

Results. The analysis of the activities of national regulatory authorities on drug safety allowed us to identify the specificity of the decision-making procedure for suspending/ withdrawing suspected medicines from the circulation and conducting the quality control. Based on the results of monitoring of SRa websites regarding information on the drug safety and data on the SEC recommendations issued regarding the need to make changes to the instructions, update information on the drug safety, implement measures to minimize the risks of serious adverse reactions (ARs), and limit the use of medicines, it was determined that 60% of recommendations concerned changes to the instructions, 34 % of them related to updating information on the drug safety, while other types of recommendations were less than 6 %. The results of the analysis of regulatory decisions of the SSMDC based on information about serious and unforeseen ARs showed that 85 orders were issued to temporarily ban the circulation of medicines within 2020-2023; as a result of additional studies, a decision was made in 22 cases to completely ban the circulation, including 14 cases related to medicines imported to Ukraine as humanitarian aid and did not have the appropriate labeling. The analysis of the list of medicinal products temporarily banned from the circulation has revealed that 94 % of them are presented in the form of parenteral dosage forms, 78 % of the list are medicines of domestic production.

Conclusions. The analysis of the activities of the national regulatory authorities on the safety of medicines in Ukraine in 2020-2023 showed that the largest number of orders to temporarily suspend the drug circulation was issued by the State Administration on Medicines in 2023. In almost 60 % of cases, the reason for stopping the drug circulation was the death of a patient, and in 16 % of cases, orders for a complete ban on the circulation concerned medicines imported as humanitarian aid. Taking into account the trends towards changing the structure of national regulatory authorities in the healthcare sector, it is promising to further study the compliance of regulatory activities on safety issues with the international practice of strict regulatory agencies.

The analysis of pharmacovigilance results of adverse reactions of antiretroviral drugs used in the treatment of HIV-positive people in Ukraine

V. V. Yefremova — 2024-12-19

Aim. To analyze the results of pharmacovigilance of adverse reactions of antiretroviral drugs (ARVD) used in the treatment of HIV-positive people in Ukraine.

Materials and methods. Historical, analytical and comparative, system, graphic, logical, hypothetical-deductive, as well as marketing, and mathematical-statistical methods of analysis were used. The study object was reports on pharmacovigilance of adverse reactions (ARs) of ARVD.

Results. During 2017-2023, the number of reports of ARs of ARVD in Ukraine was unstable. In 2017, the number of reports was 732 compared to only 199 cases in 2023. The highest number of reports was typical for the pre-war 2021 (1330 cases). According to the results of the structural analysis of the reports, it was found that the largest number of them occurred with the use of combined ARVD - FTC + TDF + EFV (1261 cases or 40.43 %); TDF + FTC (607 and 19.46 %); DTG (496 and 15.90 %); AZT + lamivudine (312 and 10.00 %). These combined drugs occupy the leading positions in the number of both serious and non-serious adverse reactions. In addition, for five years, it was the combined ARVs that were characterized in time by the nature of receiving reports about ARs. It should be noted that there was a significant range of variation in the number of reports for different drugs. They ranged from 1 (ABC + lamivudine; AZT + lamivudine + NVP) to 1261 reports (FTC + TDF + EFV). The ratio between serious and non-serious ARs in the use of ARVs during 2008-2012 was 1:2, and according to our (2019-2023) studies, this indicator was 1:16.

Conclusions. A comprehensive analysis of the ARVP PR in Ukraine for the period from 2007-2013 and 2017-2023 was conducted. The results presented indicate that since 2017, there has been an unstable nature of changes in the number of reports and their structure by year. This fact makes it necessary to conduct further research aimed at analyzing the impact of the volume and composition of state purchases of ARV drugs on the frequency of detection of RP in the case of their use in the treatment of HIV-infected people in Ukraine.

Analysis of the market of pharmacy assortment products based on the lavender raw material in Ukraine

O.O. Bogatyryova — 2024-12-19

Aim. To analyze the market of pharmacy products based on the lavender raw material in Ukraine.

