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Background

Background. The Lao PDR National Drug Policy (NDP) Program, implemented by the Ministry of Health supported by the Swedish International Development Agency, has rational use of drug (RUD) as one component.

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Background

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  1. Background • The Lao PDR National Drug Policy (NDP) Program, implemented by the Ministry of Health supported by the Swedish International Development Agency, has rational use of drug (RUD) as one component. • The RUD aims to improve Use of Drug especially the prescribing in hospitals through Drug and Therapeutic Committee (DTC), using indicators, regular meeting, and feedback to all prescribers.

  2. MTP Approach • The MTP approach implemented in 2001, provided hospitals with a complementary tool for intervening specific problems. • The MTP focused on solving problems that had not responded well to the previous approach.

  3. Objective • To evaluate the effectiveness of the MTP approach in reducing irrational use of drugs for specific diseases, with targets defined by individual departments in study hospitals. • To solve the problems that had not responded well to the previous approach.

  4. Intervention • The MTP approach involves a series of small group discussions among prescribers in individual hospital departments. • After training in the use of MTP, these groups: defined a problem of interest, selected targets to be achieved, applied a problem solving approach, and monitored indicators to observe response.

  5. Experiences on using MTP • General teaching hospitals • Provincial hospitals

  6. Health facilityTeaching Hospital: - Mahosoth - Mittaphap Provincial Hospital - Bokeo - Oudomxay - Vientiane - Saravane District: - Site of intervention - Post Operation - Operation theatre - OPDs- OPDs - General OPD- General ward Priority problems identified in the facilities Priority problem- Overuse of Abs post operative - Overuse of Injection- Overuse of ABs surgery- Over use IV fluid Gastritis - Waiting time for Ultrasound- Overuse of ABs in PODs - Overuse of ABs in ARI- Low respiratory rate record in pneumonia - Overuse of Abs

  7. General Teaching Hospitals Problem: Over Antibiotic use and Injection Indicator: - % patients receiving antibiotics - % patients receiving injections Injection Antibiotic use

  8. Provincial Hospitals Problem: - Overuse of AB Indicator: - % patients receiving antibiotics

  9. Provincial Hospitals Problem: Long waiting time Indicator: minutes

  10. Provincial Hospitals Problem: - Low record respiratory rate pneumonia in pediatric ward Indicator: - % patients record RR Pneumonia

  11. Conclusion • The MTP approach was effective in solving specific problems, especially in district hospitals and departments of provincial and central hospitals. • MTP can be used complementary with DTC program to solve difficult problems.

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