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首页> 外文期刊>Health policy and planning >An evaluation of the Essential Medicines List, Standard Treatment Guidelines and prescribing restrictions, as an integrated strategy to enhance quality, efficacy and safety of and improve access to essential medicines in Papua New Guinea
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An evaluation of the Essential Medicines List, Standard Treatment Guidelines and prescribing restrictions, as an integrated strategy to enhance quality, efficacy and safety of and improve access to essential medicines in Papua New Guinea

机译：对基本药物清单，标准治疗指南和规定的限制进行评估，以此作为提高巴布亚新几内亚基本药物的质量，疗效和安全性以及改善其获取途径的综合策略

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摘要

The World Health Organization (WHO) has advocated the development and use of country specific Standard Treatment Guidelines (STGs) and Essential Medicines Lists (EML) as strategies to promote the rational use of medicines. When implemented effectively STGs offer many health advantages. Papua New Guinea (PNG) has official STGs and a Medical and Dental Catalogue (MDC) which serves as a national EML for use at different levels of health facilities. This study evaluated consistency between the PNG Adult STGs (2003 and 2012) and those for children (2005 and 2011) with respect to the MDCs (2002, 2012) for six chronic and/or acute diseases: asthma, arthritis, diabetes, hypertension, pneumonia and psychosis. Additionally, the potential impact of prescriber level restrictions on rational medicines use for patient's living in rural areas, where no medical officer is present, was evaluated. Almost all drugs included in the STGs for each disease state evaluated were listed in the MDCs. However, significant discrepancies occurred between the recommended treatments in the STGs with the range of related medicines listed in the MDCs. Many medicines recommended in the STGs for chronic diseases had prescriber level restrictions hindering access for most of the PNG population who live in rural and remote areas. In addition many more medicines were listed in the MDCs which are commonly used to treat arthritis, high blood pressure and psychosis than were recommended in the STGs contributing to inappropriate prescribing. We recommend the public health and rational use of medicines deficiencies associated with these findings are addressed requiring: reviewing prescriber level restrictions; updating the STGs; aligning the MDC to reflect recommendations in the STGs; establishing the process where the MDC would automatically be updated based on any changes made to the STGs; and developing STGs for higher levels of care.
机译：世界卫生组织（WHO）提倡制定和使用特定于国家的标准治疗指南（STG）和基本药物清单（EML）作为促进合理使用药物的策略。有效实施STG可以带来许多健康优势。巴布亚新几内亚（PNG）拥有官方的STG和《医疗和牙科目录》（MDC），可作为国家EML，用于不同级别的医疗机构。这项研究评估了PNG成人STG（2003年和2012年）与儿童（2005年和2011年）相比，针对六个慢性和/或急性疾病（哮喘，关节炎，糖尿病，高血压，肺炎和精神病。此外，评估了开处方水平限制对农村地区无医务人员的患者合理用药的潜在影响。 MDC中列出了每种评估疾病状态的STG中几乎所有药物。但是，STG中推荐的治疗方法与MDC中列出的相关药物范围之间存在显着差异。 STG中推荐的许多用于治疗慢性病的药物都有处方水平的限制，阻碍了大多数生活在农村和边远地区的PNG人群的使用。此外，MDC中列出了比STG中推荐的更多药物，这些药物通常用于治疗关节炎，高血压和精神病，而不是STG中推荐的药物。我们建议解决与这些发现有关的公共卫生和合理使用药物的缺陷，要求：审查处方水平限制;更新STG;调整MDC以反映STG中的建议;建立一个流程，在该流程中，将根据对STG所做的任何更改自动更新MDC;并开发STG，以提高护理水平。

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