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Publikacije (117)

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Zora Ćetković, Marija Egerić, Dušanka M. Krajnović

Background: Patients' ability to understand and apply medicines information is a prerequisite for optimal and safe use of medicines. Patients should be able to know and understand basic medicines information, either written or verbal, and calculate the prescribed dose in order to avoid health risks associated with the use of medicines. Methods and Objectives: The objective of the study was to evaluate medication literacy (knowledge, understanding and numerical skills regarding the use of medicines) in hospitalized orthopedic patients. A prospective, cross-sectional study was conducted at 2 orthopedic hospitals in Belgrade, Serbia, between September 2021 and February 2022, using medication literacy questionnaire. Results: Among 210 eligible patients, 53.3% were male, with more than 12 years of education (58.6%), who described their health (57.6%) and financial status (66.2%) as average. Most patients understood storage information (80%) and drug-food interactions (82%) in patient information leaflet (PIL). Nearly all patients (94%) understood instructions on medicine label. However, only 23.8% patients could properly interpret shelf life printed on the package. When it comes to verbal information given by pharmacist, most patients understood instructions on drug-food interactions (87%) and the use of antibiotics (78%). More than half patients (55.2%) knew that expired medicines should be returned to community pharmacy for safe disposal. In the case of missed dose, only 45% patients knew they should wait to take the next dose at the scheduled time. Regarding numerical skills, most patients could calculate maximum daily dose (86%), as well as maximum therapeutic dose (85%). Conclusions: The study indicates that written medicines information in combination with verbal instructions have proven to be understandable for most patients, but highlights a lack of sufficient knowledge regarding the proper disposal of expired medicines and missed dose. Assessment of medication literacy is a crucial for implementation of medication adherence intervention and health risks prevention.

Jelena Aleksandrić, Dušanka M. Krajnović, Jelena Milojković, Jagoda Nikolić, Dragana Đorđević-Šopalović, Violeta Stajić-Simić, Marija Jovanović

Objective. The main objective of this research was to determine whether and to what extent the level of health literacy affects the reproductive health of young people. Methods. The research belongs to the group of epidemiological studies, conducted according to the type of cross-sectional study. It was carried out in the period from 1st to 17th of June, 2019.A total of 230 students of professional health studies participated in the research. The questionnaire, in addition to demo-graphic data, contained the S-TOFHLA health literacy test and specially designed questions about reproductive health. Results: Our research showed that six respondents (2.61%) had inadequate health literacy, 80 (34.78%) had marginal health literacy, and 144 (62.61%) had adequate health literacy. Greater health literacy is associated with sexual activity, number of partners and the use of anti-baby pills. Health literacy is influenced by many factors, including knowledge of reproductive health, age, gender, sociodemographic factors, economic status, level of education, and more. Insufficient promotion of sexual education in our society, potential mistrust in the official education system and the desire of respondents to independently research this area. Conclusion. More than two thirds of students show the adequate level of health literacy. Students who are older in terms of age and years of study have a higher level of health literacy. This research can serve as a starting point for the creation of new programs on reproductive health and health literacy, especially those aimed at the population of health professionals.

Aleksandar Stevanović, V. Bjegović-Mikanović, S. Cvjetković, Dušanka M. Krajnović, S. Mandić-Rajčevič, M. Mirković, D. Popović, Milena Šantrić-Milićević et al.

The rapidly evolving landscape of public health challenges requires national public health associations (NPHA) to take leadership and play a multifaceted role (1). NPHAs usually serve as primary non-governmental advocates for population health and manage complex intersections of policy, education, and community engagement to address both traditional and emerging public health threats. One of their key roles is to shape strategies that promote equitable access to healthcare, thereby significantly impacting public health outcomes. NPHAs exert their influence across local, regional, and global levels, advancing global health agendas. The establishment of the Serbian Public Health Association (SPHA) in 2003 was a significant milestone in the country's public health history. SPHA added new value to traditional partnerships for public health, led by the Network of Institutes of Public Health, along with the Serbian Medical Chamber, academic institutions, United Nations agencies, Serbian Medical Society, civil society organizations, and interested groups and individuals. SPHA has been active in various public health areas, including strengthening community resilience by supporting families and visiting nurses, promoting the response to the COVID-19 pandemic, providing continuous medical education, and facilitating public dialogue on health reforms. Today, SPHA is a national, not-for-profit association of current and future public health professionals and other individuals devoted to promoting scientific evidence and multidisciplinary collaboration in health promotion and protection (2). SPHA is a permanent member of the European Public Health Association and the World Federation of Public Health Associations (3). It brings together 96 members of public health practitioners from various backgrounds and affiliations, working together to protect and improve the health of all individuals and reduce health inequalities.

