scholarly journals Are antibiotic prescription practices in Eastern Uganda concordant with the national standard treatment guidelines? A cross-sectional retrospective study.

2021 ◽  
Author(s):  
Samuel Baker Obakiro ◽  
Agnes Napyo ◽  
Mayoka John Wilberforce ◽  
Pamella Adongo ◽  
Kenedy Kiyimba ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Antibiotic Prescription ◽  
National Standard ◽  
Cross Sectional ◽  
Prescription Practices ◽  
Standard Treatment Guidelines ◽  
Eastern Uganda

scholarly journals Changes to the ART guidelines – an overview

2010 ◽  
Vol 11 (1) ◽  
Author(s):  
Celicia Serenata
Keyword(s):  
Antiretroviral Therapy ◽  
South African ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Dual Therapy ◽  
National Standard ◽  
Child Transmission ◽  
Task Team ◽  
Standard Treatment Guidelines ◽  
Mother To Child

In 2009 the South African National AIDS Council (SANAC) Treatment Technical Task Team (TTT) finalised recommendations for changes to the national standard treatment guidelines for adult and paediatric management and treatment, as well as changes in the prevention of mother-to-child transmission of HIV (PMTCT) guidelines, moving away from monotherapy to dual therapy. President Zuma announced changes in the national antiretroviral therapy (ART) programme on World AIDS Day 2009. Subsequently additional changes were made to the treatment guidelines to be in line with these new Presidential mandates, which came into effect on 1 April 2010.

scholarly journals Use of evidence and negotiation in the review of national standard treatment guidelines and essential medicines list: experience from Ghana

2019 ◽  
Vol 34 (Supplement_2) ◽  
pp. ii104-ii120 ◽  
Author(s):  
Augustina Koduah ◽  
Brian A Asare ◽  
Edith Gavor ◽  
Martha Gyansa-Lutterodt ◽  
Edith Andrews Annan ◽  
...  
Keyword(s):  
Review Process ◽  
Standard Treatment ◽  
Service Providers ◽  
Treatment Guidelines ◽  
Essential Medicines ◽  
National Standard ◽  
Expert Committee ◽  
Research And Practice ◽  
Essential Medicines List ◽  
Standard Treatment Guidelines

Abstract Understanding how countries review their national standard treatment guidelines (STGs) and essential medicines list (EML) is important in the light of ever-changing trends in public health and evidence supporting the selection and use of medicines in disease management. This study examines the 2017 STGs and EML review process, the actors involved and how the list of medicines and disease conditions evolved between the last two editions. We examined expert committee reports, stakeholder engagement reports and the last two editions (2010, 2017) STGs and EML. The review process occurred in both bureaucratic and public arenas where various actors with varied power and interest engaged in ways to consolidate their influence with the use of evidence from research and practice. In the bureaucratic arena, a national medicines selection committee inaugurated by the Minister of Health assessed the 2010 edition through technical sessions considering the country’s disease burden, hierarchical healthcare structure and evidence on safety and efficacy and expert opinion. To build consensus and ensure credibility service providers, professional bodies and healthcare managers scrutinized the assessed guidelines and medicines list in public arenas. In such public arenas, technical discussions moved towards negotiations with emphasis on practicability of the policies. Updates in the 2017 guidelines involved the addition of 64 new disease conditions in the STG, with the EML including 153 additional medicines and excluding 56 medicines previously found in the 2010 EML. Furthermore, the level of care categorization for Level ‘A’ [i.e. community-based health planning and services (CHPS)] and Level ‘M’ (i.e. midwifery and CHPS with a midwife) evolved to reflect the current primary healthcare and community mobilization activities for healthcare delivery in Ghana. Ghana’s experience in using evidence from research and practice and engaging wide stakeholders can serve as lessons for other low and middle-income countries.

scholarly journals Adherence to standard treatment guidelines among prescribers in primary healthcare facilities in the Dodoma region of Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karin Wiedenmayer ◽  
Eva Ombaka ◽  
Baraka Kabudi ◽  
Robert Canavan ◽  
Sarah Rajkumar ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Standard Treatment Guidelines ◽  
Tract Infections

Abstract Background Tanzania’s primary healthcare system suffers from a scarcity of financial and human resources that impedes its effectiveness to deliver dependable and uniform quality healthcare. Adherence to standard treatment guidelines (STG) can help provide more consistent and correct diagnoses and treatments and limit the irrational use of medicines and the negative health consequences that can occur as a result. The purpose of this study was to investigate prescribers’ adherence of their diagnoses and respective treatments to national STG and to identify potential areas for planning interventions. Methods A cross-sectional study on prescribers’ adherence to diagnosis and treatment, according to national STG, was conducted in 2012 in public primary healthcare facilities (HCF) in the Dodoma region of Tanzania. Information on 2886 patients was collected, prospectively and retrospectively, from 120 HCF across the Dodoma region using a structured questionnaire. Twenty-five broadly defined main illness groups were recorded and the nine most prevalent and relevant conditions were statistically analysed in detail. Results Diagnoses and related treatments were recorded and analysed in 2872 cases. The nine most prevalent conditions were upper respiratory tract infections (25%), malaria (18%), diarrhoea (9.9%), pneumonia (6.1%), skin problems (5.8%), gastrointestinal diagnoses (5%), urinary tract infections (4%), worm infestations (3.6%) and eye problems (2.1%). Only 1.8% of all diagnoses were non-communicable diseases. The proportion of prescribers’ primary diagnoses that completely adhered to national STG was 599 (29.9%), those that partially adhered totalled 775 (38.7%), wrong medication was given in 621 cases (30.9%) and no diagnosis or medication was given in nine cases (0.5%). Sixty-one percent of all patients received an antibiotic regardless of the diagnoses. Complete adherence was highest when worms were diagnosed and lowest for diarrhoea. The proportion of cases that did not adhere to STG was highest with patients with skin problems and lowest for malaria. Conclusion Prescribers’ general adherence to national STG in primary HCF in the public sector in Dodoma region is sub-optimal. The reasons are multifaceted and focused attention, directed at improving prescribing and pharmacotherapy, is required with a view of improving patient care and health outcomes.

