INDICATORS OF RATIONAL DRUG USE
Open article in archive

Pharmacotherapy is the main treatment of the majority of diseases. It influences clinical outcomes, survival and quality of life of patients. Pharmacotherapy should be effective, safe, efficient, and evidence-based. State expenditures for pharmacotherapy are the fastest growing article of healthcare budgets reaching 40% in some countries. Due to the lack of financial resources and qualified medical assistance, many developing countries apply unreasonable medical interventions including irrational drug therapy, which leads to excessive costs and may have a negative effect onpatients’ quality of life and results of treatment. Polypharmacy, adverse drug reactions and insufficient use of evidence-based pharmacotherapy lead to increased costs and reduced effectiveness of treatment.

In this article we summarize modern methods of detecting polypharmacy used in developed countries. These methods have been shown to improve efficiency, safety of pharmacotherapy, reduce the number of prescribed irrational drugs / drug combinations and to reduce treatment costs. We present the Beers criteria, STOPP and START criteria, Medication Appropriateness Index criteria, drug–drug interactions use, risk management problems associated with drug use (GerontoNet advers drugs reaction risk score) and discuss advantages and disadvantages of drug therapy rationality evaluation criteria.

Aigul Z. Mussina 1, http://orcid.org/0000-0003-4603-2131

Nazgul A. Seitmaganbetova 1, http://orcid.org/0000-0002-7718-4464

Lazzat M. Zhamalieva 1, http://orcid.org/0000-0003-3625-3651

Gaziza A. Smagulova 1, http://orcid.org/0000-0001-7222-620X

Andrej M. Grjibovski 2-5, http://orcid.org/0000-0002-5464-0498

 

1West Kazakhstan State Medical University named after Marat Ospanov, Aktobe, Kazakhstan

2Norwegian Institute of Public Health, Oslo, Norway

3Northern State Medical University, Arkhangelsk, Russia

4North-Eastern Federal University, Yakutsk, Russia

5International Kazakh-Turkish University, Turkestan, Kazakhstan

1.         Ахимова А.Д., Мушанова З.Е., Макалкина Л.Г., Гурцкая Г.М., Жиренова Ж.Т. Результаты исследования практики назначения лекарственных средств по индикаторам ВОЗ // Денсаулык сактауды дамыту. 2012. №3 (64). С. 79-84.

2.         ВОЗ. Восьмой форум по вопросам будущего. Управление безопасностью пациентов. – Копенгаген: Европейское региональное бюро ВОЗ, 2005. 38 с.

3.         Всемирная организация здравоохранения. Шестьдесят вторая сессия всемирной ассамблеи здравоохранения. Рациональное использование лекарственных средств (резолюция WHA60/16). Женева.2009. 6с. / Серия технических докладов ВОЗ. №950.

4.         Данилина К.С., Сычев Д.А., Головина О.В., Ильина Е.С., Горботенкова С.В. Частота назначения потенциально нерекомендованных лекарственных препаратов (по критериям «stopp start») пожилым пациентам, находящимся в терапевтических отделениях стационара: результаты фармакоэпидемиологического исследования // Фарматека. 2015. №13. С.25-28.

5.         Кодекс Республики Казахстан «О здоровье народа и системе здравоохранения» (с изменениями и дополнениями по состоянию на 01.01.2016 г.).

6.         Кузденбаева Р.С. «Что такое полипрагмазия и как ее избежать»: Национальный центр экспертизы лекарственных средств, изделий медицинского назначения и медтехники, г. Алматы // Издательский дом «Здоровье Казахстана». 2014. №11/31. URL: http://www.health-kz.com/ (дата обращения: 04.14.16г.)

7.         Кукес В.Г. Клиническая фармакология: учебник / Под ред. В. Г. Кукеса. - 4-е изд., переработ. и доп. - М. : ГЭОТАР-Медиа, 2013. 1056 с.

8.         Манешина О.А., Белоусов Ю.Б. Полипрагмазия и лекарственные взаимодействия у пожилых пациентов // Качественная клиническая практика. 2008. №3. С.90-93

9.         Молдахметова Б.С., Ахимова А.Д., Жусупова Г.К., Ихамбаева А.Н., Есбатырова Л.М. Формулярная система – инструмент рационального использования лекарственных средств // Денсаулык сактауды дамыту. 2013. №3 (68). С. 37-41.

