M. MALIK & col
500
RESUMEN
Juicio sobre la adherencia a las directrices de tratamiento de la malaria. Un
estudio transversal comparativo en Pakistán
Se diseñó un estudio transversal comparativo para evaluar la adherencia de los
prescriptores a las pautas estándar nacionales de tratamiento de la malaria, en
veinte instalaciones sanitarias terciarias, públicas y privadas, de dos ciudades de
Pakistán. Se evaluaron un total de 600 encuestas a pacientes sometidos al régimen
estándar nacional de tratamiento contra la malaria. No se observó diferencia
significativa alguna (a nivel de p ≤ 0.05) sobre la adherencia de prescriptores con
diferentes niveles de experiencia con el régimen de tratamiento estándar para la
malaria en las dos ciudades. Los resultados del presente estudio mostraron baja
adhesión de los prescriptores al régimen de tratamiento estándar para la malaria en
Pakistán.
Keywords:
Pautas de tratamiento estándar; Adherencia; Malaria; Pakistán
.
1. INTRODUCTION
The rational use of drugs demands that appropriate drugs must be
prescribed and available at the right time and at an affordable price to the patients.
Prescribing patterns might influence the effectiveness of treatment and the control
of disease. Inadequate, excessive or incorrect prescribing practices are most likely
to be the commonest forms of irrational prescribing habits. Development of
resistance to antibiotics, ineffective treatment, adverse effects, drug dependence
and economic burden to the patient and society due to irrational prescribing
practices are the major dilemma of present medical practice in case of malaria (1).
Rational prescribing requires that the prescribers adhere to standard
treatment guidelines to facilitate a constant, therapeutically effective and
economically efficient use of drugs. This greatly enhance the compliance of
patients and outcome of therapy (2). But most of the medical practitioners in
developing countries including Pakistan are prone to practice their own protocols
to treat malaria rather than adhering to standard regimens. Promoting the rational
use of drugs remains a major challenge.
Standard treatment guidelines are one of the tools to support effective
clinical practice and promotion of rational use of drugs. These guidelines must be
implemented and the monitoring of case management according to these
guidelines must be evaluated (3). Standard treatment guidelines for Malaria have
been formulated and introduced in 2005 through collaborative efforts of
directorate of malaria control, WHO and technical core group in Pakistan (4).
Chloroquine is recommended as first line drug in the treatment of all types of
