Search

Uvod: Zdravstvene navike predstavljaju način života, obično se uspostavljaju tokom rane mladosti i mogu se menjati tokom života. Na zdravstvene navike utiču zdravstveno stanje, stavovi pojedinca i zdravstveno ponašanje. Promenom rizičnog ponašanja kroz primarnu prevenciju može se smanjiti rizik od nastanka mnogih bolesti i prerane smrti u kasnijem periodu.Zdravi stilovi života obuhvataju dobro izbalansiranu i zdravu ishranu, svakodnevno vežbanje, odgovarajuću dužinu i kvalitet sna, pravilno upravljanje stresom, odsustvo upotrebe duvanskih proizvoda, alkoholnih pića i pića koja sadrže kofein. Nacionalni program prevencije, lečenja i kontrole kardiovaskularnih bolesti u Republici Srbiji do 2020. godine kao jednu od mera prevencije hipertenzije naveo je pored promena stilova života i ponašanja, bolju informisanost, edukaciju i podizanje nivoa svesti o povećanom riziku za razvoj hipertenzije, što je moguće postići istraživanjima ponašanja u vezi sa zdravstvenim navikama.Neophodno je posvetiti posebnu pažnju promociji zdravlja među populacijom studenata, jer dokazi ukazuju da su ponašanja i životni stilovi mladih problematični, a period studiranja kritičan za zdravstveni život mladih, jer se mnogi studenti suočavaju sa brojnim izazovima, naročito vezanim za promene u društvenoj i životnoj sredini. Prevalenca arterijske hipertenzije u populaciji odraslih u Republici Srbiji iznosi 33,2%, a poznato je da se arterijska hipertenzija može javiti i kod mladih osoba. Faktori rizika koji dovode do nastanka arterijske hipertenzije mogu biti ireverzibilni faktori rizika, kao što su: telesna građa, pol, uzrast, pozitivna porodična anamneza, genetska predispozicija. Potencijalno reverzibilni faktori rizika su gojaznost, upotreba duvanskih proizvoda, konzumacija alkohola, prekomeran unos soli, neadekvatne nutritivne navike, nedovoljna fizička aktivnost, materijalni status, nizak nivo informisanosti i obrazovanja.Ciljevi istraživanja su bili da se :(i) Ispita prevalenca određenih zdrav, Introduction: Health habits are a way of life. They are usually established during early youth and can change throughout life. Health habits are influenced by health condition, health behavior and attitudes of an individual. By changing risky behavior through primary prevention, numerous diseases and premature death occurrence can be reduced in the later period.A healthy lifestyle includes a well-balanced and healthy diet, daily exercise, adequate length and quality of sleep, proper stress management, and not consuming tobacco, alcohol and caffeinated beverages. The National Programme for Prevention, Treatment and Control of Cardiovascular Diseases in the Republic of Serbia until 2020, as one of the measures for the prevention of hypertension, stated, in addition to changes in lifestyle and behavior, better information, education and raising awareness of the increased risk of hypertension, which could be achieved by behavioral research related to health habits.It is necessary to pay special attention to the promotion of health among student population, because the evidence indicates that their behavior and youth lifestyles are problematic, while the period of studying is critical for youngsters’ health because many students face numerous challenges especially those related to social and environmental changes. The prevalence of arterial hypertension in the adult population in the Republic of Serbia is 33.2%, and it is known that arterial hypertension can also occur in young people. The risk factors leading to arterial hypertension can be irreversible, such as body structure, gender, age, positive family anamnesis and genetic predisposition. Potentially reversible risk factors are obesity, tobacco use, alcohol consumption, excessive salt intake, inadequate nutritional habits, insufficient physical activity, material status, low level of information and education.Aim: The objectives of the research were:(i) To examine the prevalence of certain health habits in the stud

Uvod: Zdravstvene navike predstavljaju način života, obično se uspostavljaju tokom rane mladosti i mogu se menjati tokom života. Na zdravstvene navike utiču zdravstveno stanje, stavovi pojedinca i zdravstveno ponašanje. Promenom rizičnog ponašanja kroz primarnu prevenciju može se smanjiti rizik od nastanka mnogih bolesti i prerane smrti u kasnijem periodu. Zdravi stilovi života obuhvataju dobro izbalansiranu i zdravu ishranu, svakodnevno vežbanje, odgovarajuću dužinu i kvalitet sna, pravilno upravljanje stresom, odsustvo upotrebe duvanskih proizvoda, alkoholnih pića i pića koja sadrže kofein. Nacionalni program prevencije, lečenja i kontrole kardiovaskularnih bolesti u Republici Srbiji do 2020. godine kao jednu od mera prevencije hipertenzije naveo je pored promena stilova života i ponašanja, bolju informisanost, edukaciju i podizanje nivoa svesti o povećanom riziku za razvoj hipertenzije, što je moguće postići istraživanjima ponašanja u vezi sa zdravstvenim navikama. Neophodno je posvetiti posebnu pažnju promociji zdravlja među populacijom studenata, jer dokazi ukazuju da su ponašanja i životni stilovi mladih problematični, a period studiranja kritičan za zdravstveni život mladih, jer se mnogi studenti suočavaju sa brojnim izazovima, naročito vezanim za promene u društvenoj i životnoj sredini. Prevalenca arterijske hipertenzije u populaciji odraslih u Republici Srbiji iznosi 33,2%, a poznato je da se arterijska hipertenzija može javiti i kod mladih osoba. Faktori rizika koji dovode do nastanka arterijske hipertenzije mogu biti ireverzibilni faktori rizika, kao što su: telesna građa, pol, uzrast, pozitivna porodična anamneza, genetska predispozicija. Potencijalno reverzibilni faktori rizika su gojaznost, upotreba duvanskih proizvoda, konzumacija alkohola, prekomeran unos soli, neadekvatne nutritivne navike, nedovoljna fizička aktivnost, materijalni status, nizak nivo informisanosti i obrazovanja. Ciljevi istraživanja su bili da se : (i) Ispita prevalenca određenih z, Introduction: Health habits are a way of life. They are usually established during early youth and can change throughout life. Health habits are influenced by health condition, health behavior and attitudes of an individual. By changing risky behavior through primary prevention, numerous diseases and premature death occurrence can be reduced in the later period. A healthy lifestyle includes a well-balanced and healthy diet, daily exercise, adequate length and quality of sleep, proper stress management, and not consuming tobacco, alcohol and caffeinated beverages. The National Programme for Prevention, Treatment and Control of Cardiovascular Diseases in the Republic of Serbia until 2020, as one of the measures for the prevention of hypertension, stated, in addition to changes in lifestyle and behavior, better information, education and raising awareness of the increased risk of hypertension, which could be achieved by behavioral research related to health habits. It is necessary to pay special attention to the promotion of health among student population, because the evidence indicates that their behavior and youth lifestyles are problematic, while the period of studying is critical for youngsters’ health because many students face numerous challenges especially those related to social and environmental changes. The prevalence of arterial hypertension in the adult population in the Republic of Serbia is 33.2%, and it is known that arterial hypertension can also occur in young people. The risk factors leading to arterial hypertension can be irreversible, such as body structure, gender, age, positive family anamnesis and genetic predisposition. Potentially reversible risk factors are obesity, tobacco use, alcohol consumption, excessive salt intake, inadequate nutritional habits, insufficient physical activity, material status, low level of information and education. Aim: The objectives of the research were: (i) To examine the prevalence of certain health habits in the