10.     Назаренко Г.И., Клейменова Е.Б., Отделенов В.А., Пающик С.А., Яшина Л.П., Сычев Д.А. Использование триггеров нежелательных событий для выявления побочных реакций при применении лекарственных средств в стационаре // Клиническая фармакология и терапия. 2015. 24 (4). С.55-62.

11.     Нургожин Т.С. Фармакологические принципы создания «Списка основных лекарственных средств» и лекарственных формуляров как основа повышения эффективности медикаментозной терапии: автореферат дис.…канд.мед.наук. Караганда, 1999, 28 с.

12.     Онлайн-чекер межлекарственного взаимодействия/ [Электронный ресурс]. – URL: http://www.drugs.com/drug_interactions.php?interaction_list_id=101277922 (дата обращения: 27.03.16)

13.     Отделёнов В.А., Новакова А.И., Карасев А.В., Яшина Л.П., Пающик С.А., Сычев Д.А., Клейменова Е.Б., Назаренко Г.И. Оценка частоты потенциально значимых межлекарственных взаимодействий у больных с полипрагмазией в многопрофильном стационаре. // Клиническая фармакология и терапия.2012. №5. С. 81-85.

14.     Приказ Министерства Здравоохранения и Социального Развития Республики Казахстан №173 от 27.03.15г. «Правила организации и проведения внутренней и внешней экспертиз качества медицинских услуг»

15.     Приказ Министра Здравоохранения Республики Казахстан №421 от 29.05.2015г. «Об утверждении Правил проведения фармаконадзора лекарственных средств и мониторинга побочных действий лекарственных средств, изделий медицинского назначения и медицинской техники»

16.     Сычев Д.А., Данилина К.С., Отделенов В.К. Клинико-фармакологические подходы к решению проблемы полирпагмазии у пожилых пациентов в условиях многопрофильного стационара.// Клиническая фармакология и терапия. 2013. №22 (2). С.1-9.

17.     Хохлов А.А., Сычев Д.А., Сироткина А.М. Аспекты безопасного применения статинов: межлекарственное взаимодействие, фармакогенетические вопросы // Universum: Медицина и фармакология: электрон. науч. журн. 2016. №1-2 (24).

18.     American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults // J. Am. Geriatr. Soc. 2012. 60 (4). Р. 616-631.

19.     Bacic-Vrca V., Marusic S., Erdeljic V., Falamic S., Gojo-Tomic N., Rahelic D. The incidence of potential drug–drug interactions in elderly patients with arterial hypertension// Pharmacy World & Science 2010. Volume 32. Issue 6. pp 815.

20.     Bregnhоj L., Thirstrup S., Kristensen M.B., Bjerrum L, Sonne J Prevalence of inappropriate prescribing in primary care//Pharmacy World & Science 2007. Volume 29. Issue 3. Р. 109-115

21.     Dalleur O., Spinewine A., Henrard S., Losseau C., Speybroeck N., Boland B. Inappropriate Prescribing and Related Hospital Admissions in Frail Older Persons According to the STOPP and START Criteria// Drugs & Aging 2012. Volume 29. Issue 10. Р. 829-837

22.     Doupi P., Svaar H., Bjørn B., Deilkås E., Nylén U., Rutberg H. Use of the Global Trigger Tool in patient safety improvement efforts: Nordic experiences Cognition, Technology & Work // 2015. Volume 17. Issue 1. Р. 45-54.

23.     Frankenthal D., Lerman Y., Lerman Y. The impact of hospitalization on potentially inappropriate prescribing in an acute medical geriatric division // International Journal of Clinical Pharmacy 2015. Volume 37. Issue 1. Р. 60-67.

24.     Gallagher P.Ryan C.Byrne S.Kennedy J.O'Mahony D. STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation // Int J Clin Pharmacol Ther. 2008. 46(2). Р.72-83.

25.     Gallagher P.F., O’Connor M.N., O’Mahony D. Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria // Clin Pharmacol Ther 2011. 89. Р.845–854.

26.     Giorgio C.D., Provenzani A., Polidori P. Potentially inappropriate drug prescribing in elderly hospitalized patients: an analysis and comparison of explicit criteria // International Journal of Clinical Pharmacy 2016. 16. Р 1-7.

27.     Goldberg R.M., Mabee J., Chan L., Wong S. Drug–drug and drug–disease interactions in the ED: analysis of a high-risk population // Am J Emerg Med. 1996.14. Р.447–450.

