In recent years, many countries have struggled with the fact that expenditures on health care are growing much faster than the overall level of wealth. Research objectives: 1) to conduct a meta-analysis of heparins by the means of their efficacy, safety parameters and treatment outcomes; 2) to conduct pharmacoepidemiological assessment of long-term heparins utilization in Lithuania; 3) to develop a pharmacoeconomic cost-minimization model for low-molecular-weight heparins based on reference pricing methodology; 4) to investigate heparins prescribing trends and to evaluate heparins prescription adherence to international clinical guidelines at a secondary level clinical hospital. Meta-analysis results showed that low-molecular-weight heparins could be considered interchangeable due to similar therapeutic profiles in some indications. In Lithuania consumption of heparins and corresponding costs were constantly increasing during the period of investigation; therefore it would be relevant to implement modern pharmacoeconomic methodologies to regulate costs. Cost-minimization model suggested that expenditures on this group of medicines could be decreased by nearly 70 percent. Analysis of pharmacoepidemiological study data confirmed that heparins prescription practices at the clinical hospital were insufficiently regulated. In addition this study conducted at the clinical hospital revealed non-compliance of heparins safety monitoring practices with clinical guidelines. / Pastaraisiais metais daugelyje šalių sveikatos priežiūros išlaidos augo daug greičiau nei bendras gerovės lygis, todėl yra nuolat diskutuojama, kaip šį išlaidų augimą reikėtų kontroliuoti. Darbo uždaviniai: 1) atlikti heparinų preparatų meta-analizę, palyginant jų efektyvumo ir saugumo parametrus bei gydymo baigtis; 2) atlikti heparinų preparatų ilgalaikio suvartojimo Lietuvoje farmakoepidemiologinį tyrimą; 3) suformuluoti farmakoekonominį kaštų mažinimo sprendimų modelį mažos molekulinės masės heparinų preparatų grupei, remiantis referentinės kainos metodika; 4) ištirti heparinų preparatų skyrimo tendencijas antrinio lygio klinikinėje ligoninėje ir palyginti heparinų preparatų skyrimo atitikimą tarptautinėms gairėms. Meta-analizės rezultatai parodė, jog mažos molekulinės masės heparinai gali būti tarpusavyje pa¬keičiami dėl analogiškų terapinių savybių tam tikrose indikacijose. Heparinų preparatų suvartojimas ir atitinkamos išlaidos tiriamuoju laikotarpiu Lietuvoje nuolat didėjo, todėl būtų aktualu taikyti šiuolaikines farmakoekonomines išlaidų reguliavimo metodikas. Pritaikius kaštų mažinimo modelį heparinų preparatų grupei, būtų galima sumažinti išlaidas šios grupės preparatams beveik 70 procentų. Farmakoepidemiologinio tyrimo rezultatai atskleidė, jog heparinų preparatų skyrimo praktika klinikinėje ligoninėje buvo nepakankamai reglamentuota. Taip pat heparinų preparatų saugumo parametrų stebėjimo praktika ligoninėje neatitiko tarptautinių rekomendacijų.

