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Improving Primary Care Pharmaceutical Use

Reference

Region

Design

Target group

Sample Size

Focus

Intervention

Key Outcomes

Reported Change in Outcomes

1. Workshop / Training Course

Angunawela

(1991)

Asia

RCT

Prescribers (MDs/

parameds)

15 OPDs (5/gp,  3 prescribers per unit)

AB use for all conditions

5 newsletters about proper AB use (E1), with small group training seminar (E2)

% AB use

ΔE1= 31.5%24.1% = -7.4%

ΔE2= 38.8%31.5% = -7.3%

ΔC = 32.2%31.8% = -0.4%

Bexell

(1994)

Africa

RCT

MDs & parameds

8 E & 8 C HCs (26 prescribers in each group)

ARI, malaria, diarrhea

2-day multi-method training seminars

Correct drug given

% AB use

% injection use

ΔE = 52.5%69.3% = +16.8%

ΔC = 54.3%61.9% = +7.6%

ΔE = 48.9%49.1% = +0.2%

ΔC = 46.6%48.5% = +1.9%

ΔE = 11.9% to 12.6% = +0.7%

ΔC = 13.1%11.2% = -1.9%

Chowdhury

(1995)

Asia

RCT

MDs

18 H facilities (6 facilities with 24 MDs per group)

Diarrhea

Dissemination of printed STG for diarrhea Tx (E1), plus brief small group training (E2); ORS corners set up in all E & C facilities during intervention period

% treated according to STG

% receiving ABs

ΔE1 = 29.3%91.1% = +61.8%

ΔE2 = 22.8%95.3% = +72.5%

ΔC = 31.1%85.8% = +54.7%

ΔE1 = 70.1%8.9% = -61.2%

ΔE2 = 65.0%1.1% = -63.9%

ΔC = 66.3%15.3% = -51.0%

de Vries (1995)

Asia, Africa, Europe, USA

RCT

Med.studs.

7 medical schools, 219  med.students

(E 111; C 108)

Knowledge about prescribing

Problem-oriented training module in therapeutics and prescribing

Avg knowledge retention effect (points)

Avg knowledge transfer effect (points)

ΔE = 1.132.04 = +80.5%

ΔC = 1.191.30 = +9.2%

ΔE = 1.131.89 = +67.3%

ΔC = 1.19>1.27 = +6.7%

Gani

(1995)

Asia

PP&C

MDs & parameds

95 MDs (37 E from 3 districts, 58 C from 5 districts)

Diarrhea

Workshop on clinical mgmt and communication, leaflet on ORS and diarrhea treatment

% ORT prescribed

% AB use

E = 35%53% = +18%

C = 51%48% = -3%

E = 46%28% = +18%

C = 32%32% = +0%

-34-

Improving Primary Care Pharmaceutical UseApril, 1997

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