The issue of vaccine refusal: study of risky behaviour.

BACKGROUND: The aim of this study is to identify the influence of factors that determine the refusal of influenza vaccine among three subjects groups. METHODS: A survey was conducted amongst three high­risk groups in years 2018-2019 (Moscow, Russia). The survey involved 1,620 parents and pregnant women (group 1), 324 doctors (group 2) and 433 students (group 3). The analysis revealed a poor vaccine uptake among respondents of all three groups. RESULTS: According to the survey results, only 22.2 % of children and 13.8 % of adults were vaccinated against influenza. The group 2 showed higher rates for vaccinated adults and children, namely 36.7 % and 58.7 % , respectively. The lowest adherence to annual vaccinations was recorded in group 3 (only 17.3 %). There is also a negative correlation between adherence to vaccination and smoking -0.66), unhealthy diet -0.73), poor oral hygiene -0.61) as well as insufficient awareness of the need of influenza vaccine -0.81). CONCLUSION: The general lack of vaccination awareness has a fundamental role in forming a negative attitude toward influenza vaccine. It is necessary to conduct research to promote vaccination against influenza to improve vaccine uptake among high­risk groups, particularly in students (Tab. 1, Fig. 1, Ref. 32).

Specific features of rational pharmacotherapy in elderly patients.

OBJECTIVE: It is well-known that finding an optimum medication at the correct dose for elderly patients is challenging for the practitioner. This study aimed to examine the main trends in prescribing medications for elderly patients and their compliance with the principles of rational pharmacotherapy, and to establish the main factors affecting adherence to treatment in these patients. METHODS: 956 records of outpatients over 60 years of age were examined. The groups of medications prescribed, the dosage simultaneously prescribed to one patient, the structure of nosologies among elderly patients, and the frequency of side effects were studied. The second stage of the study with 147 patients involved examining the adherence to medications by elderly patients using the Brief Medication Questionnaire. RESULTS: A total of 147 patients (79 (53.7%) women and 68 (46.3%) men) aged over 60 years who were taking ≥4 medications for primary and concomitant diseases were surveyed. The phenomenon of polypragmasy is clearly seen when prescribing pharmacotherapy to elderly patients. Thus, 39% of patients were prescribed 2-4 drugs simultaneously, 55.4% were prescribed ≥5 drugs, and only 5.6% were prescribed one type of medication. Consequently, 90.5% of patients did not comply with the prescribed regimen of drugs. The main reasons for low adherence to treatment were: the complexity of the drug regimen (72.1% of cases); the high cost of drugs (63.9%); lack of appropriate knowledge about disease (67.3%); and no understanding of the necessity for drug intake and the pharmacotherapeutic effect in a particular situation (61.9%). CONCLUSION: Optimisation of pharmacotherapy for elderly and senile patients requires consideration of functional changes in the body, the peculiarities of the pharmacodynamics and pharmacokinetics of drugs prescribed, the presence of polymorbidity, the prevalence of polypragmasy, and the low adherence to treatment.

The modern Russian pharmaceutical market: consumer attitudes towards distance retailing of medicines.

BACKGROUND: In Russia, remote retail trade of over-the-counter (OTC) medicines was legalised. According to statistics as of April 2020, consumer demand in the categories of "online pharmacies" increased by 803%. METHODS: The study was conducted in two stages by cross-sectional method using a structured questionnaire in the central region of Russia: 1st stage - July-August 2020; 2nd stage - February-March 2021. The results of the study were obtained using qualitative (method of discussions in focus groups) and quantitative methods (survey) of sociological research, logical and statistical analysis. The representativeness of the data was ensured by a sufficient sample size including 1194 consumers (with confidence probability = 0.95 and confidence interval ≤ 0.05). RESULTS: The number of respondents fully supporting the legalisation of online trade in medicines increased. Consumer attitudes towards online commerce depend on the age group of the respondents. 1.5 times more respondents over 46 years (12.1%) are strongly against distance selling of medicines compared to survey participants aged 18 to 25 years (7.8%). Six months after the first survey, no respondent strongly opposed the sale of prescription medicines through the internet, whereas in the first survey half of consumers held this view. The percentage of respondents who considered pharmaceutical counselling when purchasing medicines online as extremely important decreased by a factor of 4 over time (10.9%) M (08.2020) = 3.66 (0.992); M (03. 2021) = 3.17 (0.981) t = 7.66 (p < 0.05). Consumers consider accessibility for people with disabilities (80.3%) to be the most significant advantage of distance selling medicines. CONCLUSION: Consumer demand for the purchase of medicines online will grow as this type of sale has undeniable advantages. However, some risks remain when buying medicines online.