Background and Objectives: To perform the analysis of medicines consumption in HKUM from 2001 to 2005; to analyze more comprehensively the usage of Heparins and Antibiotics. Design and Setting: The data about medicines consumption was taken from the hospital pharmacy database in Hospital of Kaunas University of Medicine. Main Outcome Measures: The consumption of medicines was evaluated from the financial stand-point and by the mean of DDD methodology. Also the Meta-analysis of Heparins was performed. In the end, the usage of Antibiotics was evaluated from the financial and DDD stand-points. Results: The total drug expenses in HKUM increased dramatically during the five year period i.e. more than 46%, from 5.261 thousand Lt in 2001 to 9.804 thousand Lt in 2005. The mostly consumed medicines by the means of the number of DDDs per 1000 hospitalization days managed to remain almost the same during the mentioned period. After the performed Meta-analysis of heparins, the price of Dalteparinum natricum was set as the reference one. It was done, because UFH showed significantly lower efficacy in comparison with different LMWHs. The further calculations demonstrated that it could be possible to rationalize the usage of 93-144 thousand Lt yearly, if the reference pricing methodology for heparins were adopted. Besides, total expenses of Antibiotics increased more than 70% during the five-year period, from 1.229 thousand Lt in 2001 to 2.112 thousand Lt in 2005. This is extremely... [to full text]

Objective: To compare statins according to the pharmacokinetic and pharmacodynamic characteristics within the drug class and to perform the comprehensive analysis of statins consumption in Lithuania between 2005 and 2007 years. Methods: MEDLINE database was searched to identify and evaluate all literature relating to pharmacokinetic and pharmacodynamic chareacteristics of statins. The statins sales data on units and wholesale prices in all Lithuanian regions over three years (2005 – 2007) were obtained from SoftDent, JSC database. Drugs were classified according to the Anatomic Therapeutic Chemical system and use was quantified in terms of defined daily doses. The consumption of statins was calculated by DDD methodology and expressed as DDD per 1.000 inhabitants per day. Expenditures were calculated using retail drug costs noted in basic price catalogue for reimbursement medicines, for each year separately. Pharmacoeconomic calculations were done according to cost minimization and reference price methodologies. Results: According to meta-analysis, Nice (2006 years) recommendations and clinical trials data statins are therapeutically equivalent medicines. The total consumption of these drugs increased from 3.9 DDD/1000 inhabitants/day in 2005 and reached the value 8.4 DDD/1000 inhabitants/day in 2007 in Lithuania, so the total consumption of statins increased by 53.6% over three years (2005 – 2007) period. Comparing with statins consumption in other countries, this meaning... [to full text] / Tikslai: Šio darbo tikslas yra palyginti statinus tarpusavyje pagal farmakokinetines ir farmakodinamines savybes bei atlikti statinų suvartojimo Lietuvoje analizę 2005 – 2007 metais. Metodai: Duomenys apie statinų farmakokinetines ir farmakodinamines savybes buvo surinkti iš MEDLINE elektroninių duomenų šaltinių. Duomenys apie statinų pardavimus vienetais ir didmeninėmis kainomis Lietuvoje per 2005 – 2007 metus gauti iš UAB SoftDent duomenų bazės. Vaistai buvo suklasifikuoti pagal anatominę terapinę cheminę (ATC) klasifikaciją. Statinų suvartojimas buvo vertinamas pagal apibrėžtos dienos dozės (DDD – daily defined dose) metodiką, o duomenys įvertinti pagal DDD skaičių, tenkantį 1000 gyventojų per vieną dieną. Išlaidos statinams buvo suskaičiuotos mažmeninėmis kainomis, remiantis kiekvienų metų kompensuojamųjų vaistų bazinių kainų kainynu. Statinų farmakoekonominei analizei atlikti buvo taikytas kainų mažinimo bei referentinės kainos nustatymo principas. Rezultatai: Remiantis metaanalizių, Nice (2006 metų) rekomendacijų ir klinikinių tyrimų duomenimis galima teigti, kad statinai prilygsta vienas kitam klinikiniu poveikiu. Bendras statinų suvartojimas padidėjo nuo 3,9 DDD/tūkstančiui gyventojų/dieną 2005 metais iki 8,4 DDD/tūkstančiui gyventojų/dieną 2007metais, taigi, per trejus metus bendras šių vaistų suvartojimas išaugo 53,6%. Palyginus su kitų šalių duomenimis, statinų suvartojimas 2007 metais Lietuvoje buvo apie 20 kartų mažesnis. Išlaidos statinams per trejus metus ( 2... [toliau žr. visą tekstą]

