Methods for assessing the quality of pharmacotherapy as tools for improving the effectiveness and safety of treatment interventions

Introduction. Improving the efficiency and safety of pharmacotherapy in healthcare are priority tasks for healthcare systems. Irrational pharmacotherapy, polypharmacy, and adverse drug interactions typically lead to undesirable side effects, which not only reduces the efficacy and safety of treatment but also increases its cost. The selection of methods for assessing the quality of drug therapy prescribed to an individual patient, as well as the organization of quality control for pharmacotherapy in medical institutions, remain highly relevant.

Objective. To study the experience of using various methods for assessing the quality and safety of pharmacotherapy in the clinical practice of domestic and foreign healthcare systems.

Materials and methods. A review analysis of the use of methods for assessing the quality and safety of pharmacotherapy in domestic and international clinical practice was conducted based on a selection of publications identified through a keyword search. A list of the most frequently used methods for assessing the quality of pharmacotherapy was determined, including: the GTT method, Beers criteria, the GerontoNet scale, the STOPP/START criteria, and the Medication Appropriateness Index (MAI). Restrictive drug lists adopted in Sweden, France, Germany, and Turkey, which were developed using these methods to prevent the inappropriate use of medications, were also considered. Specialists widely use drug databases, such as Drug-drug interaction databases, to improve the quality of pharmacotherapy and prevent adverse drug interactions.

Conclusions. Currently, comprehensive approaches and methodologies for assessing the quality and safety of pharmacotherapy, suitable for regulatory purposes and widespread implementation, have not yet been fully established in many countries, including the domestic healthcare system. Previously, by Order of the Ministry of Health of Russia No. 494 dated October 22, 2003, "On Improving the Activities of Physicians — Clinical Pharmacologists," the "Form of Expert Assessment of the Quality of Pharmacotherapy" was adopted, which allows for an assessment of the quality of pharmacotherapy with a conclusion based on expert opinion. Modern evidence-based medicine approaches require a quantitative assessment of pharmacotherapy review results to enable an objective conclusion. In this regard, it is relevant to create an expert tool for assessing the quality and safety of pharmacotherapy based on the integrated use of existing assessment methods. This tool should be capable of determining compliance with: clinical guidelines, the clinical efficacy of drug therapy, rationality and safety indicators, including an assessment of the risks of adverse reactions.

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