Consumption of Antibacterials for Systemic Use in Slovakia: A National Study and the Quality Indicators for Outpatient Antibiotic Use.

This paper aims to analyse the consumption of antibiotics in the Slovak health care system from 2011 to 2020. The data source on the consumption of antibiotics is sales data from SUKL and NCZI. The study employed the ATC/DDD Index and focused on the consumption of antibiotics in the primary care sector. Total antibiotic consumption decreased from 19.21 DID in 2011 to 13.16 DID in 2020. Consumption of beta-lactamase-sensitive penicillins, expressed as a percentage of the total consumption of antibiotics, decreased from 8.4% in 2011 to 4.2% in 2020. Consumption of the combination of penicillins, including beta-lactamase inhibitor, expressed as a percentage of the total consumption of antibiotics, increased from 16.2% in 2011 to 17.9% in 2020. Consumption of third- and fourth-generation cephalosporins, expressed as the percentage of the total consumption of antibiotics, increased from 2.0% in 2011 to 4.6% in 2020. Consumption of fluoroquinolones, expressed as the percentage of the total consumption of antibiotics, decreased from 10.7% in 2011 to 8.6% in 2020. Overall, antibiotic consumption significantly changed in Slovakia from 2011 to 2020. The ratio of the consumption of broad-spectrum to the consumption of narrow-spectrum penicillins, cephalosporins and macrolides decreased from 14.98 in 2011 to 13.38 in 2020.

INTRODUCTION OF HEALTH TECHNOLOGY ASSESSMENT FOR MEDICINES IN SLOVAKIA.

OBJECTIVES: The aim of our study was to describe approaches to health technology assessment (HTA) for medicines in the Slovak healthcare system and the related decision-making processes concerning reimbursement for medicines. METHODS: Analysis of the Slovak legislative framework related to HTA and the reimbursement process for medicines was performed. Additionally, current practices of the Working Group for Pharmacoeconomics, Clinical Outcomes and Health Technology Assessment of the Slovak Ministry of Health were evaluated. RESULTS: In Slovakia, there is always at least one treatment available in each determined therapeutic class with no co-payment. HTA is becoming an established method for the evaluation of cost-effectiveness of medicines in Slovak healthcare policy. The majority of decision makers within Slovakia support the idea of increased use of and the quality and efficiency of HTA methods. However, it is crucial to overcome several practical barriers to facilitate progress in the field of HTA in the Slovak Republic. CONCLUSIONS: It can be seen that participation within the European Network for Health Technology Assessment (EUnetHTA JA 2 and EUnetHTA JA 3 projects) has significantly improved the quality of the process of HTA in Slovakia. Further legislative activities in this field are required due to the approved strategy for European Union cooperation on HTA.

[The quality of life of patients suffering from the osteoporosis]. / Kvalita zivota pacientov trpiacich osteoporózou.

Osteoporosis (OP) is a systemic skeletal disease characterized by an imbalance of bone remodelling process due to the prevalence of osteoresorption over osteosynthesis. As a result of these changes, the decrease in bone mass and density occur followed by an increase in fracture risk1). Its clinical manifestation is initially asymptomatic but in the course of time it is quite the contrary - really severe (bone pain, movement disorders, fractures) with a lot of further adverse consequences, including death2). The presented study deals with the impact of osteoporosis and its consequences on the quality of life of patients. The research is focused on patients diagnosed with or treated for osteoporosis that is to say by non-uniform etiology. By questioning of the sample of 128 patients evaluating various dimensions of the patients quality of life (physical condition, mental state, and social status, overall satisfaction with life and health state) and tracking patients satisfaction with the therapy as well. By analysing the results, we found that osteoporosis affects the quality of life, especially physical state of health because up to 31.25% of patients say that they have suffered from every days backaches. It affects social life in the member of 7.81% patients, and 28.13% patients say that biggest problem with osteoporosis is the loss of free movement and possible fracture.Key words: osteoporosis quality of life pharmacotherapy questionnaire survey fractures.

[Medical and entrepreneurial character of the community pharmacy]. / Zdravotnícky a podnikatelský charakter lekárne.

UNLABELLED: Community pharmacy provides citizens with pharmaceutical care and runs its health care business on the market with state regulatory interventions. These restrictions affect its stability and because of that it has to be constantly monitored. The convenient way of monitoring the financial health of a community pharmacy is the use of financial analysis and its outcomes that are profitability, liquidity, debt and productivity ratios. The aim of this paper was to determine the economic situation in the public pharmacy services in Slovakia. A representative set of community pharmacies was established that reflected the criteria of localization by regions in Slovakia, the size of the city or municipality and the legal form of the subject. The financial analysis for the years 2007-2012 showed a declining return on sales (in 2012 to 1.98 %), a decreasing current liquidity (in 2012 to 1.87 %), a declining quick ratio (in 2012 to 1.08 %), a decrease in the time receivables turnover (in 2012 to 53.8 days), a slight increase in the inventory turnover time - days sales in inventory (in 2012 to 36.5 days) and increased turnover time commitments - liabilities turnover (in 2012 to 86.3 days). KEYWORDS: community pharmacy financial health profitability liquidity productivity.

