Paphassarang C, Wahlström R, Phoummalaysith B, Boupha B, Tomson G
National Institute of Public Health, Ministry of Health, Vientiane, Lao PDR.
Southeast Asian J Trop Med Public Health. 2002 Sep;33(3):647-53.
The National Drug Policy (NDP) of Lao PDR, endorsed in 1993, has since 1995 been implemented through an intervention program in five pilot areas out of 18 provinces, including training of health personnel. The aim was to assess the impact of the NDP program to get evidence for revising the policy. In a cross sectional design, comparisons were made between the pilot province of Luangphrabang (LPB) and the non-pilot province of Sayabury (SBR). In each province, three districts were purposively chosen. Four pharmacies at the public hospitals were included, while 20 private pharmacies were randomly selected. A set of 29 combined indicators was utilized. One hundred and ten prescriptions for under-five children with simple diarrhea and 240 adult outpatient prescriptions were sampled. Furthermore, twelve health care managers were interviewed on knowledge and attitudes. LPB health managers had better knowledge of NDP concepts. Significantly more essential drugs (ED) were available in the private pharmacies in the pilot province. The proportion of prescriptions of ED in hospitals was higher in the pilot province (95% in LPB vs 86% in SBR; p<0.001). Fewer drugs per patient were prescribed in the pilot province (2.7 vs 3.3, p<0.001), and the management of simple diarrhea in children was significantly more in accordance with Standard Treatment Guidelines. The pilot province performed significantly better regarding several aspects of quality and rational use of drugs, probably related to the implementation program. National as well as regional and global diffusion of research findings is recommended towards evidence-based national drug policies.
老挝人民民主共和国的国家药物政策（NDP）于1993年获得批准，自1995年起通过在18个省份中的5个试点地区实施干预计划来推行，包括对卫生人员的培训。目的是评估国家药物政策计划的影响，以便为修订该政策获取证据。采用横断面设计，对琅南塔省（LPB）这个试点省份和沙耶武里省（SBR）这个非试点省份进行了比较。在每个省份，有目的地选择了三个地区。纳入了公立医院的四家药房，同时随机选择了20家私人药房。使用了一组29个综合指标。抽取了110份五岁以下单纯腹泻儿童的处方和240份成人门诊处方。此外，还对12名医疗保健管理人员进行了关于知识和态度的访谈。琅南塔省的卫生管理人员对国家药物政策概念的了解更好。试点省份的私人药房中有更多的基本药物（ED）。试点省份医院中基本药物处方的比例更高（琅南塔省为95%，沙耶武里省为86%；p<0.001）。试点省份每位患者开具的药物更少（2.7种对3.3种，p<0.001），并且儿童单纯腹泻的管理明显更符合标准治疗指南。在药物质量和合理使用的几个方面，试点省份表现明显更好，这可能与实施计划有关。建议在国家以及区域和全球范围内传播研究结果，以制定基于证据的国家药物政策。