Iskustva iz apotekarske prakse pokazuju da postoji veliki broj grešaka prilikom upotrebe lekova za decu predškolskog uzrasta, pre svega zbog neadekvatnog doziranja i nedovoljnog razumevanja informacija o načinu upotrebe lekova od strane roditelja. Najveći broj grešaka nastaje usled nepravilne upotrebe analgetika i antipiretika kao najčešće korišćenih lekova koji se izdaju bez recepta, a rezultat je niskog nivoa pismenosti u vezi sa upotrebom lekova – farmakoterapijske pismenosti. Farmakoterapijska pismenost, prema Kingu i sar. predstavlja „sposobnost pojedinaca da pronađe, proceni, izračuna i razume pouzdane informacije u vezi sa farmakoterapijom i uslugama koje se odnose na lekove a potrebne su da bi se donele odgovarajuće odluke u vezi sa lekovima, bez obzira na način prenosa i sadržaj informacije (pisana, izgovorena informacija, slika ili simbol).“ Predmet ovog istraživanja je konstrukcija upitnika za procenu farmakoterapijske pismenosti roditelja dece u predškolskom uzrastu u vezi sa razumevanjem informacija o upotrebi najčešće korišćenih lekova (analgetika i antipiretika), i ispitivanje psihometrijskih karakteristika tog konstruisanog upitnika, kao i određivanje nivoa farmakoterapijske pismenosti roditelja u vezi sa informacijama o upotrebi lekova u terapiji kod dece predškolskog uzrasta primenom upitnika za ispitivanje razumevanja informacija o upotrebi lekova kod roditelja dece u predškolskom uzrastu (Parental pharmacotherapy literacy Questionnaire in Serbian, PTHL-SR). Predmet naučnog istraživanja je i procena nivoa funkcionalne zdravstvene pismenosti roditelja dece u predškolskom uzrastu i ispitivanje uticaja nivoa funkcionalne zdravstvene pismenosti na razumevanje informacija o upotrebi lekova koji se izdaju bez recepta za decu predškolskog uzrasta. Dalje, istraživani su i stavovi, praksa i očekivanja roditelja predškolske deceo razumevanju informacija o načinu upotrebe analgetika i antipiretika koji se izdaju bez lekarskog recepta kod dece u predškolskom, Experiences from pharmacy practice shows that there are as many errors during use of medicines among pre-school children, mainly because of inappropriate dosage and parental misunderstanding of information about medicines use. The largest number of mistakes is due to inappropriate use of analgesics and antipyretics as the most commonly used non-prescription medicines, as a result of low level of literacy related to the use of medicines – pharmacotherapy literacy. According to King et al, pharmacoptherapy literacy is the „personal capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g. written, oral, visual images and symbols)“. The aim of this study was to construct questionnaire for assessment of pharmacotherapy literacy of parents of pre-school children related to understanding of information about use of most commonly used medicines (analgetics and antipyretics), and evaluation of its psychometric characteristics of that questionnaire, as well as to assess pharmacotherapy literacy of parents of pre-school children related to understanding of information about most commonly used medicines (analgesics and antipyretics) with constructed and validated questionnaire for assessment of understanding of information about medicines use among parents of pre-school children (Parental pharmacotherapy literacy Questionnaire in Serbian, PTHL-SR). The study also included assessment of functional health literacy among parents of pre-school children and understanding information about medicines use, and evaluation of impact of functional health literacy on understanding information of over- the-counter medicines for pre-school children. The objective of the study was also to examine attitudes, practice and expectations of parents of pre-school children related to understanding of information about analge

Iskustva iz apotekarske prakse pokazuju da postoji veliki broj grešaka prilikom upotrebe lekova za decu predškolskog uzrasta, pre svega zbog neadekvatnog doziranja i nedovoljnog razumevanja informacija o načinu upotrebe lekova od strane roditelja. Najveći broj grešaka nastaje usled nepravilne upotrebe analgetika i antipiretika kao najčešće korišćenih lekova koji se izdaju bez recepta, a rezultat je niskog nivoa pismenosti u vezi sa upotrebom lekova – farmakoterapijske pismenosti. Farmakoterapijska pismenost, prema Kingu i sar. predstavlja „sposobnost pojedinaca da pronađe, proceni, izračuna i razume pouzdane informacije u vezi sa farmakoterapijom i uslugama koje se odnose na lekove a potrebne su da bi se donele odgovarajuće odluke u vezi sa lekovima, bez obzira na način prenosa i sadržaj informacije (pisana, izgovorena informacija, slika ili simbol).“ Predmet ovog istraživanja je konstrukcija upitnika za procenu farmakoterapijske pismenosti roditelja dece u predškolskom uzrastu u vezi sa razumevanjem informacija o upotrebi najčešće korišćenih lekova (analgetika i antipiretika), i ispitivanje psihometrijskih karakteristika tog konstruisanog upitnika, kao i određivanje nivoa farmakoterapijske pismenosti roditelja u vezi sa informacijama o upotrebi lekova u terapiji kod dece predškolskog uzrasta primenom upitnika za ispitivanje razumevanja informacija o upotrebi lekova kod roditelja dece u predškolskom uzrastu (Parental pharmacotherapy literacy Questionnaire in Serbian, PTHL-SR). Predmet naučnog istraživanja je i procena nivoa funkcionalne zdravstvene pismenosti roditelja dece u predškolskom uzrastu i ispitivanje uticaja nivoa funkcionalne zdravstvene pismenosti na razumevanje informacija o upotrebi lekova koji se izdaju bez recepta za decu predškolskog uzrasta. Dalje, istraživani su i stavovi, praksa i očekivanja roditelja predškolske deceo razumevanju informacija o načinu upotrebe analgetika i antipiretika koji se izdaju bez lekarskog recepta kod dece u predškolskom, Experiences from pharmacy practice shows that there are as many errors during use of medicines among pre-school children, mainly because of inappropriate dosage and parental misunderstanding of information about medicines use. The largest number of mistakes is due to inappropriate use of analgesics and antipyretics as the most commonly used non-prescription medicines, as a result of low level of literacy related to the use of medicines – pharmacotherapy literacy. According to King et al, pharmacoptherapy literacy is the „personal capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g. written, oral, visual images and symbols)“. The aim of this study was to construct questionnaire for assessment of pharmacotherapy literacy of parents of pre-school children related to understanding of information about use of most commonly used medicines (analgetics and antipyretics), and evaluation of its psychometric characteristics of that questionnaire, as well as to assess pharmacotherapy literacy of parents of pre-school children related to understanding of information about most commonly used medicines (analgesics and antipyretics) with constructed and validated questionnaire for assessment of understanding of information about medicines use among parents of pre-school children (Parental pharmacotherapy literacy Questionnaire in Serbian, PTHL-SR). The study also included assessment of functional health literacy among parents of pre-school children and understanding information about medicines use, and evaluation of impact of functional health literacy on understanding information of over- the-counter medicines for pre-school children. The objective of the study was also to examine attitudes, practice and expectations of parents of pre-school children related to understanding of information about analge