Objective: To evaluate the consumption of analgesics in Lithuania in the year 2005 – 2007. Material and methods: The data on sales of analgesics drugs in Lithuanian over a 3-year period (2005 – 2007) were obtained from Softdent database. Data were calculated by defined daily dose (DDD) methodology and expressed in DDDs per 1000 inhabitants per day. Results: The total analgesic drugs consumption increased by 16.55% in a 3-year period (2005 – 2007): from 58.37 DDDs/1000 inhabitants/day to 68.03 DDDs/1000 inhabitants/day. Diclofenac (ATC M01A) seemed to be the most highly consumed drug in Lithuania in the three-year period. Diclofenac (M01A) price/DDD is only 0.28 Lt. For these reasons diclofenac was more often used than other painkillers. The second most used agent for pain control was glucosamine (6.38 DDDs/1000 inhabitants/day in 2005), which is used for the treatment of osteoarthritis and, along with new products, its popularity increased sharply. Its consumption grew by 29.80% and achieved 8.28 DDDs/1000 inhabitants/day in 2007. Glucosamine value (Price/DDD) is 1.39 Lt, while paracetamol - 0.59 Lt. Glucosamine is OTC drug so people can buy it easily without control. Maybe for this reasons the usage of glucosamine is enough high. Ibuprofen has regained its popularity after the problems with coxibs. In 2005, the consumption of ibuprofen (4.42 DDDs/1000 inhabitants/day) grew rapidly once again, reached 7.26 DDDs/1000 inhabitants/day in 2007 and showed 64.25% increase... [to full text] / Tikslas. Įvertinti analgetikų vartojimo tendencijas Lietuvoje 2005 – 2007 m. Metodai. Duomenys apie analgetikų pardavimą Lietuvoje 2005 – 2007 metais rinkti iš UAB „Softdent" duomenų bazės. Vaistai buvo klasifikuojami pagal anatominę terapinę cheminę (ATC) klasifikaciją. Vaistų suvartojimas buvo vertinamas pagal apibrėžtos dienos dozės (DDD – angl. defined daily dose) metodiką, o duomenys pateikiami apibrėžta dienos doze tūkstančiui gyventojų. Rezultatai. Lietuvoje per trejus metus (2005 – 2007) analgetikų vartojimas padidėjo 16.55%: nuo 58.37 iki 68.03 DDD/tūkstančiui gyventojų. Daugiausiai buvo suvartojama diklofenako (ATC grupė M01A), tai galėjo būtų dėl tam tikrų priežasčių: diklofenako vieno DDD kaina tik 0.28 lito. Antroje vietoje pagal suvartojimą – gliukozaminas, kuris vartojamas osteoartritui gydyti. Jo suvartojimas išaugo 29.80% ir 2007 m. pasiekė 8.28 DDD/tūkstančiui gyventojų. Gliukozamino vieno DDD vertė 1.39 Lt, kai paracetamolio – 0.59 Lt. Gliukozaminas yra bereceptis vaistas, taigi žmonėms jis legvai prieinamas. Galbūt dėl šių priežasčių gliukozamino suvartojama gana daug. Ibuprofenas susigrąžino savo populiarumą: 2005 metais jo suvartojimas pradėjo vėl sparčiai didėti, 2007 metais pasiekė 7.26 DDD/tūkstančiui gyventojų, ir parodė 64.25% augimą. Nimesulido vartojimas dramatiškai išaugo ir 2007 metais pasiekė 4.91 DDD/tūkstančiui gyventojų. Jo vieno DDD vertė 1.69 Lt, kai paracetamolio ir kitų analgetikų ši vertė nesiekė 1 Lt. Airijoje nimesulidas buvo... [toliau žr. visą tekstą]

<p>Zbog visoke stope morbiditeta i mortaliteta od kardiovaskularnih bolesti, udeo lekova za terapiju kardiovaskularnih bolesti značajno učestvuje u ukupno utro&scaron;enoj količini lekova u svetu. Evidentan je porast potro&scaron;nje lekova za kardiovaskularne bolesti. Radi postizanja &scaron;to je moguće vi&scaron;eg stepena racionalizacije terapije u većini zemalja stručna tela donose farmakoterapijske smernice kako bi se mogućnost pogre&scaron;nog lečenja svela na najmanju moguću meru. Na ovaj način lekaru-praktičaru pružena je sigurnost pravilnog izbora i najadekvatnijeg postupka u datim okolnostima. Ciljevi ovog istraživanja bili su: 1) izračunavanje ukupne vanbolničke potro&scaron;nje lekova za lečenje kardiovaskularnih bolesti na teritoriji Novog Sada i njeno poređenje sa propisivanjem u Republici Srbiji i u zemljama sa razvijenom farmakoterapijskom praksom; 2) analiza strukture propisanih lekova za lečenje kardiovaskularnih