Analyzing data from the digital healthcare exchange platform for surveillance of antibiotic prescriptions in primary care in urban Kenya: A mixed-methods study
| Autor: | Mekuria, Legese A., de Wit, Tobias FR, Spieker, Nicole, Koech, Ramona, Nyarango, Robert, Ndwiga, Stanley, Fenenga, Christine J., Ogink, Alice, Schultsz, Constance, van’t Hoog, Anja |
|---|---|
| Přispěvatelé: | Global Health, AII - Infectious diseases, APH - Quality of Care, APH - Global Health |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Medical Doctors
Pulmonology Economics Science Health Care Providers Social Sciences Microbiology Geographical Locations Health Economics Drug Therapy Antibiotics Microbial Control Medicine and Health Sciences Medical Personnel Primary Care Pharmacology Treatment Guidelines Health Care Policy Multidisciplinary Antimicrobials Pharmaceutics Drugs Biology and Life Sciences Kenya Health Care Professions People and Places Africa Respiratory Infections Medicine Population Groupings Research Article |
| Zdroj: | PLoS ONE, 14(9):e0222651. Public Library of Science PLoS ONE PLoS ONE, Vol 14, Iss 9, p e0222651 (2019) |
| Popis: | BACKGROUND:Knowledge of antibiotic prescription practices in low- and middle-income countries is limited due to a lack of adequate surveillance systems. OBJECTIVE:To assess the prescription of antibiotics for the treatment of acute respiratory tract infections (ARIs) in primary care. METHOD:An explanatory sequential mixed-methods study was conducted in 4 private not-for-profit outreach clinics located in slum areas in Nairobi, Kenya. Claims data of patients who received healthcare between April 1 and December 27, 2016 were collected in real-time through a mobile telephone-based healthcare data and payment exchange platform (branded as M-TIBA). These data were used to calculate the percentage of ARIs for which antibiotics were prescribed. In-depth interviews were conducted among 12 clinicians and 17 patients to explain the quantitative results. RESULTS:A total of 49,098 individuals were registered onto the platform, which allowed them to access healthcare at the study clinics through M-TIBA. For 36,210 clinic visits by 21,913 patients, 45,706 diagnoses and 85,484 medication prescriptions were recorded. ARIs were the most common diagnoses (17,739; 38.8%), and antibiotics were the most frequently prescribed medications (21,870; 25.6%). For 78.5% (95% CI: 77.9%, 79.1%) of ARI diagnoses, antibiotics were prescribed, most commonly amoxicillin (45%; 95% CI: 44.1%, 45.8%). These relatively high levels of prescription were explained by high patient load, clinician and patient perceptions that clinicians should prescribe, lack of access to laboratory tests, offloading near-expiry drugs, absence of policy and surveillance, and the use of treatment guidelines that are not up-to-date. Clinicians in contrast reported to strictly follow the Kenyan treatment guidelines. CONCLUSION:This study showed successful quantification of antibiotic prescription and the prescribing pattern using real-world data collected through M-TIBA in private not-for-profit clinics in Nairobi. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|