Izdavanje lekova, jedna od osnovnih aktivnosti u farmaceutskoj praksi, predstavljaproces koji je rizičan i sklon nastanku grešaka, zbog čega potencijalno moţe ugrozitibezbednost pacijenata. Sa porastom nivoa svesti o značaju ovog problema, došlo je i dopovećanja broja studija u ovoj oblasti tokom protekle decenije, koje su primarnofokusirane na ispitivanje incidence, tipova i uzroka propusta u izdavanju lekova. Ipak,sa razvojem modernog pristupa medicinskim greškama, u sve većoj meri se naglašavaznačaj proaktivnog upravljanja rizicima, pre nanošenja štete pacijentu. Primena alata zaprospektivnu analizu rizika već je počela u velikom broju procesa zdravstvene zaštite,uključujući izdavanje lekova. Ipak, ove studije se uglavnom sprovode u bolnicama, dokih na primarnom nivou gotovo uopšte nema, posebno u javnim apotekama, gde senajvećem broju pacijenata vrši izdavanje lekova.Ova doktorska disertacija imala je za cilj sprovoĎenje prospektivnih sistemskih analizarizika u procesima izdavanja lekova u javnim apotekama u Republici Srbiji i SRNemačkoj, radi identifikacije potencijalnih grešaka, kvantifikacije i rangiranja prioritetapridruţenih rizika, kao i definisanja korektivnih mera za smanjenje rizika za bezbednostpacijenata. Cilj je takoĎe bilo sprovoĎenje komparativne analize dobijenih rezultata uRepublici Srbiji, kao zemlji u razvoju, i SR Nemačkoj, kao razvijenoj zemlji.Analize načina (oblika) i efekata otkaza (FMEA) su sprovedene u periodu od januara domaja 2016. godine u Republici Srbiji i u oktobru 2016. godine u SR Nemačkoj. Najpresu multidisciplinarni timovi, koji su se sastojali od moderatora i eksperata u izdavanjulekova, primenom tehnike „oluja ideja‖ kreirali dijagram toka analiziranog procesa, iidentifikovali potencijalne greške, zajedno sa njihovim uzrocima i posledicama. Zatimje izvršena kvantifikacija pridruţenih rizika, izračunavanjem broja prioriteta rizika(RPN) za svaku potencijalnu grešku, na osnovu njene ozbiljnosti, učestalosti idetektabilnosti. Naj, Dispensing of medicines, one of the central activities in pharmaceutical practice, isconsidered to be inherently risky and susceptible to errors, thereby posing a constantpotential threat to patient safety. Raising awareness of this issue has resulted in anincreasing number of studies over the last decade, focusing primarily on the incidence,types and causes of dispensing incidents. However, the modern approach to medicationerrors emphasizes the importance of proactive risk mitigation, i.e. acting before thepatient harm has occurred. The application of prospective risk analyses tools to varioushealth care processes, including dispensing of medicines, has already started. However,these studies are mostly conducted in the hospital setting, while they are almost nonexistentat the primary level of health care, particularly in community pharmacies,where the greatest number of patients are habitually issued medicines.This doctoral dissertation aimed to conduct prospective systemic risk analyses of themedicines dispensing processes in the community pharmacy settings in Serbia andGermany, so as to identify, quantify and prioritize potential failure modes, as well as todefine adequate measures for patient safety risk reduction. Furthermore, the aim was toperform a comparative risk analysis of the findings obtained in Serbia, as developingcountry, and Germany, as developed country.Failure Mode and Effects Analyses (FMEA) were conducted from January to May 2016in Serbian and in October 2016 in German community pharmacies. First,multidisciplinary teams consisting of a leader and process experts employedbrainstorming techniques to map medicines dispensing processes and identify failuremodes, along with their causes and effects. Then, the associated risks were quantified bycalculating Risk Priority Numbers (RPNs) for each failure mode based on its severity,occurrence and detectability. Finally, corrective actions were developed and theirpotential effects were evaluated for the fa

Nutritivne deficijencije prepoznate su kao jedan od glavnih preventabilnih faktora rizika za nastanak kongenitalnih anomalija i drugih neželjenih ishoda trudnoće. Naučni napredak u oblasti etiopatogeneze kongenitalnih anomalija doveo je do zaključka da je optimalno izbalansirana ishrana majki uz adekvatan unos makro i mikronutrijenata izuzetno važna za obezbeđivanje normalnog embrionalnog razvoja. Zaštitni efekat perikoncepcijske primene suplemenata folne kiseline u redukciji rizika od nastanka i rekurence defekata nervne cevi naučno je potvrđen mnogim obzervacionim i interventnim studijama. Folati učestvuju kao koenzimi u transferu monougljeničnih grupa u reakcijama metabolizma aminokiselina i sintezi i reparaciji nukleinskih kiselina, pa je uloga ovog hidrosolubilnog B9 vitamina posebno značajna za uspešno odvijanje intenzivne ćelijske deobe i proliferacije tokom embriogeneze. Ipak, uprkos postignutom naučnom konsenzusu o koristima folne kiseline u obezbeđivanju zdravog potomstva i činjenici da su mnoga regulatorna tela u oblasti zdravlja izdala preporuke o primeni folne kiseline u periodu planiranja začeća i ranim fazama trudnoće, studije ukazuju da je među ženama reproduktivne dobi unos ovog esencijalnog nutrijenta i dalje suboptimalan. Na varijabilnost situacije u različitim zemljama utiče niz faktora kao što su: stepen obaveštenosti žena o merama prevencije defekata nervne cevi, postojanje, primena i obuhvat strategija za unapređenje unosa i statusa folata u ciljnoj populacionoj grupi, dostupnost i priuštivost suplemenata folne kiseline i konačno, izloženost stanovništva namirnicama koje su fortifikovane ovim vitaminom.Procena nutritivnog statusa danas je prepoznata kao važan deo zdravstvene nege na individualnom i populacionom nivou. Prvi korak u suočavanju sa izazovom ostvarivanja adekvatnog unosa folata kao esencijalnih nutrijenata je pouzdana i objektivna procena nutritivnog statusa zasnovana na primeni standardizovanih, validiranih instrumenata, koji su p, Nutritive deficiencies are well-recognized preventable risk factors for the development of congenital anomalies and other adverse pregnancy outcomes. Scientific progress in the comprehension of congenital anomalies has led to the conclusion that optimally balanced maternal diet with adequate intake of macro- and micronutrients can contribute to reducing the incidence of these disorders. Protective effect of the periconceptional folic acid supplementation in reducing the risk for both occurrence and recurrence of neural tube defects (NTDs) is scientifically confirmed through many observational and interventional studies. Folate derivatives are involved as coenzymes in the single-carbon units’ transfer in metabolism of amino acids and synthesis and reparation of nucleic acids. Accordingly, the role of this water-soluble B9 vitamin is of special importance for intense cell maturation, division and proliferation during embryogenesis. However, regardless the unequivocal epidemiological evidence, achieved scientific consensus on the folic acid benefits in ensuring healthy offspring, and the fact that many health authorities officially recommended the use of folic acid prior to conception and during early phases of pregnancy, numerous studies revealed suboptimal intake of this essential nutrient among women of reproductive age. The variability of the situation in different countries is affected by a number of factors such as: the awareness of women of prevention measures for NTDs; the existence, application and coverage of strategies for improving folate intake and status in the targeted population group; the availability and affordability of folic acid supplements; and finally, the population exposure to folic acid- fortified foods.Nutritional status assessment is nowadays recognized as an important part of medical care at individual and population level. In facing the challenge of achieving folate adequacy, the first step is reliable and objective nutritional assessment

