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Medicine Availability and Prescribing Policy for Non-Communicable Diseases in the Western Balkan Countries

Published on Nov 8, 2017in Frontiers in Public Health
· DOI :10.3389/fpubh.2017.00295
Tanja Pekez-Pavlisko1
Estimated H-index: 1
Maja Račić3
Estimated H-index: 3
(University of East Sarajevo),
Srebrenka Kusmuk1
Estimated H-index: 1
(University of East Sarajevo)
Background: During the transition processes, the Western Balkan countries were affected by conflicts and transition related changes. Life expectancy in these countries is lower, while the mortality from non-communicable diseases is higher in comparison with western and northern parts of Europe. The primary aim of this study was to analyze the treatment possibilities for the most common non-communicable diseases in the Western Balkan countries. The secondary aim was to understand and compare the policies regarding prescribing-related competencies of family physicians. Methods: In June and July 2017, a document analysis was performed of national .positive medicines lists, strategic documents and clinical guidelines for the treatment of the most frequent non-communicable diseases; arterial hypertension, diabetes, hyperlipidemia, asthma and chronic obstructive pulmonary disease. All text phrases that referred to medicines prescribing were extracted and sorted into following domains: medicine availability, prescribing policy and medication prescribing - related competencies. Results: Possibilities for treatment of arterial hypertension, diabetes, hyperlipidemia, asthma and chronic obstructive pulmonary disease vary across the Western Balkan countries. This variance is reflected in the number of registered medicines, a number of parallels and number of different combinations, as well as restrictions placed on family physicians in prescribing insulin, inhaled corticosteroids, statins and angiotensin II receptor blockers (ARBs), without consultant’s recommendation. Conclusions: Western Balkan countries are capable of providing essential medicines for the treatment of NCDs, with full or partial reimbursement. There are some exceptions, related to statins, the new generation of oral antidiabetic agents and some of the antihypertensive combinations. Prescribing-related competencies of family physicians are limited. However, this practice is not compliant with the practices of family medicine, its principles, and primary care structures, and may potentially result in increased healthcare financial ramifications to both the system and patients due to frequent referrals to the specialists.
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Published on Dec 1, 2017in BMC Geriatrics 2.87
Sven Streit6
Estimated H-index: 6
(University of Bern),
Marjolein Verschoor2
Estimated H-index: 2
(University of Bern)
+ 35 AuthorsKathryn Hoffmann11
Estimated H-index: 11
(Medical University of Vienna)
Abstract Background In oldest-old patients (>80), few trials showed efficacy of treating hypertension and they included mostly the healthiest elderly. The resulting lack of knowledge has led to inconsistent guidelines, mainly based on systolic blood pressure (SBP), cardiovascular disease (CVD) but not on frailty despite the high prevalence in oldest-old. This may lead to variation how General Practitioners (GPs) treat hypertension. Our aim was to investigate treatment variation of GPs in oldest-...
6 Citations Source Cite
Published on Nov 1, 2017in The Lancet 53.25
Mahshid Dehghan22
Estimated H-index: 22
(Population Health Research Institute),
Andrew Mente30
Estimated H-index: 30
(McMaster University)
+ 352 AuthorsAnders H. Rosengren84
Estimated H-index: 84
(University of Gothenburg)
Summary Background The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear. Methods The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median fo...
168 Citations Source Cite
Published on Oct 3, 2017in Journal of Medical Economics
Ana Pejcicand4
Estimated H-index: 4
(University of Kragujevac),
Mihajlo Jakovljevic29
Estimated H-index: 29
(University of Kragujevac)
6 Citations Source Cite
Published on Jul 1, 2017in Journal of the American College of Cardiology 16.83
Gregory A. Roth48
Estimated H-index: 48
(University of Washington),
Catherine O. Johnson27
Estimated H-index: 27
(University of Washington)
+ 168 AuthorsKhurshid Alam28
Estimated H-index: 28
(University of Melbourne)
Abstract Background The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. Objectives The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. Methods CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health s...
