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Article: Practical Approach to Lung Health in Nepal: Better prescribing and reduction of cost

TitlePractical Approach to Lung Health in Nepal: Better prescribing and reduction of cost
Authors
KeywordsHealth worker education
Nepal
Prescription costs
Quality of care
Rational prescribing
Respiratory care guidelines
Issue Date2006
Citation
Tropical Medicine and International Health, 2006, v. 11, n. 5, p. 765-772 How to Cite?
AbstractOBJECTIVES: To assess the impact of Practical Approach to Lung Health (PAL) guidelines on prescription behaviour and the total cost of prescription for patients with asthma, chronic obstructive pulmonary disease and pneumonia. METHODS: Pre- and post-intervention comparison in a cluster randomized trial of primary care facilities. Seven health posts and 33 subhealth posts in Nepal were stratified by type and randomized into intervention and control groups. Health workers from the intervention facilities received 5 days training on the adapted PAL guidelines and their use. To collect prescription details, we used carbon-copy prescription pads in both groups. To measure the impact of PAL guidelines we used the World Health Organization's rational use of drug indicators and drug cost indicators, in a multivariate regression analysis. RESULTS: The PAL guidelines led to fewer prescriptions of multiple drugs and to more prescriptions of generic and essential drugs. The guidelines also lowered average prescription cost and wastage by disease except for chronic obstructive pulmonary disease although not to a statistically significant degree. Similarly, the prescription of antibiotics and adherence to guidelines improved, albeit not statistically significant. CONCLUSION: There is evidence that the implementation of PAL guidelines promotes rational use of drugs for some respiratory diseases. The expected health effects of PAL guidelines should be compared with their implementation costs before continuing training on lung health, and strategies put in place to sustain the effects. © 2006 Blackwell Publishing Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/326708
ISSN
2023 Impact Factor: 2.6
2023 SCImago Journal Rankings: 0.830
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorShrestha, Naveen-
dc.contributor.authorSamir, K. C.-
dc.contributor.authorBaltussen, Rob-
dc.contributor.authorKafle, Kumud K.-
dc.contributor.authorBishai, David-
dc.contributor.authorNiessen, Louis-
dc.date.accessioned2023-03-31T05:25:57Z-
dc.date.available2023-03-31T05:25:57Z-
dc.date.issued2006-
dc.identifier.citationTropical Medicine and International Health, 2006, v. 11, n. 5, p. 765-772-
dc.identifier.issn1360-2276-
dc.identifier.urihttp://hdl.handle.net/10722/326708-
dc.description.abstractOBJECTIVES: To assess the impact of Practical Approach to Lung Health (PAL) guidelines on prescription behaviour and the total cost of prescription for patients with asthma, chronic obstructive pulmonary disease and pneumonia. METHODS: Pre- and post-intervention comparison in a cluster randomized trial of primary care facilities. Seven health posts and 33 subhealth posts in Nepal were stratified by type and randomized into intervention and control groups. Health workers from the intervention facilities received 5 days training on the adapted PAL guidelines and their use. To collect prescription details, we used carbon-copy prescription pads in both groups. To measure the impact of PAL guidelines we used the World Health Organization's rational use of drug indicators and drug cost indicators, in a multivariate regression analysis. RESULTS: The PAL guidelines led to fewer prescriptions of multiple drugs and to more prescriptions of generic and essential drugs. The guidelines also lowered average prescription cost and wastage by disease except for chronic obstructive pulmonary disease although not to a statistically significant degree. Similarly, the prescription of antibiotics and adherence to guidelines improved, albeit not statistically significant. CONCLUSION: There is evidence that the implementation of PAL guidelines promotes rational use of drugs for some respiratory diseases. The expected health effects of PAL guidelines should be compared with their implementation costs before continuing training on lung health, and strategies put in place to sustain the effects. © 2006 Blackwell Publishing Ltd.-
dc.languageeng-
dc.relation.ispartofTropical Medicine and International Health-
dc.subjectHealth worker education-
dc.subjectNepal-
dc.subjectPrescription costs-
dc.subjectQuality of care-
dc.subjectRational prescribing-
dc.subjectRespiratory care guidelines-
dc.titlePractical Approach to Lung Health in Nepal: Better prescribing and reduction of cost-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1365-3156.2006.01599.x-
dc.identifier.pmid16640631-
dc.identifier.scopuseid_2-s2.0-33646262085-
dc.identifier.volume11-
dc.identifier.issue5-
dc.identifier.spage765-
dc.identifier.epage772-
dc.identifier.eissn1365-3156-
dc.identifier.isiWOS:000237097800025-

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