Farmaceuti danas rade u uslovima intenzivnog tehnološkog, informatičkog ibiomedicinskog napretka koji njihovom profesionalnom radu donose nove etičkeizazove. Etička pitanja su neizbežno povezana sa farmaceutskom praksom i mnogiproblemi koji se javljaju prilikom pružanja farmaceutskih usluga mogu da sadrže etičkukomponentu. Farmaceuti rešavaju etička pitanja u situacijama kada se od njih zahtevada donesu odluku koja će imati direktno ili indirektno uticaja na prava i/ili dobrobitdrugih ljudi (pacijenta, kolega, i sl.). Pružanje farmaceutske zdravstvene zaštite seobavlja u intersekciji etičkih, profesionalnih i zakonskih propisa. Takođe, mnogesituacije iz svakodnevne farmaceutske prakse, koje uključuju etičko pitanje, poredprofesionalnog rasuđivanja i procene uključuju i razmatranja o vrednostima, pravima iodgovornostima.Iako su empirijska istraživanja o etičkoj orijentaciji kod farmaceuta veoma maloprisutna u literarnom korpusu, većina studija pokazala je da se u osnovi etosafarmaceutske profesije nalaze dva najstarija etička principa, ne naškoditi i dobročinstvo,kao i briga o zaštiti prava pacijenata. Iz prethodnih studija je poznato da su etičkapitanja s kojima se suočavaju farmaceuti povezana sa kršenjem zakona, alokacijomresursa, komunikacijom sa pacijentima i timskim radom sa ostalim zdravstvenimradnicima. U ovim istraživanjima pokazano je da su farmaceuti demonstrirali svesnostkada se radi o etičkim pitanjima iz svakodnevnog rada, ali za razliku od drugihzdravstvenih radnika, koristili su pristup zdravog razuma i posvećenost zakonskim iprofesionalnim obavezama, u većoj meri nego normativne principe ili Etički kodeks.Broj validiranih instrumenata za izvođenje empirijske analize u profesionalnojfarmaceutskoj etici je limitiran. S obzirom da raste broj etičkih pitanja sa kojima sesusreću farmaceuti, javlja potreba za njihovim istraživanjem u uslovima javnih apoteka..., Intensive technological, informational and biomedical progress bring novel ethicalchallenges to work surroundings of today`s pharmacists. Ethical issues are inevitablyconnected to the practice of pharmacy, and they comprise all the problems that arisewhen providing pharmacy services which might have an ethical component.Pharmacists deal with and resolve ethical issues in situations when they are required tomake decisions which would have a direct or indirect impact on the rights and/or wellbeingof other people (patients, colleagues, etc.). Therefore, the delivery of pharmacists’services must be performed at the meeting point of ethical, professional and legalregulations. In addition, many situations in the pharmaceutical practice compriseconsiderations of values, rights and responsibilities as well.In contrast to other areas of healthcare, relatively little is known about the application ofthese principles to ethical issues related to a pharmacy practice, and which pharmacistsmust deal with in their everyday work. Although the empirical findings of the ethicalorientation among pharmacists are scanty and most studies indicate that the core ethosunderlying the pharmacy profession comprises: best interest of patients (patient welfare)and patient rights. Based on some previous studies, it has been known that ethical issuesfaced by pharmacists are related to violations of rules and regulations, resourceallocation, patient communication, and teamwork with other health professionals. Thosestudies have shown that pharmacists demonstrate awareness when it comes to ethicalissues in their everyday work. However, in contrast to other health workers, they haveused the approach of the common sense and the commitment to legal and professionalobligations to a greater extent than the normative principles or the Code of Ethics. Thenumber of validated instruments for performing an empirical analysis in professionalpharmaceutical ethics has been limited. Given the growing number of eth

Nutritivne deficijencije prepoznate su kao jedan od glavnih preventabilnih faktora rizika za nastanak kongenitalnih anomalija i drugih neželjenih ishoda trudnoće. Naučni napredak u oblasti etiopatogeneze kongenitalnih anomalija doveo je do zaključka da je optimalno izbalansirana ishrana majki uz adekvatan unos makro i mikronutrijenata izuzetno važna za obezbeđivanje normalnog embrionalnog razvoja. Zaštitni efekat perikoncepcijske primene suplemenata folne kiseline u redukciji rizika od nastanka i rekurence defekata nervne cevi naučno je potvrđen mnogim obzervacionim i interventnim studijama. Folati učestvuju kao koenzimi u transferu monougljeničnih grupa u reakcijama metabolizma aminokiselina i sintezi i reparaciji nukleinskih kiselina, pa je uloga ovog hidrosolubilnog B9 vitamina posebno značajna za uspešno odvijanje intenzivne ćelijske deobe i proliferacije tokom embriogeneze. Ipak, uprkos postignutom naučnom konsenzusu o koristima folne kiseline u obezbeđivanju zdravog potomstva i činjenici da su mnoga regulatorna tela u oblasti zdravlja izdala preporuke o primeni folne kiseline u periodu planiranja začeća i ranim fazama trudnoće, studije ukazuju da je među ženama reproduktivne dobi unos ovog esencijalnog nutrijenta i dalje suboptimalan. Na varijabilnost situacije u različitim zemljama utiče niz faktora kao što su: stepen obaveštenosti žena o merama prevencije defekata nervne cevi, postojanje, primena i obuhvat strategija za unapređenje unosa i statusa folata u ciljnoj populacionoj grupi, dostupnost i priuštivost suplemenata folne kiseline i konačno, izloženost stanovništva namirnicama koje su fortifikovane ovim vitaminom. Procena nutritivnog statusa danas je prepoznata kao važan deo zdravstvene nege na individualnom i populacionom nivou. Prvi korak u suočavanju sa izazovom ostvarivanja adekvatnog unosa folata kao esencijalnih nutrijenata je pouzdana i objektivna procena nutritivnog statusa zasnovana na primeni standardizovanih, validiranih instrumenata, koji su, Nutritive deficiencies are well-recognized preventable risk factors for the development of congenital anomalies and other adverse pregnancy outcomes. Scientific progress in the comprehension of congenital anomalies has led to the conclusion that optimally balanced maternal diet with adequate intake of macro- and micronutrients can contribute to reducing the incidence of these disorders. Protective effect of the periconceptional folic acid supplementation in reducing the risk for both occurrence and recurrence of neural tube defects (NTDs) is scientifically confirmed through many observational and interventional studies. Folate derivatives are involved as coenzymes in the single-carbon units’ transfer in metabolism of amino acids and synthesis and reparation of nucleic acids. Accordingly, the role of this water-soluble B9 vitamin is of special importance for intense cell maturation, division and proliferation during embryogenesis. However, regardless the unequivocal epidemiological evidence, achieved scientific consensus on the folic acid benefits in ensuring healthy offspring, and the fact that many health authorities officially recommended the use of folic acid prior to conception and during early phases of pregnancy, numerous studies revealed suboptimal intake of this essential nutrient among women of reproductive age. The variability of the situation in different countries is affected by a number of factors such as: the awareness of women of prevention measures for NTDs; the existence, application and coverage of strategies for improving folate intake and status in the targeted population group; the availability and affordability of folic acid supplements; and finally, the population exposure to folic acid- fortified foods. Nutritional status assessment is nowadays recognized as an important part of medical care at individual and population level. In facing the challenge of achieving folate adequacy, the first step is reliable and objective nutritional assessment