296 Citations Source Cite
Published on May 4, 2017in Journal of Medical Economics
Mihajlo Jakovljevic29
Estimated H-index: 29
(University of Kragujevac),
Jelena Arsenijevic6
Estimated H-index: 6
(Maastricht University Medical Centre)
+ 3 AuthorsWim Groot35
Estimated H-index: 35
(Maastricht University Medical Centre)
AbstractObjective: Inter-regional comparison of health-reform outcomes in south-eastern Europe (SEE).Methods: Macro-indicators were obtained from the WHO Health for All Database. Inter-regional comparison among post-Semashko, former Yugoslavia, and prior-1989-free-market SEE economies was conducted.Results: United Nations Development Program Human Development Index growth was strongest among prior-free-market SEE, followed by former Yugoslavia and post-Semashko. Policy cuts to hospital beds and ...
11 Citations Source Cite
Published on Mar 17, 2017in Frontiers in Pharmacology 3.83
Sabina Mujkic1
Estimated H-index: 1
Valentina Marinković5
Estimated H-index: 5
(University of Belgrade)
2 Citations Source Cite
Barbara Yawn1
Estimated H-index: 1
Byron Thomashaw1
Estimated H-index: 1
+ 6 AuthorsRobert A. Wise86
Estimated H-index: 86
6 Citations Source Cite
Published on Oct 13, 2016in Frontiers in Pharmacology 3.83
Aleksandra Kovacevic5
Estimated H-index: 5
(Military Medical Academy),
Nemanja Rancic8
Estimated H-index: 8
(Military Medical Academy)
+ 1 AuthorsViktorija Dragojevic-Simic10
Estimated H-index: 10
(Military Medical Academy)
In the low- and middle-income countries some non-communicable diseases (NCDs), such are cardiac diseases, strokes, chronic lung diseases, certain cancers, and diabetes, tend to overtake the morbidity and mortality of poverty diseases (Adams and Butterly, 2015; Jakovljevic and Getzen, 2016). Such diseases, conditionally labeled as diseases of affluence (Nutrition Health Topics, 2016), are growing rapidly in the developing countries, making almost 80% of deaths due to NCDs (New WHO report: deaths ...
2 Citations Source Cite
Vanda Marković-Peković9
Estimated H-index: 9
(Ministry of Health and Social Welfare),
Ranko Škrbić7
Estimated H-index: 7
+ 8 AuthorsIlse Truter10
Estimated H-index: 10
(Nelson Mandela Metropolitan University)
ABSTRACTThe prescribing of medicines is a fundamental component of care for the elderly; however, there is increasing concern with polypharmacy and its impact on morbidity, mortality and costs. As a result, long-term prescription-medicine use and the prevalence of polypharmacy in the elderly in the Republic of Srpska were analyzed. The findings were subsequently used to suggest potential future measures. A retrospective study of all elderly patients during 2005–2010 stratified by age group (thre...
5 Citations Source Cite
Published on Sep 1, 2016in Slovenian Journal of Public Health
Davorina Petek11
Estimated H-index: 11
Mitja Mlakar1
Estimated H-index: 1
Background A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care perfor...
3 Citations Source Cite
Cited By1
Published on Mar 5, 2018in Frontiers in Public Health
Maria Kamusheva4
Estimated H-index: 4
(Sofia Medical University),
Mariya Vassileva + 2 AuthorsGuenka Petrova10
Estimated H-index: 10
(Sofia Medical University)
Background: Policy makers face a lot of challenges in the process of drug reimbursement decision making, especially in the context of entering the market of more and more innovative medicinal products. The aim of the current study is to make an overview of the reimbursement system development and to evaluate the access of innovative medicines, which have entered the EU market in the period 2015-2017, in Bulgaria as a reference example for the middle-income European country. Methods: A literature...
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