Due to frequent clinical trial failures and consequently fewer new drug approvals, the need for improvement in drug development has, to a certain extent, been met using model-based drug development. Pharmacometrics is a part of pharmacology that quantifies drug behaviour, treatment response and disease progression based on different models (pharmacokinetic - PK, pharmacodynamic - PD, PK/PD models, etc.) and simulations. Regulatory bodies (European Medicines Agency, Food and Drug Administration) encourage the use of modelling and simulations to facilitate decision-making throughout all drug development phases. Moreover, the identification of factors that contribute to variability provides a basis for dose individualisation in routine clinical practice. This review summarises current knowledge regarding the application of pharmacometrics in drug development and clinical practice with emphasis on the population modelling approach.
Thyroid dysfunction is one of the most prevalent endocrine disorders, especially common in female patients. If patients are not diagnosed in time or adequately treated, the patients' quality of life can be significantly impaired and additional health problems may occur, considering the key roles of thyroid hormones in the body. Therefore, it is necessary to raise awareness about the importance of recognition of symptoms that may indicate a potential problem with the thyroid gland and help to identify possible causes. For patients who are already being treated with levothyroxine (hypothyroidism), or thiamazole, carbimazole or propylthiouracil (hyperthyroidism), it is necessary to point out the necessity of proper, regular use of the drugs and implementation of accompanying nonpharmacological measures, as well as the potential for the occurrence of adverse reactions and interactions with other drugs or food. A significant role in the mentioned activities should be played by the pharmacist, as the most accessible member of the health team, who can, if necessary, refer the patient to a doctor for diagnosis, monitor the effectiveness and safety of the therapy, and provide appropriate patient counseling.
Background: COPD is a chronic condition requiring care from a multidisciplinary team in which pharmacists play an important role. Aim: We aimed to evaluate the impact of structured pharmacist-patient counseling on patient’s knowledge, attitudes about medicines and the impact of COPD on patients’ health status. Methods: A prospective study was conducted in ten community pharmacies. Patients were counseled using detailed approach after completing validated questionnaires. The patients returned to a pharmacy for a follow-up after three months. Four validated questionnaires have been used to assess different aspects of patient’s knowledge about the disease, their attitudes about medicines and the impact of disease on patients’ health status: COPD Assessment Test (CAT), Modified Medical Research Council Dyspnea Scale (mMRC), Bristol COPD Knowledge Questionnaire (BCKQ), and The Beliefs about Medicines Questionnaire (BMQ). Results: Pharmacists recruited 83 COPD patients, from which 73 patients attended a follow-up visit. Before pharmacist intervention, the CAT median score was 20. After counseling, the CAT score decreased to 18 (p<0.05). The highest improvement in patient’s knowledge was observed for inhaled bronchodilators (28.2%), vaccination (25.8%), oral steroids (24.4%), and smoking (24.2%). The median score for necessity increased, whereas the harm and concern median scores considerably decreased (p<0.05). Conclusion: The results showed significant improvements in all aspects covered throughout pharmacist-patient counseling. Based on our results, proactive role of the pharmacist in the care of COPD patients may be beneficial to patients, to physicians and to healthcare: improving care, alleviating the strain on overloaded doctors with containing the costs.
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