Drug and Therapeutics

Committee

Standard Treatment Guidelines

 Objectives

· Understand the importance of a standard treatment

guideline in promoting rational drug use

· Describe the development and implementation of a

guideline in a hospital or clinic

· Develop a standard treatment guideline for a

specific disease or medical condition

2 Standard Treatment Guidelines

 Patient leaflets
· Advantages:
· Short sentences
· Clear text
· Layman terms
· Portable information
· Highlights important words
· Prevent taken mistaken drugs
· Disadvantages:
· Not suitable for prolong tx
· Small printing –not suitable for elderly
· Incomplete information
3 Standard Treatment Guidelines
 Dosage box
· Advantages:
· Convenient
· Helpful for forgetful patient
· Consist of colors – attractive
· Good for complicated regimen
· Contains alarm clock
· Portable
· Disadvantages :
· Forget to fill the box
· Not hygienic
· Not air tight
· Might spill the box
· Lose the box
· Costly
· Not applicable for solution
4 Standard Treatment Guidelines
 Pictorials and short description

· Advantages :
· Useful for illiterate and language barrier patients
· Patient’s reference
· Increase patient’s adherence
· Customized based on the patient’s needs

· Disdvantages :
· Information might be misunderstood
· Incomplete information
· Patients might ignored the instruction and throw away the paper

5 Standard Treatment Guidelines

 Outline

· Introduction
· Key definitions
· The need for a standard treatment guideline
· Establishing the guideline
· Implementing the guideline
· Activity
· Summary

6 Standard Treatment Guidelines

 Introduction
· Treatment of diseases may have many different
approaches

· Many practitioners will not remember the best

method of treatment

· Applying the most effective treatment benefits both

the patient and the health care system

· Formulary management will have only limited

impact if the drugs are used incorrectly
7 Standard Treatment Guidelines
 Key Definition

· Standard treatment guideline–A systematically

developed statement designed to assist practitioners
and patients in making decisions about appropriate
health care for specific clinical circumstances

8 Standard Treatment Guidelines

 Advantages for Health Care Providers

· Provides standardized guidance to practitioners

· Dictates the most appropriate drugs for use and

can produce the best quality of care

· Produces the best quality of care since patients are

receiving optimal therapy

9 Standard Treatment Guidelines

 Advantages for Health Care Providers (2)

· Utilizes only formulary drugs or essential drugs;

therefore the health system need only provide drugs
in the guideline

· Provides assistance to all practitioners, especially to

those with lower skill levels

· Enables providers to concentrate on making the

correct diagnosis

10 Standard Treatment Guidelines

 Advantages for Health Care Officials
· Provides a basis for evaluating quality of care
provided by health care professionals

· Provides a system for controlling costs

· Provides effective therapy in terms of quality

· Provides information to patients concerning the

institution’s standards of care

· Serves to integrate special programs (ARI, TB) with a

single set of guidelines
11 Standard Treatment Guidelines
 Advantages for Supply Management

· Provides information for forecasting and ordering

· Provides information for purchase of prepackaged

drugs

12 Standard Treatment Guidelines

 Advantages for Patients

· Enables consistent and predictable treatment from all

levels of providers and at all locations

· Allows for improved availability of drugs because of

consistent and known usage patterns

· Enables improved outcomes

· Lowers cost

13 Standard Treatment Guidelines

 Disadvantages

· Inaccurate guidelines will provide the wrong

information. Often guidelines are based on existing
practices rather than evidenced-based medicine

· Guideline development and maintenance takes much

time and effort

· May give false sense of security

14 Standard Treatment Guidelines

 Establishing the Guideline

· Establish STG committee

· Develop comprehensive plan for development

¨ Select format
¨ recruit authors, writers, reviewers

· Identify diseases that the STG will cover

15 Standard Treatment Guidelines

 Establishing the Guideline (2)

· Determine appropriate treatment options

¨ Use fewest drugs necessary
¨ Choose cost effective treatment
¨ Use formulary drugs
¨ Give treatment of first choice, and may include
treatment option for exceptional cases
¨ Provide dose, duration, contraindications, side-
effects

16 Standard Treatment Guidelines

 Establishing the Guideline (3)

· Determine what information should be included in the

STG
¨ Clinical condition
¨ Treatment objectives
¨ Non-drug treatment
¨ Drugs of choice
¨ Important prescribing information
¨ Referral criteria
¨ Patient education information

17 Standard Treatment Guidelines

 Establishing the Guideline (4)

· Draft the STG for comments and pilot testing

· Publication and dissemination

¨ Official launch
¨ Training
¨ Monitoring and evaluation

· Revisions and updates

18 Standard Treatment Guidelines

 Establishing the Guideline (5)
· Key features
¨ Simplicity
¨ Credibility
¨ Same standards for all levels
¨ Drug supply based on standards
¨ Use in training students
¨ Regular updates
¨ Provided in a usable pocket manual

19 Standard Treatment Guidelines

 Establishing the Guideline (6)
· Important considerations

¨ Create from evidence-based guidelines

¨ Make explicit the strength of recommendations

and level of evidence that supports them

¨ Choose cost-effective treatments

¨ Use only approved formulary drugs

20
¨ Involve respected clinicians and specialists
Standard Treatment Guidelines
 Establishing the Guideline (7)

· Selecting diseases for guideline

¨ Individual
>Standard treatments are prepared for only one
problem
¨ Selective
>Treatments are prepared for high-priority
problems, 6-12 treatments
¨ Comprehensive
>Standard treatments are prepared for all of the
most common health problems
21 Standard Treatment Guidelines
 Implementing the Guideline

· Printed reference materials

¨ STG manual, posters, training materials
· Official launch–utilize DOH officials
· Initial training
¨ Vital concept in implementing guidelines
¨ Provide training in advance of actual start date
· Reinforcement training
· Monitoring of the use of the guidelines
· Supervision

22 Standard Treatment Guidelines

 Activity

· Preparation of a standard treatment guideline for your

hospital

23 Standard Treatment Guidelines

 Summary

· STGs are a time-honored system to improve

patient outcomes and to improve efficiency within
the health care system

· Only evidence-based medicine concepts should be

used in preparation of an STG

· Provides standardized guidance to practitioners

24 Standard Treatment Guidelines

 Summary (2)

· Lists the most appropriate drugs for use in specific

diseases

· Can produce the best quality of care

· Uses only formulary drugs so procurement is

improved and costs are reduced

· Providers can concentrate on diagnosis

25 Standard Treatment Guidelines