Promoting safe and appropriate use of miltefosine to treat tegumentary leishmaniasis in Brazil: a best practice implementation project.

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2024-04-02 DOI:10.1097/XEB.0000000000000416
Sarah Nascimento Silva, Laís Raquel Ribeiro, Kelli Borges Dos Santos, Gláucia Cota
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Abstract

Introduction: Miltefosine is a new drug that was recently approved for the treatment of tegumentary leishmaniasis (TL) by the Brazilian health system. It has a teratogenic potential and requires follow-up of patients undergoing treatment. Improving compliance with best practices is essential to ensure the safe and appropriate use of this drug.

Objective: This project aimed to implement best practices for the safe and appropriate use of miltefosine in the treatment of TL in the state of Minas Gerais, Brazil.

Methods: This project was guided by the JBI Evidence Implementation Framework. Five best practice criteria were established based on the best available evidence. A baseline audit was conducted to measure current practice against best practice. Barriers to best practice were then identified and a follow-up audit was conducted to evaluate changes after the implementation of improvement strategies. Two sites were analyzed: a leishmaniasis reference service in Belo Horizonte, the capital of Minas Gerais, and 28 regional offices.

Results: The baseline audit evaluated data from 197 miltefosine requests distributed across 13 regional sites. All requests from the reference service were compliant (100%). This is in contrast to the 60% compliance rate at the regional offices. The improvement strategies included intensifying direct communication with the regional health professionals, which increased the average compliance rate to 79.5%, 6 months after the interventions were introduced.

Conclusion: This best practice implementation project effectively increased the compliance rate for the audited procedures. Communication from the reference site with the regional health professionals successfully increased compliance with best practices and promoted the safe and appropriate use of miltefosine. These strategies should analyzed and applied to improve other programs.

Spanish abstract: http://links.lww.com/IJEBH/A184.

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在巴西推广安全、适当地使用米替福新治疗利什曼病:最佳实践质量改进项目。
简介米替福新是巴西卫生系统最近批准用于治疗利什曼病(TL)的一种新药。该药有致畸可能,需要对接受治疗的患者进行随访。要确保安全、适当地使用这种药物,就必须更好地遵守最佳操作规范:本项目旨在巴西米纳斯吉拉斯州实施安全、合理使用米替福新治疗 TL 的最佳实践:该项目以 JBI 证据实施框架为指导。根据现有的最佳证据制定了五项最佳实践标准。进行了基线审计,以对照最佳实践衡量当前实践。然后确定最佳实践的障碍,并进行后续审核,以评估实施改进策略后的变化。对两个地点进行了分析:米纳斯吉拉斯州首府贝洛奥里藏特的利什曼病参考服务机构和 28 个地区办事处:基线审计评估了分布在 13 个地区办事处的 197 份米替福新申请数据。参考服务机构的所有申请均符合要求(100%)。而地区办事处的合规率仅为 60%。改进策略包括加强与地区卫生专业人员的直接沟通,从而在采取干预措施 6 个月后将平均达标率提高到 79.5%:结论:这一最佳实践实施项目有效地提高了审计程序的合规率。参考点与地区卫生专业人员的沟通成功提高了最佳实践的依从性,并促进了米替福新的安全和合理使用。应分析并应用这些策略来改进其他项目。西班牙文摘要:http://links.lww.com/IJEBH/A184。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
3.20
自引率
13.00%
发文量
23
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