Improving physician prescribing patterns to treat rhinopharyngitis. Intervention strategies in two health systems of Mexico.
To improve prescribing practices for rhinopharyngitis, an interactive educational intervention and a managerial intervention were carried out in 18 primary care facilities in metropolitan Mexico City.
Four family medicine clinics of the Mexican Social Security Institute (IMSS) and 14 health centres of the Ministry of Health (SSA) were included.
A quasi-experimental design was employed
One hundred and nineteen physicians (IMSS 68, SSA 51) participated.
Sixty-five physicians (IMSS 32, SSA 33) were in the study group, while 54 were in the control group (IMSS 36, SSA 18).
The study had four stages
(I) baseline, to evaluate the physicians'prescribing behaviour for rhinopharyngitis ; (II) intervention, using an interactive educational workshop and a managerial peer review committee ; (III) post-intervention evaluation of short-term impact ; and (IV) follow-up evaluation of long-term effect 18 months after the workshop.
The control group did not receive any intervention but was evaluated at the same time as the study group.
At baseline, most patients in both institutions received antibiotic prescriptions (IMSS 85.2%, SSA 68.8%). After the workshop, the percentage of patients receiving antibiotic prescriptions in the IMSS went from 85.2% to 48.1%, while in the SSA it went from 68.8% to 49.1%. Appropriateness of treatment was analyzed using the physician as the unit of analysis.
At baseline, 30% of IMSS physicians in the study group treated their patients approp...
Mots-clés Pascal : Personnel sanitaire, Médecin, Pratique professionnelle, Rhinopharyngite, Prescription médicale, Qualité, Formation permanente, Rationalisation, Service santé, Antibiotique, Mexique, Homme, Amérique Centrale, Amérique, ORL pathologie, Pharynx pathologie
Mots-clés Pascal anglais : Health staff, Physician, Professional practice, Rhinopharyngitis, Medical prescription, Quality, Continuing education, Rationalization, Health service, Antibiotic, Mexico, Human, Central America, America, ENT disease, Pharynx disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0236327
Code Inist : 002B30A09. Création : 199608.