Abstract
Introduction: The main task of palliative care is to improve the quality of life of a patient, and the therapy of chronic pain with opioids is a significant problem for palliative care patients in Ukraine. Therefore, this study aimed to assess the opioid availability for palliative care patients in Ukraine.
Methods: Analysis of the list and consumption of opioids according to the scientific publications and legal documents.
Results: It was found that in Ukraine as of June 2021, 12 international non-proprietary names of opioids were registered, most of which are represented by several dosage forms, which makes it possible for patients to receive adequate pain relief through non–invasive therapy with oral forms. It was shown that two thirds (63.2%) of trade names of opioids registered in Ukraine were of domestic origin. Based on a comparative analysis of the range of opioids, available in current regulatory documents, it was established that in the State Register of Medicines of Ukraine and the Unified clinical protocol there is an almost identical list of opioids (12 drugs). However, in the State Drug Formulary and the National List of Essential Medicines, this list is much smaller (8 and 5 drugs, respectively). Since 2013 changes in the regulatory documents on the medical use of opioids in Ukraine have occurred, and oral morphine was registered for the first time, allowing access to adequate pain relief. Analysis of the morphine consumption level by dosage forms has shown that before 2013, the pharmacies sold only morphine in injections, and since 2013, the consumption of oral morphine increased.
Conclusions. Changes in regulatory documents partially simplified the complicated process of obtaining opioids by patients. However, more than 80% of patients still do not receive adequate pain therapy due to the hesitancy of doctors to prescribe opioids and an extremely insufficient number of pharmacies (1.8%) that sell opioids for the population.
Introduction
Many clinical studies have proved the effectiveness of probiotics in metabolic disorders associated with insulin resistance. However, the impact of probiotic therapy on pancreatic β-cell function is ambiguous. The influence of probiotic supplementation vs. placebo on β-cell function in people with type 2 diabetes (T2D) was assessed in a double-blind, single-center, randomized, placebo-controlled trial (RCT).
Methods
Sixty-eight patients with T2D were selected for participation in the RCT. Patients were randomly allocated to consumption of live multistrain probiotics or a placebo for 8 weeks, administered as a sachet formulation in double-blind treatment. The primary main outcome was the assessment of β-cell function as change in C-peptide and HOMA-β (homeostasis model assessment-estimated β-cell function), which was calculated using the HOMA2 calculator (Diabetes Trials Unit, University of Oxford). Secondary outcomes were the changes in glycemic control-related parameters, anthropomorphic variables, and cytokines levels. Analysis of covariance was used to assess the difference between groups.
Results
Supplementation with live multiprobiotic was associated with slight significant improvement of β-cell function (HOMA-β increased from 32.48 ± 13.12 to 45.71 ± 25.18; p = 0.003) and reduction of fasting glucose level (13.03 ± 3.46 vs 10.66 ± 2.63 mmol/L and 234.63 ± 62.36 vs 192.07 ± 47.46 mg/dL; p < 0.001) and HbA1c (8.86 ± 1.28 vs 8.48 ± 1.22; p = 0.043) as compared to placebo. Probiotic therapy significantly affects chronic systemic inflammation in people with T2D by reducing pro-inflammatory cytokine levels.
Conclusions
Probiotic therapies modestly improved β-cell function in patients with T2D. Modulating the gut microbiota represents a new diabetes treatment and should be tested in more extensive studies.
Trial Registration
NCT05765292.
The aim. Research on the peculiarities of the use of modern motivational tools by domestic employers in the pharmaceutical industry (including training and involvement of pharmaceutical specialists in social projects).
Materials and methods. An anonymous online survey in the Google Form was conducted from April 3, 2021 to November 1, 2021 on the social network "Facebook" (including in four pharmaceutical groups of this network). Methods: analysis, synthesis, and generalization.
Results of the research. The main motivating factors of respondents and the main motivational tools used by employers in the pharmaceutical industry have been identified. The state of training and education during professional activities and the evaluation of their effectiveness by respondents have been studied. Professional and motivational-psychological trainings are in the lead in the ranking of educational projects (75.2 % of respondents). The methods of evaluation of pharmaceutical specialists used by employers in the pharmaceutical industry have been generalized. The attitude of respondents to the participation of employers in the pharmaceutical industry in social and charitable projects has been studied. Most respondents (67.5 %) positively perceives the participation of employers in social and charitable projects, for some of them this is a motivational advantage when choosing a place of work.
