Glatiramer acetát je imunomodulační lék, který je dlouhodobě používán v léčbě roztroušené sklerózy ve fázi klinicky izolovaného syndromu a remitujícího/relabujícího průběhu. V etiopatogenezi roztroušené sklerózy jsou zahrnuty vrozené i získané heterogenní imunitní zánětlivé mechanizmy a plíživé neurodegenerativní změny. Předpokládaný terapeutický efekt glatiramer acetátu je protizánětlivý a neuroprotektivní. Je schválen jako lék první linie v 57 zemích světa a jeho expozice je již více než 20 let nepřetržitého klinického používání a sledování. Při včasném zahájení léčby u klinicky izolovaného syndromu glatiramer acetát zpomalí nástup klinicky definitivní roztroušené sklerózy, u relabujcí formy redukuje roční průměr relapsů a má vliv na aktivitu nálezů na magnetické rezonanci. Nepůsobí imunosupresivně, nezvyšuje počet infekcí, nevyvolává tvorbu neutralizačních protilátek a má příznivý bezpečnostní profil. Každodenní subkutánní aplikace glatiramer acetátu 20 mg může vést v dlouhodobém průběhu ke kumulaci lokálních nežádoucích účinků. Nová forma glatiramer acetátu 40 mg/ml aplikovaná subkutánně třikrát týdně přináší nemocným úlevu od častých injekcí, snížení výskytu kožních nežádoucích účinků, a tím zlepšení životního komfortu a adherence k léčbě. t

Glatiramer acetate, an immunomodulatory drug which has long been used in the treatment of multiple sclerosis in the phase of a clinically isolated syndrome and relapsing- remitting course. The etiopathogenesis of multiple sclerosis are included in both the innate and heterogeneous immune inflammatory mechanisms and creeping neurodegenerative changes. Expected therapeutic effect of Glatiramer acetate is an anti-inflammatory and neuroprotective. It is approved as first-line drug in 57 countries, and its exposure is over 20 years of continuous clinical use and monitoring. Its effect upon the early treatment of clinically isolated syndrome slows the onset of clinically definite multiple sclerosis with relapsing/remitting forms reduces annual average relapse rate, affects the activity of the findings on magnetic resonance imaging. It is not associated with immunosuppression, does not increase the number of infections, does not produce neutralizing antibodies and has a favorable safety profile. Daily application of 20mg / ml Glatiramer acetate brings in the long course of escalating local side effects. The new formula Glatiramer acetate 40mg / ml applied three times a week to patients brings significant reduction in unpleasant side effects, thereby improving life comfort and adherence to treatment.

• MeSH
• Medication Adherence psychology   MeSH
• Demyelinating Diseases diagnosis   therapy   MeSH
• Glatiramer Acetate * administration & dosage   adverse effects   therapeutic use   MeSH
• Drug Evaluation * methods   trends   utilization   MeSH
• Immunomodulation physiology   immunology   drug effects   MeSH
• Clinical Trials as Topic MeSH
• Humans MeSH
• Disability Evaluation MeSH
• Multiple Sclerosis, Relapsing-Remitting diagnosis   drug therapy   MeSH
• Multiple Sclerosis * diagnosis   etiology   therapy   MeSH
• Statistics as Topic MeSH
• Outcome and Process Assessment, Health Care methods   utilization   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

BACKGROUND: Inhaled corticosteroids have been widely reported as a preventive measure against the development of severe forms of COVID-19 not only in patients with asthma. METHODS: In 654 Czech and Slovak patients with asthma who developed COVID-19, we investigated whether the correct use of inhaler containing corticosteroids was associated with a less severe course of COVID-19 and whether this had an impact on the need for hospitalisation, measurable lung functions and quality of life (QoL). RESULTS: Of the studied cohort 51.4% had moderate persistent, 29.9% mild persistent and 7.2% severe persistent asthma. We found a significant adverse effect of poor inhaler adherence on COVID-19 severity (p=0.049). We also observed a lower hospitalisation rate in patients adequately taking the inhaler with OR of 0.83. Vital capacity and forced expiratory lung volume deterioration caused by COVID-19 were significantly reversed, by approximately twofold to threefold, in individuals who inhaled correctly. CONCLUSION: Higher quality of inhalation technique of corticosteroids measured by adherence to an inhaled medication application technique (A-AppIT) score had a significant positive effect on reversal of the vital capacity and forced expiratory lung volume in 1 s worsening (p=0.027 and p<0.0001, respectively) due to COVID-19. Scoring higher in the A-AppIT was also associated with significantly improved QoL. All measured variables concordantly and without exception showed a positive improvement in response to better adherence. We suggest that corticosteroids provide protection against the worsening of lungs in patients with COVID-19 and that correct and easily assessable adherence to corticosteroids with appropriate inhalation technique play an important role in preventing severe form of COVID-19.