28.     Hamilton H., Gallagher P., Ryan C., Byrne S., O’Mahony D. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients // Arch Intern Med 2011. 171.Р. 1013–9.

29.     Hanlon J.T., Schmader K.E. The medication appropriateness index at 20: where it started, where it has been, and where it may be going. Drugs Aging. 2013.30(11). Р. 893-900.

30.     Hudhra K., García-Caballos M., Jucja B., Casado-Fernández E., Espigares-Rodriguez E., Bueno-Cavanillas A. Frequency of potentially inappropriate prescriptions in older people at discharge according to Beers and STOPP criteria // International Journal of Clinical Pharmacy June 2014. Volume 36. Issue 3.Р. 596-603.

31.     James J.T. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf. 2013. 9(3). Р.122-8.

32.     Mazhitov T.M., Makalkina L.G. Introduction of the indicators of rational use of medicines in the management system and the quality of the medical organization. Astana Medical University // Abstracts Book: International Conference, dedicated to 35th anniversary of the World Health Organization‘s Alma-Ata Declaration on Primary Health Care (PHC). 2013.Р. 191

33.     O'Connor M.N., Gallagher P., Byrne S., O'Mahony D. Adverse drug reactions in older patients during hospitalisation: are they predictable? // Age Ageing. 2012. 41(6). Р.771-6.

34.   Onder G., Petrovic M., Tangiisuran B., Meinardi M.C., Markito-Notenboom W.P., Somers A., Rajkumar C., Bernabei R., van der Cammen T.J. Development and validation of a score to assess risk of adverse drug reactions among in-hospital patients 65 years or older: the GerontoNet ADR risk score // Arch Intern Med. 2010. 12. 170(13). Р.1142-8.

35.     Patterson S.M., Cadogan C.A., Kerse N., Cardwell C.R., Bradley M.C., Ryan C. et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2014.10. CD008165. doi:10.1002/ 14651858.CD008165.pub3.

36.     Price S.D., Holman C., Sanfilippo F.M., Emery J.D. Impact of Specific Beers Criteria Medications on Associations between Drug Exposure and Unplanned Hospitalisation in Elderly Patients Taking High-Risk Drugs: A Case-Time-Control Study in Western Australia // Drugs & Aging April 2014. Volume 31. Issue 4. Р. 311-325.

37.     Ray S, Bhattacharyya M, Pramanik J, Todi S. Drug-drug interactions in the ICU // Critical Care 2009. 13. P.495

38.     Rose O., Schaffert C., Czarnecki K., Mennemann H.S., Waltering I., Hamacher S., Felsch M., Herich L., Köberlein J. Effect evaluation of an interprofessional medication therapy management approach for multimorbid patients in primary care: a cluster-randomized controlled trial in community care (WestGem study protocol) // BMC Family Practice 2015, 16. Р.84

39.     Seddon M.E., Jackson A., Cameron C., Young M.L., Escott L., Maharaj A., Miller N. The Adverse Drug Event Collaborative: a joint venture to measure medication-related patient harm. NZ Med J 2013. 126 (1368). Р.9-20.

40.     Stafford A.C., Tenni P.C., Peterson G.M., Jackson S.L., Hejlesen A., Villesen C. et al. Drug-related problems identified in medication reviews by Australian pharmacists. Pharm World Sci. 2009. 31(2). Р.216–23.

41.     Sychev D.A., Danilina K.S., Golovina O.V. The frequency of potentially inappropriate medication use according to the Beers' criteria in elderly people at the therapy departments of a multidisciplinary hospital // Ter Arkh. 2015. 87(1). Р. 27-30.

42.     Williams D. Monitoring Medicines Use and Reducing Medication errors: The role of the Clinical Pharmacologist. Br J Clin Pharmacol. 2012.3.

 

References:

1.    Ahimova A.D., Mushanova Z.E., Makalkina L.G., Gurtskaya G.M., Zhirenova Zh.T. Rezul'taty issledovaniya praktiki naznacheniya lekarstvennykh sredstv po indikatoram VOZ [The results of the study prescribing practices Indicators WHO]. Densaulyk saktaudy damytu [Health development]. 2012. № 3 (64). рр. 79-84.