D. Jocic, Svetlana Vuksanović Pintar, Maja Pavlović, Dušanka M. Krajnović

The evolution of training and skills development at BENU Pharmacies represents a remarkable journey characterized by strategic foresight and adaptability within the rapidly evolving pharmaceutical industry. Since its inception, BENU Pharmacies has exemplified a strong commitment to operational excellence and workforce development through a meticulously structured approach to training (1-3). Training and development are essential components of organizational success, particularly in industries as dynamic and regulated as pharmaceuticals (4). The ability to continuously enhance both technical and interpersonal skills is crucial for maintaining high standards of service delivery, adapting to emerging industry trends, and meeting the ever-changing needs of customers (5,6). Effective training programs not only ensure that employees are proficient in their technical roles but also foster a culture of continuous improvement and innovation.

Aleksandar Jovanović, Anđela Dragićević, D. Pavlović, Dušanka M. Krajnović

The use of medicinal plants dates back to ancient civilizations, where they were the primary form of treatment. This interest has evolved with scientific advances and led to their modern use. Around 13000 medicinal plants are used worldwide, and 65-80% of the population uses them for therapeutic purposes. In Serbia, approximately 700 medicinal plant species are found, of which around 420 are actively used. An important medical field in which medicinal plants play a crucial therapeutic role is the treatment of urinary tract infections (UTIs). This study aimed to collect and document the diverse uses of medicinal plants and the traditional knowledge in Serbia regarding their therapeutic applications in treating UTIs.

D. Jocic, Jelena Avramović, Valentina Marinković, Dušanka M. Krajnović

The PHOENIX Group, founded by Adolf Merckle in 1994, stands as a prominent entity in the European pharmaceutical distribution sector. With origins tracing back over a century, the company has experienced significant growth and transformation, positioning itself as a market leader in numerous countries (1-3). Over the decades, PHOENIX has navigated the dynamic and often challenging landscape of the pharmaceutical industry with strategic foresight and adaptability (3,4). This paper examines the evolution of the PHOENIX Group, its strategic acquisitions, and its substantial impact on the pharmaceutical distribution landscape in Europe. By delving into the company’s historical milestones, strategic decisions, and innovative approaches, we aim to highlight how PHOENIX has not only adapted to but also shaped the evolving needs of the healthcare sector. The analysis will also explore the company’s role in enhancing supply chain efficiency, expanding market reach, and fostering advancements in pharmaceutical retail and distribution across the continent.

The paper analyzes the effects of medicines policy on the functional separation of pharmacy and drugstore businesses from the early 19th century to the Second World War. Attempts to maintain personal and professional interests in the delivery of medicines prompted the long-standing dispute between pharmacists and druggists over the control and trade of drugs and poisons. The issue of state control generated complex processes that emphasized the professional role of pharmacists as providers of pharmaceutical services and druggists as wholesalers of medicines.

Marija Levic, N. Bogavac-Stanojević, Stana Ubavić, Dušanka M. Krajnović

Background Pharmacotherapy literacy (PTHL) is a specific ability to safely access, appraise and understand the available information concerning medication and to calculate and act accordingly. The concept of PTHL is mostly unknown for the majority of diabetes mellitus type 2 (DMT2) patients in Serbia. With diabetes being one of the major public health problems in Serbia with a prevalence of 9.1%, this two-study research aims at constructing performance-based instrument and estimating the prevalence of PTHL levels and identification of predictors of low PTHL scores in patients with DMT2. Methods Multistage study was performed to adapt the existing performance–based instrument (PTHL-SR) into specific questionnaire for DMT2 population (PTHL-DM instrument). PTHL levels were assessed through cross-sectional study categorising patients into groups of low, medium, and high PTHL levels. We considered 19 predictors for low PTHL scores, from sociodemographic characteristics, health behaviours and health characteristics, access to health-related information and empowerment-related indicators. Univariate and multivariate logistic regression analyses were used to determine independent predictors of low PTHL. Results The final 15-item PTHL-DM instrument proved to have satisfactory reliability (KR20 = 0.475) and internal reliability [ICC for the whole instrument was 0.97 with 95% confidence intervals (0.95–0.99)]. Positive correlation (rho = 0.69) between PTHL-DM score (15 questions) and the total PTHL-SR score (14 questions) was also observed. It was demonstrated that the majority of 350 patients had low PTHL (62%), and only 5% high PTHL level. Mean score on PTHL-DM was 7.8 ± 2.3. Probability of low PTHL increased among smokers, patients with low interest in health and those who estimated their health as bad. Patients who used pharmacists as sourse of information were less likely to be pharmacotherapy illiterate. Combined therapy with insulin and Oral Hypoglycemic Agents was associated with higher PTHL. Conclusions Our data indicate that specific PTHL-DM tool is objective, valid, and reliable. It was found that low level of PTHL prevailed among DMT2 patients. Medication literacy is influenced by age, residence, education, and family status. Patients with better health literacy also reported better health behaviours. Different patient empowerment programs and approaches aimed at raising PTHL would be essential to improve self-management and control of this widespread chronic disease in Serbia.

