2018 № 6 Social significance of the use of medicines according to actual scientific data
Research rationale. The results of legislative changes in a healthcare system are reflected in social consequences based on indicators of achieving the treatment goals and the outcomes of diseases and, ultimately, the number of demographic and economic indicators. The scientific approach based on the data of high quality clinical, epidemiological, economical, and sociological researches is a tool to make a decision on the use of medicines that is implemented via normative documents. The urgent objective is to upgrade and harmonize these documents timely on the base of modern scientific achievements in order to obtain the most possible social outcome of pharmacotherapy of diseases.
Goal. To demonstrate social importance of the scientific approach to implementation of normative documents in the field of the use of medicines by the example of pharmacotherapy of various pathological conditions of high social significance.
Research methods. The general research methods (content-analysis, synthesis, generalization, formalization, etc) and the methods of comparative analysis are used. The current national and foreign normative documents, which regulate the use of medicines, were analyzed. Also analyzed are scientific publications in e-Library, Pubmed, Cochrane Library, Сlinicaltrials, Scopus databases and sites of biomedical journals on key queries reflecting the research topics.
Results. Results of implementation of the global programs on improving the efficiency of medicines use and the prospect proposals are presented by the authors of the article. These results will promote advancement of the normative documents which regulate the use of medicines, such as clinical recommendations, standards of medical care, manuals and guidelines on socially significant diseases treatment.
Conclusions. Translation of the relevant research data into a real clinical practice through improving the normative documents makes it possible to use fully the scientific outcomes for the benefit of population health in the country that brings health, social, and economic results.
Timely updating the normative documents in the field of the use of medicines is possible on the base of scientific analysis of current normative documents and publication on the outcomes of qualitative clinical researches with using the methodology for complex medicines assessment and, more generally, methodology for health technology assessment (HTA).
Organizational process of updating the normative documents can be carried out at various levels: national, regional, and local; while the local level provides more rapid implementation of the innovations in medical practice
2020 № 4 Training in clinical recommendations and assessment of the level of knowledge of doctors involved in providing primary health care, using remote educational technologies
The implementation of clinical recommendations is an urgent task, and it is important to maintain continuity between primary health care and specialized medical care. Distance learning courses were developed for 25 modules, and a testing system was created, which was implemented during the training of 1928 doctors from 128 medical organizations in three regions. The purpose of the work was to analyze and evaluate the effectiveness of the developed and implemented set of measures for training and testing doctors in three regions of Russia who participate in primary health care, on the implemen- tation of clinical recommendations.
Data analysis was performed using the IBM SPSS Statistics 16 software package. The samples were checked for the normality of the distribution using the Kolmogorov-Smirnov method. A nonparametric Wilcoxon test for dependent samples was used to assess the statistical significance of differences in cases where the distribution in the samples differs from the normal one. The level of statistical significance was defined as p ≤ 0.05.
The program of work consisted of five stages and included the development and implementation of distance courses in the format of multimedia lectures for doctors providing primary health care, studying a number of clinical recommendations, as well as conducting primary and repeated testing with automated evaluation of results for groups of clinical recommendations at the level of the region, medical organization and specific doctor.
The original software made it possible to evaluate the initial and received level of knowledge, to get differentiated results online, and on this basis to give reasonable targeted recommendations for further training of a particular employee, as well as for planning training events in the region as a whole.
The developed methodology of distance learning cycles allows to provide training of a significant number of doctors in a rel- atively short time with operational control of the quality of knowledge of doctors of various specialties, which is why the tested system can be easily scaled and adapted to solve any problems to improve professional competence of doctors.
2015 № 4 Standards of medical care in Russia and USA
Annotation. The analysis of the use of the term «standard of care» in the Russian Federation and the United States. The list of normative documents regulating the process of standardization of medical care, defined role and scope of clinical guidelines and standards of their legal component in the resolution of conflict and controversial clinical situations in health care. It is noted that the work on standardization of medical care due to objective socio-economic necessity of generalization, unification, of the desire to improve access to health care, including new medical technologies associated with the development of quality management of medical care.