bolesti (grupa C prema ATC klasifikaciji) po grupama i njeno poređenje sa propisivanjem u Republici Srbiji i u zemljama sa razvijenom farmakoterapijskom praksom; 3) analiza strukture propisanih lekova po dijagnozama i provera usklađenosti sa farmakoterapijskim smernicama; 4) komparacija propisanih lekova sa morbiditetnom statistikom kardiovaskularnih bolesti; 5) analiza farmakoekonomskih aspekata propisivanja lekova za kardiovaskularne bolesti. Sprovedeno istraživanje spada u IV fazu kliničkih ispitivanja-farmakoepidemiolo&scaron;ko, retrospektivno, opservaciono. Podaci su prikupljeni na osnovu izve&scaron;taja iz elektronske baze podataka za period od 6 meseci (01. 01. 2012 &minus; 01. 07. 2012), na teritoriji grada Novog Sada. Na osnovu ovih podataka na teritoriji grada Novog Sada analizirana je upotreba lekova za kardiovaskularne bolesti na 100% uzorku stanovnika. Ispitivanje se sastojalo iz dva dela. Prvi deo obuhvata prikupljanje, obradu i analizu podataka o ukupno propisanoj količni lekova za kardiovaskularne bolesti na teritoriji grada Novog Sada. U drugom delu istraživanja kori&scaron;ćenjem podataka dobijenih iz državne &bdquo;Apoteke Novi Sad&ldquo; detaljnije je analizirana upotreba lekova za lečenje kardiovaskularnih bolesti izdatih na recept. Upotreba lekova analizirana je: prema uzrastu i polu pacijenata, prema dijagnozama za koje su lekovi propisani i prema ceni. Sruktura upotrebe lekova po indikacijama za dijagnoze kod kojih je ukupna upotreba propisanih lekova bila veća od 1 DDD/1000stanovnika/dan upoređena je sa postojećim nacionalnim vodičima i sa upotrebom u zemljama sa razvijenom farmakoterapijskom praksom, odnosno sa međunarodnim vodičima. Ovi podaci upoređeni su sa morbiditetnom statistikom na teritoriji grada Novog Sada. Ukupno propisana količina lekova za kardiovaskularne bolesti u posmatranom periodu iznosila je 399,79 DDD/1000st/dan. Od te količine, preko polovine (201,11DDD/1000st/dan) propisivanih lekova za kardiovaskularne bolesti su lekovi koji deluju na sistem renin-angiotenzin, slede blokatori kalcijumskih kanala, zatim blokatori beta-adrenergičkih receptora, a na četvrtom mestu po ukupno propisanoj količini su lekovi za terapiju bolesti srca. Od najče&scaron;ćih dijagnoza za koje su propisivani lekovi za kardiovaskularne bolesti, najzastupljenije su bile arterijska hipertenzija, a potom ishemijska bolest srca. Upotreba lekova za kardiovaskularne bolesti u vanbolničkoj sredini na teritoriji grada Novog Sada (399,79 DDD/1000st/dan) vi&scaron;a je u odnosu na zemlje u okruženju (Hrvatsku, Crnu Goru), a niža u odnosu na zemlje sa razvijenom farmakoterapijskom praksom. U odnosu na zemlje sa razvijenom farmakoterapijskom praksom postoje odstupanja u pogledu strukture propisivanja. Struktura propisivanja lekova za kardiovaskularne bolesti odstupa od važećih nacionalnih vodiča o racionalnoj upotrebi lekova za kardiovaskularne bolesti u Republici Srbiji. Istovremeno struktura propisanih lekova nije u skladu sa morbiditetnom statistikom kardiovaskularnih bolesti prema zvaničnim podacima. Među 10 najče&scaron;će propisanih lekova nalaze se i skupi lekovi, koji imaju adekvatne, a mnogo jeftinije paralele. Nedovoljno i neracionalno lečenje kardiovaskularnih bolesti verovatno su jedan od značajnih razloga za visoku smrtnost od kardiovaskularnih bolesti u Srbiji.</p> / <p>Due to high rates of morbidity and mortality from cardiovascular diseases, the share drugs for the treatment of cardiovascular diseases significantly contributes to a total utilization among drugs in the world. There is an evident increase in the consumption of drugs for cardiovascular diseases. In order to achieve as much as possible a higher level of rationalization of therapy in most countries the professional bodies making pharmacotherapeutic guidelines to the possibility of the wrong treatment was reduced to a minimum. In this way, the physician-practitioner provided the security proper selection and the most appropriate procedure in the circumstances. The objectives of this study were: 1) the calculation of the total outpatient consumption of drugs for the treatment of cardiovascular diseases on the territory of Novi Sad and its comparison with the prescribing in the Republic of Serbia and the countries