Farmaceuti danas rade u uslovima intenzivnog tehnološkog, informatičkog i biomedicinskog napretka koji njihovom profesionalnom radu donose nove etičke izazove. Etička pitanja su neizbežno povezana sa farmaceutskom praksom i mnogi problemi koji se javljaju prilikom pružanja farmaceutskih usluga mogu da sadrže etičku komponentu. Farmaceuti rešavaju etička pitanja u situacijama kada se od njih zahteva da donesu odluku koja će imati direktno ili indirektno uticaja na prava i/ili dobrobit drugih ljudi (pacijenta, kolega, i sl.). Pružanje farmaceutske zdravstvene zaštite se obavlja u intersekciji etičkih, profesionalnih i zakonskih propisa. Takođe, mnoge situacije iz svakodnevne farmaceutske prakse, koje uključuju etičko pitanje, pored profesionalnog rasuđivanja i procene uključuju i razmatranja o vrednostima, pravima i odgovornostima. Iako su empirijska istraživanja o etičkoj orijentaciji kod farmaceuta veoma malo prisutna u literarnom korpusu, većina studija pokazala je da se u osnovi etosa farmaceutske profesije nalaze dva najstarija etička principa, ne naškoditi i dobročinstvo, kao i briga o zaštiti prava pacijenata. Iz prethodnih studija je poznato da su etička pitanja s kojima se suočavaju farmaceuti povezana sa kršenjem zakona, alokacijom resursa, komunikacijom sa pacijentima i timskim radom sa ostalim zdravstvenim radnicima. U ovim istraživanjima pokazano je da su farmaceuti demonstrirali svesnost kada se radi o etičkim pitanjima iz svakodnevnog rada, ali za razliku od drugih zdravstvenih radnika, koristili su pristup zdravog razuma i posvećenost zakonskim i profesionalnim obavezama, u većoj meri nego normativne principe ili Etički kodeks. Broj validiranih instrumenata za izvođenje empirijske analize u profesionalnoj farmaceutskoj etici je limitiran. S obzirom da raste broj etičkih pitanja sa kojima se susreću farmaceuti, javlja potreba za njihovim istraživanjem u uslovima javnih apoteka..., Intensive technological, informational and biomedical progress bring novel ethical challenges to work surroundings of today`s pharmacists. Ethical issues are inevitably connected to the practice of pharmacy, and they comprise all the problems that arise when providing pharmacy services which might have an ethical component. Pharmacists deal with and resolve ethical issues in situations when they are required to make decisions which would have a direct or indirect impact on the rights and/or wellbeing of other people (patients, colleagues, etc.). Therefore, the delivery of pharmacists’ services must be performed at the meeting point of ethical, professional and legal regulations. In addition, many situations in the pharmaceutical practice comprise considerations of values, rights and responsibilities as well. In contrast to other areas of healthcare, relatively little is known about the application of these principles to ethical issues related to a pharmacy practice, and which pharmacists must deal with in their everyday work. Although the empirical findings of the ethical orientation among pharmacists are scanty and most studies indicate that the core ethos underlying the pharmacy profession comprises: best interest of patients (patient welfare) and patient rights. Based on some previous studies, it has been known that ethical issues faced by pharmacists are related to violations of rules and regulations, resource allocation, patient communication, and teamwork with other health professionals. Those studies have shown that pharmacists demonstrate awareness when it comes to ethical issues in their everyday work. However, in contrast to other health workers, they have used the approach of the common sense and the commitment to legal and professional obligations to a greater extent than the normative principles or the Code of Ethics. The number of validated instruments for performing an empirical analysis in professional pharmaceutical ethics has been limited. Given th

Izdavanje lekova, jedna od osnovnih aktivnosti u farmaceutskoj praksi, predstavlja proces koji je rizičan i sklon nastanku grešaka, zbog čega potencijalno moţe ugroziti bezbednost pacijenata. Sa porastom nivoa svesti o značaju ovog problema, došlo je i do povećanja broja studija u ovoj oblasti tokom protekle decenije, koje su primarno fokusirane na ispitivanje incidence, tipova i uzroka propusta u izdavanju lekova. Ipak, sa razvojem modernog pristupa medicinskim greškama, u sve većoj meri se naglašava značaj proaktivnog upravljanja rizicima, pre nanošenja štete pacijentu. Primena alata za prospektivnu analizu rizika već je počela u velikom broju procesa zdravstvene zaštite, uključujući izdavanje lekova. Ipak, ove studije se uglavnom sprovode u bolnicama, dok ih na primarnom nivou gotovo uopšte nema, posebno u javnim apotekama, gde se najvećem broju pacijenata vrši izdavanje lekova. Ova doktorska disertacija imala je za cilj sprovoĎenje prospektivnih sistemskih analiza rizika u procesima izdavanja lekova u javnim apotekama u Republici Srbiji i SR Nemačkoj, radi identifikacije potencijalnih grešaka, kvantifikacije i rangiranja prioriteta pridruţenih rizika, kao i definisanja korektivnih mera za smanjenje rizika za bezbednost pacijenata. Cilj je takoĎe bilo sprovoĎenje komparativne analize dobijenih rezultata u Republici Srbiji, kao zemlji u razvoju, i SR Nemačkoj, kao razvijenoj zemlji. Analize načina (oblika) i efekata otkaza (FMEA) su sprovedene u periodu od januara do maja 2016. godine u Republici Srbiji i u oktobru 2016. godine u SR Nemačkoj. Najpre su multidisciplinarni timovi, koji su se sastojali od moderatora i eksperata u izdavanju lekova, primenom tehnike „oluja ideja‖ kreirali dijagram toka analiziranog procesa, i identifikovali potencijalne greške, zajedno sa njihovim uzrocima i posledicama. Zatim je izvršena kvantifikacija pridruţenih rizika, izračunavanjem broja prioriteta rizika (RPN) za svaku potencijalnu grešku, na osnovu njene ozbiljnosti, učestalost, Dispensing of medicines, one of the central activities in pharmaceutical practice, is considered to be inherently risky and susceptible to errors, thereby posing a constant potential threat to patient safety. Raising awareness of this issue has resulted in an increasing number of studies over the last decade, focusing primarily on the incidence, types and causes of dispensing incidents. However, the modern approach to medication errors emphasizes the importance of proactive risk mitigation, i.e. acting before the patient harm has occurred. The application of prospective risk analyses tools to various health care processes, including dispensing of medicines, has already started. However, these studies are mostly conducted in the hospital setting, while they are almost nonexistent at the primary level of health care, particularly in community pharmacies, where the greatest number of patients are habitually issued medicines. This doctoral dissertation aimed to conduct prospective systemic risk analyses of the medicines dispensing processes in the community pharmacy settings in Serbia and Germany, so as to identify, quantify and prioritize potential failure modes, as well as to define adequate measures for patient safety risk reduction. Furthermore, the aim was to perform a comparative risk analysis of the findings obtained in Serbia, as developing country, and Germany, as developed country. Failure Mode and Effects Analyses (FMEA) were conducted from January to May 2016 in Serbian and in October 2016 in German community pharmacies. First, multidisciplinary teams consisting of a leader and process experts employed brainstorming techniques to map medicines dispensing processes and identify failure modes, along with their causes and effects. Then, the associated risks were quantified by calculating Risk Priority Numbers (RPNs) for each failure mode based on its severity, occurrence and detectability. Finally, corrective actions were developed and their potential effects w

