REMEDIUM

Aim. Development of logical-semantic model of choice of fixed combinations of antihypertensive drugs (FC AHD) to optimize the algorithm of choice of drugs for the treatment of hypertension and the time of medical admission. Determination of factors affecting the screening selection of drugs, identification of the place and role of the doctor and pharmacist in the effective pharmacotherapy of arterial hypertension (AH). Materials and methods. The research was conducted on the basis of a systematic approach using analytical, logical, semantic methods, content analysis and modeling. Results. A logical-semantic model of the choice of fixed combinations of drugs for the treatment of arterial hypertension (hereinafter the model) was proposed, taking into account significant factors in the choice of drugs. The model will optimize the algorithm for prescribing fixed combinations of antihypertensive drugs by doctors of different specialties. Conclusion. To improve the quality of medical and pharmaceutical care for patients with hypertension, further improvement of antihypertensive treatment from the point of view of evidence-based medicine is necessary, the conduct of pharmacoeconomic studies of FC AHD, increase of professional level of doctors and pharmaceutical professionals on issues of pharmaceutical care to patients with hypertension, the improvement of interaction in the system «patient-doctor-pharmacist».

The article considers the legislative acts of the member states of the Commonwealth of Independent States concerning immunoprophylaxis. A comparative legal comparison of the main concepts and institutions, requirements for the behavior of the subjects of the relevant legal relations has been made. Based on the analysis of the regulatory approaches proposed in various countries, conclusions were drawn about the types of vaccination, the difference between the legal regimes of voluntary and mandatory vaccination, and proposals were formulated to improve the Russian legislation on immunoprophylaxis.

Legislative regulation of contacts related to conflicts of interest has also affected the pharmaceutical business. Both objective and subjective factors can influence on the pharmacists’ performance of their professional duties. First of all is an impossibility and inexpedient to inform the patient about all available interchangeable medicines. Second one is the personal (sometimes property) interest of a pharmacist in promoting certain trade names. In this case, the issue of a conflict of interest can be raised. The concept of a conflict of interest in pharmaceutical business proposed by the Federal Law on the Basis of Public Health Protection does not disclose the concept of personal interest and, moreover, the legal structure of a conflict of interest, due to the problematic nature of its proof. This is does not add efficiency to the legal regulation of retail sales of medicines. Legal regulation of the pharmacists’ duties and ethical requirements for the impartiality and objectivity of their activities are sufficient standards for the relationship between a pharmacist and a patient.

The article presents an economic overview of the Russian market of medicines during the global pandemic, examines the results of the pharmaceutical industry in 2020 and 2021, as well as its actions for the future in order to obtain more effective innovative projects from its activities, presents directions for improving the state of the Russian pharmaceutical market. The features of the formation of market preferences and the need to sell groups of pharmaceuticals for the treatment of coronavirus, its consequences and complications are considered in detail and highlighted. Marketing concepts of the modern pharmaceutical market of the Russian Federation are investigated. A factor analysis of the preferences of the population and medical workers for certain drugs used for the treatment of COVID-19 and its varieties is made.

Analysis of the activities of any organization over the past period is an important element in forecasting future plans, in the development and adoption of management decisions in order to improve the efficiency of their work. In order to identify patterns in the activities of the Center for Hygiene and Epidemiology (CHaE), it is necessary to analyze the activities over a number of years, which makes it possible to develop and make rational decisions.Purpose: to study some aspects of the activities of the CHaE in Kazan from 2012 to 2019.Methods: retrospective, analytical, mathematical.Results. Every year there are changes in the structure of the CHaE staff. There is an increase in the number of junior and other medical personnel, and there are no significant changes among other specialists with higher education. As part of the equipment of the new laboratory building, more than 500 units of equipment that meets all modern requirements were purchased. Before the mass events in 2012, the total number of studies conducted was 1,457,869, and since 2013, when the Universiade was held, the number of studies increased by 30% and amounted to 2,082,671. Over the past 7 years, the number of studies conducted has remained virtually unchanged, and remains at a high level, because the period of one mass event is superimposed on the period of preparation for the next one. During the preparation and holding of mass events, working groups were created in which issues and problems related to the preparation and holding of Championships were discussed and resolved.Conclusion. For the rational organization and management of the activities of the CHaE during the preparation and holding of mass events, it is necessary to differentiate and develop a management model in order to plan in advance the personnel, material, technical, and financial support in the CHaE, the purpose of which is to optimize the work of the center, and ultimately reduce economic costs, rationalize the burden on employees, effectively use equipment, prevent the occurrence and spread of infectious diseases, epidemics and poisoning.

