Authors: Zidouni, N.¹; Baough, L.¹; Laid, Y.²; Chaulet, P.³

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 8, August 2009 , pp. 1029-1037(9)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: A total of 77 health care facilities in 10 provinces.

OBJECTIVE: To perform a feasibility study before the extension of the Practical Approach to Lung (PAL) health strategy.

METHOD: A cross-sectional study comparing before and after findings of a training course for general practitioners.

RESULTS: Respiratory symptoms were the main reason for attending the primary health care services, accounting for 31.6% and 31.1% in the two periods studied. Acute respiratory infections constituted 70% of all respiratory disorders identified during the two periods. Chronic respiratory disorders, particularly asthma, were diagnosed more frequently after the training course (15.9% vs. 10.9%). Tuberculosis (TB) suspects accounted for only a minority of patients seeking health care and were more easily identifi ed post-training. Treatment recommendations were more rational after training, which led to a reduction in prescription costs.

CONCLUSIONS: The adoption of the PAL strategy by general practitioners led to an improvement in the quality of diagnosis of respiratory disorders and TB, fewersecondary investigations, less patient travel and an increase in the efficiency of medical practice by loweringprescription costs.

French
CADRE : Un total de 77 établissements de santé de proximité, répartis dans 10 provinces.

OBJECTIF : Enquêter la faisabilité préalable à l'extension de la stratégie de l'approche pratique de la santé respiratoire (APSR).

MÉTHODE : Enquête transversale comparant les résultats observés « avant » puis « après » une session de formation des médecins généralistes.

RÉSULTATS : Les symptômes respiratoires représentent le principal motif de consultation dans les services de santé de premier recours : 31,6% et 31,1% au cours des deux périodes. Les infections respiratoires aiguës constituent environ 70% des maladies respiratoires identifiées au cours des deux périodes. Les maladies respiratoires chroniques, en particulier l'asthme, sont plus fréquemment identifiées après l'intervention de formation (15,9% au lieu de 10,9%). Les malades suspects de tuberculose (TB) ne représentent qu'une minorité des demandeurs de soins. Ils sont mieux sélectionnés après la formation. La prescription thérapeutique a été plus rationnelle après la formation, entraînant une diminution du coût des ordonnances médicales.

CONCLUSIONS : L'adoption de la stratégie de l'APSR par les médecins généralistes améliore la qualité du diagnostic des maladies respiratoires et de la TB, réduit les investigations complémentaires et les déplacements de malades et accroît l'efficience des activités médicales par la réduction du coût des prescriptions.

Keywords: santé respiratoire; approche pratique; tuberculose

Document Type: Regular paper

Affiliations: 1: Centre hospitalier universitaire de Beni Messous, Alger, Algérie 2: Institut National de Santé Publique, Alger, Algérie 3: Senior Consultant, Organisation mondiale de la santé, Alger, Algérie

Publication date: 2009-08-01

More about this publication?

• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

  Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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