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许多国家的基本药物供应仍然不理想:范围综述。

Essential medicines availability is still suboptimal in many countries: a scoping review.

机构信息

Department of Clinical Pharmacology, Zenica Cantonal Hospital, Crkvice 67, 72000 Zenica, Bosnia and Herzegovina; Faculty of Medicine, University of Zenica, Fakultetska 3, 72000 Zenica, Bosnia and Herzegovina.

Department of Pediatrics, University of Hospital Split, Spinčićeva 1, 21000 Split, Croatia.

出版信息

J Clin Epidemiol. 2018 Jun;98:41-52. doi: 10.1016/j.jclinepi.2018.02.006. Epub 2018 Feb 13.

Abstract

OBJECTIVES

To identify uses of WHO Model list of essential medicines (EMs) and summarize studies examining EM and national EM lists (NEMLs).

STUDY DESIGN AND SETTING

In this scoping review, we searched PubMed, Scopus, WHO website and WHO Regional Databases for studies on NEMLs, reimbursement medicines lists, and WHO EML, with no date or language restrictions.

RESULTS

Three thousand one hundred forty-four retrieved documents were independently screened by two reviewers; 100 full-text documents were analyzed; 37 contained data suitable for quantitative and qualitative analysis on EMs availability (11 documents), medicines for specific diseases (13 documents), and comparison of WHO EML and NEMLs (13 documents). From the latter, two documents analyzed the relevance of evidence from Cochrane systematic reviews for medicines that were on NEMLs but not on the WHO EML. EMs availability is still suboptimal in low-income countries. Availability of children formulations and EMs for specific diseases such as chronic, cancer, pain, and reproductive health is suboptimal even in middle-income countries.

CONCLUSION

WHO EML can be used as a basic set of medicines for different settings. More evidence is needed into how NEMLs can contribute to better availability of children formulations, pain, and cancer medicines in developing countries.

摘要

目的

确定世界卫生组织(WHO)基本药物示范目录(EML)的使用情况,并总结研究 EM 和国家 EML 清单的研究。

研究设计和设置

在本次范围审查中,我们在 PubMed、Scopus、WHO 网站和 WHO 区域数据库中搜索了关于国家 EML、报销药品清单和 WHO EML 的研究,没有日期或语言限制。

结果

独立筛选了两名评审员检索到的 3144 篇文献;分析了 100 篇全文文献;37 篇文献包含关于 EM 可用性(11 篇文献)、特定疾病药物(13 篇文献)和 WHO EML 与 NEML 比较(13 篇文献)的定量和定性分析数据。后者有两份文件分析了纳入 NEML 但未纳入 WHO EML 的 Cochrane 系统评价证据的相关性。在低收入国家,EM 的可获得性仍然不理想。即使在中等收入国家,儿童制剂和特定疾病(如慢性、癌症、疼痛和生殖健康)的 EM 可获得性也不理想。

结论

WHO EML 可作为不同环境下基本药物的基础。需要更多证据来证明国家 EML 如何有助于改善发展中国家儿童制剂、疼痛和癌症药物的可获得性。

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