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Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors

BACKGROUND: Kerala is facing challenges in the secondary prevention efforts of non-communicable diseases (NCDs). In spite of being the top performer in health parameters among Indian states, the burden of NCDs, especially diabetes mellitus (diabetes) and hypertension, is higher in Kerala. This resea...

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Autores principales: Krishnapillai, Vijayakumar, Nair, Sanjeev, T. N, Anand, T. P, Sreelal, Soman, Biju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006375/
https://www.ncbi.nlm.nih.gov/pubmed/32028918
http://dx.doi.org/10.1186/s12889-020-8214-y
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author Krishnapillai, Vijayakumar
Nair, Sanjeev
T. N, Anand
T. P, Sreelal
Soman, Biju
author_facet Krishnapillai, Vijayakumar
Nair, Sanjeev
T. N, Anand
T. P, Sreelal
Soman, Biju
author_sort Krishnapillai, Vijayakumar
collection PubMed
description BACKGROUND: Kerala is facing challenges in the secondary prevention efforts of non-communicable diseases (NCDs). In spite of being the top performer in health parameters among Indian states, the burden of NCDs, especially diabetes mellitus (diabetes) and hypertension, is higher in Kerala. This research endeavours to identify the role of quality of medical prescriptions in secondary prevention of diabetes and hypertension and suggest corrective measures. METHODS: This cross-sectional study involved collection of prescription data and other details from consenting doctors across seven districts in Kerala. After the quality of prescription was assessed using a checklist, scores were generated, and cutoff points were used to classify the prescriptions. PASW version 18 software, was used for data analysis which included univariate and bivariate analyses and logistic regression. The proportion of quality prescriptions was estimated after adjusting for clustering, and the proportion of doctors writing quality prescriptions was also estimated. Prior to the study, ethical clearance from Independent ethics committee in Health action by People (HAP) and informed consent from all the study participants were obtained. RESULTS: After assessing 9199 prescriptions from 344 doctors, it was found that about 37.2% (95% CI: 34.9–39.4%) of the prescriptions were of good quality, and 48.2% (95% CI: 42.9–53.7%) of the doctors provided quality prescriptions. Factors associated with quality prescriptions were found to be knowledge about NCD guidelines, quality certifications of hospitals and usage of patient data management software. CONCLUSIONS: In the context of rising prevalence of NCDs and the challenges in the secondary prevention efforts, this is one of the first studies in Kerala to evaluate the quality of prescriptions to manage NCDs as prescriptions often reflect the quality of medical management. The study also addresses other factors associated with quality medical management. The findings indicate that the scope for improvement is more than 50%, when considered for the overall quality of prescriptions in diabetes and hypertension management. Further, it was found that appropriate training of doctors, adherence to treatment guidelines and the use of technology may improve the overall quality of prescriptions.
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spelling pubmed-70063752020-02-13 Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors Krishnapillai, Vijayakumar Nair, Sanjeev T. N, Anand T. P, Sreelal Soman, Biju BMC Public Health Research Article BACKGROUND: Kerala is facing challenges in the secondary prevention efforts of non-communicable diseases (NCDs). In spite of being the top performer in health parameters among Indian states, the burden of NCDs, especially diabetes mellitus (diabetes) and hypertension, is higher in Kerala. This research endeavours to identify the role of quality of medical prescriptions in secondary prevention of diabetes and hypertension and suggest corrective measures. METHODS: This cross-sectional study involved collection of prescription data and other details from consenting doctors across seven districts in Kerala. After the quality of prescription was assessed using a checklist, scores were generated, and cutoff points were used to classify the prescriptions. PASW version 18 software, was used for data analysis which included univariate and bivariate analyses and logistic regression. The proportion of quality prescriptions was estimated after adjusting for clustering, and the proportion of doctors writing quality prescriptions was also estimated. Prior to the study, ethical clearance from Independent ethics committee in Health action by People (HAP) and informed consent from all the study participants were obtained. RESULTS: After assessing 9199 prescriptions from 344 doctors, it was found that about 37.2% (95% CI: 34.9–39.4%) of the prescriptions were of good quality, and 48.2% (95% CI: 42.9–53.7%) of the doctors provided quality prescriptions. Factors associated with quality prescriptions were found to be knowledge about NCD guidelines, quality certifications of hospitals and usage of patient data management software. CONCLUSIONS: In the context of rising prevalence of NCDs and the challenges in the secondary prevention efforts, this is one of the first studies in Kerala to evaluate the quality of prescriptions to manage NCDs as prescriptions often reflect the quality of medical management. The study also addresses other factors associated with quality medical management. The findings indicate that the scope for improvement is more than 50%, when considered for the overall quality of prescriptions in diabetes and hypertension management. Further, it was found that appropriate training of doctors, adherence to treatment guidelines and the use of technology may improve the overall quality of prescriptions. BioMed Central 2020-02-06 /pmc/articles/PMC7006375/ /pubmed/32028918 http://dx.doi.org/10.1186/s12889-020-8214-y Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Krishnapillai, Vijayakumar
Nair, Sanjeev
T. N, Anand
T. P, Sreelal
Soman, Biju
Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors
title Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors
title_full Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors
title_fullStr Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors
title_full_unstemmed Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors
title_short Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors
title_sort quality of medical prescriptions in diabetes and hypertension management in kerala and its associated factors
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006375/
https://www.ncbi.nlm.nih.gov/pubmed/32028918
http://dx.doi.org/10.1186/s12889-020-8214-y
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