• MeSH
• Asthma * drug therapy   MeSH
• COVID-19 * MeSH
• Adrenal Cortex Hormones MeSH
• Quality of Life MeSH
• Humans MeSH
• Forced Expiratory Volume MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Cíl: Nepravidelné dávkování inzulinu je jedním z hlavních problémů spojených s inzulinovou terapií u pacientů s diabetem 2. typu; jeho skutečný rozsah však není přesně znám. Cílem průzkumu provedeného v ČR v rámci mezinárodního projektu GAPP2TM – Globální přehled přístupů pacientů a lékařů (Global Attitudes of Patients and Physicians) proto bylo ověřit, jaký je výskyt a dopad nepravidelného užívání bazálních inzulinových analog u pacientů s diabetem 2. typu, jakým způsobem a z jakých důvodů k těmto nepravidelnostem dochází, a jakým způsobem zdravotníci o nepravidelné aplikaci inzulinu s pacienty diskutují. Metodika: Projekt GAPP2TM je mezinárodní průřezovou studií provedenou on-line formou dotazníku prostřednictvím internetu u pacientů s diabetem 2. typu léčených inzulinovými analogy a u lékařů a zdravotníků, kteří tyto pacienty ošetřují. Průzkum proběhl ve dvou vlnách v celkem 17 zemích světa; do první vlny, která byla dokončena začátkem roku 2012, bylo zahrnuto 6 zemí, do druhé, dokončené v roce 2014, pak dalších 11 zemí včetně České republiky. Průzkum měl za cíl získat data o pohledech pacientů a lékařů na některé aspekty léčby diabetu 2. typu inzulinem a o přetrvávajících problémech v této oblasti v reálné každodenní praxi. Zabýval se zejména incidencí a zvládáním lehkých hypoglykemií a nepravidelnostmi v aplikaci inzulinu. V části zaměřené na adherenci k aplikaci bazálního inzulinu byly sledovány 3 typy nepravidelností v léčbě inzulinem: vynechání dávky, časový posun dávky (? 2 hodiny oproti předepsanému času) a snížení dávky, ve všech v případech během uplynulých posledních 30 dnů před vyplněním dotazníku. Dále bylo zkoumáno chování pacientů ve vztahu k této problematice a jejich vnímání těchto problémů. Výsledky: Výsledky průzkumu ukázaly, že nepravidelné dávkování inzulinu je v České republice méně časté než v ostatních zemích, v nichž probíhal výzkum GAPP2TM. I tak se ovšem týká cca pětiny všech nemocných s DM 2. typu léčených inzulinovými analogy v režimu bazál-bolus nebo pouze bazál. Při poslední nepravidelné aplikaci bazálního inzulínu se jednalo o záměr pacienta při úplném vynechání dávky ve 13 % případů, posun aplikace byl záměrný ve 23 % a snížení dávky inzulínu v 61 % případů. Nejčastěji hlášenými důvody bylo snížení rizika hypoglykemie a dodržování doporučení zdravotníků. Obavu z vynechání dávky bazálního inzulinu má 40 % českých pacientů a 35 % by mělo pocit viny, pokud by svou dávku bazálního inzulinu vynechali (u pacientů s intenzivním inzulinovým režimem je to 47 %). Pouze 60 % pacientů si uvědomuje, že vynechávání dávek bazálního inzulinu může mít negativní dopad na jejich dlouhodobý zdravotní stav. Dotazovaní lékaři měli podezření, že během pravidelných kontrol hlásí nižší počet vynechaných dávek bazálního inzulínu nebo vynechávání zcela zatajuje přibližně třetina pacientů. Tuto skutečnost však připustilo jen 11 % pacientů užívajících bazální inzulin a 15 % pacientů léčených intenzifikovaným režimem. Čtvrtina předepisujících lékařů navíc uvádí, že se svými pacienty nepravidelné užívání bazálního inzulinu během kontrol běžně neprobírá. Závěry: Ačkoli pacienti s diabetem 2. typu dodržují v České republice předepsané schéma léčby bazálním inzulinem častěji než v jiných zemích účastnících se průzkumu GAPP2TM, vynechání, časový posun a snížení dávky inzulinu je poměrně časté a ze strany zdravotníků si zasluhuje během pravidelných kontrol více pozornosti a cílenou edukaci.

