In the contemporary reality of globalization and urbanization in Bulgaria, traditional empiric ethnobotanical knowledge is disappearing. The aim of our study was to check the attitude of a random sample of people to the herbs and the traditional way of healing: 1) to find out which herbs are the most popular in Bulgaria; 2) what is their most popular application; 3) to study the distribution of negative or positive attitudes to the traditional use of medicinal plants according to age and gender of Bulgarian people. In total, 77 plant species (including the ones in the formula combinations) were mentioned during the study. They belong to 38 families. The most important families are Lamiaceae, Rosaceae, Asteraceae and the plants which most commonly referred to as “Granny’s cure” were Hypericum perforatum, Cotinus coggigria, Plantago major, Sempervivum sp. div., Calendula officinalis, Melissa officinalis, Allium sativum, Aesculus hippocastanum, Matricaria chamomilla and Cornus mass. The greatest number of herbs were the ones used to treat disorders of central nervous system (CNS), bones, skin, gastro-intestinal and respiratory system. Key words: Traditional healing, medicinal plants, remedial properties.

Bulgaria is among the European Union (EU) countries with the highest burden of cervical cancers and life expectancy below the EU average. The majority of cervical cancer cases (more than 95%) are caused by the human papillomavirus (HPV). The aim of this retrospective, cost of illness study is to identify direct healthcare costs of cervical cancer in Bulgaria from the payer perspective and to calculate indirect costs and the associated years of life lost. Costs data were sourced from the National Health Insurance Fund from January 2018 to December 2020. Years of life lost were calculated based on the country and gender-specific life expectancy. Indirect costs due to productivity loss were calculated using the human capital approach. The total treatment costs for 3540 patients with cervical cancer are EUR 5,743,657 (2018), EUR 6,377,508 (2019), and EUR 6,751,182 (2020). The costs associated with drug acquisition and administration accounted for the majority (63%) of total healthcare costs followed by hospital management costs (14%). An estimated total of 20,446 years of life were lost due to cervical cancer for the period 2018–2020. The costs of productivity losses are estimated at EUR 7,578,014. Our study showed that the economic burden of cervical cancer in Bulgaria is substantial. Focus on cervical cancer prevention via vaccination against the human papillomavirus, timely screening, early diagnosis, and higher vaccine coverage rates could reduce its economic burden in Bulgaria.

Summary: The most common cause of antibiotic resistance is the irrational use of antibiotics. Most of the irrational use of antibiotics is related to use in the community and the prevalence of self-medication in different populations. This review aimed to explore the prevalence of self-medication with antibiotics in European countries and the main sources of antibiotics. An online search of Pubmed and Scopus was conducted to identify relevant studies. A two-phase mapping approach was used. All steps in this scoping review were carried out using the Covidence® software. A total of 22 studies were included. The prevalence of self-medication with antibiotics is greater in Southern European countries than in Northern and Western European countries. The main sources of over-the-counter antibiotics are community pharmacies and leftovers from previous courses. Targeted communication strategies and interventions are needed to reduce the overuse of antibiotics and to slow down the spread of antibiotic resistance until new classes of effective antibiotics are developed.

The aim of the study is to identify the current practices of self-medication in Bulgaria, estimate the extent patients are influenced by information about the safety of OTC products and pharmacists’ role and behavior in the process. An anonymous, questionnaire-based, descriptive study was carried out among 280 pharmacists. The majority of the patients (92.6%) ask for pharmacists’ advice before buying OTC products. Most often patients need OTC drugs for mild conditions (80.7%), to save time (63.9%), and because they are unable to consult a physician (61.9%). The medium duration of consultation for an OTC product is between 5 and 10 minutes. The main barriers hindering the process are unwillingness from the patient (72.5%), lack of time (27.5%), and lack of confidentiality (26.6%). OTC medicines are considered safer than prescription-only medicines by pharmacists. Pharmacists could substantially contribute to rational self-medication and alleviate the burden on healthcare systems.

The digitization of health systems is a topic of immense significance for the modern world. It holds the potential to transform the delivery of healthcare services, enhancing their quality, efficiency, and accessibility. Electronic prescriptions are a key element of this process, but it is crucial to ensure their implementation protects patients’ personal data and privacy. This article examines the digitization of health systems in Bulgaria, with a focus on electronic prescriptions. It highlights aspects of data protection, the potential risks associated with data misuse, and the advantages of electronic prescriptions.

Ensuring the quality and safety of medicinal products is of paramount importance to the pharmaceutical industry. Good manufacturing practice (GMP) regulations are part of a pharmaceutical manufacturer’s quality management system and ensure that medicinal products are manufactured, imported and controlled consistently to quality standards appropriate to their intended use. The aim of the present study is to analyze the non-compliant operations identified during GMP inspections carried out by national competent authorities (NCA) in the EU/EEC between 2013 and 2022. A retrospective analysis of non-compliance reports published in the EudraGMDP database between 2013 and 2022 was performed. Overall, 99 reports by 21 national competent authorities were analyzed presenting the results of inspections in 19 countries. A total of 1458 deficiencies were identified, of which 544 (37%) were classified as major and 127 (9%) as critical. The most common non-compliant operations were the manufacturing of active substances (49 deficiencies) and the preparation of non-sterile products (47 deficiencies). In 41 cases, the NCA recommended suspension or voiding of the certificate of suitability (CEP) and in 36 cases revocation of the GMP certificates. The observed deficiencies highlight the importance and need for continuous monitoring and improvement of manufacturers’ production processes and quality management systems.