2.    Vsemirnaya organizatsiya zdravookhraneniya. Shest'desyat vtoraya sessiya vsemirnoi assamblei zdravookhraneniya. Ratsional'noe ispol'zovanie lekarstvennykh sredstv [WHO. Eighth Futures Forum on. Manage patient safety]. – Kopengagen: Evropeiskoe regional'noe byuro VOZ [WHO Regional Office for Europe], 2005. 38 р.

3.    Vsemirnaya organizatsiya zdravookhraneniya. Shest'desyat vtoraya sessiya vsemirnoi assamblei zdravookhraneniya. Ratsional'noe ispol'zovanie lekarstvennykh sredstv [World Health Organization. Sixty-second World Health Assembly. Rational use of medicines (resolution WHA60 / 16)]. Zheneva.2009.6s / [WHO Technical Report Series]; №950.

4.    Danilina K.S., Sychev D.A., Golovina O.V., Il'ina E.S., Gorbotenkova S.V. Chastota naznacheniya potencial'no nerekomendovannykh lekarstvennykh preparatov (po kriteriyam «stopp start») pozhilym patsientam, nakhodyashhimsya v terapevticheskikh otdeleniyakh statsionara: rezul'taty farmakoepidemiologicheskogo issledovaniya [The frequency of appointments potentially non-recommended drugs (according to the criteria «stopp start») to elderly patients in therapeutic departments of the hospital: the results of pharmacoepidemiological studies]. Farmateka [Farmateka]. 2015. №13. рр.25-28.

5.    Kodeks Respubliki Kazakhstan «O zdorov'e naroda i sisteme zdravookhraneniya» [Code of the Republic of Kazakhstan "On people's health and the health care system"] (with alterations and amendments as of 01.01.2016)

6.    Kuzdenbaeva R.S. «Chto takoe polipragmaziya i kak ee izbezhat'»: Natsional'nyi tsentr ekspertizy lekarstvennykh sredstv, izdelii meditsinskogo naznacheniya i medtekhniki, g. Almaty ["What is polypharmacy and how to avoid the" National Center for Expertise of medicines, medical devices and medical equipment, Almaty]. Izdatel'skii dom «Zdorov'e Kazakhstana». [Publishing House "Health of Kazakhstan"] 2014. №11/31. URL: http://www.health-kz.com/ (accessed: 04.14.16)

7.    Kukes V.G. Klinicheskaya farmakologiya : uchebnik [Clinical pharmacology textbook] / M .: GEOTAR Media. 2013. 1056 р.

8.    Maneshina O.A., Belousov Ju.B. Polipragmaziya i lekarstvennye vzaimodeistviya u pozhilykh patsientov [Polypragmasy and drug interactions in elderly patients]. Kachestvennaya klinicheskaya praktika [Good clinical practice]. 2008. №3. pp.90-93

9.    Moldakhmetova B.S., Akhimova A.D., Zhusupova G.K., Ikhambaeva A.N., Esbatyrova L.M. Formulyarnaya sistema – instrument ratsional'nogo ispol'zovaniya lekarstvennykh sredstv [Formulary system - a tool of rational use of medicines]. Densaulyk saktaudy damytu [Health development]. 2013. № 3 (68). pp. 37-41.

10.   Nazarenko G.I., Kleimenova E.B., Otdelenov V.A., Paiushhik S.A., Jashina L.P., Sychev D.A. Ispol'zovanie triggerov nezhelatel'nykh sobytii dlya vyyavleniya pobochnykh reaktsii pri primenenii lekarstvennykh sredstv v statsionare [The use of adverse event triggers to detect adverse reactions with the use of drugs in a hospital]. Klinicheskaya farmakologiya i terapiya [Clinical Pharmacology and Therapeutics]. 2015. 24 (4). pp.55-62.

11.   Nurgozhin T.S. Farmakologicheskie printsipy sozdaniya «Spiska osnovnykh lekarstvennykh sredstv» i lekarstvennykh formulyarov kak osnova povysheniya effektivnosti medikamentoznoi terapii (avtoref. cand. dis.) [Pharmacological principles of "essential drug list" and drug formularies as a basis for enhancing the effectiveness of drug therapy. Author’s Abstract of Cand. Diss.]. Karaganda, 1999, 28 p.

