Development of standard therapeutic guidelines for selected common diseases for the primary health care centres of a South Indian district

N. Mohan, B.G. Nagavi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Context: The concept of standard therapeutic guidelines is relatively new in the primary health care setting in India. Objective: To develop standard therapeutic guidelines for selected common diseases for the primary health care centres (PHCs) of a South Indian district and to evaluate medical officers' perceptions about the proposed guidelines and about guidelines in general. Method: A questionnaire survey of medical officers was conducted to collect data on the most commonly-presenting diseases and doctors' treatment choices in PHCs in Mysore. Draft guidelines were developed for these conditions based on available literature, together with microbiological sensitivity data from the three district hospitals. User feedback on the draft guidelines and on guidelines in general was obtained from medical officers using a postal questionnaire. Setting: Sample of 17 of the 93 PHCs in Mysore. Key findings: Upper respiratory tract infection was the most commonly-presenting condition. Procaine penicillin was the most commonly-used drug and there were examples of inappropriate treatment choices. The survey produced evidence that access to medicines on the government's "essential" list was not uniform, with many patients having to purchase prescribed drugs that were not on the list. The response rate to the user feedback questionnaire was 62 per cent (31 doctors). The medical officers had positive opinions about guidelines in general and felt that the guidelines we proposed were useful and would help them to improve their prescribing habits. Conclusions: Prescribing in primary care in India needs to be improved. The involvement of potential users of the guidelines in their development should increase their acceptability and thus their use in practice.
Original languageEnglish
Pages (from-to)169-174
Number of pages6
JournalInternational Journal of Pharmacy Practice
Volume11
Issue number3
DOIs
Publication statusPublished - 2003

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Health care
Primary Health Care
Penicillin G Procaine
Guidelines
Feedback
Pharmaceutical Preparations
Medicine
Therapeutics
India
District Hospitals
Respiratory Tract Infections
Habits
Surveys and Questionnaires

