Evaluation of awareness & utilisation of clinical practise guideline for management of adult Dengue infection among Malaysia doctors

Abstract

Clinical Practice Guideline (CPG) provides evidence-based guidance for the management of Dengue Infection in adult patients. A cross sectional study was conducted to evaluate awareness and utilization of CPG among doctors in public or private hospitals and clinics in Malaysia. Doctors practicing only at hospital Medical and Emergency Departments were included, while private specialist clinics were excluded in this study. A multistage proportionate random sampling according to region (Central, Northern, Southern, Eastern, Sabah and Sarawak) was performed to select study participants. The overall response rate was 74% (84% for public hospitals, 82% for private hospitals, 70% for public clinics, and 64% for private clinics). The CPG Awareness and Utilization Feedback Form were used to determine the percentage in the study. The total numbers of respondent were 634 with response rate of 74%. The mean lengths of service of the respondent were 13.98 (11.55).A higher percentages of doctors from public facilities (99%) were aware of the CPG compared to those in private facilities (84%). The percentage of doctors utilising the CPG were also higher (98%) in public facilities compared to private facilities (86%). The percentage of Medical Officer in private facilities that utilizing the CPG were 84% compares to Medical Officer in public facilities 98%. The high percentage of doctors using the CPG in both public (97%) and private (94%) hospitals were also observed. However, only 69% of doctors in private clinics utilised the CPG compared to doctors in public clinics (98%). Doctors in both public and private facilities were aware of the dengue CPG. However, most doctors in private clinic were less likely to utilise the CPG. Therefore, there is a need to increase the level of CPG utilisation especially in private clinics.

Different Domains of Dengue Research in Malaysia: A Systematic Review and Meta-Analysis of Questionnaire-Based Studies

“…Amongst health practitioners, it was shown that the level of awareness on Clinical Practice Guidelines (CPG) was higher amongst public health practitioners (99%) as compared to private practitioners (84%) [ 53 ]. Not surprisingly, the percentage of Medical Officer in private facilities utilising CPG was lower than those from public facilities (84% versus 98%, respectively).…”

“…Out of 57 articles reviewed, 22 articles have piloted or pretested the questionnaire [ 24 , 29 , 34 , 36 , 38 , 41 , 48 , 50 , 53 , 57 , 63 , 65 , 66 , 67 , 68 , 71 , 72 , 73 , 75 , 77 , 78 , 79 ] before surveying. A total of 14 articles [ 26 , 30 , 31 , 33 , 35 , 37 , 42 , 43 , 47 , 51 , 54 , 62 , 74 , 80 ] were considered as having a high risk of bias on the questionnaire due to lack of evidence on validity and reliability (data not shown), among which two articles were adapted directly from the similar previous study, and 10 articles were a newly developed questionnaire.…”

Using clinical practice guidelines to manage dengue: a qualitative study in a Malaysian hospital

“…They may be problematic, however, if patients requiring more tailored fluid regimes are not identified. Given previous survey evidence of good awareness and utilization of CPGs [13], this is concerning, as many participants reported having been unaware of how to calculate accurate fluid management. The reported high awareness of, and utilization of, ‘guidelines’ in surveys [13] may well refer to these fixed regime algorithms for fluid management.…”

“…CPGs also need to be routinely embedded in clinical practice, such that care can be co-ordinated across primary, secondary and tertiary levels and across departments within health care facilities. Quantitative survey evidence suggests a high degree of awareness and utilization of dengue management CPGs among Malaysian doctors, in both the public and private sectors (98 and 86% respectively) [13]. However, as in other settings, these self-reports of high utilization may not reflect actual practice.…”

Health Technology Assessment in Malaysia: Past, Present, and Future

“…Usage of Quick Reference is monitored by using feedback forms. Evaluation on users' awareness and adherence to selected CPGs such as the Dengue CPG (revised second edition) has also been conducted (12).…”