Interactional group discussion: Results of a controlled trial using a behavioral intervention to reduce the use of injections in public health facilities

Hadiyono, J.E. Prawitasari; Suryawati, Sri; Danu, Sulanto Saleh; Sunartono,; Santoso, Budiono

doi:10.1016/0277-9536(95)00391-6

Cited by 75 publications

(43 citation statements)

References 6 publications

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“…33 The priority of implementation of policy options preferably is like managerial and educational, respectively. 30,31 This is what our report shows too. The financial policy options were not in favorable position to be implemented.…”

Section: Developing Clear Guidance For Use Of Injectable Medicines Insupporting

confidence: 86%

“…30 According to the literature review, researchers mostly focus on educational options 5,26 and their effectiveness in reducing use of injections. 31 Educational options refer to train people via mass media, schools or group discussion, continuous medical education for doctors and developing related educational curriculum in schools of pharmacy and medicine. Interactive group discussions can be more effective educational strategies to decrease the rate of unnecessary injections.…”

Section: Developing Clear Guidance For Use Of Injectable Medicines Inmentioning

confidence: 99%

“…Interactive group discussions can be more effective educational strategies to decrease the rate of unnecessary injections. 31,32 Briefly, empowering people and changing their beliefs and norms regarding overuse of injections may sound time taking process but it can be useful. 4 But there are other leverages that we have considered as policy option in the category of managerial, like monitoring (doctors, pharmacies, and injection units), restricting pharmaceutical list, developing guidelines, restricting delivery of over the counter medicines and revision of existing interventions.…”

Section: Developing Clear Guidance For Use Of Injectable Medicines Inmentioning

confidence: 99%

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Improving Injectable Medicines Prescription in Outpatient Services: A Path Towards Rational Use of Medicines in Iran

Bairami¹,

Soleymani²,

Rashidian³

2016

Int J Health Policy Manag

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Injection is one of the most common medical procedures in the health sector. Annually up to 16 billion injections are prescribed in low-and middle-income countries (LMICs), many of them are not necessary for the patients, increase the healthcare costs and may result in side effects. Currently over 40% of outpatient prescriptions in Iran contain at least one injectable medicine. To address the issue, a working group was established (August 2014 to April 2015) to provide a comprehensive policy brief to be used by national decision-makers. This report is the extract of methods that were followed and the main policy options for improving injectable medicines prescribing in outpatient services. Thirty-three potential policy options were developed focusing on different stakeholders. The panel reached consensus on seven policy options, noting effectiveness, cost, durability, and feasibility of each policy. The recommended policy options are targeted at patients and public (2 policies), insurers (2), physicians (1), pharmacies (1), and the Ministry of Health and Medical Education (MoHME) (1).

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Section: Developing Clear Guidance For Use Of Injectable Medicines Insupporting

confidence: 86%

Section: Developing Clear Guidance For Use Of Injectable Medicines Inmentioning

confidence: 99%

Section: Developing Clear Guidance For Use Of Injectable Medicines Inmentioning

confidence: 99%

See 1 more Smart Citation

Improving Injectable Medicines Prescription in Outpatient Services: A Path Towards Rational Use of Medicines in Iran

Bairami¹,

Soleymani²,

Rashidian³

2016

Int J Health Policy Manag

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“…Evidence supports educational programs for HCPs, with outcomes such as more appropriate diagnostic procedures, more accurate perceptions about patient preferences, and more appropriate use of antimicrobial treatments. [37][38][39][40] Further evidence suggests that coaching clinicians to educate patients about symptomatic care might decrease antibiotic prescribing but preserve patient satisfaction. 41 Effective educational interventions may require repeated and frequent interaction with participants, including refresher courses and sustained outreach efforts.…”

Section: Discussionmentioning

confidence: 99%

What Happens When “Germs Don't Get Killed and They Attack Again and Again”: Perceptions of Antimicrobial Resistance in the Context of Diarrheal Disease Treatment Among Laypersons and Health-Care Providers in Karachi, Pakistan

Joseph

Agboatwalla

Hurd

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. In south Asia, where diarrhea is common and antibiotics are accessible without prescription, antimicrobial resistance is an emerging and serious problem. However, beliefs and behaviors related to antimicrobial resistance are poorly understood. We explored laypersons' and health-care providers' (HCP) awareness and perceptions of antimicrobial resistance in the context of treatment of adult diarrheal disease in Karachi, Pakistan. In-depth, open-ended interviews were conducted with 40 laypersons and 45 HCPs in a lower-middle-class urban neighborhood. Interviews conducted in Urdu were audiotaped, transcribed, translated, and coded using applied thematic analysis. Slightly over half of laypersons and two-thirds of HCPs were aware that antimicrobial medication could lose effectiveness, but misperceptions were common. Laypersons and HCPs often believed that "the body becomes immune" or "bacteria attack more strongly" if medications are taken "improperly." Another prevalent theme was that causes and effects of antimicrobial resistance are limited to the individual taking the antimicrobial medication and to the specific diarrheal episode. Participants often attributed antimicrobial resistance to patient behaviors; HCP behavior was rarely discussed. Less than half of the HCPs were aware of treatment guidelines. To combat antimicrobial resistance in urban Pakistan, a health systems strategy and community-supported outreach campaigns on appropriate antimicrobial use are needed.

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“…'Injections are commonly overused in Indonesia … which increases clinical risk and has adverse economic impact'. 6 A successful behavioural intervention program aimed at reducing the inappropriate use of injections in Indonesia focused on 'reality-testing prescribers' beliefs about patient assumptions'.…”

Section: A Mirror?mentioning

confidence: 99%

The hollow needle: inappropriate injection in practice

Brokensha¹

1999

Aust Prescr

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SYNOPSISDoctors and needles seem to go together, but the hypodermic has only a relatively brief history. The curious tale of its enthusiastic adoption has much to teach us about contemporary practice. Our powerful medical culture seldom questions the role of injections, particularly of medicines that are often regarded as innocuous or harmless.Experience from developing cultures of the multiple factors motivating injections will inevitably illuminate our own. The misleading role of personal clinical experience in this context makes rational evidence-based practice difficult.The primacy of personal experience is a pitfall for doctors, but a potential benefit for patients. A greater understanding of the unjustly maligned placebo effect and the difference between controlling a clinical trial and healing the individual will assist practitioners to avoid both hollow and sharp practice.

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Interactional group discussion: Results of a controlled trial using a behavioral intervention to reduce the use of injections in public health facilities

Cited by 75 publications

References 6 publications

Improving Injectable Medicines Prescription in Outpatient Services: A Path Towards Rational Use of Medicines in Iran

Improving Injectable Medicines Prescription in Outpatient Services: A Path Towards Rational Use of Medicines in Iran

What Happens When “Germs Don't Get Killed and They Attack Again and Again”: Perceptions of Antimicrobial Resistance in the Context of Diarrheal Disease Treatment Among Laypersons and Health-Care Providers in Karachi, Pakistan

The hollow needle: inappropriate injection in practice

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