Materials and methods. The analysis of the range of products based on the lavender raw material was carried out using generalization, structural, logical, graphical methods, as well as data from the State Register of Medicines of Ukraine, the information resource “Tabletki.ua”, websites of pharmacy chains, and the e-commerce website “iHerb”.

Results. It has been determined that among the goods in the pharmacy assortment, products based on the lavender raw material are presented in the form of medicines (5 items), dietary supplements (7 items) and herbal teas (3 items) produced by 6 foreign and 9 domestic manufacturers. The analysis of the offer of this group of products in pharmacies showed the absence of the registered homeopathic product “Solum Oil”, a skin liquid manufactured by WALA Heilmittel GmbH (Germany). It has been noted that the range of medicines is represented by groups of products used for coughs and colds, psycholeptic drugs, and a dermatological agent. The dietary supplements include symptomatic remedies for menopause, sleep aids and emotional stress relievers, while the herbal teas include sedatives, tonics and sleep aids. It has been found that the composition of the vast majority of products for internal use contains the lavender flower extract, and all products for external use contain the lavender essential oil. It has been determined that the variability of retail prices for medicines ranges from 17 % to 36 %, and the results of calculating the liquidity ratio of prices for pharmacy products with the lavender raw material indicate their relative economic affordability.

Conclusions. The analysis of the range of medicinal products, dietary supplements and herbal teas based on the lavender raw material registered in Ukraine and available in the market has shown a limited number of manufacturers’ offers, as well as the predominance of products used for coughs and colds, sedatives and sleep aids. According to the results of the analysis, it is possible to note the possibility of developing new domestic medicines based on the lavender raw material, in particular, Lavandula angustifolia Mill.

The frequency and VEN analysis of medical prescriptions for patients with duodenal ulcer disease in healthcare institutions

O. P. Balitska — 2024-12-19

Aim. To perform the frequency and VEN analysis of medical prescriptions for patients with duodenal ulcer disease (DUD) in a healthcare institution.

Materials and methods. Depersonalized information base containing data from 112 histories of patients with DUD who were treated in one of the healthcare institutions in Vinnytsia, prescription sheets, the National List of Essential Medicines, the Unified Clinical Protocol of Primary and Specialized Medical Care “Peptic ulcer of the stomach and duodenal ulcer in adults and children” (2023), the State Formulary of Medicines (2023) were used. Research methods such as retrospective, system-analytical, frequency and VEN analysis were applied.

Results. As a result of the frequency and VEN analysis conducted during the study period, doctors prescribed a total of 48 active substances by INN and 109 drugs by trade names (TN). A total of 817 drugs were prescribed by TN. According to the results of this analysis, it was found that the largest number of prescriptions fell on proton pump inhibitors of different generations (21.3 % of all prescriptions) and multienzyme drugs (15.06 % of all prescriptions). For the eradication of Helicobacter pylori, agents for the treatment of peptic ulcer and gastroesophageal reflux disease, combinations for the eradication of Helicobacter pylori were prescribed (14.89 % of all prescriptions). There were also many prescriptions from groups of drugs affecting the digestive system (13.89 %). For the treatment of concomitant pathologies, drugs used to treat the liver and biliary tract (4.28 %), intestinal anti-inflammatory drugs (2.08 %), anti-anemic drugs (1.46 %), antibacterial drugs, antibiotics, hypolipidemic, hypnotic, sedative drugs, antidepressants, etc., were prescribed. It was proved that the main of pharmacotherapy of DUD was etiological and pathogenetic therapy. According to the VEN analysis, 8 drugs (17 %) were included in category V, 22 drugs (46 %) – in category E, and 18 drugs (37 %) – in category N, out of 48 drugs by INN.

Conclusions. Therefore, the study conducted showed that a significant number of prescriptions and financial resources were directed to the use of secondary drugs that were not included in the regulatory legal acts regulating the pharmaceutical provision of patients with DUD.