Standard treatment guidelines in primary healthcare practice

Abstract

In India, healthcare delivery is implemented at primary, secondary and tertiary levels. Of these, primary health care is the essential health care and is the first point of care for the public across the country. The primary health care system caters to nearly 70% of the population by treating about 90% of the common and locally prevailing problems. One of the integral elements of primary health care is provision of essential medicines, which should be available at all times in adequate amounts in appropriate dosage forms and at an affordable cost. It has an important bearing on the medical, economical and social outcomes of the healthcare delivery system. This situation mandates the need for rational use of medicines by standardizing the treatment of commonly occurring illness at the primary health care level. Standard Treatment Guidelines (STGs) have been in vogue in India only since recent times and is gaining popularity among practitioners. STGs have many advantages for the patients, healthcare providers, drug manufacturers and marketing agencies, and above all, the policy makers and the legislative system of the country. The drawback in STGs lies in the difficulties in implementation on a large scale. With due efforts to prioritize the health needs, comprehensive coverage of national health programs involving all the stakeholders including professional organizations, undergraduate medical curriculum planners and medical practitioners, STGs can be implemented effectively and thereby we can ensure a quality health care at the primary care level at an affordable cost as part of the now redefined Universal Health Coverage. This article is intended as a guide to understand the concept of STGs, prepared with the aim of capacity building for medical professionals in rationally treating patients in their day-to-day clinical practice.

Irrational Use of Medicines—A Summary of Key Concepts

“…Over the years, the rational use of medicines has come to be regarded as one of the key principles in delivering effective and quality healthcare [8,9]. …”

“…The concept of the rational use of medicines is an old one, dating as far back as 300 B.C, when the Greek physician Herophilus said that “ medicines are nothing in themselves, but are the very hands of god if employed with reason and prudence ” [ 7 ]. Over the years, the rational use of medicines has come to be regarded as one of the key principles in delivering effective and quality healthcare [ 8 , 9 ].…”

Microbial Resistance Movements: An Overview of Global Public Health Threats Posed by Antimicrobial Resistance, and How Best to Counter

“…The World Bank has also defined RUM in two tiers: (i) the utilization of medicines based on scientific data regarding drug efficacy, safety, and compliance; and (ii) the need to maximize the benefit of medicine in the resource-limited health system to ensure cost-efficacy ( 232 , 233 ). RUM has been considered as the strategic issue in providing effective and quality healthcare ( 234 , 235 ).…”

A Retrospective Audit of Pharmacologic and Non-Pharmacologic Management of Childhood Acute Asthma Exacerbation at Usmanu Danfodiyo University Teaching Hospital, Sokoto: Adherence to Global Treatment Guidelines

“…In fact, physicians’ non-adherence to the existing treatment guidelines for asthma is a major contributory factor to poor treatment outcomes ( Gupta and Weiss, 2009 ). Treatment guidelines, otherwise called clinical practice guidelines, are documents systematically developed from evidence-based medicine to guide decisions and criteria regarding diagnosis, management, and treatment in specific areas of health care ( Gopalakrishnan et al, 2014 ). The use of asthma treatment guidelines could reduce childhood asthma visits and hospitalizations to the pediatric emergency department, thus saving an estimated $1.3 to $1.59 billion annually in the United States ( Gupta and Weiss, 2009 ; Perry et al, 2019 ), and saving a cumulative national cost of $0.16 billion constituting 0.002% of the national GDP in Nigeria ( Ughasoro et al, 2020 ).…”