Professional Documents
Culture Documents
Uganda Clinical Guidelines and EMHSLU 2016
Uganda Clinical Guidelines and EMHSLU 2016
Changes
in
New
epidemics
Guidelines
New drugs
NEW
TECHNOLOGIES
New
treatment
policies
New
diagnosDc
tests
2
How
are
UCG
produced/reviewed
Socio-‐cultural
Expert
Health
system
ScienDfic
Evidence
factors
InternaDonal
knowledge
resources
NaDonal
Cost
guidelines
guidelines
effecDveness
Discussion
Consensus
3
GOALS OF UCG
q OPTIMIZE q COST EFFECTIVE AND
PATIENTS’CARE EFFICIENT USE OF
RESOURCES
4
History
of
UCG
1993 2003
2010
2012
5
UCG
AND
EMHSLU
2016
6
Process
1.
EXPERTS’
REVIEW
2.
STAKEHOLDERS’
WORKSHOP
3.
COMPILATION
4.
QUALITY
CONTROL
(harmonizaDon,
peer
review,
clarificaDons,
re-‐consultaDon)
5. EDITING/LAYOUT
7
WHAT
IS
NEW
q CHAPTERS
REORGANIZED
⇒ Emergencies: Common emergencies, trauma and
injuries, poisoning
NEW!
⇒ Infections, HIV and STDs
⇒ Medical chapters: cardiovascular, respiratory,
gastrointestinal and hepatic, renal and urinary,
endocrino, mental, neurological and substance abuse,
muscoloskeletal and joint, blood, oncology and
palliative care
⇒ MCH chapters: gynaecology, family planning,
obstetrics, childhood illnesses, immunization, nutrition
⇒ Specialist chapters: eye, ENT, skin, oro-dental,
surgery, radiology and anaesthesia
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WHAT
IS
NEW
⇒ DETAILED TABLE
OF CONTENTS
for easier
consultation
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WHAT
IS
NEW
⇒ Haemorrhagic fevers, yellow fever, chronic hepatitis
B, stroke, COPD, anaemia, sickle cell disease, atrial
fibrillation, headache, Nodding disease,
menopause, prostate diseases etc added
⇒ sections on non-communicable diseases expanded
(diabetes, hypertension, asthma etc) and diagnostic
criteria included
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Example:
type
2
DM
13
New guidelines included
MOH guidelines WHO guidelines
q Palliative care guidelines q Integrated management
2014 of pregnancy and
q New HIV guidelines 2016 Childbirth 2015
q New TB guidelines 2016 q Integrated Management
q Integrated Malaria of Childhood Illnesses
2014
Management 2015
q Mental health GAP
q Nutrition Guidelines 2016
intervention guide 2010
q Management of chronic
hepatitis B 2016
q Other guidelines
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AnDmicrobials
in
UCG
q Input/Sources
of
informaDon
⇒ Guidance from microbiology expert (Dr. Najjuka)
⇒ Situation analysis/recommendations, 2015
by UNAS
⇒ MOH and WHO guidelines and publications
⇒ Experts’ opinion
q Challenges
⇒ Insufficient information on causes of diseases and
antimicrobial resistance patterns
q Principles
⇒ Access
⇒ Clinical effectiveness
⇒ “parsimony”
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Annexes
q Standard
Infec3on
Control
Precau3ons
q Pharmacovigilance
and
Adverse
Drug
reac3on
q Essen3al
Medicine
List
2016
q Na3onal
Laboratory
Test
Menu
16
UCG
Pdf
-‐
Xodo
What
can
I
use
it
for?
IN
THE
DIAGNOSTIC
PROCESS
q E.g.
I
think
it
could
be
typhoid
fever:
⇒ are the symptoms and signs of my
patient consistent with what it is in the
manual?
⇒ What are the differentials?
⇒ Which test should I do to confirm?
⇒ What are the diagnostic criteria?
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What
can
I
use
it
for?
IN
THE
PRESCRIBING
PROCESS
q Which
is
the
first
line
treatment?
q Which
dosages
and
route
and
dura3on
of
medicines?
q Which
other
measures
are
necessary
besides
medicines?
q At
which
level
is
this
condi3on
managed?
Should
I
refer
this
pa3ent?
And
to
which
level?
q What
is
the
second
line
treatment
if
the
1st
line
fails
or
is
not
available
or
is
not
tolerated?
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EMHSLU
2016
q Reorganiza3on
to
align
with
WHO
EML
2015
q Specialist
medicines
presented
within
each
therapeu3c
category
q Some
changes
⇒ Amoxicillin 250 mg dispersible tablets
introduced
⇒ Ceftriaxone to HC3 (for MCH conditions)
⇒ Ergometrine and nalidixic acid removed
⇒ Atorvastatin introduced
⇒ Hydroxyurea introduced
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Way
forward
q Capillary
distribu3on
copies
through
NMS/JMS
q Dissemina3on
⇒ Ensure guidelines are available at prescribing
points
⇒ Ensure HWs understand the rational and aims
of UCG
⇒ Ensure HWs know how to use UCG
⇒ Monitor use and compliance with guidelines
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