[A procedure for calculating needs for antituberculous drugs].

Abstract

Objective: to develop a procedure for calculating needs for antituberculous drugs (ATD).

Materials and methods: A unified E-form (UEF) was developed as an "Excel" file with the underlying invariable formulas and coefficients for the computer-based calculation of ATD needs in any subject of the Russian Federation. The needs were estimated using the average number of tablets (capsules, vials) of each ATD required per man/course, by taking into account the conventional chemotherapy regimens, the duration of chemoprophylaxis, antirecurrent courses, ATD test therapy, a treatment regimen for complications due to BCG vaccination. Information on the inventory of ATDs at the end of the previous year and their estimated deliveries from various sources was additionally considered. Data to be filled in the UEF were obtained from the reporting documents: 1) TB Form No. 2 "Information on patients registered for treatment" approved by Order No. 50 "On Consummation of Recording and Reporting Documents as to Tuberculosis Monitoring" issued by the Ministry of Health of the Russian Federation on February 13, 2002; 2) Form No. 030-4/y "Tuberculosis Patient Follow-Up Schedule"; and 3) Form No. 33 "Information on Patients with Tuberculosis" approved by Regulation No. 80 issued by the Russian Statistics Agency on November 11, 2005. The filled-in UEFs were obtained from 82 subjects of the Russian Federation.

Results: among all the contingents of antituberculosis dispensaries, who were given ATDs, the absolute majority was the persons receiving chemoprophylaxis. Only 18.3% received chemotherapy for active tuberculosis. Of them, 56.8 and 15.3% were treated in accordance with chemotherapy regimens 1 and 3, respectively. The regimes (2B and 4) using second-line agents were given least frequently (7.1 and 7.1%, respectively). Comparing the data from Form No. 33 and those obtained on filling in UEF showed with a fair degree of assurance that the treatment of patients with a chronic tuberculous process had been incompletely registered. Personified registration of patients with multidrug Mycobacterium tuberculosis resistance should be performed in order to have objective information on the scope of required medical aid and the real calculation of needs for second-line ATDs. For unified calculation of needs for ATDs for chemotherapy, it is necessary to introduce a standardized approach to its performance at different dispensaries. By taking into account that ATDs are purchased and dispensed free of change, one should have a responsible attitude to consuming drugs, determining indications for their usage, and filling the UEF. TB Form No. 2 "Information on patients registered for treatment" and Register No, 03-TB/y "Register of patients with tuberculosis" should be improved, by adding data on the number of patients receiving chemoprophylaxis, antirecurrent courses, test therapy, and treatment of complications due to BCG vaccination.