Vakcinacija se smatra jednom od najkorisnijih preventivnih intervencija, zbog sposobnosti da kroz ciljane aktivacije ljudskog imunog sistema indukuje zaštitu protiv infektivnih bolesti. Svake godine imunizacijom se spasavaju životi oko tri miliona dece. Ipak i dalje 2,5 miliona ljudi širom sveta svake godine umire od bolesti koje mogu biti sprečene upotrebom vakcina. Razlozi za ovakav mortalitet su najčešće: finansijski aspekt, nedostatak neophodne zdravstvene infrastrukture i / ili nedostatak objekata upravljanja u hladnom lancu snabdevanja. Farmaceutska / biotehnološka industrija ima jedinstveno važnu ulogu u razvoju novih prijemčivih vakcina za sprečavanje i lečenje bolesti, i poboljšavanja života pacijenata. Rukovođeni ovim principom osnovno usmeravanje proizvođača vakcina odnosi se na unapređenje proizvodnje, distribucije i troškovno efektivne primene. Proizvodnja treba da odgovori zahtevima legislative i standardima menadžmenta kvalitetom koji su zahtevi savremenog tržišta. U istraživanju su analzirani zahtevi legislative – Dobre proizvođačke prakse (eng. Good manufacture practice, GMP) i Dobre distributivne prakse (eng. Good distribution practice, GDP) i tržišta koje nameće sisteme upravljanja prema standardima- ISO 9001, ISO 14001, OHSAS 18001, ISO 27001 i ISO 17025, a koji se odnose na famaceutsku kompaniju. Korišćenjem sistemskog pristupa, razvijen je model integrisanog menadžment sistema (IMS) koji odgovara potrebama i tendencijama savremenog farmaceutskog poslovanja na svim tržištima i koji je prilagodljiv budućim zahtevima, i stoga omogućava šire korišćenje od strane proizvođača i distributera vakcina različitog nivoa sistema kvaliteta. Model je baziran na Deming-ovom ciklusu povratne veze, tzv. PDCA ciklusu. Razvijeni model „Sunce“ je prvi model koji integriše pet standarda sistema menadžmenta kvalitetom i zahteve dobrih praksi u proizvodnji i distribuciji vakcina. Takođe, ovo je jedini IMS model namenjen za korišćenje u farmaceutskoj kompaniji. Povere, Vaccination is considered the one of the most useful prevention interventions due to its ability that through targeted activation of the human immune , induce protection against infectious diseases. Every year the immunization saves lives of about three million children. Nevertheless, 2,5 million people worldwide die each year from diseases that can be prevented by the use of vaccines. The most common reasons for this mortality are: the financial aspect, the lack of the necessary health infrastructure and / or lack of facilities management in the supply cold chain. Pharmaceutical / biotechnology industry has a unique role in the development of new receptive vaccines for the prevention and treatment of diseases, and improvment of the lives of patients. Guided by this principle, basic gudelines for vaccine manufacturers relate to the improvement of production, distribution and cost - effective implementation. Production should meet the requirements of legislation and standards of quality management which are the demands of the modern market. The study analyzed legislation requirements - Good Manufacturing Practice (GMP) and Good Distribution Practices (GDP) and market imposed management systems standards: ISO 9001, ISO 14001, OHSAS 18001 ISO 27001 and ISO 17025, which relate to the pharmaceutical company. By using a systematic approach a model of integrated management system (IMS) is developed that meets the needs and tendencies of the modern pharmaceutical business in all markets and that is adaptable to future requirements, and thus allows wider use by producers and distributors of vaccines with different levels of quality systems. The model is based on Deming feedback loop, the so called PDCA cycle. The „Sun” model, is the first model that integrates five quality management system and the requirements of good practices in the production and distribution of vaccines. Also, this is the only IMS model intended for use in the pharmaceutical company. Confidence in the s