As part of the study, the associations of iron deficiency conditions with lifestyle and psychological health in women were studied. The authors found positive correlations in the ferritin level dependence model with the following factors: the level of total blood protein (p < 0.001), the consumption of beef liver (p < 0.001), the consumption of vegetables, fruits, fresh herbs 3 or more times a week (p < 0.001), eating meat every day (p < 0.001). Negative correlations were noted with factors: bedtime after 11 pm (p < 0.001) and bedtime after 00.00 (p < 0.001). An analysis of the factors influencing the level of total protein showed that its decrease is affected by marital status in the «divorced» status (p = 0.006), situational anxiety (p = 0.007), difficulty falling asleep (p < 0.001), frequent interruption of sleep (p = 0.001) the quality and consumption of carbohydrates each day (p = 0.021). Based on the results of the study, a cognitive-behavioral model of the development of iron deficiency conditions was described for the first time, which made it possible to start developing a relevant prevention program.

In the study there were analysed the indicative indicators of the implementation of the federal program «Essential Medicine Provision» in 23 constituent entities of the Russian Federation.The purpose of this study was to analyse the features of the implementation of the federal program in the constituent entities of the Russian Federation in 2020.Materials and methods. The data were received in the form of responses to specially developed request cards from the health authorities of the constituent entities of the Russian Federation. In the study there were used methods of comparative, structural, logical and content analysis, as well as the method of grouping data.Results. The results obtained in the course of the study indicate a significant variation in the values of the indicators of the implementation of the federal program, which may be due to differences in the contingent of beneficiaries, in the structure of their morbidity, as well as in the structure of the range of prescribed medicines. The amount of actual costs per month per 1 beneficiary who applied in the studied subjects of the Russian Federation exceeded the standards of financial costs per month established by the Decree of the Government of the Russian Federation per citizen receiving state social assistance in the form of a set of social services.Discussion. The results obtained confirm the previously identified problems in the field of preferential medicine provision, caused by the refusal of federal beneficiaries to receive state social assistance in the form of a set of social services in favor of monetary compensation.Conclusion. The creation of a unified federal register of citizens entitled to the provision of medicines, medical devices and specialized health food products at the expense of budgetary allocations from the federal budget and the budgets of the constituent entities of the Russian Federation represents a promising opportunity for correct forecasting and accounting of the expenditure of public funds, as well as monitoring the correctness of prescriptions and quality of medical care.

The aticle is devoted to the history of pharmacy business in Smolensk province - a typical province of the European part of Russia. The activity of private, factory, city and zemstvo pharmacies is analyzed. The formation of zemstvo and town pharmacies took place against the background of legislative restrictions protecting commercial interests of private pharmacy owners. The activities of local government pharmacies were socially oriented, as their main objective was to provide the poorest strata of the population with affordable and high-quality medicines, rather than to make a profit. From the very beginning of its existence, zemstvo council of the Smolensk province have set the task of providing the rural population not only with free medical consultations, but also with free medicines in full. For half a century, the Zemstvo pharmacy business has gone through a difficult evolutionary path from fourteen pharmacies in 1865 to forty pharmacies in 1916. Since Smolensk city authorities were deprived of an opportunity to establish cheap city pharmacies, citizens of the provincial centre could get free medicine in the pharmacies at the outpatient clinic of the local Charitable Society (1872), the provincial Zemstvo Hospital (1875), the Society of Smolensk Doctors (1892) and the Smolensk Community of Sisters of Charity ROKK (1897), in the city outpatient clinic (1903).