scholarly journals Adherence to Standard Treatment Guidelines Among Prescribers in Primary Healthcare Facilities in the Dodoma Region of Tanzania

2021 ◽  
Author(s):  
Karin Anne Wiedenmayer ◽  
Eva Ombaka ◽  
Baraka Kabudi ◽  
Robert Canavan ◽  
Sarah Rajkumar ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Standard Treatment Guidelines ◽  
Tract Infections

Abstract Background: Tanzania’s primary healthcare system suffers from a scarcity of financial and human resources which impedes its effectiveness to deliver dependable and uniform quality healthcare. Adherence to standard treatment guidelines (STG) can help provide more consistent and correct diagnoses and treatments and limit the irrational use of medicines and the negative health consequences that can occur as a result. The purpose of this study was to investigate prescribers’ adherence of their diagnoses and respective treatments to national STG and to identify potential areas for planning interventions.Methods: A cross sectional study on prescribers’ adherence to diagnosis and treatment, according to national STG, was conducted in 2012 in public, primary healthcare facilities (HCF) in the Dodoma region of Tanzania. Information on 2886 patients was collected, prospectively and retrospectively, from 120 HCF across the Dodoma region using a structured questionnaire. Twenty-five, broadly defined, main illness groups were recorded and the nine most prevalent and relevant conditions were statistically analysed in detail. Results: Diagnoses and related treatments were recorded and analysed in 2872 cases. The nine most prevalent conditions were upper respiratory tract infections (25%), malaria (18%), diarrhoea (9.9%), pneumonia (6.1%), skin problems (5.8%), gastrointestinal diagnoses (5%), urinary tract infections (4%), worm infestations (3.6%) and eye problems (2.1%). Only 1.8% of all diagnoses were non-communicable diseases. The proportion of prescribers’ primary diagnoses that completely adhered to national STG was 599 (29.9%), those that partially adhered totalled 775 (38.7%), wrong medication was given in 621 (30.9%) cases and no diagnosis or medication was given in nine cases (0.5%). Sixty-one percent of all patients received an antibiotic regardless of the diagnoses. Complete adherence was highest when worms were diagnosed and lowest for diarrhoea. The proportion of cases that did not adhere to STG was highest with patients with skin problems and lowest for malaria.Conclusion: Prescribers’ general adherence to national STG in primary HCF in the public sector in Dodoma region is sub-optimal. The reasons are multifaceted, and focused attention directed at improving prescribing and pharmacotherapy is required with a view of improving patient care and health outcomes.

scholarly journals Adherence to recommended intra-partum guidelines of high risk pregnancies: a study in North Bengal Medical College, Darjeeling district, West Bengal, India

2019 ◽  
Vol 6 (8) ◽  
pp. 3490
Author(s):  
Sumanta Chakraborty ◽  
Sunamika Banerjee
Keyword(s):  
High Risk ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Health Service Delivery ◽  
Near Miss ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Standard Treatment Guidelines ◽  
North Bengal

Background: High risk pregnancies in intra-partum period are vulnerable, and if not appropriately attended, may roll on to maternal death or dreaded maternal near-miss cases. Despite the presence of a number of standard treatment guidelines designed to address most of the high risk conditions, their adherence and implementation continues to be uncommon. To assess the adherence to recommended guidelines during referral of high risk pregnancies in labour in mothers of the difficult terrains of eastern Himalaya.Methods: A descriptive epidemiological study with cross-sectional design was conducted among mothers with high risk pregnancies admitted in the labour ward, North Bengal Medical College Hospital, Darjeeling. 433 subjects were studied using complete enumeration technique.Results: Anaemia in pregnancy (22%), obstructed labour (19%), pre-term rupture of membranes (15%) and pregnancy induced hypertension (15%) were the high risk conditions identified. Referral linkage existed in most (70.7%) but no pre-referral treatment was given to 61.4% of the intra-partum mothers. Multivariate analysis shows mothers with age more than 35 years (AOR 4.97), bad obstetric history (AOR 2.40) & not attended by doctors (AOR 5.02) were found to be having more odds of missing the pre-referral treatment. About 86% of the gaps in pre-referral treatment were due to doctors not attending patients, lack of referral communication, not providing JSSK facilities and non-maintenance of Partograph as per Pareto analysis.Conclusions: Most of the non-adherence to standard treatment guidelines in high risk intra-partum mothers are related to health service delivery and can be ameliorated through proper administrative measures. 

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