Uvod i ciljevi. Stopa abortusa u Srbiji je duplo veća od stope fertiliteta i među najvišim je u Evropi. Glavni faktor koji tome doprinosi je mala upotreba moderne kontracepcije. Ciljevi disertacije su bili da se istraže stavovi i praksa ginekologa u vezi sa metodama planiranja porodice, kao i da se ispita uticaj socio-demografskih karakteristika i stavova na primenu ovih metoda. Takođe, da se istraže znanje, stavovi i praksa farmaceuta u vezi sa hitnom kontracepcijom i da se ispita veza između socio-demografskih karakteristika, znanja i stavova sa praksom. Metode istraživanja. Sprovedene su dve studije preseka sa ginekolozima i farmaceutima javnih apoteka. Podaci su analizirani chi-kvadrat testom, univarijantnom i multiplom logističkom regresijom. Rezultati i diskusija. Polovina ispitanih ginekologa je izjavila da ima moralne/etičke zamerke na metode kontracepcije, kao i da ih ne bi ponudili pacijentkinji. Ginekolozi sa zamerkama na kontracepciju imali su manje šanse da imaju zamerke na abortus (OR: 0,422). Ovakav stav je najizraženiji u Južnoj i Istočnoj Srbiji. Značajno veći broj farmaceuta nego ginekologa (12% vs. 2%, p<0,001) ne bi izdao hitnu kontracepciju ni pod kakvim uslovima. Takođe, veliki broj farmaceuta je izjavio da bi odbili izdavanje ovih proizvoda generalno (15%), kao i u specifičnim situacijama: za buduću upotrebu (72%), kada je prošlo >72 sata od odnosa (78%), kada nije došla krajnja korisnica (70%), kao i zbog godina korisnice (75%). Polovina ispitanika imala je nedovoljno znanje o hitnoj kontracepciji i upravo ta grupa je imala veće šanse da odbije njeno izdavanje generalno (OR: 1,862) i u određenim situacijama (nije krajnja korisnica (OR: 1,412) ili >72 sata od odnosa (OR: 1,445)). Farmaceuti sa više godina radnog iskustva imali veće šanse da odbiju izdavanje korisnici mlađoj od 16 godina (OR: 1,023). Zaključak. Naše istraživanje proizvelo je značajne rezultate koji se mogu primeniti za buduća istraživanja i unapređenje zdravstvene politike i pr, Introduction and aims. Abortion rate in Serbia is duble fertility rate and amog the highest in Europe. A major factor contributing to this is the low prevalence of use of modern contraception. The aims of dissertation were to investigate attitudes and practice of gynaecologists related to family planning methods, and to examine the influence of sociodemogrphic characteristics and attitudes on use of these methods. Also, to investigate knowledge, attitudes and practice of pharmacists regarding emergency contraception and to examine the influence of socio-demogrphic characteristics, knowledge and attitudes on their practice. Methods. Two cross-sectional studies, with ginaecologists and community pharmacists, were conducted. Data were analysed by chi-square test, univariate and multiple logistic regression. Results and discussion. Half of the surveyed gynaecologists had moral/ethical objections to certain contraceptive methods, and would not offer them to patients. Those who objected to contraceptives were less likely to object to abortions (OR: 0,422). This attitude was more prevalent in Southern and Eastern Serbia. Significantly more pharmacists than gynaecologists (12% vs. 2%, p<0.001) would not provide emergency contraception to anybody under any circumstance. Also, pharmacists in large number denied these products provision overall (15%) and in particular circumstances; when it was for future use (72%), >72 h after intercourse (78%), for non-intended user (70%) and because of patient age (75%). Half of the surveyed pharmacists had poor knowledge of emergency contraception and that group was more likely to decline the provision overall (OR: 1.862) and in particular circumstances (non-intended user (OR: 1.412) or >72 h after intercourse (OR: 1.445)). Pharmacists with more work experience were more likely to deny emergency contraception requests to user younger than 16 (OR: 1.023).Conclusion. Our study produced important results that can be used to inform future rese

Zdravstvene profesije kao što je farmaceutska, zbog moralnih načela kojima se rukovode i zbog odgovornosti za ljudsko zdravlje i život, posebno su posvećene kvalitetu i visokim standardima u svom radu. Obezebeđivanje kvaliteta usluge i visoki standardi profesionalnog odnosa prema pacijentu, zajednički su interes stručanjaka, pacijenata, kao i regulatornih stručnih tela. Za obezbeđenje kvaliteta zdravstvene zaštite i postizanje odgovarajućih standarda, jedan od neophodnih faktora je korpus znanja, veština i stavova koji će omogućiti donošenje odgovarajućih odluka u interesu pacijenata. U uslovima stalnih promena, koje su bile najintenzivnije u drugoj polovini dvadesetog veka, vezanih za nove zdravstvene potrebe, pojavu novih zdravstvenih tehnologija, zahteve opšte i stručne javnosti, razvoja i primene informacionih tehnologija, stručnjaci iz oblasti zdravstva i obrazovanja tragali su za modelima koji će omogućiti ispunjavanje potreba svih relevantnih činilaca. Tradicionalni sistem obrazovanja farmaceuta nije dao očekivane rezulatate. Neprilagođeni obrazovni sadržaji, neodgovarajuća praksa i loši rezultati, izazivali su nezadovoljstvo i brigu stručne i šire javnosti, što je rezultovalo zaokretom u vidu reforme, kada je nastao sistem obrazovanja zasnovan na kompetencijama. Pored toga, krajem dvadesetog veka oblikovan je i novi koncept farmaceutske prakse, u kojoj farmaceut odgovorno pruža sigurnu i racionalnu terapiju pacijentu, u čijem se fokusu nalazi pacijent, odnosno, njegove potrebe: farmaceutska zdravstvena zaštita (farmaceutska nega). Prema Hepleru i Strandu, reč je o profesionalnoj delatnosti u kojoj farmaceut preuzima odgovornost za pozitivan ishod terapije. Stoga je od izuzetne važnosti da farmaceuti poseduju znanja, veštine i sposobnosti za pružanje odgovarajućih usluga, kao i stavove za njihovo usvajanje u svakodnevnom radu. Dinamički okvir koji obuhvata ove činioce, nazivamo okvir kompetencija farmaceuta. U poslednjoj deceniji XX veka, kompetencije farmace, Health professions, such as pharmaceutics, are especially dedicated to quality and high standards in their work due to moral principles that serve as a guide, and responsibility towards human health and life. Providing quality service and high standards in professional relations towards the patients are a common interest of experts and patients, as well as regulatory bodies. In order to provide quality healthcare and achieve adequate standards, one of the necessary factors is knowledge, skills and attitude corpus, which would lead to making adequate decisions in patients' best interest. In the conditions of constant changes, which were most intensive in the second half of the twentieth century, regarding recent healthcare needs, appearance of new healthcare technologies, general and expert public demands, development and implementation of information technologies, the experts from the fields of healthcare and education have been searching for models which will provide fulfilment of needs of all relevant factors. Traditional pharmaceutical education system did not yield expected results. Maladjusted education content, unsuitable practice and poor results have caused dissatisfaction and concern among expert and general public, which resulted in change through reform, leading to an education system based on competency. Aside from this, a new concept in pharmaceutical practice was formed in the late twentieth century, in which a pharmacist responsibly provides safe and rational therapy for the patient. The focus of the therapy is the patient, i.e. his/her needs: pharmaceutical healthcare (pharmaceutical care). According to Hepler and Strand, the point in question is professional service in which a pharmacist takes responsibility for the positive outcome of the therapy. For this reason, it is exceptionally important that pharmacists possess knowledge, skills and abilities to provide adequate services, as well as willingness to implement them into everyday practice. Dynam

