Українська Abstract
Disorders involving impaired gastrointestinal peristalsis are widely prevalent both globally and in Ukraine. Propulsives drugs, which enhance the motor activity of the gastrointestinal tract and prevent antiperistaltic contractions of the intestinal smooth muscle, are used in the treatment of such conditions. This study aimed to assess the outpatient consumption of medicinal products classified under group A03F propulsives in Ukraine between 2020 and 2022, in comparison with published data on the use of the same drug group in Norway, Estonia, Lithuania, and Latvia. Consumption volumes were determined using the ATC/DDD methodology and expressed in DDDs per 1,000 inhabitants per day (DIDs). The results were compared with corresponding published statistical data from Norway and the Baltic countries. The findings indicated that the consumption of medicines in group A03F ranged from 0.98 to 1.21 DIDs over the study period, with a decrease observed in 2022. Ukraine differed only slightly from Norway and the Baltic states in terms of the consumption levels of these medicines. The leading position in the consumption of A03F group medicines varied by year: in 2020 – Norway; in 2021 – both Ukraine and Norway; and in 2022 – Lithuania. The lowest consumption volumes were recorded in Estonia. During the study period, domperidone was the most commonly used propulsives in Ukraine, while metoclopramide was most widely used in Norway and the Baltic countries. A comparative assessment of approaches to the use of propulsives in these countries was conducted. The findings may be used to determine the level of access in Ukraine to essential medicines for patients with gastrointestinal motility disorders and to support decision-making by healthcare authorities regarding regulatory measures
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[1] Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome foundation global study. Gastroenterol. 2021;160(1):99–114. DOI: 10.1053/j.gastro.2020.04.014
[2] Vernon-Roberts A, Safe M, Day AS. Editorial: Pediatric functional gastrointestinal disorders: Challenges in diagnosis and treatment. Gastrointest Disord. 2024;6(1):308–12. DOI: 10.3390/gidisord6010021
[3] Fikree A, Byrne P. Management of functional gastrointestinal disorders. Clin Med. 2021;21(1):44–52. DOI: 10.7861/ clinmed.2020-0980
[4] Karulina YV. Impaired motor function of the upper digestive tract in children with autonomic dysfunction. Child’s Health. 2020;15(1):12–8.
[5] Chernyavskyi VV, Pavlovskyi LL. Correction of motility as a cornerstone of the treatment of functional disorders of the gastroduodenal zone. Health of Ukraine. 2020;15(484):49–51.
[6] Camilleri M, Atieh J. New developments in prokinetic therapy for gastric motility disorders. Front Pharmacol. 2021;12:711500. DOI: 10.3389/fphar.2021.711500
[7] Bor S, Kalkan İH, Savarino E, Rao S, Tack J, Pasricha J, et al. Prokinetics-safety and efficacy: The European Society of Neurogastroenterology and Motility/The American Neurogastroenterology and Motility Society expert review. Neurogastroenterol Motil. 2024;36(5):e14774. DOI: 10.1111/nmo.14774
[8] Nikiforova YV. The place and role of domperidone in the practice of a gastroenterologist. Overview of options at the present stage. Mod Gastroenterol. 2020;6(116):55–63. DOI: 10.30978/MG-2020-6-34
[9] Gerasymova ОO, Iakovlieva LV, Krykun VV. Peristalsis stimulants: Analysis of consumption in different countries of the world. Management Econ Qual Ass Pharm. 2020;1(61):67–73. DOI: 10.24959/uekj.20.2
[10] Pană M, Crăciun P, Lupuliasa D, Hîrjău M, Tăerel A-E. The alimentary and metabolism market in Romania 1998-2018. Analysis and evolution. Farmacia. 2021;4(69):813–20. DOI: 10.31925/farmacia.2021.4.25
[11] Bernaz EP. Evaluation of consumption in defined daily doses of drugs used in hospitals. Curierul Med. 2015;4(58):13–20.