Objective: Irregular insulin dose is one of the main problems associated with insulin therapy in patients with type 2 diabetes; its extent is not known precisely. The aim of survey conducted in the Czech Republic in the international project GAPP2™ – Global Attitudes of Patients and Physicians was to determine the incidence and the impact of irregular use of basal insulin analogues in patients with type 2 diabetes, to point out the reasons for these irre­gularities and to focus on how physicians discuss irregular application of insulin with patients. Methods: The project GAPP2™ is an international cross-sectional study performed on-line via the Internet using a questionnaire filled by diabetic patients treated with insulin analogues and physicians who treat these patients. The survey was conducted in two steps in 17 countries; the first step included 6 countries and was completed in the beginning of 2012, the second step involved 11 other countries including the Czech Republic with termination in 2014. The survey was designed to obtain the views of patients and physicians on certain aspects of insulin treatment and persistent issues in this field in the real daily practice. Special focus was on the incidence and management of hypoglycaemia as well as on irregularities of insulin application. In the part dedicated to adherence to basal insulin application were observed three types of irregular insulin therapy: missed dose, time imprecision of dose (? 2 hours vs. the prescribed time) and dose reduction in all cases in the past 30 days before completing the questionnaire. In addition, it was investigated the attitude and relation of patients to these issues. Results: The results have shown that irregular insulin dose in the Czech Republic is less frequent than in other countries involved in the GAPP2™ research. Ne­vertheless, approximately one fifth of diabetic patients using insulin analogues in basal-bolus or only basal therapy regimen is related to this problem. The last irregular insulin application was due to missed dose in 13% of cases, time imprecision in 23% and reduction of dose in 61% of cases. The most commonly reported reason was risk reduction of hypoglycaemia and the recommendations of health professionals. Fear of missed dose is present in 40% Czech patients and 35% would feel guilty if their insulin dose is missed (up to 47% in patients with intensified insulin regimen). Only 60% patients are aware of negative impact on their long-term health after missed dose of basal insulin. Questioned doctors have suspected that the patients report lower number of missed doses during regular medical check because one third of patients doesn´t admit missed dose. However, this fact conceded only 11% of patients on basal insulin and 15% of patients on intensified insulin therapy. Quarter of prescribing doctors admit that they usually don´t discuss with patients irregularities in basal insulin treatment. Conclusion: Although, type 2 diabetes patients in the Czech Republic follow prescribed basal insulin therapy scheme more often than patients in other countries participating in the survey GAPP2 ™, missed dose, time imprecision and reduction of dose is quite common and it deserves more attention from medical side during regular medical check together with appropriate education of patients.

• MeSH
• Medication Adherence * statistics & numerical data   MeSH
• Diabetes Mellitus, Type 2 * drug therapy   MeSH
• Insulin * administration & dosage   MeSH
• Middle Aged MeSH
• Humans MeSH
• Surveys and Questionnaires MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

Aim: The aim of study was to assess the adherence of children with type 1 diabetes to the treatment with an emphasis on insulin application using insulin pen. Method: The method of observation was used to gather empirical data. Observation form contained 15 items (representing individual interventions of insulin application technique) which were monitored directly during administration and were based upon the recommendations on the interventions leading to proper application of insulin by insulin pen. Sample: We observed 45 children with type 1 diabetes at the age of 6-18 years who administered insulin by insulin pen. The study was conducted in the household of children, at the Clinic of Children and Adolescents of the University Hospital in Martin and at the Paediatric Department of the National Endocrinology and Diabetology Institute in Ľubochňa. Results: Adhering to recommendations for proper application of insulin was particularly noticeable in following interventions: choosing the right injection site, adjusting the right insulin dose, injection site disinfection, verification of insulin cartridge. Failure to comply with recommendations for proper application of insulin using insulin pen appeared most frequently in the interventions: applying pressure to the injection site, handwashing prior the application. With regard to adherence, age period 13-18 years was noticed to be a problematic one. In this period, we recorded the lowest percentage of success in performing the interventions while administering insulin. When comparing individual interventions of insulin application in relation to the age, statistically significant differences (p < 0.05) were confirmed in following skills: handwashing prior the application, insulin administration in 90 degree angle, and applying pressure to the injection site. Conclusions: The age and developmental maturity are significant factors that affect not only children’s adherence to the treatment but also their responsibility for insulin application that is closely related to the adherence.