Conclusions. An online survey of 508 pharmaceutical professionals, conducted in a Google Form has allowed us to establish the features of current motivational approaches used today in pharmaceutical organizations and the attitude of respondents to them. It has been found that such motivational tools as trainings (innovative form of education) (55.1 %), as well as material forms of incentives (73.2 %) are widely used. At the same time, the main topics of the trainings are regarding the professional aspects of activity. An important factor in the life of a pharmaceutical organization is its social and charitable work, which forms a positive attitude towards it on the part of pharmaceutical professionals, and sometimes serves as a motivational advantage in choosing a place of work
The aim. Study of the attitude of parents with medical and pharmaceutical and other educations to vaccination of their children from the point of view of social pharmacy.
Materials and methods. An anonymous online survey of 1,566 respondents (of whom 302 are parents with medical and pharmaceutical education) on the Google Form online service in the Viber mobile application and on the Facebook social network, which was conducted from September 16, 2021 to October 6, 2021.
Methods of analysis, synthesis and generalization were used.
Results. A high degree of commitment to vaccination among the respondents was established (almost 9 out of 10 parents). 26.1 % of respondents motivate the refusal by the inadequate quality of vaccines, 25.7 % consider vaccination to be inappropriate; 24.3 % do not administer preventive vaccinations to children due to their unsatisfactory state of health; 20.4 % - due to possible side reactions. 67.1 % of parents are interested in the composition of vaccines, 95.6 % know the symptoms and complications of the diseases for which vaccination is carried out, and 96.6 % - side effects after vaccination, although 74.5 % want to receive more information about possible complications. At the same time, there are slightly fewer supporters of vaccination among respondents with medical and pharmaceutical education than among respondents without such education, although this difference is not statistically significant. However, depending on the education, significant differences (more than 10 %) were observed among the respondents regarding interest in the composition of vaccines, adherence to vaccination against COVID-19 of their children older than 12 years and the opening of vaccination points in pharmacies.
Conclusions. It was found that to increase the level of awareness of medical and pharmaceutical professionals regarding vaccination, it is necessary to optimize educational professional programs and curricula for their training. It is shown that increasing the level of their knowledge will increase the commitment of parents with other education to children's vaccinations. The need to expand the professional role of pharmacists by involving them in vaccinations has been confirmed
The SARS-CoV-2 pandemic affected the entire world and contributed to severe health and economic consequences. A safe and effective vaccine is a tool allowing the pandemic to be controlled. Hence, we aimed to conduct a survey on vaccinations against seasonal influenza and COVID-19 in Poland, Lithuania, and Ukraine. We also evaluated societal attitudes towards influenza and COVID-19 vaccinations. Materials and methods: We conducted the study between December 2020 and May 2021. At the time, the countries subject to the research were between the second and third waves of the COVID-19 pandemic. We used an anonymous and self-designed questionnaire comprised of eleven closed-ended questions and a short socio-demographic section. The questionnaire was administered by direct contact or mainly (due to the COVID-19 pandemic) by e-mail or Facebook. Finally, we included 2753 answers from Poland, 1852 from Ukraine, and 213 from Lithuania. Results: Between 61% (Poland) and 72.9% (Ukraine) of the study participants have never been vaccinated against influenza (p < 0.05). Totals of 67.6% of the respondents in Poland, 73.71% in Lithuania, and 29.5% in Ukraine responded that they want to be vaccinated against COVID-19 (p < 0.05). Vaccine hesitancy was mainly related to worries about its side effects. There were also vaccine non-adopters in the study. In Ukraine, 67% of the respondents were clearly opposed to mandatory COVID-19 vaccines, compared to 41.7% in Poland and 30.99% in Lithuania (p < 0.05). Conclusions: There are still many people who present vaccine hesitancy or are opposed to vaccines. Thus, societal education about vaccination and the pandemic is crucial. Vaccine hesitancy or refusal might be related to vaccine origin. Shortages of influenza vaccines made it impossible to vaccinate those who were determined to be vaccinated. There is room for discussion of mandatory COVID-19 vaccinations.