E-drug: Re: Indicators of quality use of medicines (contd)
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Having being involved in indicator studies for some time, I was
delighted to hear about the development of indicators for quality use
of medicines.
I am aware that there are many ways to approach prescribing indicator
development, but I would like to share some of our experiences.
While I was working with the Medical University of Southern Africa
(MEDUNSA), we were challenged with finding a way of assessing the
impact of a training programme on the prescribing practices of nurses
in rural clinics. We found the WHO publication: Guide to Good
Prescribing most useful as it actually outlines the steps to be
followed in the process of prescribing. Once the steps in a process
are defined, it becomes easier to identify indicators that are
appropriate to measure each step.
The challenges to measure prescribing practices are numerous. Not
only is it difficult to identify indicators that are actually
sensitive to measure the outcome (or processes), but often one
have to rely on retrospective data from incomplete and poorly written
medical records. And making the methodology appropriate for
underserved communities is even more of a challenge.
However, I do believe that it is possible to define appropriate
indicators, and I am keenly looking forward to hear more about
developments in this field.
Helene Moller
Training Adviser, South African Drug Action Programme
Tel: 27-12-312 0375
Fax: 27-12-323 6745
mollerh@hltrsa.pwv.gov.za
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