Cite this

@article{981efae95e77464289fc5c23c56bc46d,
title = "Development of standard therapeutic guidelines for selected common diseases for the primary health care centres of a South Indian district",
abstract = "Context: The concept of standard therapeutic guidelines is relatively new in the primary health care setting in India. Objective: To develop standard therapeutic guidelines for selected common diseases for the primary health care centres (PHCs) of a South Indian district and to evaluate medical officers' perceptions about the proposed guidelines and about guidelines in general. Method: A questionnaire survey of medical officers was conducted to collect data on the most commonly-presenting diseases and doctors' treatment choices in PHCs in Mysore. Draft guidelines were developed for these conditions based on available literature, together with microbiological sensitivity data from the three district hospitals. User feedback on the draft guidelines and on guidelines in general was obtained from medical officers using a postal questionnaire. Setting: Sample of 17 of the 93 PHCs in Mysore. Key findings: Upper respiratory tract infection was the most commonly-presenting condition. Procaine penicillin was the most commonly-used drug and there were examples of inappropriate treatment choices. The survey produced evidence that access to medicines on the government's {"}essential{"} list was not uniform, with many patients having to purchase prescribed drugs that were not on the list. The response rate to the user feedback questionnaire was 62 per cent (31 doctors). The medical officers had positive opinions about guidelines in general and felt that the guidelines we proposed were useful and would help them to improve their prescribing habits. Conclusions: Prescribing in primary care in India needs to be improved. The involvement of potential users of the guidelines in their development should increase their acceptability and thus their use in practice.",
author = "N. Mohan and B.G. Nagavi",
note = "Cited By :2 Export Date: 10 November 2017 CODEN: IJPPF Correspondence Address: Nagavi, B.G.; JSS College of Pharmacy, SS Nagar, Mysore 570 015, Karnataka, India; email: jsspharma@lycos.com Chemicals/CAS: amoxicillin, 26787-78-0, 34642-77-8, 61336-70-7; ciprofloxacin, 85721-33-1; doxycycline, 10592-13-9, 17086-28-1, 564-25-0; folic acid, 59-30-3, 6484-89-5; gentamicin, 1392-48-9, 1403-66-3, 1405-41-0; iron, 14093-02-8, 53858-86-9, 7439-89-6; norfloxacin, 70458-96-7; procaine penicillin, 54-35-3, 6130-64-9; ranitidine, 66357-35-5, 66357-59-3 References: Vinker, S., Nakar, S., Rosenberg, E., Bero-Aloni, T., Kitai, E., Attitudes of Israeli family physicians toward clinical guidelines (2000) Arch Fam Med, 9, pp. 835-840; Jaju, B.P., Essential drugs for the Indian community (1987) Eastern Pharm, 30, pp. 83-95; Hogerzeil, H.V., Bimo, Ross-Degnan, D., Laing, R.O., Ofori-Adjei, D., Santoso, B., Field tests for rational drug use in twelve developing countries (1993) Lancet, 342, pp. 1408-1410; Forshaw, C., Hogerzeil, H.V., (1997) Treatment Guidelines and Formulary Manuals. Managing Drug Supply: The Selection, Procurement, Distribution and Use of Pharmaceuticals. 2nd Ed., pp. p137-p149. , Bloomfield, Connecticut: Kumarian Press; Petrie, J., Clinical guidelines in Scotland: A SIGN of the times (1996) Essential Drugs Mon, 2, pp. 13-14; (1992) The Use of Essential Drugs. Fifth Report of the WHO Expert Committee, pp. p1-p15. , Geneva: WHO; Kshirsagar, M.J., Langade, D., Patil, S., Patki, P.S., Prescribing patterns among medical practitioners in Pune, India (1998) Bull World Health Org, 76, pp. 271-275; (2001) Respiratory Drug Guidelines, , Victorian Drug Usage Advisory Committee, Victoria, Australia; Ho, M., McDonald, C., Lauderdale, T.L., Yeh, L.L.L., Chen, P.C., Shiau, Y.R., Surveillance of antibiotic resistance in Taiwan 1998 (1999) J Microbiol Immunol Infect, 32, pp. 239-249",
year = "2003",
doi = "10.1211/0022357021981",
language = "English",
volume = "11",
pages = "169--174",
journal = "International Journal of Pharmacy Practice",
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publisher = "Pharmaceutical Press",
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TY - JOUR

T1 - Development of standard therapeutic guidelines for selected common diseases for the primary health care centres of a South Indian district

AU - Mohan, N.

AU - Nagavi, B.G.

N1 - Cited By :2 Export Date: 10 November 2017 CODEN: IJPPF Correspondence Address: Nagavi, B.G.; JSS College of Pharmacy, SS Nagar, Mysore 570 015, Karnataka, India; email: jsspharma@lycos.com Chemicals/CAS: amoxicillin, 26787-78-0, 34642-77-8, 61336-70-7; ciprofloxacin, 85721-33-1; doxycycline, 10592-13-9, 17086-28-1, 564-25-0; folic acid, 59-30-3, 6484-89-5; gentamicin, 1392-48-9, 1403-66-3, 1405-41-0; iron, 14093-02-8, 53858-86-9, 7439-89-6; norfloxacin, 70458-96-7; procaine penicillin, 54-35-3, 6130-64-9; ranitidine, 66357-35-5, 66357-59-3 References: Vinker, S., Nakar, S., Rosenberg, E., Bero-Aloni, T., Kitai, E., Attitudes of Israeli family physicians toward clinical guidelines (2000) Arch Fam Med, 9, pp. 835-840; Jaju, B.P., Essential drugs for the Indian community (1987) Eastern Pharm, 30, pp. 83-95; Hogerzeil, H.V., Bimo, Ross-Degnan, D., Laing, R.O., Ofori-Adjei, D., Santoso, B., Field tests for rational drug use in twelve developing countries (1993) Lancet, 342, pp. 1408-1410; Forshaw, C., Hogerzeil, H.V., (1997) Treatment Guidelines and Formulary Manuals. Managing Drug Supply: The Selection, Procurement, Distribution and Use of Pharmaceuticals. 2nd Ed., pp. p137-p149. , Bloomfield, Connecticut: Kumarian Press; Petrie, J., Clinical guidelines in Scotland: A SIGN of the times (1996) Essential Drugs Mon, 2, pp. 13-14; (1992) The Use of Essential Drugs. Fifth Report of the WHO Expert Committee, pp. p1-p15. , Geneva: WHO; Kshirsagar, M.J., Langade, D., Patil, S., Patki, P.S., Prescribing patterns among medical practitioners in Pune, India (1998) Bull World Health Org, 76, pp. 271-275; (2001) Respiratory Drug Guidelines, , Victorian Drug Usage Advisory Committee, Victoria, Australia; Ho, M., McDonald, C., Lauderdale, T.L., Yeh, L.L.L., Chen, P.C., Shiau, Y.R., Surveillance of antibiotic resistance in Taiwan 1998 (1999) J Microbiol Immunol Infect, 32, pp. 239-249

