X hits on this document

Word document

CITATION: Presented at the International Conference on Improving Use of - page 37 / 51

144 views

0 shares

0 downloads

0 comments

37 / 51

Improving Primary Care Pharmaceutical Use

Gonzalez Ochoa

(1996)

Latin America

RCT

MDs, community

4 health areas in Havana, 10 clinics in each

ARI

Multi-method MD training, supervision (E1 & E2) with or without  intensive small group public ed (E1 & E3)

% AB use in community for mild ARI

ΔE1 = 26.6%7.8% = -18.8%

ΔE2 = 20.6%11.7% = -8.9%

ΔE3 = 11.4%12.3% = +0.9%

ΔC = 19.6%20.3% = +0.7%

Kafuko

(1994)

Africa

RCT

MDs, parameds

6 districts, with 42 H units in E1, 29 in E2, 14 in E3, and 42 in C

Diarrhea, malaria, Rxg for all conditions, dispensing

Dissemination of book of national STGs (E1); plus on-site training in therapeutic problems (E2); plus 4 supervisory visits in 6 mos (E3)

# drugs Rxd

% Txd according to STG

% patients given proper dispensing instructions

ΔE1 = 2.372.45 = +3.4%

ΔE2 = 2.352.09 = -11.1%

ΔE3 = 2.392.14 = -10.5%

ΔC = 2.452.45 = -0.0%

ΔE1 = 24.8%32.3% = +7.5%

ΔE2 = 24.0%52.0% = +28.0%

ΔE3 = 21.4%55.2% = +33.8%

ΔC = 24.8%29.9% = +5.1%

ΔE1 = 43.1%49.0% = +5.9%

ΔE2 = 44.8%57.6% = +12.8%

ΔE3 = 43.8%63.7% = +19.9%

ΔC = 49.8%33.5% = -16.3%

Lopez Linares

(1991)

Latin America

PP&C

CHWs (& community)

5 E, 2 C slums (pre-post survey with ~650 E, ~475 C HHs)

ARI, diarrhea, lack of appetite

Series of workshops for CHWs about drug use, then community outreach (radio, displays, discussions, radio)

% HHs Adid nothing@ for common cold

% HHs Adid nothing@ for infant  diarrhea

ΔE = 5.7%21.9% = +16.2%

ΔC = 12.0%1.7% = -11.3%

ΔE = 5.3%28.8% = +23.5%

ΔC = 0.0%4.4% = +4.4%

Naivalulevu

(1990)

Asia

TS

(repeat meas.)

MDs, parameds

MIS for all H facilities (~2000 ARI cases)

ARI

Training workshops on ARI case mgmt

% AB use for ARI

Δ = 43%22% = -21% (3 mo)

Δ = 43%37% = -6% (9mo)

Ofori-Adjei

(1996)

Africa

PP&C

Parameds

20 medical assistants with early training (E1), 20 later training (E2),  20 no training (C)

Malaria

Standard didactic in-serv ice training in malaria treatment using case histories and case presentations

% use chloroquine (CQ) injection

% of std. WHO CQ dose for 2-year old

ΔE1 = 17.0%15.9% = -1.1%

ΔE2 = 16.9%15.6% = -1.3%

ΔC = 19.9%18.3% = -1.6%

ΔE1 = 191%203% = +12%

ΔE2 = 198%169% = -29%

ΔC = 185%135% = -50%

-35-

Improving Primary Care Pharmaceutical UseApril, 1997

Document info
Document views144
Page views144
Page last viewedFri Dec 09 06:21:40 UTC 2016
Pages51
Paragraphs1380
Words16826

Comments