Clinical and economic analysis of medicinal prescriptions for children and adolescents with Helicobacter pylori-associated gastroduodenal pathology

Abstract

The significant prevalence of chronic gastritis and/or duodenitis among children and adolescents, the ability of H. pylori to induce serious complications lead to the importance of effective anti-helicobacter therapy.
 The aim of the work was to determine the rationality of prescribed drugs and the expediency of financial expenses for pharmacotherapy of chronic gastritis and/or duodenitis associated with H. pylori and gastro-esophageal reflux disease based on the results of a retrospective clinical and economic analysis of medical prescriptions in Dnipro.
 The material for the study were the 92 prescription sheets (form No. 003-4/y) of stationary patients aged 5–17 years with a diagnosis of chronic gastritis and/or duodenitis associated with H. pylori and gastro-esophageal reflux disease undergoing treatment at the Dnipropetrovsk Children's City Clinical Hospital № 6 for the period 2012–2017.
 Analysis of the prescriptions frequency, their ranking for cost and importance for the treatment were carried out using pharmacoeconomic methods: ABC-, VEN-, frequency analysis and integrated frequency/ABC/VEN analysis.
 Frequency analysis of treatment regimens showed that only 47.8% of patients were prescribed a «gold standard» of treatment, while 52.2% of patients had medical prescriptions that did not comply with the national treatment protocols adopted by the Ministry of Health of Ukraine. It was found that in the structure of medical prescriptions for the treatment of chronic gastritis and/or duodenitis associated with H. pylori and GERD, there was excessive use of non-essential drugs «N» (43.9%), which were prescribed almost in the same volume as vital drugs «V» (56.1%).
 According to the ABC-analysis, it was established, that the main financial resources were spent on the medicines of six groups: dietary supplements for normalization and maintenance of normal intestinal microflora, omeprazole, mozapride, clarithromycin, domperidone and amoxicillin. It was found, that on average one patient was prescribed 6.6 preparations worth 722.42 UAH.
 It can be concluded that the main funds was not spent on the necessary and important medicines for the treatment of the studied nosologies.

The analysis of medical prescriptions for patients with duodenal ulcer in hospital setting

“…Клініко-економічний аналіз лікарських призначень дітям та підліткам, хворим на Helicobacter pylory-асоційовану гастродуоденальну патологію, здійснили О. В. Макаренко, М. М. Карімова, А. М. Машейко на базі КЗ «Дніпропетровська дитяча міська клінічна лікарня № 6». У результаті дослідження було встановлено, що в структурі лікарських призначень для лікування хронічного гастриту та/або дуоденіту, асоційованого з H. Pylori, спостерігалося надлишкове застосування другорядних ЛЗ «N» (43,9 %), які призначали майже в такому самому обсязі, як і життєво необхідні препарати «V» (56,1 %), що свідчить про те, що основні фінансові ресурси в достатньому обсязі не витрачали на необхідні і важливі ліки для лікування досліджуваних нозологій [6].…”