A study assessing the impact of academic detailing program on childhood diarrhoea management among the primary healthcare providers in Banke region, Nepal
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Date
2010
Authors
Khanal, Saval
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Abstract
ABSTRACT
Childhood diarrhoea is common in Nepal. Studies had reported poor knowledge and
irrational prescribing practice among healthcare professionals for childhood diarrhoea
management. Academic detailing had been used to promote rational prescribing in
many developed countries, but uncommon in developing countries like Nepal. With this
background, a prospective interventional study was conducted in Banke district of
Nepal to evaluate the impact of academic detailing on childhood diarrhoea and its
management to the randomly divided 235 primary healthcare providers. Data on
knowledge, attitude and practice were collected with the help of validated semistructured
questionnaire; and data on prescribing pattern was collected with the help of
simulated clients. At baseline, Knowledge (K) score, Attitude (A) score, Practice (P)
score and Total KAP score for the participants in control group were 7, 38, 26 and 71,
respectively which was not significantly different than the participants of intervention
group. K-score, A-score, P-score and KAP-score for the participants in intervention
group were 7, 37, 25 and 70, respectively. However, it improved significantly in
participants of intervention group during first and second follow up phases ofthe study.
The K-score, A-score, P-score and KAP-score of the participants during first follow up
among the participants in control group were 8, 38, 26 and 71 respectively, whereas for
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participants in intervention group were 11, 40, 31 and 83, respectively. At second
follow up, K-score, A-score, P-score and KAP-score for participants in control group
were 8, 35, 24 and 67, respectively and those of participants in intervention group were
10,37,28 and 79, respectively. The academic detailing also significantly improved the
prescribing pattern among the participants in intervention group compared to the control
group. At baseline, only 6.0% of the participants in control group and 8.3% in
intervention group were adhering to the childhood diarrhoea treatment guidelines,
which significantly increased among the participants in intervention group (65.1 %) than
control group (16.0%) at first follow up. At second follow up, 69.7% of participants in
intervention group were adhering to the guidelines, which was significantly greater than
control group (19.0%). The cost of prescription was significantly low in participants in
intervention group than control group during first and second follow up phases. In
conclusion, academic detailing significantly improved knowledge, attitude and practice
of participants regarding childhood diarrhoea and its management. It also significantly
improved the prescribing pattern, increased adherence of participants towards clinical
guidelines and decreased the prescription cost to treat childhood diarrhoea.