Page 82 - 78_04

M.
MALIK
&
col

RESUMEN

Juicio
sobre
la
adherencia
a
las
directrices
de
tratamiento
de
la
malaria.
Un

estudio
transversal
comparativo
en
Pakistán

Se
diseñó
un
estudio
transversal
comparativo
para
evaluar
la
adherencia
de
los

prescriptores
a
las
pautas
estándar
nacionales
de
tratamiento
de
la
malaria,
en

veinte
instalaciones
sanitarias
terciarias,

públicas
y
privadas,
de
dos
ciudades
de

Pakistán.
Se
evaluaron
un
total
de
600
encuestas
a
pacientes
sometidos
al
régimen

estándar
nacional
de
tratamiento
contra
la
malaria.
No
se
observó
diferencia

significativa
alguna
(a
nivel
de
p
=
0.05)

sobre
la
adherencia
de
prescriptores
con

diferentes
niveles
de
experiencia
con
el
régimen
de
tratamiento
estándar
para
la

malaria
en
las
dos
ciudades.
Los
resultados
del
presente
estudio
mostraron
baja

adhesión
de
los
prescriptores
al
régimen
de
tratamiento
estándar
para
la
malaria
en

Pakistán.

Keywords:
Pautas
de
tratamiento
estándar;
Adherencia;
Malaria;
Pakistán.

1.
INTRODUCTION

The
rational
use
of
drugs
demands
that
appropriate
drugs
must
be

prescribed
and
available
at
the
right
time
and
at
an
affordable
price
to
the
patients.

Prescribing
patterns
might
influence
the
effectiveness
of
treatment
and
the
control

of
disease.
Inadequate,
excessive
or
incorrect
prescribing
practices
are
most
likely

to
be
the
commonest
forms
of
irrational
prescribing
habits.
Development
of

resistance
to
antibiotics,
ineffective
treatment,
adverse
effects,
drug
dependence

and
economic
burden
to
the
patient
and
society
due
to
irrational
prescribing

practices
are
the
major
dilemma
of
present
medical
practice
in
case
of
malaria
(1).

Rational
prescribing
requires
that
the
prescribers
adhere
to
standard

treatment
guidelines
to
facilitate
a
constant,
therapeutically
effective
and

economically
efficient
use
of
drugs.
This
greatly
enhance
the
compliance
of

patients
and
outcome
of
therapy
(2).
But
most
of
the
medical
practitioners
in

developing
countries
including
Pakistan
are
prone
to
practice
their
own
protocols

to
treat
malaria
rather
than
adhering
to
standard
regimens.
Promoting
the
rational

use
of
drugs
remains
a
major
challenge.

Standard
treatment
guidelines
are
one
of
the
tools
to
support
effective

clinical
practice
and
promotion
of
rational
use
of
drugs.
These
guidelines
must
be

implemented
and
the
monitoring
of
case
management
according
to
these

guidelines
must
be
evaluated
(3).
Standard
treatment
guidelines
for
Malaria
have

been
formulated
and
introduced
in
2005
through
collaborative
efforts
of

directorate
of
malaria
control,
WHO
and
technical
core
group
in
Pakistan
(4).

Chloroquine
is
recommended
as
first
line
drug
in
the
treatment
of
all
types
of

500