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Improving Chloroquine Prescribing in Private Clinics in Lagos State, Nigeria

Improving Chloroquine Prescribing in Private Clinics in Lagos State, Nigeria *Taylor O, **Momodu RO, **Odufalu O *World Health Organisation **National Agency for Food and Drug Administration and Control (NAFDAC). Introduction/Background.

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Improving Chloroquine Prescribing in Private Clinics in Lagos State, Nigeria

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  1. Improving Chloroquine Prescribing in PrivateClinics in Lagos State, Nigeria • *Taylor O, **Momodu RO, **Odufalu O • *World Health Organisation • **National Agency for Food and Drug Administration and Control (NAFDAC)

  2. Introduction/Background • MALARIA IS A COMMON PUBLIC HEALTH PROBLEM IN NIGERIA AND CHLOROQUINE(CQ) IS USED AS A FIRST LINE ANITMALARIAL IN THE TREATMENT OF UNCOMPLICATED MALARIA. • IRRATIONAL PRESCRIBING IS CONTRIBUTORY TO THE PROBLEM OF DRUG RESISTANCE • MORE THAN HALF THE PRESCRIPTIONS IN BOTH PUBLIC AND PRIVATE HEALTH FACILITES IN LAGOS STATE WERE INAPPROPRIATE (TAYLOR ET AL 1998)

  3. HYPOTHESIS/OBJECTIVE HYPOTHESIS • ABILITY TO REMEMBER THE MULTIPLE DOSING SCHEDULE FOR VARIOUS AGES IN CQ MAY BE THE CRITICAL FACTOR IN IRRATIONAL PRESCRIBING RATHER THAN IGNORANCE OF THE APPROPRIATE DOSING. OBJECTIVE • TO COMPARE THE EFFECTIVENESS OF AIDE-MEMOIRE AND A PRINTED DRUG INFORMATION LEAFLET IN IMPROVING CHLOROQUINE PRESCRIBING IN PRIVATE HEALTH FACILITIES IN LAGOS STATE.

  4. METHODS • 13 PRIVATE HEALTH FACILITIES IN LAGOS STATE ,NIGERIA • A BASELINE STUDY TO DETERMINE CQ PRESCRIBING PATTERN IN THESE FACILITIES • RANDOMLY DISTRIBUTED TO RECEIVE: • ACADEMIC DETAILING WITH AIDEMEMOIRE (5) • ACADEMIC DETAILING WITH PRINTED DRUG INFORMATION LEAFLET(4) • CONTROL - NO INTERVENTION (4) • OUTCOME INDICATORS: • CORRECT DOSING OF CHLOROQUINE • PRESCRIPTIONS WITH ORAL DOSAGE FORMS • PRSECRIPTIONS WITH INJECTIONS FOLLOWED BY THE ORAL FORM. • PRESCRIPTIONS WITH CHLOROQUINE INJECTIONS ONLY.

  5. INTERVENTION METHODS ACADEMIC DETAILING KEY PRESENTATION MESSAGE: • VALUE OF CQ IN MALARIA CHEMOTHERAPY • ROLE OF DOSAGE FORM IN INAPPROPRIATE PRESCRIBING • APPROPRIATE DOSAGE REGIMEN WAS ADVICED • USE ORAL DOSAGE FORM • USE INJECTION BUT COMPLETE WITH ORAL DOSAGE FORM

  6. INTERVENTION METHODS • DRUG INFORMATION LEAFLET • CQ dosing schedule for different ages printed on a sheet of paper AIDEMEMOIRE • A gift item used by corporate organisations for publicity • Consists of plastic box filled with loose sheets • Same dosing schedule is printed on the side of the box • Placed on physician’s table

  7. INFORMATION LEAFLET

  8. INFORMATION LEAFLET

  9. INFORMATION LEAFLET

  10. INFORMATION LEAFLET

  11. CONCLUSION • THE INTERVENTION INCREASED THE PERCENTAGE OF PRESCRIPTIONS IN THE CORRECT DOSE. • THE AIDEMEMOIRE IS MORE EFFECTIVE THAN THE PRINTED INFORMATION LEAFLET IN REMINDING PRESCRIBERS OF THE APPROPRIATE DOSAGE REGIMEN OF CHLOROQUINE. • THIS INTERVENTION CAN BE USED TO IMPROVE RATIONAL DRUG USE. • THERE IS A NEED FOR CLOSER MONITORING OF DRUG USE IN THE PRIVATE CLINICS.

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