Epilepsy is one of the most severe chronic diseases of childhood. Its treatment requires many years and sometimes lasts the whole life. It is especially difficult for the families if a child does not respond to conventional medical treatment due to the so-called resistant forms of the disease. The article focuses on the changes which had occurred over the passed two centuries: from the period of zemstvo pharmacies and the use of bromides to the contemporary period of time and the preferential treatment programmes introduction into the treatment and care of children in Russia. Taking Kursk region as an example, the authors analyze some reasons and barriers which interfere getting effective treatment by the children and families. It regards whether it is expensive cost of the new generation drugs, or a shortage of pediatric neurologists number resulting in long waiting lists for getting surgical treatment in medical institutions. As the task of high priority today is to improve health care for children, hence it is necessary to create a specialized center in the region and provide the following measures: increase the number of quotas for getting surgical assistance by children, teach parents to notice and pay attention to the side effects development without cessation of the treatment course. The authors pay special attention to the pharmacoeconomic aspects, comprising: assessment of the family costs (‘out-of-pocket payments’) and the impact of adherence to the chosen treatment due to its effectiveness. [1,2]. The main idea of the article is to bridge the past and the present times so that to emphasize the similar problems and search for the best ways of getting the appropriate solutions of the existing problems.
Herbal medicinal products are traditionally regarded as an affordable and safe component of therapy for digestive diseases in children, yet the assumption of their low cost has never been verified on a set of real prescriptions. Aim. To evaluate the economic parameters of using herbal medicinal products in gastrointestinal diseases in children and to propose a formalised way of determining their place in the drug provision system. Materials and methods. The study was based on the prescription array of the medical information system of an outpatient paediatric clinic for 2023: 35,632 records under ICD-10 class XI, 5,528 patients, 535 trade names. The group of herbal products was identified by the plant origin of the active substance. Structural and statistical analysis, calculation of the course cost for a model patient weighing 20 kg and the authors’ scoring method were applied. Results. Herbal products accounted for 4.11 % of prescriptions (1,463 records, 837 patients) across nine trade names. Two thirds of the group fall on a single product. The cost of a course of Hofitol was 2.45 times higher than an equivalent course of Ursofalk oral suspension, and Mucofalk was 5.1 times more expensive than Duphalac, so herbal products have no price advantage. A scoring method with three criteria groups and three positioning categories is proposed. The share of prescriptions where a herbal product was the only agent did not exceed 2.4 %, while regimens involving it contained 5.3 to 8.8 products against 4.34 for the sample. Conclusion. Positioning a herbal product by the price criterion is incorrect; the proposed method relies on the combination of clinical, economic and organisational characteristics and is embedded in a model for optimising outpatient drug care for children.
The article discusses topical issues of hepatotropic therapy in the context of over-the-counter drug dispensing in the pharmacies of the Russian Federation. The risks associated with an increase in cases of self-medication with hepatoprotectors and choleretics, especially in chronic diseases of the liver and biliary tract, are analyzed. It is noted that hepatotropic therapy is of an auxiliary pathogenetic nature, does not replace etiotropic treatment and requires strict differentiation depending on the clinical situation. The lack of a universal hepatoprotector is emphasized: most drugs in this group have a limited evidence base, whereas ursodeoxycholic acid remains the only drug with a high level of evidence (level A–B) and belongs to prescription drugs. Due to the availability of medical information on the Internet and the active advertising of over-the-counter drugs, the role of a pharmacist in the prevention of unjustified use of hepatotropic drugs is increasing. Based on the synthesis of expert opinions and analysis of the regulatory framework, algorithms have been developed for pharmaceutical information to pharmacy visitors during the dispensing of hepatoprotectors and choleretics. The algorithms include the collection of medical history, assessment of indications and contraindications, information about the dosage regimen, possible adverse reactions and drug interactions, as well as recommendations for lifestyle correction and the need for medical monitoring. The conclusion is made about the undesirability of using hepatotropic drugs without a doctor's prescription. When requesting the selection of an over-the-counter drug, it is advisable for the pharmacist to focus on the developed algorithms and, if necessary, refer the patient to a specialist.
The availability of drug therapy for post-stroke patients during outpatient treatment is an important aspect of ensuring the timeliness and quality of medical care. In this regard, this paper presents the results of assessing the physical and affordability of pharmacotherapy in patients who have suffered an ischemic stroke. The data obtained show a high level of physical availability of the studied medicinal resource, both in the regional (Kursk) and the Russian pharmaceutical market. At the same time, the price availability of the range of medications prescribed for rehabilitation and secondary prevention of stroke has a significant variation. A list of medicines has been established that have a very high cost in the pharmaceutical market of the country and, accordingly, low price availability for the population.
