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The effect of an integrated syndromic respiratory disease guideline in primary health care settings
Author(s) -
Abouda Maher,
Hamzaoui Agnes,
Drira Ekram,
Djebeniani Ridha,
Othmani Salah,
Ben Kheder Ali
Publication year - 2015
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.12420
Subject(s) - medicine , medical prescription , guideline , referral , respiratory system , disease , respiratory tract infections , respiratory disease , disease management , pediatrics , physical therapy , intensive care medicine , emergency medicine , family medicine , lung , pathology , parkinson's disease , pharmacology
Rationale, aims and objectives The use of integrated syndromic guidelines ( ISG ) aims to improve the quality of care for patients with respiratory diseases. The impact of such ISG in clinical practice can be potentially significant in primary health care ( PHC ) settings. We report the impact of the use by general practitioners (GPs) of a Tunisian ISG for respiratory diseases in management of respiratory patients in PHC .Methods The short‐term impact was assessed through the results of the feasibility study. This study included a baseline survey, before training on ISG , and an impact survey, after training on ISG . The same 73 GPs practicing within 28 PHCs were involved in the two surveys at an interval of 6 weeks. Information on each patient mentioned gender, age, underlying conditions, symptoms, referral, diagnosis and drug prescription details. Results During the periods of the baseline and impact surveys, 36.0 and 31.1% of PHC attendees, respectively, sought care for respiratory symptoms. Acute respiratory infection ( ARI ) cases accounted for more than 85% of patients with respiratory disease. In the impact survey, chronic respiratory disease ( CRD ) diagnosis increased by approximately 50%. In the same way, the proportion of tuberculosis suspects increased 5.5 times. The number of drugs prescribed per patient decreased by 18.8%, and the proportion of patients who were prescribed antibiotics decreased by 19.0%. The prescription of steroids also significantly decreased while inhaled β‐agonist prescription increased. The average cost of drug prescription was reduced by 19%. Conclusion Training on ISG for respiratory diseases improved the diagnosis of CRD and tuberculosis, and lead to a more rational use of drugs for ARIs in PHCs .