Audit of essential medicine listing and registration status of medicines on standard treatment guidelines in Kenya, Tanzania and Uganda: Case study of malaria, tuberculosis, hypertension and type 2 diabetes mellitus.

JRSM Open Pub Date : 2024-03-29 eCollection Date: 2024-03-01 DOI:10.1177/20542704241232814
Deborah Babatunde, Allyson M Pollock, Moses Ocan, Petra Brhlikova
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Abstract

Objectives: To determine alignment between national and World Health Organization (WHO) treatment recommendations, medicines prioritisation in country's essential medicines list (EML), and medicines availability in National drug register.

Design: An audit of medicines for malaria, tuberculosis, hypertension and type 2 diabetes mellitus listed in the national standard treatment guidelines (STGs) of Kenya, Tanzania and Uganda, as of March 2021, against WHO treatment guidelines, and respective country EML and National drug register.

Setting: Not applicable.

Participants: None.

Main outcome measures: Proportion of medicine in country's STGs that align with WHO treatment recommendations, country's EML and country's drug register.

Results: Some disease areas had two sets of treatment guidelines - national STGs and disease-specific treatment guidelines (DSGs) developed at different times with different recommended medicines. Both STGs and DSGs included medicines not recommended by the WHO or not listed on the country EML and drug register. Non-WHO-recommended medicines accounted for 17/68 (25%), 10/57 (18%) and 3/30 (10%) of all STG medicines in Kenya, Tanzania and Uganda, respectively. For tuberculosis, the numbers and proportion of STG medicines listed on the respective national EMLs were 2/6 (33%), 15/19 (79%) and 4/5 (80%) in Kenya, Tanzania and Uganda. All tuberculosis medicines included in Kenya's and Uganda's STGs were registered compared with only 12/19 (63%) tuberculosis medicines in Tanzania's STG.

Conclusions: Alignment between treatment guidelines, EMLs and drug registers is crucial for effective national pharmaceutical policy. Research is needed to understand the inclusion of medicines on STGs and DSGs which fall outside WHO treatment guidelines; the non-alignment of some STGs and DSGs, and STGs and DSGs including medicines which are not on country EML and drug register.

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对肯尼亚、坦桑尼亚和乌干达的基本药物清单和标准治疗指南中的药物注册情况进行审计:疟疾、肺结核、高血压和 2 型糖尿病案例研究。
目标:确定国家与世界卫生组织(WHO)的治疗建议、国家基本药物清单(EML)中的药物优先次序以及国家药物登记册中的药物供应情况之间的一致性:确定国家治疗建议与世界卫生组织(WHO)治疗建议之间的一致性、国家基本药物清单(EML)中药物的优先次序以及国家药物登记册中药物的可用性:对肯尼亚、坦桑尼亚和乌干达截至 2021 年 3 月的国家标准治疗指南(STGs)中列出的治疗疟疾、结核病、高血压和 2 型糖尿病的药物进行审计,并与世界卫生组织治疗指南、各自国家的 EML 和国家药品登记册进行对比:不适用:主要结果测量主要结果测量:国家 STGs 中与世界卫生组织治疗建议、国家 EML 和国家药物登记册一致的药物比例:一些疾病领域有两套治疗指南--国家 STG 和特定疾病治疗指南 (DSG),这两套指南是在不同时期制定的,推荐的药物也不同。STGs和DSGs都包含了世卫组织未推荐或未列入国家EML和药物登记册的药物。在肯尼亚、坦桑尼亚和乌干达,非世卫组织推荐的药物分别占 STG 所有药物的 17/68(25%)、10/57(18%)和 3/30(10%)。在肯尼亚、坦桑尼亚和乌干达,结核病 STG 药物在各自国家 EML 中的数量和比例分别为 2/6(33%)、15/19(79%)和 4/5(80%)。肯尼亚和乌干达 STG 中的所有结核病药物都已注册,而坦桑尼亚 STG 中的结核病药物只有 12/19 种(63%):结论:治疗指南、EML 和药品注册之间的协调对于有效的国家医药政策至关重要。需要开展研究,以了解 STGs 和 DSGs 中是否纳入了世界卫生组织治疗指南之外的药品;某些 STGs 和 DSGs 不一致的情况;以及 STGs 和 DSGs 中是否纳入了未列入国家 EML 和药品登记册的药品。
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来源期刊
自引率
0.00%
发文量
16
审稿时长
12 weeks
期刊介绍: JRSM Open is a peer reviewed online-only journal that follows the open-access publishing model. It is a companion journal to the Journal of the Royal Society of Medicine. The journal publishes research papers, research letters, clinical and methodological reviews, and case reports. Our aim is to inform practice and policy making in clinical medicine. The journal has an international and multispecialty readership that includes primary care and public health professionals.
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