[12] Hollingworth S, Kairuz T. Measuring medicine use: Applying ATC/DDD methodology to real-world data. Pharmacy. 2021;9(1):60. DOI: 10.3390/pharmacy9010060
[13] WHO collaborating centre for drug statistics methodology, guidelines for ATC classification and DDD assignment 2024. 27th ed. Oslo: Norwegian Institute of Public Health; 2023. 253 P.
[14] ATC Index with DDDs. [Internet]. [cited 2024 December 30]. Available from: https://surl.li/gwvcdt
[15] The State Statistics Service of Ukraine. Annual data. Population [Internet]. [cited 2025 January 3]. Available from: https://www.ukrstat.gov.ua/
[16] Danise LS (Ed). Drug consumption in Norway 2018-2022. Oslo: Folkehelseinstituttet; 2023. 113 P.
[17] Sepp J, Sammul M, Uusküla M, editors. Statistical yearbook of the State Agency of Medicines. Tartu: State Agency of Medicines; 2023. 107 P.
[18] Ataskaita apie 2022 metais suvartotus vaistus. [Internet]. [cited 2024 December 28]. Available from: https://vvkt.lrv. lt/en/important-information/medicines-consumption-2022/
[19] Medicines consumption by DDD per 1000 inhabitants per day (DID) 2019-2023 [Internet]. [cited 2024 December 25]. Available from: https://www.zva.gov.lv/en/publications-and-statistics/statistics-medicines-consumption-ddd
[20] Order of the Ministry of Health of Ukraine No. 943. On Approval and Implementation of Medical and Technological Documents on the Standardization of Medical Care for Gastroesophageal Reflux Disease. [Internet]. 2013 October 31. [cited 2024 December 15]. Available from: https://zakon.rada.gov.ua/rada/show/v0943282-13#Text
[21] Order of the Ministry of Health of Ukraine No. 600. On Approval and Implementation of Medical and Technological Documents on the Standardization of Medical Care for Dyspepsia. [Internet]. 2012 August 03. [cited 2024 December 23]. Available from: https://zakon.rada.gov.ua/rada/show/v0600282-12#Text
[22] Guideline 00172. Nausea and vomiting [Internet]. [cited 2024 December 20]. Available from: https://guidelines.moz. gov.ua/documents/3069
[23] Order of the Ministry of Health of Ukraine No. 2148 On Approval of the List of Medicinal Products Subject to Reimbursement under the Program of State Guarantees of Medical Care for the Population, as of December 23, 2024. [Internet]. 2024 December 25. [cited 2024 December 30]. Available from: https://moz.gov.ua/storage/ uploads/94007481-c844-4e8e-9946-e36f90ac8240/dn_2148_25122024.pdf
[24] Dmytryk K. What is prescribed and recommended for digestive diseases? Pharmacy Online. 2023;06(1377):10.
[25] Osiodlo HV, Fedorova OO. Main directions of using itopride hydrochloride in the treatment of gastrointestinal tract pathology. Health Ukr. 2024;4(565):36–7.
[26] Tkach SM, Dorofieiev AE. Comparative efficacy and safety of dopamine receptor antagonists in gastrointestinal disorders. Gastroenterol. 2024,58(3):57–62.
[27] Kalas MA, Trivedi B, Kalas M, Chavez LO, McCallum RW. Metoclopramide in gastroparesis: Its mechanism of action and safety profile. Gastrointestinal Disorders. 2023;5(3):317–28. DOI: 10.3390/gidisord5030026
[28] Cowan A, Garg AX, McArthur E, Tsobo FM, Weir MA. Cardiovascular safety of metoclopramide compared to domperidone: A population-based cohort study. J Can Assoc Gastroenterol. 2021;4(5):e110–9. DOI: 10.1093/jcag/gwaa041
[29] Alkhowaiter S, Al Rasheed MM, Alammar N, Alotaibi A, Altuwaijri M, Alshankiti S, et al. Safety of prolonged use of metoclopramide and domperidone as treatment for chronic gastrointestinal dysmotility disorders in patients with systemic sclerosis. Saudi Pharm J. 2024;32(5):102039. DOI: 10.1016/j.jsps.2024.102039