12.   Onlain-cheker mezhlekarstvennogo vzaimodejstvija [Online-drug interactions checker] [electronic resource]. – URL: http://www.drugs.com/drug_interactions.php?interaction_list_id=101277922 (accessed: 27.03.16)

13.   Otdeljonov V.A., Novakova A.I., Karasev A.V., Jashina L.P., Pajushhik S.A., Sychev D.A., Klejmenova E.B., Nazarenko G.I. Otsenka chastoty potentsial'no znachimykh mezhlekarstvennykh vzaimodeistvii u bol'nykh s polipragmaziei v mnogoprofil'nom statsionare [Evaluation of the frequency of potentially significant drug interactions in patients with polypharmacy in a multidisciplinary hospital] // Klinicheskaya farmakologiya i terapiya [Clinical Pharmacology and Therapeutics]. 2012. №5. pp. 81-85.

14.   Prikaz Ministerstva Zdravookhraneniya i Sotsial'nogo Razvitiya Respubliki Kazakhstan [Order of the Minister of Health of the Republic of Kazakhstan №173 fr om 27.03.2015 "Terms of organizing and conducting internal and external examination of the quality of medical services"].

15.   Prikaz Ministra Zdravoohranenija Respubliki Kazahstan [Order of the Minister of Health of the Republic of Kazakhstan № 421 fr om 29.05.2015 "On approval of the Rules of the pharmacovigilance of medicinal products and monitoring adverse effects of medicines, medical devices and medical equipment»].

16.   Sychev D.A., Danilina K.S., Otdelenov V.K. Kliniko-farmakologicheskie podhody k resheniju problemy polirpagmazii u pozhilyh pacientov v uslovijah mnogoprofil'nogo stacionara [Clinical and farakologicheskie approaches to solving problems polirpagmazii in elderly patients in a general hospital]. Klinicheskaya farmakologiya i terapiya [Clinical Pharmacology and Therapeutics]. 2013. №22 (2). pp.1-9.

17.   Hohlov A.A., Sychev D.A., Sirotkina A.M. Aspects of safe use of statins: Drug interactions, pharmacogenetic issues. Medicine and Pharmacology: elektron. nauch. zhurn. 2016. 1-2(24).

18.   American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J. Am. Geriatr. Soc. 2012. 60 (4). pp. 616-631.

19.   Bacic-Vrca V., Marusic S., Erdeljic V., Falamic S., Gojo-Tomic N., Rahelic D. The incidence of potential drug–drug interactions in elderly patients with arterial hypertension. Pharmacy World & Science 2010. Volume 32. Issue 6. pp 815.

20.   Bregnhoj L., Thirstrup S., Kristensen M.B., Bjerrum L., Sonne J. Prevalence of inappropriate prescribing in primary care. Pharmacy World & Science 2007. Volume 29. Issue 3. pp. 109-115

21.   Dalleur O., Spinewine A., Henrard S., Losseau C., Speybroeck N., Boland B. Inappropriate Prescribing and Related Hospital Admissions in Frail Older Persons According to the STOPP and START Criteria. Drugs & Aging 2012. Volume 29. Issue 10. pp. 829-837

22.   Doupi P., Svaar H., Bjørn B., Deilkås E., Nylén U., Rutberg H. Use of the Global Trigger Tool in patient safety improvement efforts: Nordic experiences Cognition. Technology & Work. 2015. Volume 17. Issue 1. pp. 45-54.

23.   Frankenthal D., Lerman Y., Lerman Y. The impact of hospitalization on potentially inappropriate prescribing in an acute medical geriatric division. International Journal of Clinical Pharmacy. 2015. Volume 37. Issue 1. pp. 60-67

24.   Gallagher P., Ryan C., Byrne S., Kennedy J., O'Mahony D. STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther. 2008. 46(2). pp.72-83.

25.   Gallagher P.F., O’Connor M.N., O’Mahony D. Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria. Clin Pharmacol Ther. 2011. 89. pp.845–854

26.   Giorgio C.D., Provenzani A., Polidori P. Potentially inappropriate drug prescribing in elderly hospitalized patients: an analysis and comparison of explicit criteria. International Journal of Clinical Pharmacy. 2016. 16. R 1-7.

27.   Goldberg R.M., Mabee J., Chan L., Wong S. Drug–drug and drug–disease interactions in the ED: analysis of a high-risk population. Am J Emerg Med. 1996.14. pp.447–450.

28.   Hamilton H., Gallagher P., Ryan C., Byrne S., O’Mahony D. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients. Arch Intern Med. 2011. 171.pp. 1013–9

29.   Hanlon J.T., Schmader KE. The medication appropriateness index at 20: where it started, wh ere it has been, and wh ere it may be going. Drugs Aging. 2013.30(11). pp. 893-900.

