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 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 xxiii 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.
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