Clinical pharmacology - one of the world health organization strategies in promoting rational use of medicines

The review covers the history of Clinical Pharmacology discipline origin from the thirties of the twentieth century until now. Establishment of the research group on clinical pharmacology by the World Health Organization in 1969 is surveyed. The current status of clinical pharmacology in Russia is described with emphasis on potential impact of the discipline on health system in the rational use of medicines and access to medicines. The connection between clinical pharmacology development and pharmaceutical regulation and «thalidomide tragedy» of the sixties is traced. The main developing sections of the discipline of Clinical Pharmacology: pharmacoepidemiology, pharmacoeconomics, pharmacogenetics, pharmacovigilance and drug clinical trials are presented. The objectives and phases of clinical trials, the current problems of their conduction - global and Russian - are presented. Perspectives for the clinical pharmacology development using the evidence-based medicine approach are reviewed. Review reveals the multidisciplinary nature of clinical pharmacology, its bridging role between the fundamental and practical clinical disciplines, and a close connection with the development of healthcare system. Problems of clinical pharmacologists’ training and employment are discussed. The review presents the current status and development of the discipline in different countries and in the Russian Federation with reference to the federal regulations and laws. The potential of clinical pharmacology as a research, teaching and practicing medical discipline allowing the healthcare system to ensure the rational use of medicines providing drug efficiency, safety and affordability for the population is described. The results of the own authors’ research of the impact of clinical pharmacology services introduction in the practice of internal diseases departments of Kazan municipal hospitals on the outcome of coronary heart disease are presented with consideration of the various confounding factors. Review explains the need for wide use of clinical pharmacology potentials on all levels of healthcare system, particularly for administrative decision-making

clinical pharmacology, World Health Organization, healthcare management, drug efficiency, drug safety, drug affordability, coronary artery disease