PLoS ONE (Jan 2017)

Adherence to Clinical Practice Guidelines (CPG) management of dengue infection in adults (revised 2nd edition).

  • Marzilawati Abd Rahman,
  • Rafdzah Ahmad Zaki,
  • Roza Sarimin,
  • Mohd Izhar Ariff,
  • Zailiza Suli,
  • Maimunah Mahmud,
  • Ker Hong Bee,
  • Cecilia Anthonysamy,
  • Azahirafairud Abdul Rahim,
  • Balvinder Singh Gill,
  • Shanti Rudra Deva,
  • Ana Fizalinda Abdullah Sani,
  • Erni Zurina Romli,
  • Izzuna Mudla Mohamed Ghazali,
  • Mohd Aminuddin Mohd Yusof,
  • Nafisah Ahmad Lutfi,
  • Shahril Effendi Shuib,
  • Noormah Mohd Darus,
  • Rugayah Bakri,
  • 'Abqariyah Yahya

DOI
https://doi.org/10.1371/journal.pone.0184559
Journal volume & issue
Vol. 12, no. 11
p. e0184559

Abstract

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The Malaysian Dengue Clinical Practice Guidelines (CPG) have been developed to provide evidence-based guidance in the management of dengue infections. The use of these guidelines is essential to ensure its recommendations are being practiced. However, the adherence to the guidelines for management of dengue (revised 2nd edition) by healthcare providers still remains unknown. Therefore, the aim of this study was to evaluate the proportion among healthcare providers that adhere to this Dengue CPG. A retrospective cohort study of dengue cases registered from 1 January 2014 to 1 June 2015 was conducted in public hospitals and health clinics in Selangor, Putrajaya and Kuala Lumpur. Adherence to the CPG recommendations were recorded by reviewing patients' case notes. Overall proportion of adherence in clinical components of the recommendation were (7.1 to 100.0% versus 7.7 to 73.8%) in history taking, (6.7 to 100.0% versus 12.3 to 60.0%) in physical examinations, (18.4 to 100.0% versus 23.1 to 83.2%) in assessment of warning signs, (0.6 to 100.0% versus 12.3 to 87.7%) in assessment of haemodynamic status, (60.0 to 100.0% versus 27.7 to 40.0%) in diagnosis, (46.6 to 80.0% versus 52.3%) in case notifications, (73.2 to 100.0% versus 89.2 to 96.9%) in performing specific laboratory investigations and (7.9 to 100.0% versus 21.5%) in monitoring, for outpatient versus inpatient, respectively. Adherence trends were demonstrated to be higher in hospital settings compared to outpatient settings. Adherence to this Dengue CPG varies widely with overall good clinical outcomes observed.