30.   Hudhra K., García-Caballos M., Jucja B., Casado-Fernández E., Espigares-Rodriguez E., Bueno-Cavanillas A. Frequency of potentially inappropriate prescriptions in older people at discharge according to Beers and STOPP criteria. International Journal of Clinical Pharmacy. 2014. Volume 36. Issue 3.pp. 596-603

31.   James J.T. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf. 2013. 9(3). pp.122-8.

32.   Mazhitov T.M., Makalkina L.G. Introduction of the indicators of rational use of medicines in the management system and the quality of the medical organization. Astana Medical University. Abstracts Book: International Conference, dedicated to 35th anniversary of the World Health Organization‘s Alma-Ata Declaration on Primary Health Care (PHC). 2013.pp. 191

33.   O'Connor M.N., Gallagher P., Byrne S., O'Mahony D. Adverse drug reactions in older patients during hospitalisation: are they predictable? Age Ageing. 2012. 41(6). R.771-6.

34.   Onder G., Petrovic M., Tangiisuran B., Meinardi M.C., Markito-Notenboom W.P., Somers A., Rajkumar C., Bernabei R., van der Cammen T.J. Development and validation of a score to assess risk of adverse drug reactions among in-hospital patients 65 years or older: the GerontoNet ADR risk score. Arch Intern Med. 2010. 12. 170(13). R.1142-8.

35.   Patterson S.M., Cadogan C.A., Kerse N., Cardwell C.R., Bradley M.C., Ryan C. et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2014.10. CD008165. doi:10.1002/ 14651858.CD008165.pub3.

36.   Price S.D., Holman C., Sanfilippo F.M., Emery J.D. Impact of Specific Beers Criteria Medications on Associations between Drug Exposure and Unplanned Hospitalisation in Elderly Patients Taking High-Risk Drugs: A Case-Time-Control Study in Western Australia. Drugs & Aging. 2014. Volume 31. Issue 4.pp. 311-325

37.   Ray S., Bhattacharyya M., Pramanik J., Todi S Drug-drug interactions in the ICU. Critical Care. 2009. 13. P.495

38.   Rose O., Schaffert C., Czarnecki K., Mennemann H.S., Waltering I., Hamacher S., Felsch M., Herich L., Köberlein J. Effect evaluation of an interprofessional medication therapy management approach for multimorbid patients in primary care: a cluster-randomized controlled trial in community care (WestGem study protocol). BMC Family Practice 2015, 16. pp.84

39.   Seddon M.E., Jackson A., Cameron C., Young M.L., Escott L., Maharaj A., Miller N. The Adverse Drug Event Collaborative: a joint venture to measure medication-related patient harm. NZ Med J 2013. 126 (1368). pp.9-20.

40.   Stafford AC, Tenni PC, Peterson GM, Jackson SL, Hejlesen A, Villesen C, et al. Drug-related problems identified in medication reviews by Australian pharmacists. Pharm World Sci. 2009. 31(2). pp.216–23.

41.   Sychev D.A., Danilina K.S., Golovina O.V. The frequency of potentially inappropriate medication use according to the Beers' criteria in elderly people at the therapy departments of a multidisciplinary hospital. Ter Arkh. 2015. 87(1). pp. 27-30.

42.   Williams D. Monitoring Medicines Use and Reducing Medication errors: The role of the Clinical Pharmacologist. Br J Clin Pharmacol. 2012.3.

Number of Views: 1266


Category of articles: Research methodology

Bibliography link

Мусина А.З., Сейтмаганбетова Н.А., Жамалиева Л.М., Смагулова Г.А., Гржибовский А.М. Индикаторы оценки рациональности лекарственной терапии / / Наука и Здравоохранение. 2016. №2. С. 29-46.

Mussina A.Z., Seitmaganbetova N.A., Zhamalieva L.M., Smagulova G.A., Grjibovski A.M. Indicators of rational drug use. Nauka i Zdravookhranenie [Science & Healthcare]. 2016, 2, pp. 29-46.

Мусина А.З., Сейтмағанбетова Н.А., Жамалиева Л.М., Смағулова Ғ.Ә., Гржибовский А.М. Дәрілік терапия тиімділігін бағалау индикаторлары / / Ғылым және Денсаулық сақтау. 2016. №2. Б. 29-46.


Авторизируйтесь для отправки комментариев