Skornyakov S.N., Lugovkina T.K., Egorov E.A., Golubeva L.A., Sharapova M.V.
Ural Research Institute for Phthisiopulmonology, Ministry of Health of the Russian Federation, Ekaterinburg

Contacts: Tatyana Lugovkina, E-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Abstract. Significance of this study is based on the need to minimize risks of drug interaction during TB surgical interventions especially in multimorbid patients that require continuous medication. One way to reduce risks of drug interaction is controlled medication load, i.e. medication management.

The purpose of the study was to design a model for quality medication management of TB surgical patients at the perioperative period.

Material and methods. Clinical and pharmacological audit of medication prescriptions for TB surgical patients in pulmonary surgery and bones and joints TB departments was carried out. Clinical pharmacologist analyzed charts of 72 patients. The subjects for analysis were prescriptions to TB surgical patients during the perioperative period, including: premedication, peri-surgical antibiotic and thromboembolia prophylaxis, post-surgery analgesia, additional medication management of multimorbid patients.

Results. The study shows that 83% of patients at the TB surgical department had multimorbid clinical status and needed additional pharmacotherapy. Polypharmacotherapy was registered in 100% of cases. The share of polypragmasy (administration of medications that do not interact excluding drugs for basic TB modes) in such patients equaled to 70%.

Compliance with clinical guidelines for antibiotic prophylaxis added up to 48%. Compliance with post-surgery analgesia guidelines equaled to 60%. There were no standard guidelines for perioperative medication management in multimorbid TB surgical patients.

Conclusion. Quality of TB perioperative medication needs improvement through introducing rules of medication management and monitoring over compliance with antibiotic prophylaxis and post-surgery analgesia guidelines.

Key words: quality; medication management; perioperative period; phthisiology.

References

1. Avksent'eva M. V., Omel'yanovskiy V.V. Mezhdunarodnyy opyt otsenki tekhnologiy v zdravookhranenii. [International experience in assessment of health care technologies]. Pediatricheskaya farmakologiya 2011; (2): 6-12 (In Russian).
2. Gallinger E. Yu., Likhvantsev V. V., Mizikov V. M. Anesteziya v maloinvazivnoy laparoskopicheskoy khirurgii s pozitsiy menedzhmenta kachestva. [Anesthesia in low-invasive laparoscopic surgery from positions of quality management]. Anesteziologiya i reanimatologiya 2008; (5): 68-70. (In Russian).
3. Zhiburt E.B., Shestakov E.A. Dokazatel'naya transfuziologiya: ch.2. Audit gemotransfuziy. [Evidential transfusion medicine: part 2. Audit of hemotransfusion]. Zdravookhranenie 2007; (12): 36-44. (In Russian).
4. Zabolotskikh I.B., Sin'kov S.V., Shaposhnikov S.A. Diagnostika i korrektsiya rasstroystv sistemy gemostaza: ruk. dlya vrachey. [Diagnostics and correction of frustrations in the system of a hemostasis. Manual for physicians]. Moscow: ID Prakticheskaya meditsina; 2008. 333p. (In Russian).
5. Ignatovskiy A. Ekspertiza kachestva meditsinskoy pomoshchi. [Examination of the quality of medical care]. Vrach 2010; (7): 79-80. (In Russian).
6. Kabanova N.V., Yasnogor L.A. K voprosu o premedikatsii: komponenty, kriterii adekvatnosti: obzor literatury [To the issue of premedication: components, criteria of adequacy. Literature review]. Meditsina neotlozhnykh sostoyaniy 2011; 35 (4): 19-24. (In Russian).
7. Lindenbraten A.L. Teoreticheskie i prakticheskie aspekty organizatsii upravleniya kachestvom meditsinskoy pomoshchi. [Theoretical and practical aspects in the organization of quality management of medical care]. Menedzhment kachestva v sfere zdravookhraneniya i sotsial'nogo razvitiya 2012; 13(3): 23-26. (In Russian).
8. Khaykin S.S., Bobrinskaya I.G., Yaltonskiy V.M., Shil'nikov V.A. Psikhoemotsional'noe sostoyanie bol'nykh v predoperatsionnom periode kak kriteriy effektivnosti premediktsii. [A psycho-emotional status of patients in the preoperative period as the criteria of premedication efficiency]. Zabaykal'skiy meditsinskiy vestnik 2007; (1):15-18. (In Russian).
9. Rossiyskie klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike venoznykh tromboembolicheskikh oslozhneniy. [Russian clinical recommendations for diagnostics, treatment and prevention of the venous thrombo -embolic complications]. Flebologiya 2010; 4(2): 6-27. (In Russian).
10. Strategiya i taktika primeneniya antimikrobnykh sredstv v lechebnykh uchrezhdeniyakh Rossii [The strategy and tactics for implementation of antimicrobial medicine at health care facilities of Russia. Russian national recommendations]. Moscow: ID "Planida"; 2012. 96 p. (In Russian).
11. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Antithrombotic Therapy and Prevention of Thrombosis; 2012. February (2-suppl). 141p.
12. Dolin S, Cashman J., Bland J. Effectiveness of acute postoperative pain management: Evidence from published data. Br J Anaesth. 2002; 89: 409–423.

Write Comment

Please keep the topic of messages relevant to the subject of the article. Personal verbal attacks will be deleted. Please don't use comments to plug your web site. Such material will be removed. Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button. Keep in mind that the above process only applies if you simply entered the wrong security code.
Name:
E-mail
Comment:
Code:*