Uvod i ciljevi. Upotreba lekova u trudnoći čest je razlog brige lekara koji ihpropisuju i trudnica koje ih koriste. Iako bi bilo veoma korisno poznavati rizičnepopulacije trudnica koje imaju veću verovatnoću upotrebe lekova u toku trudnoće,mali je broj studija koje su se bavile istraživanjima u ovoj oblasti. Uloga i doprinosfarmaceuta u procesu izdavanja ili prodaje lekova trudnicama mogu biti ključni zabezbednu primenu lekova u trudnoći. Cilj disertacije bio je da se istraži upotrebalekova u periodu od šest meseci pre i tokom trudnoće, da se izvrši evaluacijaupotrebljenih lekova prema anatomsko-terapijsko-hemijskoj (ATC) klasifikaciji,prema riziku za plod i režimu izdavanja (na recept i bez recepta (samomedikacija)),zatim, da se ispita da li postoji povezanost između faktora životnogstila, socio-ekonomskih faktora i zdravstvenog stanja ispitanica i upotrebe lekovapre i tokom trudnoće, kao i da se ispita na koji način pomenuti faktori utiču naupotrebu navedenih klasa lekova. Cilj je bio i da se ispita potencijalni doprinosfarmaceuta kod upotrebe lekova u trudnoći.Metode istraživanja. Radi postizanja postavljenih ciljeva sprovedene su dvestudije. Prva studija bila je multi-centrična i sprovedena je u šest domova zdravlja ipet apoteka na teritoriji opština Vračar, Voždovac, Lazarevac, Loznica, Čačak iSubotica, u periodu mart 2009 – mart 2010. Prikupljanje podataka sprovedeno jeupitnikom specijalno dizajniranim za potrebe studije. Trudnice su upitnikpopunjavale samostalno, bez pomoći zdravstvenih radnika, anonimno, dobrovoljnoi volonterski. Prikupljeni su podaci o socio-ekonomskim karakteristikama,životnom stilu i zdravstvenom statusu ispitanica, kao i o upotrebi lekova u perioduod šest meseci pre i tokom trudnoće. Radi klasifikovanja lekova prema riziku zaplod korišćena je klasifikacija američke Agencije za hranu i lekove (Food and DrugAdministration - FDA). Upotreba lekova izražavana je kao proporcija žena izloženaleku ili ATC grupi ili podgrupi lekova. Razlike u upo, Background and Aims. Drug use in pregnancy is often a reason of concernfor mothers and their physicians. However, only few studies investigatedpredictors of drug use in pregnancy. The role and contribution of pharmacists inthe process of drug dispensing could be very important for improvement of safedrug use in pregnancy. The aim of dissertation was to investigate prescription andover the counter drug use among Serbian women in the 6 months beforepregnancy and in the first 6 months of pregnancy, and to evaluate the drugs usedaccording to anatomical-therapeutic-chemical classification, according to the riskfor the fetus and according to dispensing status (proscription (Rx) or over-thecounter(OTC)). The aim was also to examine if a significant association betweensocio-economic factors, life style and health status of women and drug use exist, aswell as to investigate how much these factors impact drug use before and duringpregnancy. Finally, the aim was to investigate a potential contribution ofpharmacist in safe drug use in pregnancy.Methodology. Two studies were carried out in order to gain all the aims. Thefirst study was multi-center and performed in the six maternity care units and fivecommunity pharmacies (municipalities: Vračar, Voždovac, Lazarevac, Loznica,Čačak i Subotica) during the period from March 2009–March 2010. A selfreportingquestionnaire was used as a data source. Participation in the study wasvoluntarily and anonymous. Data according to socio-economic characteristics, lifestyle, health status and drug use six months before and during pregnancy werecollected. Food and Drug Administration (FDA) risk classification system was usedto determine the risk of used drugs for the fetus. Proportion of women exposed todrugs or class of drugs. Differences between subgroups were assessed usingMcNemar’s test on paired proportions. Logistic regression was used to identifyfactors associated with medication use. Adjusted odds ratios (aOR) and 95 %confidence intervals

Uvod i ciljevi. Upotreba lekova u trudnoći čest je razlog brige lekara koji ih propisuju i trudnica koje ih koriste. Iako bi bilo veoma korisno poznavati rizične populacije trudnica koje imaju veću verovatnoću upotrebe lekova u toku trudnoće, mali je broj studija koje su se bavile istraživanjima u ovoj oblasti. Uloga i doprinos farmaceuta u procesu izdavanja ili prodaje lekova trudnicama mogu biti ključni za bezbednu primenu lekova u trudnoći. Cilj disertacije bio je da se istraži upotreba lekova u periodu od šest meseci pre i tokom trudnoće, da se izvrši evaluacija upotrebljenih lekova prema anatomsko-terapijsko-hemijskoj (ATC) klasifikaciji, prema riziku za plod i režimu izdavanja (na recept i bez recepta (samomedikacija)), zatim, da se ispita da li postoji povezanost između faktora životnog stila, socio-ekonomskih faktora i zdravstvenog stanja ispitanica i upotrebe lekova pre i tokom trudnoće, kao i da se ispita na koji način pomenuti faktori utiču na upotrebu navedenih klasa lekova. Cilj je bio i da se ispita potencijalni doprinos farmaceuta kod upotrebe lekova u trudnoći. Metode istraživanja. Radi postizanja postavljenih ciljeva sprovedene su dve studije. Prva studija bila je multi-centrična i sprovedena je u šest domova zdravlja i pet apoteka na teritoriji opština Vračar, Voždovac, Lazarevac, Loznica, Čačak i Subotica, u periodu mart 2009 – mart 2010. Prikupljanje podataka sprovedeno je upitnikom specijalno dizajniranim za potrebe studije. Trudnice su upitnik popunjavale samostalno, bez pomoći zdravstvenih radnika, anonimno, dobrovoljno i volonterski. Prikupljeni su podaci o socio-ekonomskim karakteristikama, životnom stilu i zdravstvenom statusu ispitanica, kao i o upotrebi lekova u periodu od šest meseci pre i tokom trudnoće. Radi klasifikovanja lekova prema riziku za plod korišćena je klasifikacija američke Agencije za hranu i lekove (Food and Drug Administration - FDA). Upotreba lekova izražavana je kao proporcija žena izložena leku ili ATC grupi ili podgr, Background and Aims. Drug use in pregnancy is often a reason of concern for mothers and their physicians. However, only few studies investigated predictors of drug use in pregnancy. The role and contribution of pharmacists in the process of drug dispensing could be very important for improvement of safe drug use in pregnancy. The aim of dissertation was to investigate prescription and over the counter drug use among Serbian women in the 6 months before pregnancy and in the first 6 months of pregnancy, and to evaluate the drugs used according to anatomical-therapeutic-chemical classification, according to the risk for the fetus and according to dispensing status (proscription (Rx) or over-thecounter (OTC)). The aim was also to examine if a significant association between socio-economic factors, life style and health status of women and drug use exist, as well as to investigate how much these factors impact drug use before and during pregnancy. Finally, the aim was to investigate a potential contribution of pharmacist in safe drug use in pregnancy. Methodology. Two studies were carried out in order to gain all the aims. The first study was multi-center and performed in the six maternity care units and five community pharmacies (municipalities: Vračar, Voždovac, Lazarevac, Loznica, Čačak i Subotica) during the period from March 2009–March 2010. A selfreporting questionnaire was used as a data source. Participation in the study was voluntarily and anonymous. Data according to socio-economic characteristics, life style, health status and drug use six months before and during pregnancy were collected. Food and Drug Administration (FDA) risk classification system was used to determine the risk of used drugs for the fetus. Proportion of women exposed to drugs or class of drugs. Differences between subgroups were assessed using McNemar’s test on paired proportions. Logistic regression was used to identify factors associated with medication use. Adjusted odds ratios (aOR) and