Effectiveness of feedback for improving case management of malaria, diarrhoea and pneumonia--a randomized controlled trial at provincial hospitals in Lao PDR.

摘要: BACKGROUND Standard Treatment Guidelines were introduced to all prescribers at provincial hospitals in Lao PDR and treatment indicators developed within the National Drug Policy programme monitor compliance. OBJECTIVES To evaluate effects of an educational intervention improve practices malaria, diarrhoea pneumonia. METHODS Randomized controlled trial with 24 departments eight hospitals, matched into four pairs. The three internal medicine, paediatrics out-patients each pair randomized or control group. 6-month was conducted by members Therapeutics Committees, comprised monthly audit sessions form outcome feedback using indicator scores on recorded We measured 6 months after end compared baseline. RESULTS aggregated mean for diseases, malaria diarrhoea, improved significantly. For pneumonia, improvement seen both groups. Record keeping diseases. there improvements recording patients' history, frequency microscope testing; regarding weight measurements, palpation fontanel children under 2 years, reduction irrational use anti-diarrhoeals antibiotics; respiratory count, reducing anti-histamines anti-cough medications. CONCLUSIONS Audit-feedback systems quality care are feasible effective also hospital settings low-income countries.