with developed pharmacotherapeutical practice; 2) analysis of the structure of prescribed drugs for the treatment of cardiovascular diseases (group C according to the ATC classification) by the groups and its comparison with the prescribing in the Republic of Serbia and the countries with developed pharmacotherapeutical practice 3) analysis of the structure of prescribed drugs per diagnosis and verification of compliance with pharmacotherapeutic guidelines; 4) comparison of prescribed drugs with morbidity statistics cardiovascular diseases; 5) analysis of pharmacoeconomic aspects of prescribing drugs for cardiovascular diseases. A research conducted among the phase IV clinical trials-pharmacoepidemiological, retrospective observational. Data were collected on the basis of a report from the electronic database for the period of 6 months (01. 01. 2012 - 01. 07. 2012), on the territory of the city of Novi Sad. Based on these data on the territory of the city of Novi Sad analyzed the use of drugs for cardiovascular diseases at 100% sample of the population. The research consisted of two parts. The first part comprises the collection, processing and analysis of data on the total quantity of the prescribed cardiovascular drugs on the territory of the city of Novi Sad. In the second part of this research using data from the public &quot;Pharmacy Novi Sad&quot; is a more detailed analysis of the utilization of drugs for the treatment of cardiovascular diseases of prescription. The utilization of drugs is analyzed: according to the age and sex of patients, in diagnosis for which the drugs prescribed and to the cost. Structure of the use of drugs by indications for diagnosis in which the total utilization of prescribed drugs was greater than 1 DDD/1000inhabitants/day was compared with the existing national guidelines and use in countries with developed pharmacotherapeutical practice, and with international guidelines. These data were compared with morbidity statistics on the territory of the city of Novi Sad. Total amount of prescribed drugs for cardiovascular diseases in the examined period was 399.79 DDD/1000inh/day. Of this amount, more than half (201.11 DDD/1000inh/day) were drugs acting on the renin-angiotensin system, followed by calcium channel blockers, beta adrenergic receptor blockers, and fourth in total prescribed quantity drugs for treatment of heart diseases. Of the most common diagnosis for which drugs for cardiovascular diseases were prescribed, the most common were arterial hypertension, and then ischemic heart disease. The use of drugs for cardiovascular diseases in outpatient environment on the territory of the city of Novi Sad (399.79 DDD/1000inh/day) is higher compared to neighboring countries (Croatia, Montenegro), and lower than in countries with developed pharmacotherapeutical practice. Compared to countries with developed pharmacotherapeutical practice there are variations in terms of the structure of prescribing. Structure of prescribing of drugs for cardiovascular diseases deviates from the existing national guidelines on rational use of drugs for cardiovascular diseases in the Republic of Serbia. At the same time the structure of prescribed drugs is not in compliance with morbidity statistics cardiovascular diseases according to official data. Among the 10 most commonly prescribed drugs are costly drugs, that have adequate, and much cheaper parallels. Insufficient and irrational treatment of cardiovascular diseases are probably one of the major reasons for the high mortality from cardiovascular diseases in Serbia.</p>

<p>Iako je dijabetes melitus (DM) tip 2 je hronično oboljenje čija se stopa značajno povećala poslednjih decenija, podaci o odnosu pacijenta prema leku i lečenju dijabetes melitusa su retki i odnose se na pojedine aspekte terapije. Glavni kamen spoticanja u lečenju dijabetesa jeste nepridržavanje pacijenata propisanim lekovima, &scaron;to otežava održavanje normalne glikoregulacije i doprinosi razvoju te&scaron;kih komplikacija koje značajno utiču na kvalitet života pacijenata sa DM. Raspolaganje tačnim podacima o upotrebi antidijabetičnim lekova, kao i uvidom u realno stanje o odnosu pacijenata prema leku u lečenju DM tipa 2, omogućava pobolj&scaron;anje