Improving Chloroquine Prescribing in Private Clinics in Lagos State, Nigeria *Taylor O, **Momodu RO, **Odufalu O *World Health Organisation **National Agency for Food and Drug Administration and Control (NAFDAC)

Introduction/Background MALARIA IS A COMMON PUBLIC HEALTH PROBLEM IN NIGERIA AND CHLOROQUINE(CQ) IS USED AS A FIRST LINE ANITMALARIAL IN THE TREATMENT OF UNCOMPLICATED MALARIA. IRRATIONAL PRESCRIBING IS CONTRIBUTORY TO THE PROBLEM OF DRUG RESISTANCE MORE THAN HALF THE PRESCRIPTIONS IN BOTH PUBLIC AND PRIVATE HEALTH FACILITES IN LAGOS STATE WERE INAPPROPRIATE (TAYLOR ET AL 1998)

HYPOTHESIS/OBJECTIVE ABILITY TO REMEMBER THE MULTIPLE DOSING SCHEDULE FOR VARIOUS AGES IN CQ MAY BE THE CRITICAL FACTOR IN IRRATIONAL PRESCRIBING RATHER THAN IGNORANCE OF THE APPROPRIATE DOSING. OBJECTIVE TO COMPARE THE EFFECTIVENESS OF AIDE-MEMOIRE AND A PRINTED DRUG INFORMATION LEAFLET IN IMPROVING CHLOROQUINE PRESCRIBING IN PRIVATE HEALTH FACILITIES IN LAGOS STATE.

METHODS OUTCOME INDICATORS: 13 PRIVATE HEALTH FACILITIES IN LAGOS STATE ,NIGERIA A BASELINE STUDY TO DETERMINE CQ PRESCRIBING PATTERN IN THESE FACILITIES RANDOMLY DISTRIBUTED TO RECEIVE: ACADEMIC DETAILING WITH AIDEMEMOIRE (5) ACADEMIC DETAILING WITH PRINTED DRUG INFORMATION LEAFLET(4) CONTROL - NO INTERVENTION (4) OUTCOME INDICATORS: CORRECT DOSING OF CHLOROQUINE PRESCRIPTIONS WITH ORAL DOSAGE FORMS PRSECRIPTIONS WITH INJECTIONS FOLLOWED BY THE ORAL FORM. PRESCRIPTIONS WITH CHLOROQUINE INJECTIONS ONLY.

INTERVENTION METHODS ACADEMIC DETAILING KEY PRESENTATION MESSAGE: VALUE OF CQ IN MALARIA CHEMOTHERAPY ROLE OF DOSAGE FORM IN INAPPROPRIATE PRESCRIBING APPROPRIATE DOSAGE REGIMEN WAS ADVICED USE ORAL DOSAGE FORM USE INJECTION BUT COMPLETE WITH ORAL DOSAGE FORM

INTERVENTION METHODS DRUG INFORMATION LEAFLET AIDEMEMOIRE CQ dosing schedule for different ages printed on a sheet of paper AIDEMEMOIRE A gift item used by corporate organisations for publicity Consists of plastic box filled with loose sheets Same dosing schedule is printed on the side of the box Placed on physician’s table

INFORMATION LEAFLET

INFORMATION LEAFLET

INFORMATION LEAFLET

INFORMATION LEAFLET

CONCLUSION THE INTERVENTION INCREASED THE PERCENTAGE OF PRESCRIPTIONS IN THE CORRECT DOSE. THE AIDEMEMOIRE IS MORE EFFECTIVE THAN THE PRINTED INFORMATION LEAFLET IN REMINDING PRESCRIBERS OF THE APPROPRIATE DOSAGE REGIMEN OF CHLOROQUINE. THIS INTERVENTION CAN BE USED TO IMPROVE RATIONAL DRUG USE. THERE IS A NEED FOR CLOSER MONITORING OF DRUG USE IN THE PRIVATE CLINICS.