Republic of Moldova
2 articles
Family physicians’ perceptions of digital health technologies as enablers of personalised medicine in primary care: a cross-sectional survey in Moldova
Introduction.
The aim of this study was to assess family physicians’ perceptions and practices regarding the use of digital health technologies in clinical practice and to identify potential barriers to implementing digitalization as a pillar of personalised medicine.
Materials and methods.
A descriptive, observational, cross-sectional study was conducted among 319 family physicians from primary healthcare institutions across the Republic of Moldova. Data were collected between March and June 2024 using a paper-based, self-administered questionnaire developed specifically for this study and validated through expert review and pilot testing. Statistical analysis was performed using IBM SPSS Statistics and Microsoft Excel and included descriptive statistics, Pearson’s chi-square tests for categorical comparisons, Bonferroni-adjusted post-hoc comparisons where appropriate, and age-adjusted ordinal logistic regression to assess differences by practice setting. Statistical significance was set at p < 0.05.
Results.
Only 106 respondents (33.2%; 95% CI: 28.0–38.4) identified electronic health data integration as a component of personalised medicine, despite near-universal use of electronic medical record systems (310; 97.2%; 95% CI: 95.4–99.0). While perceptions of the usefulness of digital tools were predominantly positive (approximately 65–70%), with 209 respondents (65.5%; 95% CI: 60.3–70.7) indicating that electronic medical records facilitate clinical activity and 204 (64.0%; 95% CI: 58.7–69.3) reporting that digital technologies can improve quality of care, only 142 respondents (44.5%; 95% CI: 39.1–50.0) supported patient access to medical data and 114 (35.8%; 95% CI: 30.5–41.1) perceived benefits of such access. Comfort with digital systems was moderate, with 220 respondents (69.0%; 95% CI: 63.9–74.1) expressing agreement or strong agreement regarding their comfort with using health information systems.
Conclusions.
Primary-care electronic medical record use was nearly universal among surveyed family physicians, while awareness of digital data integration as a component of personalised medicine and support for patient access to records were less frequent. Age-adjusted analyses showed persistent urban–rural differences. These findings support the development of user-centred digital solutions and targeted education on digital health, interoperability, data sharing, and patient access
Advances in disease-modifying therapies for multiple sclerosis: global updates and a regional comparison between the Republic of Moldova and Romania
Introduction
The therapeutic landscape of multiple sclerosis has undergone a remarkable transformation over the past two decades. The paradigm has shifted from reliance on moderate-efficacy, first-generation injectable therapies toward earlier adoption of high-efficacy disease-modifying treatments, particularly in relapsing forms of MS. This evolution reflects an increasing focus on early intensive treatment strategies aimed at preserving long-term neurological function and brain health.
Materials and methods
This narrative review synthesizes recent global evidence on progress in disease-modifying treatments across all multiple sclerosis phenotypes, drawing from randomized controlled trials, real-world studies, and expert consensus guidelines. In addition, it includes a comparative health policy analysis assessing DMT availability, access, and implementation in Romania and the Republic of Moldova, based on national formularies, reimbursement frameworks, and care delivery models.
Results
Globally, the MS treatment algorithm has been reoriented toward early intensive treatment, supported by emerging evidence favoring high-efficacy therapies in the early disease course. While many countries have aligned their protocols accordingly, regional discrepancies persist. Romania, as an EU member, has expanded patient access to 16 reimbursed therapies and biomarker-driven monitoring, and has developed a network of specialized Multiple Sclerosis centers. Conversely, the Republic of Moldova faces structural and economic barriers that restrict access to high-efficacy treatments, advanced diagnostics, and multidisciplinary care—factors contributing to delayed treatment and suboptimal outcomes.
Conclusions
Understanding both global innovations and regional realities is necessary to place current Multiple Sclerosis care in context. Further advancements in science, health policy, and infrastructure will ultimately determine how effectively different nations can convert therapeutic progress into actual improvements in patient outcomes.