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Doctors' compliance with national guidelines and clinical pathway on the treatment of tuberculosis inpatients in H ubei, C hina
Author(s) -
Zheng Xiaofei,
Zhong Fangying,
Zhang Xinping
Publication year - 2014
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12127
Subject(s) - medicine , ethambutol , pyrazinamide , rifampicin , tuberculosis , isoniazid , dose , christian ministry , emergency medicine , medical record , drug , pulmonary tuberculosis , intensive care medicine , pediatrics , pharmacology , philosophy , theology , pathology
Rationale, aims and objectives The Ministry of Health in China has enacted a revised National Tuberculosis Control Program (NTP) guidelines and clinical pathway ( CP ) on new smear‐positive pulmonary tuberculosis ( TB ) inpatients to improve the quality of TB care and asked doctors' compliance to them on the treatment of TB inpatients. However, it remains unknown whether doctors adhere to them well. So this study focuses on evaluating the doctors' compliance with them in one representative TB hospital for medical quality improvement. Methods A hospital‐based retrospective study involving all medical records of newly diagnosed smear‐positive pulmonary TB inpatients from J uly 2011 to J uly 2013. Analysis indicators including adequate drug regimens rate, adequate drug dosages rate and adequate length of hospital stay rate were chosen to assess doctors' compliance with NTP guidelines and CP on the treatment of new smear‐positive pulmonary TB inpatients. The optimal value of these indicators is 100%. Results Of the 334 inpatients selected, the rate of adequate drug regimens prescribed is 26.95% (90/334), and the rate of adequate drug dosages is 0% (0/90). For the dosage of single drug, the rates of adequate dosage of isoniazid, rifampicin, pyrazinamide and ethambutol are 24.44% (22/90), 85.56% (77/90), 70% (63/90) and 13.33% (12/90). Moreover, 75.56% (68/90) of isoniazid was prescribed too high and 83.34% (75/90) of ethambutol was prescribed too low. The rate of adequate length of hospital stay provided is 28.44% (95/334). Conclusion Doctors' compliance with NTP guidelines and CP on new smear‐positive pulmonary TB inpatients is depressed and needs improvement.