The effectiveness of the use of schemes for the treatment of bronchial asthma and COPD on the example of the CNCE "Vinnytsia city clinical hospital № 1”

Abstract

Bronchial asthma (BA) and chronic obstructive pulmonary disease(COPD) remain among the most common and socially significant diseases of therespiratory system, which significantly affect the quality of life of patients and theeconomic burden on the healthcare system. Optimization of treatment regimens for these conditions, taking into account the individual characteristics of patients, is a key factor in increasing the effectiveness of therapy. Analysis of the effectivenessof modern diagnostic and treatment methods implemented in multidisciplinarymedical institutions allows us to assess their practical significance. Research ontherapeutic approaches contributes to the improvement of existing protocols and provides opportunities for improving the long-term results of treatment of thesecommon pathologies. The aim of the study was to conduct a comparative analysisof the effectiveness and cost-effectiveness of different treatment regimens forbronchial asthma and chronic obstructive pulmonary disease in patientsof thepulmonology department of the CNCE “Vinnytsia City Clinical Hospital No1”. Thedisease histories and dates of the next exacerbation of the disease of these patientswere analyzed using a medical information system. The treatment regimens Symbicort Turbuhaler (formoterol + budesonide) and Seretide Diskus (salmeterol + fluticasone) were selected for the study.The effectiveness assessment included an analysis of technical efficiency according to the Farrell index and cost-effectivenessfor each regimen, taking into account dosage, resource consumption and theinfluence of concomitant factors such as age, sex, and year of observation. Theanalysis showed that only 4 out of 172 patients demonstrated optimal basic therapyregimens, and the optimal dosage was found in only 1 patient. Patients with asthma showed a higher level of prescription effectiveness compared to patients withCOPD. Analysis by treatment regimens revealed a significant advantage of the firstregimen over the second in both technical efficiency and cost-effectiveness. At thesame time, the allocative efficiency of all regimens was optimal, without disparitiesbetween the main and accompanying therapy. Comparative analysis showed that thecost-effectiveness of the first regimen deteriorated over time, and for the secondregimen, the length of hospital stay was a significant influencing factor. Overall, existing treatment regimens require revision to improve the adaptation of therapy to the needs of patients. Further research should be aimed at improving dosing and developing individualized approaches.