Scientific and practical approaches to optimizing the pharmaceutical supply of pediatric palliative patients with paralytic syndromes
Today, palliative care (PC) as a system has a complex structure with stable orderliness, interrelated elements and subsystems. The problem of providing PD with an appropriate level and quality to the children population is particularly acute; it is due to differences in the duration of provision, the necessity to provide educational services, and the socialization of palliative children. At the same time, an important aspect in achieving an appropriate quality of life for children and their families related to health is the assessment of not only medical and social, but also pharmaceutical provision.
The aim of the work is to substantiate the approaches to optimization of pharmaceutical support of pediatric palliative patients with paralytic syndromes.
The study objects were data from medical records, theactual consumption of medicines by pediatric patients of the Kharkiv healthcare institution where palliative care was provided, as well as data on the state registration of medicines in Ukraine. During the study, clinical and anamnestic, sociological, and marketing methods were used.
Based on the results of the analysis of clinical and anamnestic data and the overall assessment of symptoms in a sample group of palliative children with paralytic syndromes, which was 115 people, pathological conditions that led to frequent or permanent distress were identified. Among them, the spastic syndrome prevailed in 100% of cases, the pain syndrome in 66% of cases, the convulsive syndrome in 59%, respectively, and digestive disorders were observed in 82.6% of patients in the sample. It was found that a large proportions of drugs for pharmacological correction of symptoms in the sample of patients were formed by antiepileptic drugs, laxatives and centrally acting muscle relaxants. The results of the marketing analysis of a definite segment of the pharmaceutical market showed a rather limited range of drugs for pediatric dosage forms and concentrations, and it on average ranged from 3.1% to 25% in the pharmacotherapeutic groups studied.
Thus, the results obtained prove the need to develop mechanisms for optimizing the pharmaceutical supply of pediatric palliative patients, in particular, expanding the range of medicines approved for use in pediatric practice.
Zupanets I. V., Ruban O. A., Yevtushenko O. M., Kolisnyk T. Ye. Doslidzhennia asortymentu analhetychnykh zasobiv dlia terapii khronichnoho boliu na farmatsevtychnomu rynku Ukrainy // Farmats. zhurn. ‒ 2020. ‒ T. 75, N 3. ‒ S. 16‒28. http doi.org/ 10.32352/0367-3057.3.20.02
Kostiuk I. A. Analiz dynamiky asortymentu likarskykh zasobiv dlia farmakoterapii bronkhialnoi astmy u prohrami «Dostupni liky» // Farmats. zhurn. ‒ 2019. ‒ T. 74, N 5. ‒ S. 12‒19. https://doi.org/10.32352/0367-3057.5.19.02
Satbir Sinhkh Dzhassal. Formuliar likarskykh zasobiv Asotsiatsii dytiachoi paliatyvnoi medytsyny. 4 vydannia. Pid nauk. red. A. Iu. Penkova, O. O. Rihy. – Kharkiv: TOV «Vodnyi spektr Dzhi-Em-Pi», 2017. – Rezhym dostupu: http://www.icpcn.org/wp-content/uploads/2013/09/APPM-Master-Formulary-2017-Ukraine.pdf
Palisano R., Rosenbaum P., Walter S. et al. Development and Reliability of a System to Classify Gross Motor Function in Children with Cerebral Palsy // Developmental Medicine and Child Neurology. – 1997. – V. 39. – P. 214–223. https://doi.org// 10.1111 / j.1469-8749.1997.tb07414.x
World Health Organization. Global Atlas of Palliative Care at the End of Life, Wordwide Palliative Care Alliance, 2014. – URL: https://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf
Abdel-Hamid H. Z., Bazzano A. T. F., Ratanawongsa B. Cerebral Palsy // Medscape. –2018. – URL: https://emedicine.medscape.com/article/1179555-overview
Santamato A. Safety and efficacy of incobotulinumtoxinA as a potential treatment for poststroke spasticity // Neuropsychiatr Dis. Treat. – 2016. – V. 12. – P. 251–263. https://doi.org//10.2147 / NDT.S86978
Nakaz MOZ Ukrainy № 1422 vid 29. 12. 2016 r. «Pro vnesennia zmin do nakazu Ministerstva okhorony zdorovia Ukrainy vid 28 veresnia 2012 roku № 751". –Rezhym dostupu: https://zakon.rada.gov.ua/laws/show/z0530-17#Text
MOZ Ukrainy. Nastanova DUODECIM Medical Publications, Ltd. № 00802 Spastychnist. – Rezhym dostupu: https://guidelines.moz.gov.ua/documents/3583
MOZ Ukrainy. Nastanova DUODECIM Medical Publications, Ltd. № 00675 Epilepsiia u ditei. – Rezhym dostupu: https://guidelines.moz.gov.ua/documents/3475
MOZ Ukrainy. Nastanova DUODECIM Medical Publications, Ltd. № 00974. Zakrepy u ditei. – Rezhym dostupu: https://guidelines.moz.gov.ua/documents/3708
Derzhavnyi reiestr likarskykh zasobiv Ukrainy. – Rezhym dostupu: http://www.drlz.kiev.ua
This work is licensed under a Creative Commons Attribution 4.0 International License.