Analysis and optimization of approaches to the treatment of community-acquired pneumonia in real clinical practice
- Authors: Gavrilova A.A1,2, Bontsevich R.A1,3,4
-
Affiliations:
- Belgorod State National Research University
- Medical Center “Clinic on Maroseyka"
- Medical Cente
- Clinic
- Issue: Vol 29, No 5 (2022)
- Pages: 41-45
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/320999
- DOI: https://doi.org/10.18565/pharmateca.2022.5.41-45
- ID: 320999
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Abstract
Background. Lower respiratory tract infections, among which community-acquired pneumonia (CAP) occupies a leading position, are the third leading cause of death in the world, behind only coronary artery disease and cerebrovascular disease, and in low-income countries - the first cause. Objective. Evaluation of the quality of CAP pharmacotherapy in real outpatient practice and the effectiveness of the methods of its optimization. Methods. For the period 2017-2020 in one of the outpatient clinics in Belgorod, 242 protocols containing basic information on patients with non-severe CAP who were treated by general practitioner in outpatient settings were selected and analyzed consequently. Therapy regimens were compared with the requirements of clinical guidelines for key indicators. Based on the identified typical errors, various informational, educational and corrective measures were carried out, a program to support medical decision-making «Community-acquired pneumonia in adults in outpatient practice» which optimizes the choice of starting CAP antibiotic therapy for primary care physicians was developed and implemented in clinical practice. Results. The median primary response rate (PRR) of physicians was 0.525 or 52.5% of correct answers (Q1-Q3: 0.5-0.65). The analysis of the structure of prescriptions showed that only 75 patients (30.9%) received treatment and diagnostic examinations that corresponded to clinical recommendations, and in 167 (69.1%) it did not correspond to one degree or another. After the implementation of measures to optimize the management of patients with CAP, the repeated median PRR increased to 0.643 (64.3% of correct answers; Q1-Q3: 0.44-0.74); a statistically significant decrease in the frequency of irrational prescriptions in the treatment of CAP was found -from 70.7 to 31.6% (P<0.001). Conclusion. Pharmacoepidemiological studies to clarify the preferences of doctors in choosing pharmacotherapy for CAP, to identify factors associated with the irrational prescription of antibacterial drugs should be considered advisable.
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About the authors
A. A Gavrilova
Belgorod State National Research University; Medical Center “Clinic on Maroseyka"Belgorod, Russia
R. A Bontsevich
Belgorod State National Research University; Medical Cente; Clinic
Email: dr.bontseyich@gmail.com
Belgorod, Russia
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