Title: the Impact of Continuous Medical Education on Prescribing Habits in Mission Hospitals

Title: The Impact of Continuous Medical Education on Prescribing Habits in Mission Hospitals in Kenya

Author Name: JohnKiambuthi

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Presenter Name: JohnKiambuthi

Authors: Kiambuthi J

Institution: Mission for Essential Drugs and Supplies, Kenya

Problem Statement: TheMission for Essential Drugs and Supplies (MEDS) conducts institutional training interventions in mission hospitals. These consist of three phases: a baseline survey using the International Network for Rational Use of Drugs (INRUD) indicators, training, and a follow-up evaluation 1 year later. Some hospitals then start their own in-house continous medical education (CME) programs.

Objectives: To assess the impact of training interventions on prescribing habits in hospitals and the impact of complementing this with an in-house CME program.

Design: Retrospective before/after with a comparison.

Setting and Population: Three mission hospitals in Kenya, using patients records. In each, a hundred prescriptions were sampled.

Intervention: Institutional training interventions were conducted in each hospital. In one hospital, this was complemented by a regular, in-house CME program organized by the Drug and Therapeutics Committtee (DTC). The staff are fully involved in the CME as facilitators, and the treatment protocol is updated after each CME session.

Outcome Measures: Average number of drugs per case; percentage of generic drugs prescribed; percentage of cases prescribed antibiotics; and percentage of cases prescribed injections.

Results: In one hospital, 3 of 4 indicators showed improvement, and 1 of 4 indicators deteriorated. In the second hospital, 1 of 4 indicators showed improvement, 1 of 4 did not change, and 2 of 4 deteriorated. In the third hospital, which had the CME program, all 4 indicators showed dramatic improvement, especially antibiotic and injection use.

Conclusions: Training by external facilitators has mixed success in improving prescribing habits. When complemented by a CME program, it is much more successful. Additional studies would be helpful in assessing these two forms of educational intervention in drug use.

Study Funding: Mission for Essential Drugs and Supplies, Kenya, and donor support including CORDAID.