farmakoterapijske prakse i kreiranje intervencije za pobolj&scaron;anje adherencije pacijenata Ciljevi ovog istraživanja bili su: 1) analiza obima potro&scaron;nje i strukture antidijabetičnih lekova na teritoriji Republike Srpske i njihovo poređenje sa upotrebom i strukturom propisivanja u okolnim zemljama kao i državama sa razvijenom farmakoterapijskom praksom; 2) analiza obima potro&scaron;nje i strukture antidijabetičnih lekova u op&scaron;tini Foča i poređenje sa savremenim farmakoterapijskim smernicama; 3) određivanje procenta pokrivenosti antidijabetičnom terapijom pacijenata sa DM tip 2 tokom jedne godine u op&scaron;tini Foča; 4) određivanje adherencije pacijenata sa DM tipa 2 prema antidijabetičnoj terapiji metodom brojanja tableta/doza insulina i putem validiranog upitnika; 5) određivanje kvaliteta života povezanog sa zdravljem pacijenata sa DM tipa 2 u op&scaron;tini Foča primenom validiranog upitnika SF-36v2; 6) određivanje prediktora neadherenije kod primene obe metode merenja adherencije u odnosu na karakteristike i kvalitet života pacijenata sa DM tip 2 u op&scaron;tini Foča. Ispitivanje se sastojalo iz dva dela. U prvom delu sprovedeno je retrospektivno farmakoepidemiolo&scaron;ko praćenje upotrebe antidijabetičnih lekova kao i određivanje strukture ovih lekova na teritoriji Republike Srpske u periodu od 01.01.2013. do 31.12.2013.godine i izvr&scaron;eno je poređenje sa upotrebom i strukturom propisivanja u okolnim zemljama kao i državama sa razvijenom farmakoterapijskom praksom. U drugom delu ispitivanja sprovedeno je farmakoepidemiolo&scaron;ko ispitivanje primene antidijabetičnih lekova na nivou same op&scaron;tine Foča u okviru koje je pored analize obima potro&scaron;nje i strukture antidijabetičnih lekova u istom periodu kao i na teritoriji Republike Srpske i poređenja sa savremenim farmakoterapijskim smernicama, određivan i procenta pokrivenosti antidijabetičnom terapijom mereno redovno&scaron;ću ponovnih popunjavanja recepata od strane lekara op&scaron;te prakse tokom jednogodi&scaron;njeg perioda. Takođe je sprovedeno i ispitivanje adherencije prema antidijabetičnim lekovima primenom dve različite metode merenja kao i kvalitet života pacijenata sa DM tip 2 između 01.01.2015. i 31.12.2015.godine. Ukupna upotreba antidijabetika za lečenje dijabetesa tip 1 i tip 2 na teritoriji Republike Srpske iznosila je 38,29 DDD/1000st/dan. Upotreba insulina i analoga iznosila je 11,28 DDD/1000st/dan. Ukupna upotreba oralnih lekova koji snižavaju glukozu i krvi, isključujući insuline iznosila je 27,01 DDD/1000st/dan, a metformin je najče&scaron;će kori&scaron;ćeni predstavnik. Sličan obim i struktura upotrebe antidijabetičnih lekova utvrđena je i u op&scaron;tini Foča. Procenat pokrivenosti antidijabetičnom terapijom pacijenata sa DM tip 2 tokom jedne godine u op&scaron;tini Foča iznosio je vi&scaron;e od 94,91%. Adherencija određivana metodom brojanja tableta/doza insulina iznosila je 52,3%, a merena primenom validiranog upitnikom iznosila je svega 44,9%. Statistički značajni prediktori neadherencije određivane primenom metode brojanja tableta/doza insulina su doplata cena leka kao i niži skor dimenzije mentalnog zdravlja kada je u pitanju kvalitet života. Prediktori neadherencije merene primenom validiranog upitnikom bili su mu&scaron;ki pol, kao i niži skor dimenzije mentalnog kao i fizičkog zdravlja kada je u pitanju kvalitet života. Na osnovu ovih saznanja, intervencije za pobolj&scaron;anje adherencije pacijenata bi bile usmerene na edukaciju pacijenata mu&scaron;kog pola, zatim na smanjivanje izdataka pacijenata za lekove, &scaron;to će doprineti i boljem kvalitetu života ovih pacijenata.</p> / <p>Although diabetes mellitus (DM) type 2 is a chronic disease whose rate has increased significantly in recent decades, data on the patient&#39;s attitudes towards the medicine and the treatment of diabetes mellitus are rare and relate to individual aspects of the therapy. The main stumbling block in the treatment of diabetes is not taking prescribed drugs regularly, which makes it difficult to maintain normal glycoregulation and contribute to the development of severe complications that significantly affect the quality of life of patients with DM. The disposition of accurate data on the use of antidiabeticdrugs, as well as the insight into the real state of the patient&#39;s relationship with the medication in the treatment of DM type 2, enables the improvement of pharmacotherapeutic practice and the creation of an intervention to improve patient adherence.