• MeSH
• Patient Compliance * statistics & numerical data   MeSH
• Diabetes Mellitus, Type 1 * drug therapy   nursing   MeSH
• Child MeSH
• Syringes MeSH
• Insulin administration & dosage   MeSH
• Humans MeSH
• Adolescent MeSH
• Motor Skills MeSH
• Statistics as Topic MeSH
• Age Factors MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Publication type
• Observational Study MeSH

Inhalační cesta podání léků je preferována pro všechny pacienty s chronickou obstrukcí průdušek všech věkových kategorií. Inhalační léky jsou dostupné v různých inhalačních systémech amají i odlišnou inhalační techniku. Proto je velmi důležitá kontinuální edukace pacienta, se kterým musíme správnou inhalační techniku nacvičit a opakovaně ji kontrolovat. V atypické kazuistice je popisováno výrazné snížení chybovosti v inhalační technice z inhalačního systému Turbuhaler po plošné edukaci.

The inhaled route of application medications is preferred administration method for all patients with chronic bronchial obstruction all age categories. Inhaled medications are available in different devices with differ characteristics and with differ inhaler technique. Therefore are very important continuing education of patients, training and skill in correct inhalation technique and inhalation technique must be repeatedly checked. The important decreasing of error rate in correct inhaler technique from Turbuhaler device after super education are discussed in our atypical case report.

• Keywords
• TURBUHALER,
• MeSH
• Patient Compliance MeSH
• Metered Dose Inhalers standards   utilization   MeSH
• Anti-Asthmatic Agents administration & dosage   MeSH
• Administration, Inhalation MeSH
• Self Administration MeSH
• Asthma * drug therapy   MeSH
• Adult MeSH
• Inhalation Spacers standards   utilization   MeSH
• Humans MeSH
• Disease Management MeSH
• Treatment Outcome MeSH
• Patient Education as Topic MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

INTRODUCTION: florio® HAEMO is a hemophilia treatment monitoring application (app) offering activity tracking and wearable device connectivity. Its use might support everyday activities for people with hemophilia. The aim of this study was to evaluate user satisfaction, long-term usage and the impact on data entry when pairing a wearable with a hemophilia monitoring app. METHODS: This is a follow-up of a two-part user survey conducted in Central Europe. People with hemophilia and parents/caregivers of children with hemophilia using florio HAEMO and who completed part one were invited to complete a second online questionnaire at least 4 months later. RESULTS: Fifty participants (83.3%) who completed part one of the survey continued to use the florio HAEMO app and completed part two. Of 14 participants who chose to use the app with a wearable, more than half (57.1%) were aged between 13 and 25 years. Overall, the results demonstrated that florio HAEMO is very easy or rather easy to use, especially for individuals pairing the app with a wearable. Most people using a wearable indicated that florio HAEMO was very or rather important in bringing certainty to daily activities (85.7%). Notably, 14 of 36 (38.9%) non-wearable users indicated that they would prefer to pair the app with a wearable in the future. CONCLUSIONS: Adherence to the florio HAEMO app is maintained over an extended period of use. Pairing the app with a wearable might enable easier access to app features, increase data entry motivation and provide more certainty about daily activities for people with hemophilia.

• MeSH
• Patient Compliance statistics & numerical data   MeSH
• Child MeSH
• Adult MeSH
• Hemophilia A * MeSH
• Middle Aged MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Adolescent MeSH
• Young Adult MeSH
• Mobile Applications MeSH
• Wearable Electronic Devices * MeSH
• Patient Preference * MeSH
• Surveys and Questionnaires MeSH
• Patient Satisfaction MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH

Úvod: Základom liečby astmy a chronickej obštrukčnej choroby pľúc (CHOCHP) je inhalačná terapia, ktorá so sebou prináša viaceré výhody, a jej úspešnosť je založená na správnom prevedení inhalačnej techniky. Cieľ: Primárnym cieľom výskumu bolo zistiť. aké percento pacientov postupuje pri aplikácii svojich liekov správne, aké inhalačné systémy sú preferované pri liečbe spomínaných respiračných ochorení, aké najčastejšie chyby v inhalačnej technike robia pacienti pri používaní inhalátorov a aký je postoj pacientov k možnosti edukácie zo strany verejného lekárnika. Metodika: Potrebné údaje pre naplnenie cieľa boli získané z dotazníkového prieskumu, ktorého sa zúčastnilo 102 respondentov (pacientov). Anonymný dotazník pozostával z 18 otázok zameraných na inhalačné systémy, ktoré pacienti používajú a na jednotlivé kroky, ktoré je potrebné uskutočniť pri inhalácii lieku. Výsledky: Do prieskumu sa zapojilo 83,33 % pacientov s prieduškovou astmou a 9,8 % pacientov s chronickou obštrukčnou chorobou pľúc (CHOCHP). Najviac predpisovaným inhalátorom zo všetkých typov bol Inhaler, ktorí používalo 54,9 % respondentov. Ukázalo sa, že až u celkovo 63 % respondentov používajúcich MDI a DPI sa vyskytla nejaká chyba pri inhalácii svojich liekov. Najčastejšou chybou u oboch typov inhalačných systémov bolo nezadržanie dychu na dostatočne dlhý čas (5–10 sekúnd) po vdýchnutí z inhalátora. Vyššia chybovosť použitia bola preukázaná u inhalátorov pre práškovú formu lieku (DPI) v porovnaní s aerosólovými dávkovačmi (MDI). Záver: Získané výsledky preukázali, že chyby v inhalačnej technike sú stále aktuálnym problémom pre nadpolovičnú väčšinu pacientov s respiračnými ochoreniami. Veľký potenciál pre zlepšenie tohto stavu majú pre pacientov lekárnici, ktorí svojim poradenstvom a poučením o správnej aplikácii liekov môžu pomôcť pacientom zlepšiť prevedenie inhalácie a tým zvýšiť efektívnosť liečby.

The basis of asthma and chronic obstructive pulmonary disease (COPD) treatment is inhalation therapy, which brings several benefits and its success is based on the correct inhalation technique. Aim: The primary aim of the research was to find out what percentage of patients could apply their medicines properly, what inhalation systems were preferred in the treatment of these respiratory diseases, what most common mistakes in the inhalation technique patients made when using inhalers as well as what was patients’ approach to the possibility of being educated by a community pharmacist. Methods: Essential data to accomplish the goal were obtained by a questionnaire survey in which 102 respondents (patients) participated. The anonymous questionnaire consisted of 18 questions focusing on the inhalation systems that patients use and particular steps that need to be taken when inhaling the medicine. Results: 83.33 % of patients with bronchial asthma and 9.8 % of patients with chronic obstructive lung disease (COPD) participated in the study. “Inhaler” was the most prescribed out of all the other kinds of inhalators, used by 54.9 % of respondents. It turned out that up to 63 % of the respondents using MDIs or DPIs had encounetered some kind of error when inhaling their drugs. The most common mistake with both types of inhalation systems was not holding their breath for sufficient time (5 to 10 seconds) after inhaling from the inhaler. Dry–powder inhalers (DPIs) proved to be used more erroneously compared to aerosol dispensers (MDIs). Conclusion: The obtained results showed that errors in the inhalation technique seem yet to be a hot issue for more than half of patients with respiratory diseases. Pharmacists have a great potential to improve the situation by giving pieces of advice and instructions regarding the proper application of medicines to help patients to enhance the performance of inhalation and thus increase the treatment efficiency.

• MeSH
• Medication Adherence MeSH
• Anti-Asthmatic Agents administration & dosage   therapeutic use   MeSH
• Administration, Inhalation MeSH
• Asthma * drug therapy   MeSH
• Pulmonary Disease, Chronic Obstructive * drug therapy   MeSH
• Drug Information Services MeSH
• Humans MeSH
• Surveys and Questionnaires MeSH
• Community Pharmacy Services MeSH
• Patient Education as Topic MeSH
• Professional-Patient Relations MeSH
• Check Tag
• Humans MeSH