Dušan Vukmirović, Dušanka M. Krajnović, Marina Odalović

Purpose: To determine the level of awareness, beliefs and experience of healthcare professionals (HCPs) regarding mobile applications for self-management of type 2 diabetes mellitus. Methods: This review was done by searching the literature using three databases viz: PubMed, Web of Science and Scopus. Assessment of quality of studies was carried out using the scale of the Agency for Healthcare Research and Quality. The results were presented in accordance with the PRISMA 2020 guidelines. Results: The search strategy identified 725 unique research papers, 4 of which were included. A survey among pharmacists showed that 56 % of participants were aware of the existence of mobile health applications, and that 60 % of those who were aware recommended their use. In the multi-HCPs setting, depending on the study, apps recommendation rate varied from 45.5 to 62 %. Most of the participants (88 %) agreed that a mobile app would help strengthen their treatment recommendations to the patients (88 %), and 84 % also agreed that it would help patients manage diabetes better. Conclusion: Not much research has been done on this topic. Available data suggest that the awareness of HCPs regarding mobile applications is unsatisfactory, and that those familiar with these apps find them useful and are ready to recommend them to patients. There is need for further research and measures to increase awareness and knowledge of HCPs about available mobile applications, in order to ensure adequate support to patients with diabetes.

Marija Levic, N. Bogavac-Stanojević, D. Lakić, Dušanka M. Krajnović

Introduction: Obtaining, understanding, interpreting, and acting on health information enables people with diabetes to engage and make health decisions in various contexts. Hence, inadequate health literacy (HL) could pose a problem in making self-care decisions and in self-management for diabetes. By applying multidimensional instruments to assess HL, it is possible to differentiate domains of functional, communicative, and critical HL. Objectives: Primarily, this study aimed to measure the prevalence of inadequate HL among type 2 diabetes mellitus patients and to analyze the predictors influencing health literacy levels. Secondly, we analyzed if different self-reported measures, unidimensional instruments (Brief Health Literacy instruments (BRIEF-4 and abbreviated version BRIEF-3), and multidimensional instruments (Functional, Communicative and Critical health literacy instrument (FCCHL)) have the same findings. Methods: The cross-sectional study was conducted within one primary care institution in Serbia between March and September 2021. Data were collected through Serbian versions of BRIEF-4, BRIEF-3, and FCCHL-SR12. A chi-square test, Fisher’s exact test, and simple logistic regression were used to measure the association between the associated factors and health literacy level. Multivariate analyses were performed with significant predictors from univariate analyses. Results: Overall, 350 patients participated in the study. They were primarily males (55.4%) and had a mean age of 61.5 years (SD = 10.5), ranging from 31 to 82 years. The prevalence of inadequate HL was estimated to be 42.2% (FCCHL-SR12), 36.9% (BRIEF-3) and 33.8% (BRIEF-4). There are variations in the assessment of marginal and adequate HL by different instruments. The highest association was shown between BRIEF-3 and total FCCHL-SR12 score (0.204, p < 0.01). The total FCCHL-SR12 score correlates better with the abbreviated BRIEF instrument (BRIEF-3) than with BRIEF-4 (0.190, p < 0.01). All instruments indicated the highest levels for the communicative HL domain and the lowest for the functional HL domain with significant difference in functional HL between the functional HL of FCCHL-SR12 and both BRIEF-3 and BRIEF-4 (p = 0.006 and 0.008, respectively). Depending on applied instruments, we identified several variables (sociodemographic, access to health-related information, empowerment-related indicators, type of therapy, and frequency of drug administration) that could significantly predict inadequate HL. Probability of inadequate HL increased with older age, fewer children, lower education level, and higher consumption of alcohol. Only high education was associated with a lower probability of inadequate HL for all three instruments. Conclusions: The results we obtained indicate that patients in our study may have been more functionally illiterate, but differences between functional level could be observed if assessed by unidimensional and multidimensional instruments. The proportion of patients with inadequate HL is approximately similar as assessed by all three instruments. According to the association between HL and educational level in DMT2 patients we should investigate methods of further improvement.

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