<br />The objectives of this research were:<br />1) analysis of the volume of consumption and structure of anti-diabetic medicines on the territory of the Republic of Srpska and their comparison with the use and structure of prescribing in the surrounding countries as well as countries with developed pharmacotherapeutic practice;<br />2) analysis of the volume of consumption and structure of antidiabetic drugs in the municipality of Foča and comparison with modern pharmacotherapeutic guidelines;<br />3) determining the percentage of coverage with antidiabetic therapy of patients with DM type 2 during one year in the municipality of Foča;<br />4) determining the adherence of patients with DM type 2 in antidiabetic therapy by the method of pill counts /volume of insulin and by validated questionnaire;<br />5) determining the quality of life associated with the health of patients with DM type 2 in the municipality of Foča using the validated questionnaire SF-36v2;<br />6) determination of the predictor of nonadherence in the application of both methods of adherence measurement in relation to the characteristics and quality of life of patients with DM type 2 in the municipality of Foča.<br />The investigation consisted of two parts.<br />In the first part, a retrospective pharmacoepidemiological monitoring of the use of antidiabetic drugs was carried out, as well as determining the structure of these drugs in the territory of the Republic of Srpska in the period from January, 1st 2013 until December, 31st 2013, and a comparison was made with the use and prescription structure in neighboring countries as well as countries with developed pharmacotherapeutic practices. In the second part of the study, a pharmacoepidemiological study was carried out on the use of antidiabetic drugs at the level of the municipality of Foča itself, in which, besides analyzing the volume of consumption and structure of anti-diabetic drugs in the same period as in the territory of the Republic of Srpska and comparison with modern pharmacotherapeutic guidelines, the percentage of coverage by antidiabetic therapy was measured by the regularity of the prescription prescribed by the general practitioner over a one-year period. Medication adherence to antidiabetic drugs was also carried out using two different methods of measurement as well as the quality of life of patients with DM type 2 between January, 1st 2015 and December, 31st 2015. The total use of antidiabetic for the treatment of type 1 diabetes and type 2 in the territory of the Republic of Srpska was 38.29 DDD / 1000st / day. The use of insulin and analogs was 11.28 DDD / 1000st / day. The total use of blood glucose lowering drugs , excluding insulins, was 27.01 DDD / 1000st / day, and metformin is the most commonly used representative. A similar volume and structure of the use of anti-diabetic drugs was also determined in the municipality of Foča. The percentage of coverage of antidiabetic therapy of patients with DM type 2 during one year in the municipality of Foca amounted to more than 94.91%. Adherence determined by the pill counts and the volume of insulin method was 52.3%, and measured by applying the validated questionnaire was only 44.9%. Statistically significant predictors of nonadherence determined by the method of pill counts/volume of insulin are copayment, a fix fee for prescription made by patients as well as the lower score of the mental health dimension when it comes to quality of life. The non-adherence predictors measured using the validated questionnaire were the male sex, as well as a lower score of the mental dimension as well as physical health when it comes to quality of life. Based on these findings, interventions to improve patient adherence would focus on health education of male patients, and policy changes regarding availability of antidiabetic medication through copayment reductions , which will contribute to a better quality of life for these patients.</p>