[Identifying and solving drug-related problems in terms of the community pharmacist]. / Identifikácia a riesenie farmakoterapeutických problémov z pohladu verejného lekárnika.

The issue of drug related problems (DRPs) has been known and dealt with in many studies for a long time. It is primarily due to the fact that drug-related problems have the potential to increase patients morbidity and mortality in particular. The issue of identifying and solving drug-related problems in the area of pharmacotherapy by community pharmacists in the Slovak Republic, unlike in other European countries such as the Netherlands and the United Kingdom, is still at the beginning and gradually developing. The aim of the survey was to obtain information from pharmacy practice concerning the current state and possible solutions of potential risks of medicines in the form of drug-related problems of patients from community pharmacists point of view as well as to find out the role and status of community pharmacists in identifying and solving drug-related problems. A questionnaire survey using a sample of 237 respondents, its statistical processing and evaluation revealed the drug-related problems frequency met at their patients (the most common types of DRPs, their causes and subsequent intervention), as well as the opinions of community pharmacists on their current possibilities of (legislative, material, personnel, time) solving and risk-rating therapies for patients.

[Globalization and its impact on pharmacy services in the Slovak Republic]. / Globalizácia a jej dopady v lekárenstve SR.

Public pharmacies are excellent medical facilities having the largest number of contacts with patients. They are the facilities of the first and last contact with the health care system for the patient. Public pharmacies are unique and easily accessible places in the health care system with a high proficiency in the provision of pharmaceutical care and highly qualified medical staff. The aim of this paper was to determine geographical-demographic situation, the legal form of the ownership of public pharmacies, and the owner share of pharmacists on the capital of public pharmacies in Slovakia. The number on of providers of pharmaceutical care depends on the population at the level of regions, districts, towns and villages with differing tightness of binding. The most common legal form of the provider of pharmaceutical care in Slovakia in public pharmacies were limited companies with 73.6% share, a sole proprietor - pharmacist had 23.9%, and public limited companies had 1.3%. In the branches of public pharmacies the limited companies had 73.4% share, a sole proprietor - pharmacist had 26%, public limited companies had 1%. The owner share of the pharmacist on the capital in public pharmacies was 50.4%, and in the branches of public pharmacies it was 66%, owned by a sole proprietor or limited company.

[A view on providing care in the field of medicines in Slovakia - the pharmacist and the patient]. / Pohlad na poskytovanie starostlivosti v oblasti liekov na Slovensku - lekárnik a pacient.

The paper deals with the evaluation of care provided in a public pharmacy in terms of achieving patient / customer satisfaction. Expectations and opinions of patients are also confronted with the assumptions of pharmacists. Up to 82% of patients confirmed their satisfaction with the care given to them by the pharmacist. A key factor of patient satisfaction has proved particularly professional and human approach of pharmacist. 73.6% of patients in the survey accepted pharmacist as an expert on drugs. Pharmacist self-evaluation was more negative. Monitoring and evaluation of patient satisfaction with care delivered in the pharmacy is essential for the improvement of the quality of the health system and the implementation of pharmaceutical care focussed on the patient. The real application of pharmaceutical care in the practice currently lacks the necessary conditions and support.

Monitoring of effectiveness of some preventive measures against influenza.

In our study we dealt with the frequently occurring influenza virus that infects humans regardless of age or sex. The flu is not of importance only in health problems but also in the economic ones, such as the treatment costs and patients' ability to work. We focused particularly on the most effective preventive measure against the virus, which is vaccination and the risk groups that are the most vulnerable ones to the virus. One of the objectives of this research was to identify the advantages and disadvantages of vaccination against influenza and available risks of vaccination within a group of 390 patients. We studied a group of 195 vaccinated patients and we tried to determine the effect of the vaccines used in these patients, and to compare this group with the same number of unvaccinated patients. The goal of the research was to identify the advantages and disadvantages of the vaccination against influenza, and the potential risks resulting from the vaccination. Based on our results, we found out that out of 195 vaccinated patients, only 4% returned to the doctor with the flu. Unvaccinated patients, however, visited the doctor four times more frequently, regardless of age. The resulting morbidity ratios clearly showed the importance, effectiveness and safety of the vaccination not only in high-risk groups, but also in people that are "out-of-danger", because the current flu virus spreads by droplet infection very quickly. Appropriate education and increased awareness among the population in Slovakia could improve the general attitude towards the vaccination against influenza and the vaccination rate (Slovakia 12%) could raise to a percentage comparable to that of the EU countries (France 30%, England 32%, the Netherlands 28% and Germany 26%).