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Abstract

PREDICTORS OF ADHERENCE TO NATIONAL ANTI-MALARIAL TREATMENT GUIDELINES IN SOME NIGERIAN HOSPITALS

Background: Prescribers’ adherence to guidelines is critical for the successful implementation of any new drug policy. Nigeria in 2005 changed its antimalarial drug policy to artemether-lumefantrine (AL) for treatment of uncomplicated malaria. New national guidelines were disseminated to health providers together with in-service training. Aim: This study aimed at assessing predictors of adherence to this new antimalarial treatment policy.

Methods: The study was carried out in Enugu State of Nigeria. The study population was made up of all prescribers within the selected facilities under study. This study included one tertiary, three secondary and two primary facilities which were purposively selected from the three senatorial zones of Enugu state. To select the patients? records, systematic sampling was used. Based on the total number of cases per facility, a sampling interval ?k?, was calculated. A total of 600 patients? records between May 2005 and December 2009 were selected and reviewed (100 records from each of the selected facilities, 20 records per year). A total of 1038 antimalarial prescriptions from the selected 600 patients? case files were reviewed.

Results: The risk of adherence to NTG/NTP was higher among young prescribers who were less ten years in practice (OR = 21.05), prescribers with daily practice volume of less than 25 patients (OR = 7.271), prescribers who were aware of NTG/NTP (OR =9.847), and prescribers who received training on the new NTG/NTP (OR =29.311). The percentage adherence from May, 2005 to December, 2009 followed the same pattern with overall percentage adherence of 20.76%.

Conclusion: This study revealed that each of the variable, years of practice, practice volume, awareness and having received training at the introduction of the new antimalarial treatment policy made an independent contribution to predicting adherence to the new NTG/NTP.


Author(s): Adibe Maxwell Ogochukwu

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