Effect of combined glucocorticoid therapy on bronchial asthma dynamics

This work is aimed to compare the effectiveness of parenteral and inhalation bronchial asthma treatment in combination with glucocorticosteroids and bronchodilators. The study was conducted in 2020 in Botkin City Clinical Hospital (Moscow, the Russian Federation). Case histories of 106 patients diagnosed with bronchial asthma exacerbation of moderate severity were analyzed. Patients were divided into two equal groups based on the therapy method: (1) Group 1 received systemic glucocorticosteroids parenterally in combination with inhalation glucocorticosteroids; (2) Group 2 received systemic glucocorticosteroids parenterally, but inhalation therapy was performed with a nebulizer. Clinical manifestations of bronchial asthma have been recorded. During hospital admission, the breath rate was 22.0 for Group 1 and 21.5 for Group 2, P ≥ 0.05, and heart rates were 93.0 and 92.5, respectively (P ≥ 0.05). All indices (blood saturation, breath rate, peak output rate) in Group 1 remained unchanged 4 h after the start of the therapy, while in Group 2, peak flow rate changed to 53.5% with a median increase of 72.0 ml over 4 h, P ≤ 0.05. On Day 3, patients of Group 1 demonstrated a peak flow rate of 59.5%, P ≤ 0.05, and on Day 10, patients of Group 2 had a peak output rate of 53.0 and 59.5%, respectively (P ≤ 0.05). Systemic glucocorticoids were eliminated in 47 patients of Group 1 and in all patients of Group 2. The treatment tactics applied in Group 2 resulted in faster and more significant improvement in patients diagnosed with bronchial asthma exacerbation. Both treatment regimens showed high results (AU)

Effect of combined glucocorticoid therapy on bronchial asthma dynamics.

This work is aimed to compare the effectiveness of parenteral and inhalation bronchial asthma treatment in combination with glucocorticosteroids and bronchodilators. The study was conducted in 2020 in Botkin City Clinical Hospital (Moscow, the Russian Federation). Case histories of 106 patients diagnosed with bronchial asthma exacerbation of moderate severity were analyzed. Patients were divided into two equal groups based on the therapy method: (1) Group 1 received systemic glucocorticosteroids parenterally in combination with inhalation glucocorticosteroids; (2) Group 2 received systemic glucocorticosteroids parenterally, but inhalation therapy was performed with a nebulizer. Clinical manifestations of bronchial asthma have been recorded. During hospital admission, the breath rate was 22.0 for Group 1 and 21.5 for Group 2, P ≥ 0.05, and heart rates were 93.0 and 92.5, respectively (P ≥ 0.05). All indices (blood saturation, breath rate, peak output rate) in Group 1 remained unchanged 4 h after the start of the therapy, while in Group 2, peak flow rate changed to 53.5% with a median increase of 72.0 ml over 4 h, P ≤ 0.05. On Day 3, patients of Group 1 demonstrated a peak flow rate of 59.5%, P ≤ 0.05, and on Day 10, patients of Group 2 had a peak output rate of 53.0 and 59.5%, respectively (P ≤ 0.05). Systemic glucocorticoids were eliminated in 47 patients of Group 1 and in all patients of Group 2. The treatment tactics applied in Group 2 resulted in faster and more significant improvement in patients diagnosed with bronchial asthma exacerbation. Both treatment regimens showed high results.

Medical and Social Factors of Pediculosis.

Pediculosis is a global problem in public health. An important factor in the efficient eradication of lice is ensuring adequate recognition and treatment of the disease by the population. In the present study, awareness of the population about the physiological properties of head lice, the ways of infestation with head lice, and the methods of treatment and prevention were studied. Perception of the disease by the people who had had head pediculosis and other people around them was identified.