The methodological and practical foundations of forming a pharmacy’s manager managerial professionalism are presented. The relevance of research is substantiated, and the historical aspects of the origin of the institute of management in the context of managerial revolutions are analyzed. The activity of a pharmacy’s manager as a significant participant in the socially significant activity of an organization providing pharmaceutical care is analyzed. The degree of the manager’s compliance with the requirements imposed on him is different. The qualitatively determined degrees of the manager’s compliance with the requirements of professional activity are the levels of his professionalism. Two levels of professionalism are defined: the level of solving managerial tasks, which are algorithmized activities, which a manager can solve using management technologies known to him; and the level of solving managerial, non-programmed problems, and the possibility of solving them using standard technologies is difficult. The author emphasizes the need for a rational approach based on the allocation of meaningful parameters of the manager’s activity. It is proved that the competence approach is a methodological basis for designing the models of professionalism. The structure of the competence library for assessing the level of professionalism of the pharmacy’s manager is presented, including the clusters of competencies, the levels of competence development, and the indicators of behavior from ‘outstanding’ to ‘unsatisfactory’. The author proposes the criteria for the level of a manager’s effectiveness, suitable for their expression in quantitative indicators, and the tools for organizational development, that is managerial and career competencies.
Optimization of the activity of the pathology and anatomical department and standardization of pathology and anatomical studies is a priority task due to the high shortage of staffing, increased volume of work performed, the need to save consumables in conditions of limited financing of the industry.
The work is devoted to the study of modern problems in the appointment of choleretic drugs by doctors and dispensation in pharmacy organizations against the background of the growing popularity of self-medication among the population. The results of a survey of pharmaceutical and medical workers, as well as pharmacy visitors, on over-the-counter choleretic drugs are presented. The data was collected through a voluntary anonymous survey of respondents. This sociological survey is part of the pre-project research for the development of a pharmaceutical information algorithm for over-the-counter administration of choleretic drugs.
An algorithm for remote pharmaceutical consulting has been developed, enabling automated selection of medications by international nonproprietary names when a prescription is available, with capability for integration into regional monitoring systems. For over-the-counter cases, the algorithm generates personalized recommendations based on comprehensive analysis of symptoms and identification of ‘red flags’ associated with main manifestations of gastroesophageal reflux disease - heartburn and regurgitation. The practical implementation has been carried out through a specialized Telegram bot named ‘СтопИзжоге’, which conducts structured collection of medical history and provides recommendations in strict accordance with current clinical guidelines. The developed solution fully complies with the requirements of the Russian Ministry of Health Order No. 647n. The relevance of this development is driven by the progressively increasing prevalence of heartburn and regurgitation, along with the high frequency of uncontrolled self-medication cases in the population.
In the context of modernization of higher medical education, the personal and socio-communicative competencies of university teachers acquire special importance, as they determine the effectiveness of pedagogical interaction and the quality of professional training. The purpose of this study is to determine the role of higher education teachers’ soft skills as a resource for improving the quality of personnel training in a medical university. The empirical research was conducted at Kursk State Medical University and included 437 teachers from clinical and non-clinical departments. The results of the study showed that a high level of soft skills development correlates with increased psychosomatic well-being of teachers and is accompanied by a decrease in the intensity of professional stress and emotional exhaustion that may lead to burnout, which has a positive impact on the quality of training of medical and pharmaceutical professionals. It is concluded that teachers’ soft skills are a systemic factor in ensuring the quality of the educational process and act as a regulator between their psycho-emotional state and the effectiveness of students’ training in medical universities.
Objective. To examine the collaboration between physicians and pharmaceutical professionals in the provision of pharmacotherapy for patients with cardiovascular diseases, particularly arterial hypertension (AH). Materials and Methods. A comparative analysis of the structure and workflow of medical (MO) and pharmacy (PO) organizations in Kursk city and region was performed. The study included a survey of healthcare professionals involved in the medication provision process. Results. Significant discrepancies were identified between the prescribed and dispensed medications in four pharmacological groups, indicating insufficient coordination between physicians and pharmacy staff. Professional profiles of physicians and pharmacists were developed to characterize their roles in managing patients with AH. The study also highlighted the relevance of non-pharmacological approaches to disease management, including the improvement of patient compliance through counseling, identifying physical and psychological barriers to treatment, and preventive work with healthy individuals visiting pharmacies. Conclusion. The findings emphasize the need for close collaboration between physicians and pharmaceutical professionals, based on cross-communication and shared decision-making in the management of patients with arterial hypertension.
