Browsing by Author "Rutkovska, Ieva"
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Item Factors facilitating and hindering development of a medication use review service in Eastern Europe and Iran - cross-sectional exploratory study(2021-09) Tuula, Anita; Volmer, Daisy; Jõhvik, Liisa; Rutkovska, Ieva; Trečiokienė, Indre; Merks, Piotr; Waszyk-Nowaczyk, Magdalena; Drozd, Mariola; Tatarević, Alena; Radovanlija, Maja; Pacadi, Carmen; Meštrović, Arijana; Viola, Réka; Soós, Gyöngyvér; Rais, Cristina; Táerel, Adriana Elena; Kuzelova, Magdalena; Zare, Marziyeh; Peymani, Payam; Oona, Marje; Scott, Michael; Faculty of PharmacyPolypharmacy is a common issue in patients with chronic diseases. Eastern-European countries and Iran are exploring possibilities for implementing the Medication Use Review (MUR) as a measure for optimizing medication use and ensuring medication safety in polypharmacy patients. The aim of this study was to gain insights into the development of the community pharmacy sector and map facilitators and barriers of MUR in Eastern Europe and Iran. The representatives of the framework countries received a questionnaire on community pharmacy sector indicators, current and future developments of pharmacies, and factors encouraging and hindering MUR. To answer the questionnaire, all representatives performed document analysis, literature review, and qualitative interviews with key stakeholders. The socio-ecological model was used for inductive thematic analysis of the identified factors. Current community pharmacist competencies in framework countries were more related to traditional pharmacy services. Main facilitators of MUR were increase in polypharmacy and pharmaceutical waste, and access to patients’ electronic list of medications by pharmacists. Main barriers included the service being unfamiliar, lack of funding and private consultation areas. Pharmacists in the framework countries are well-placed to provide MUR, however, the service needs more introduction and barriers mostly on organizational and public policy levels must be addressed.Item Knowledge about Disease, Medication Therapy, and Related Medication Adherence Levels among Patients with Hypertension(2019-10-28) Gavrilova, Anna; Bandere, Dace; Rutkovska, Ieva; Šmits, Dins; Mauriņa, Baiba; Poplavska, Elita; Urtāne, Inga; Department of Pharmaceutical Chemistry; Department of Applied Pharmacy; Department of Public Health and Epidemiology; Institute of Public HealthBackground and Objectives: A particular problem in cardiology is poor adherence to pharmacological treatment among patients with hypertension. It is known that approximately half of these patients do not use their medications as prescribed by their doctor. Patients may choose not to follow the doctor's recommendations and regularly do not control their blood pressure, owing to many factors. A convenient method for measuring the level of adherence is the Morisky Medication Adherence Scale, which also provides insight into possible remedies for low adherence. We investigated their therapy, knowledge about the disease and its control, and demographic differences to assess the adherence of patients with hypertension. Materials and Methods: This was a cross-sectional observational study. Data were collected through a survey of 12 pharmacies in Latvia. The study involved 187 participants with hypertension. Results: The prevalence of non-adherence was 46.20% in Latvia. The oldest patients were the most adherent (p = 0.001, β = 0.27). The higher the self-rated extent from 0 to 10, to which the patient takes their antihypertensives exactly as instructed by their physician, the higher the level of adherence (p < 0.0001, β = 0.38), where at "0", the patient does not follow physician instructions at all, and at "10", the patient completely follows the physician's instructions. Non-adherent patients tend to assess their medication-taking behavior more critically than adherent patients. The longer the patient is known to suffer from hypertension, the more adherent he or she is (p = 0.014, β = 0.19). Conclusions: Medication non-adherence among patients with hypertension is high in Latvia. Further investigations are needed to better understand the reasons for this and to establish interventions for improving patient outcomes.Item Medication use review: does it have a future and potential in Latvia? The opinion of pharmacists after the pilot project(2023-03-27) Paidere, Madara; Pavlovska, Jūlija; Rutkovska, Ieva; Ķikute, Dace; Salmane-Kuļikovska, Ieva; Department of Applied PharmacyBackground Given that the Medication Use Review (MUR) can be used as a tool to improve the quality, safety, and appropriate use of medications, it has been implemented in several countries around the world. The MUR pilot project was carried out in Latvia, followed by this study to identify obstacles, favorable factors, and benefits of this service from the perspective of pharmacists, being one of the key stakeholders. Methods Qualitative data were obtained through a semi-structured focus group interview with pharmacists participating in the project. Inductive thematic analysis was performed on transcript to describe potential gains, obstacles, and prerequisites for implementing the MUR service from the pharmacist’s perspective. Results Lack of payment, cooperation with physicians, problems with patient involvement and insufficiency of competence, were identified as the main barriers to implementation of the MUR service as a pharmacist-led service in community pharmacy. However, there were also contributing factors for MUR service, such as the interest of patients and pharmacists involved in the project, the support from the employer, the benefit for physicians, the improvement of patient health literacy and medication adherence. Conclusions Despite the potential obstacles, the findings in Latvia, as well as other countries, show that the MUR service contributes to the benefit of patients, pharmacists and also physicians; therefore, further steps should be taken to eliminate obstacles and gain additional insights to implement the MUR service in Latvia.Item Role of multidimensional factors in the diagnosis and treatment of tonsillopharyngitis in primary care : a qualitative study(2022-12) Rutkovska, Ieva; Linde-Ozola, Zane; Poplavska, Elita; Department of Applied Pharmacy; Institute of Public HealthBackground: Tonsillopharyngitis is one of the most frequently observed upper respiratory tract infections, for which antibiotics are prescribed in ambulatory care. In most cases, tonsillopharyngitis is benign and self-limiting, mostly a viral condition. The aim of this study was to explore the diagnostic and treatment process of tonsillopharyngitis by general practitioners and to understand decisions regarding antibiotic prescribing and the factors that shape these practices. Methods/design: This was a qualitative interview study in primary care practices in Latvia. Semi-structured face-to-face interviews were conducted with general practitioners from November 2016 to January 2017. Thematic analysis was applied to identify factors that influence the prescribing practice in a primary care setting in conjunction with a specific context in which the prescriber practices. Results: Decisions and practice of general practitioner are not static over time or context; they occur within an environmental setting influenced by individual factors of general practitioners, the health care system, and practice-specific factors that shape the diagnosis and antibiotic prescribing in the tonsillopharyngitis. Interviewed general practitioners rely primarily on their personal experience, perception, and skills acquired in their practice, which are encouraged by the environment, where the necessary tools and resources are not in place to encourage rational prescribing of antibiotics. Conclusions: General practitioners’ decision regarding antibiotic prescribing is an unstable concept that differs between prescribers. The health care system could augment the experience of general practitioners through structural changes such as guidelines, availability of antibiotics, and available antibiotics package size.