PY - 2003

Y1 - 2003

N2 - Context: The concept of standard therapeutic guidelines is relatively new in the primary health care setting in India. Objective: To develop standard therapeutic guidelines for selected common diseases for the primary health care centres (PHCs) of a South Indian district and to evaluate medical officers' perceptions about the proposed guidelines and about guidelines in general. Method: A questionnaire survey of medical officers was conducted to collect data on the most commonly-presenting diseases and doctors' treatment choices in PHCs in Mysore. Draft guidelines were developed for these conditions based on available literature, together with microbiological sensitivity data from the three district hospitals. User feedback on the draft guidelines and on guidelines in general was obtained from medical officers using a postal questionnaire. Setting: Sample of 17 of the 93 PHCs in Mysore. Key findings: Upper respiratory tract infection was the most commonly-presenting condition. Procaine penicillin was the most commonly-used drug and there were examples of inappropriate treatment choices. The survey produced evidence that access to medicines on the government's "essential" list was not uniform, with many patients having to purchase prescribed drugs that were not on the list. The response rate to the user feedback questionnaire was 62 per cent (31 doctors). The medical officers had positive opinions about guidelines in general and felt that the guidelines we proposed were useful and would help them to improve their prescribing habits. Conclusions: Prescribing in primary care in India needs to be improved. The involvement of potential users of the guidelines in their development should increase their acceptability and thus their use in practice.

AB - Context: The concept of standard therapeutic guidelines is relatively new in the primary health care setting in India. Objective: To develop standard therapeutic guidelines for selected common diseases for the primary health care centres (PHCs) of a South Indian district and to evaluate medical officers' perceptions about the proposed guidelines and about guidelines in general. Method: A questionnaire survey of medical officers was conducted to collect data on the most commonly-presenting diseases and doctors' treatment choices in PHCs in Mysore. Draft guidelines were developed for these conditions based on available literature, together with microbiological sensitivity data from the three district hospitals. User feedback on the draft guidelines and on guidelines in general was obtained from medical officers using a postal questionnaire. Setting: Sample of 17 of the 93 PHCs in Mysore. Key findings: Upper respiratory tract infection was the most commonly-presenting condition. Procaine penicillin was the most commonly-used drug and there were examples of inappropriate treatment choices. The survey produced evidence that access to medicines on the government's "essential" list was not uniform, with many patients having to purchase prescribed drugs that were not on the list. The response rate to the user feedback questionnaire was 62 per cent (31 doctors). The medical officers had positive opinions about guidelines in general and felt that the guidelines we proposed were useful and would help them to improve their prescribing habits. Conclusions: Prescribing in primary care in India needs to be improved. The involvement of potential users of the guidelines in their development should increase their acceptability and thus their use in practice.

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DO - 10.1211/0022357021981

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JO - International Journal of Pharmacy Practice

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