1 / 17

KENYATTA NATIONAL HOSPITAL

KENYATTA NATIONAL HOSPITAL. PROMOTING RATIONAL USE OF ANTI-RETROVIRALS (ARV) AT KENYATTA NATIONAL HOSPITAL (KNH) IN KENYA. BY OGILE ELIZABETH BPharm Pg Cert EDM & RDU MPSK. Authorized Establishment -6,212 In-post -5,225 KNH has a total of 9 pharmacies.

yvon
Download Presentation

KENYATTA NATIONAL HOSPITAL

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. KENYATTA NATIONAL HOSPITAL

  2. PROMOTING RATIONAL USE OF ANTI-RETROVIRALS (ARV) AT KENYATTA NATIONAL HOSPITAL (KNH) IN KENYA BY OGILE ELIZABETH BPharm Pg Cert EDM & RDU MPSK

  3. Authorized Establishment -6,212 In-post -5,225 KNH has a total of 9 pharmacies

  4. INTRODUCTION AND PROBLEM STATEMENT • HIV/AIDS has been viewed to affect productivity of workers and also to increase health treatment cost. KNH also faced a similar problem. ( Ref Kenya HIV/AIDS business Council Report ) . • In Feb1998 the KNH management decided to avail free ARV treatment to staffs as non – scheduled/ Extraformulary drug. • In June 1999, the situation was getting out of hand. • There were no clear guidelines for prescribing and dispensing the ARVs. • There were no proper records. Staff collected drugs from any pharmacy. The buying and supply of ARV was very erratic. • Further investigations revealed that ARV prescribing was from other sources, not specialists only. A number of prescriptions were not genuine. There was no monitoring and follow up on the genuine patients. • Frequent stock out periods.

  5. The hospital management mandated the Medical Advisory Committee ( MAC) to review the situation and then make recommendations.

  6. OVERALL GOAL • MAC came up with the following policy interventions to be implemented at prescribing and pharmacy levels.

  7. SETTING AND POPULATION • Kenyatta National Hospital. • Staffs diagnosed to be HIV/AIDS positive and presented with prescriptions in the pharmacy ( about 100 patients )

  8. INTERVENTIONS ( MARCH 2000 ) • MAC recommendations were implemented at prescribing and dispensing level. PRESCRIBING • Limiting prescribing to only 3 appropriately trained clinical specialists and ensuring that each patient had a specific file opened. • The staffs had to take their prescriptions for countersigning by the Deputy CEO ( Clinical Service ) for verification.

  9. INTERVENTION The following procedures were implemented:- • The hospital management decided that prescribing of ARVs be limited to only 3 appropriately trained clinical specialists and based on hospital approved treatment schedules. • Introducing a requirement that authority must be sought from deputy Chief Executive Officer (clinical services) before a prescription is dispensed.

  10. INTERVENTION….CONTD DISPENSING • Dispensing was centralized to one pharmacy. • The dispensers ensured that prescriptions were countersigned and also had the recommended combinations. • Patients were required to purchase an item out of stock and bring to the pharmacy to receive available drugs ( Provision for reimbursement ). • Computerized record keeping system was introduced in the pharmacy. • ARV monitoring form was introduced in march 2001.

  11. RESULTS • Preliminary results show that 16% of the ARV prescriptions as at June 1999 were not genuine ( not real patients ). • The situation as at March 2001 show that there was still about 2% of ungenuine prescriptions. • We have created a database for monitoring ARV therapy and for controls.

  12. KENYATTA NATIONAL HOSPITAL ARV THERAPY MONITORING FORM Personal Details Patient Number: Patient Name: Gender: Address: Age: Tel: Weight: E-mail: BSA: Clinical Parameters

  13. Antiretroviral Therapy

  14. Dispensing

  15. LESSON LEARNT • It is difficult to manage ARV treatment of staffs by staffs. • Simple policy interventions can be used effectively to promote Rational ARVS usage. BUT …….. The patients were getting tired ( complaining ).

  16. CONCLUSION • Comprehensive care unit was set in October 2002 • Comprehensive care unit ( CCU ) borrowed the concepts of the policy interventions. • In April 2003 the staffs HIV/AIDS management programme was intergrated into CCU program.

  17. THANK YOU special support Dr. Mary Ojoo Mr. Mwangi Maina

More Related