Observations of pharmacy practice in the Dmitrov Raion, Russia.

During September 2000 I spent 5 days touring the Dmitrov Raion in Russia as part of a fact-finding delegation of health care professionals from Minnesota. We were there at the invitation of the Dmitrov Department of Health to assess medical practices and form partnerships to improve care in the region by taking steps to enhance medical and social programs. Our group included five physicians (family practice, endocrinology, occupational medication , emergency medication, gastroenterology), two nurse practitioners (cardiology, occupational medication), one pharmacist (the author), one health educator, and an industrial arts teacher. The American sponsoring organization was the Russian Farm Community Project (RFCP). This organization, which is funded by the Land of Lakes Dairy in Minnesota, has been working with health care professionals in the Dmitrov Raion since 1991. The Russians were seeking creative ways of integrating rural health care capabilities with those of existing hospitals and clinics in Dmitrov City, and they invited RFCP to send a medical delegation to begin working with rural practitioners in hopes of bringing the diverse experiences of the Americans to bear on this objective. For their part, the members of the American delegation intended to learn from Dmitrov health professionals about the quality of health care that can be provided with limited resources and to learn about innovative medical diagnostic and therapeutic techniques used in Russia. The social programs arm of the RFCP was officially begun with this trip. Pharmacy practice was one of eight focus areas the delegation looked at with an eye toward considering differences and similarities between health care in the United States and Russia. As a pharmacist, I was interested in observing and beginning to understand pharmacy practice in Russia. My intent in writing this article is to give an overview of health care funding in Russia today, provide background information on pharmacy practice and essential drugs, and present a broad picture of community and hospital pharmacy practice based on my personal observations and discussions with Russian colleagues in the Dmitrov Raion and filled out by the previously published literature. I hope that readers will come away with an understanding of the strengths and weaknesses of pharmacy practice in Russia. The Dmitrov Raion (a raion is similar to a county) is primarily an agricultural area with a population of 150,000 lying within the Moscow Oblast (similar to a state) of the Russian Federation. Located 70 km northeast of Moscow, Dmitrov …