Background: Adherence to inhaled medication constitutes a major problem in patients with chronic obstructive pulmonary disease (COPD) globally. However, large studies evaluating adherence in its entirety and capturing a large variety of potentially associated factors are still lacking. Objective: To study both elementary types of adherence to chronic inhaled COPD medication in "real-life" COPD patients and to assess relationships with a wide-ranging spectrum of clinical parameters. Methods: Data from the Czech Multicentre Research Database (CMRD) of COPD, an observational prospective study, were used. Overall adherence (OA) was evaluated with Morisky Medication Adherence Scale (©MMAS-4) and adherence to an application technique (A-ApplT) with the Five Steps Assessment. Mann-Whitney U test, Spearman's correlation, and logistic regression were used to explore relationships between variables. Results: Data of 546 participants (69.6% of all patients from the CMRD) were analyzed. Two-thirds self-reported optimal OA, but only less than one-third demonstrated A-ApplT without any error. OA did not correlate with A-ApplT. Next, better OA was associated with higher education, a higher number of inhalers, a lower rate of exacerbations, poorer lung function, higher degree of upper respiratory tract symptoms (SNOT-22), absence of depressive symptoms, ex-smoking status, regular mouthwash after inhaled corticosteroids (ICS), and flu vaccination. By contrast, better A-ApplT was associated with a lower number of inhalers, better lung function, and regular mouthwash after ICS. Independent predictors of nonoptimal OA included lower degree of education, absence of flu vaccination, anemia, depression, and peptic ulcer history, whereas independent predictors of lower A-ApplT were lower education, absence of regular mouthwash after ICS, and higher COPD Assessment Test score. Conclusions: Parameters associated with OA and A-ApplT differ, and those associated with both adherence domains are sometimes associated inversely. Based on this finding, we understand these as two separate constructs with an overlap.

• Publication type
• Journal Article MeSH

Komunikace s pacienty odmítajícími lékařskou péči a doporučenou medikaci je výzvou pro všechny zdravotníky i nezdravotnické pracovníky, kteří s duševně nemocnými pracují. Jednou z příčin nedostatečné adherence je absence náhledu na duševní onemocnění, tzv. anosognosie. Vhodnými komunikačními strategiemi lze posilovat motivaci pacienta k léčebnému postupu, stejně jako budovat důvěru mezi pacienty a zdravotníky, i přes absenci uvědomění si duševní poruchy. V následujícím textu představujeme základní principy komunikační techniky LEAP/4P, kterou lze efektivně uplatnit v rámci motivačních rozhovorů s duševně nemocnými, se zaměřením na její praktické využití.

Communication with patients refusing medical treatment represents a challenging task for all health-care professionals working with patients suffering from mental health disorders. Lack of insight, also known as anosognosia, is considered to be a significant factor contributing to nonadherence. Despite unawareness of one's mental health disorder, motivation to treatment as well as mutual trust between a patient and a health-care professional can be strengthen by using special communication strategies. In the article we summarize principles of the communication technique LEAP, which can be used in motivational interviews with mentally ill patients, with special focus on its practical application.

• MeSH
• Patient Compliance * MeSH
• Mental Disorders * MeSH
• Communication MeSH
• Humans MeSH
• Motivational Interviewing MeSH
• Physician-Patient Relations MeSH
• Check Tag
• Humans MeSH

Introduction: The aim of the study is to assess the degree of adherence of medical laboratories to Kidney Disease Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD) in laboratory practice in Czechia and Slovakia. Materials and methods: An electronic questionnaire on adherence to KDIGO 2012 guideline was designed by an external quality assessment (EQA) provider SEKK spol. s.r.o. The questionnaire was placed and distributed through website to all medical biochemistry laboratories in Czechia and Slovakia (N = 396). Results: A total of 212 out of 396 laboratories responded to the questions, though some laboratories only answered some questions, those applicable to their practice. A total of 48 out of 212 laboratories adopted the KDIGO 2012 guideline in full extent. The metrological traceability of creatinine measurement to standard reference material of SRM 967 was declared by 180 out of 210 laboratories (two of the responding laboratories did not measure creatinine). Thirty laboratories are not well educated on traceability of creatinine measurement and seven laboratories do not calculate estimated glomerular filtration rate (eGFR). Both urinary albumin concentration and albumin to creatinine ratio are reported by 144 out of 175 laboratories (37 of the responding laboratories did not measure urinary albumin). Conclusion: Majority of laboratories in Czechia and Slovakia adopted some parts of the KDIGO 2012 guideline in their practice, but only 23% of the laboratories apply them completely. Thus, further education and action should be conducted to improve its implementation.

• MeSH
• Renal Insufficiency, Chronic diagnosis   pathology   MeSH
• Glomerular Filtration Rate MeSH
• Creatinine urine   MeSH
• Laboratories, Hospital standards   MeSH
• Humans MeSH
• Surveys and Questionnaires MeSH
• Guidelines as Topic MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH
• Slovakia MeSH