Physician Adherence to Guideline Recommendations for Mild COVID-19 in Peru: A Cross-sectional Study

Authors

  • Kiamfun Wong Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, 15464, Peru.
  • Kathya Taipe School Medicine, Universidad Nacional San Luis Gonzaga, Ica, 11001, Peru
  • Wendy A. Tapia-Bullón Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, 15464, Peru.
  • Gustavo Tapia-Sequeiros Centro de Investigación de Estudiantes de Medicina, Universidad Privada de Tacna, Tacna, 230101, Peru. https://orcid.org/0000-0002-9277-2731
  • Anderson N. Soriano-Moreno Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, 15464, Peru.

DOI:

https://doi.org/10.35434/rcmhnaaa.2024.173.2523

Keywords:

COVID-19, Physicians, Drug Prescriptions, Drug-Related Side Effects and Adverse Reactions

Abstract

Objective: To examine the factors associated with Peruvian physicians' adherence to guidelines for managing mild COVID-19 cases. Methods: An analytical cross-sectional study was conducted, surveying certified Peruvian physicians from different regions. A simulated clinical case was used to evaluate their knowledge of the pharmacological management of mild COVID-19 and the potential adverse effects of prescribed medications. Adherence to guidelines was defined as prescribing only acetaminophen and/or non-steroidal anti-inflammatory drugs (NSAIDs) for the proposed mild COVID-19 case, in accordance with international recommendations. Factors associated with adherence were analyzed using prevalence ratios, calculated through Poisson regression with robust variance. Results: A total of 339 physicians participated, 85.0% of whom adhered to the recommended guideline. The most frequently prescribed drugs were acetaminophen (96.2%), non-steroidal anti-inflammatory drugs (11.5%), and ivermectin (6.8%). Physicians who graduated from private universities exhibited greater adherence to the guidelines (PR: 1.14; 95% CI 1.05-1.23), while those affiliated with the Ministry of Health (MINSA) demonstrated lower adherence (PR: 0.87; 95% CI: 0.79-0.84). Conclusion: Most physicians adhered to the guidelines for managing mild COVID-19. Higher adherence was associated with graduating from private universities and working outside MINSA affiliated institutions.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Kiamfun Wong, Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, 15464, Peru.

1. Physician

Kathya Taipe, School Medicine, Universidad Nacional San Luis Gonzaga, Ica, 11001, Peru

  1. Medical Student

Wendy A. Tapia-Bullón, Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, 15464, Peru.

1. Physician

Gustavo Tapia-Sequeiros, Centro de Investigación de Estudiantes de Medicina, Universidad Privada de Tacna, Tacna, 230101, Peru.

  1. Medical Student

Anderson N. Soriano-Moreno, Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, 15464, Peru.

  1. Physician

References

World Health Organization. Coronavirus (COVID-19) [Internet]. Geneva: WHO; 2024 [cited Apr 10, 2024]. Available from: https://covid19.who.int/

World Health Organization. Panorama de salud (COVID-19) [Internet]. Geneva: WHO; 2022 [cited Apr 10, 2024]. Available from: https://hia.paho.org/es/covid-2022/salud

Solari L. COVID-19 and the ongoing emergency. Rev Peru Med Exp Salud Publica. 2022;39(1):4-5. doi: 10.17843/rpmesp.2022.391.11121

Organization for Economic Co-operation and Development. OECD Reviews of Health Systems: Peru 2017 [Internet]. United States : OECD; 2017 [cited Apr 10, 2024]. Available from: https://www.oecd-ilibrary.org/social-issues-migration-health/oecd-reviews-of-health-systems-peru-2017_9789264282735-en

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA. 2020;323(13):1239–42. doi: 10.1001/jama.2020.2648

Soto A, Quiñones-Laveriano DM, Azañero J, Chumpitaz R, Claros J, Salazar L, et al. Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference hospital. PLoS One. 2022;17(3):e0264789. doi: 10.1371/journal.pone.0264789

Ministry of Health of Peru. Ministerial Resolution N°270-2020-MINSA [Internet]. Lima: MINSA; 2020 [cited Apr 10, 2024]. Available from: https://cdn.www.gob.pe/uploads/document/file/698197/RM_270-2020-MINSA.PDF?v=1589216787

Ministry of Health of Peru. Ministerial Resolution N°905-2020-MINSA [Internet]. Lima: MINSA; 2020 [cited Apr 10, 2024]. Available from: https://www.gob.pe/institucion/minsa/normas-legales/1322786-905-2020-minsa

Instituto de Evaluación de Tecnologías en Salud e Investigación. Guía de Práctica Clínica: Manejo de COVID-19 [Internet]. Lima: IETSI, 2021; [cited Apr 10, 2024]. Available from: http://www.essalud.gob.pe/ietsi/pdfs/guias/GPC_COVID_19_Version_In_Extenso.pdf

Ministry of Health of Peru. Ministerial Resolution N°834-2021-MINSA - Documento Técnico: Manejo Ambulatorio de personas afectadas por la COVID-19 en el Perú [Internet]. Lima: MINSA; 2020 [cited Apr 10, 2024]. Available from: https://www.gob.pe/institucion/minsa/normas-legales/2015593-834-2021-minsa

Caira-Chuquineyra B, Fernandez-Guzman D, Alvarez-Arias PM, Zarate-Curi ÁA, Herrera-Añazco P, Benites-Zapata VA. Association between prehospital medication and fatal outcomes in a cohort of hospitalized patients due to coronavirus disease-2019 in a referral hospital in Peru. Travel Med Infect Dis. 2022;50:102472. doi: 10.1016/j.tmaid.2022.102472

Mayta-Tristán Percy. Los tsunamis por Covid-19 en Perú: El primero malo, segundo peor. Rev. Cuerpo Med. HNAAA. 2021;14(3):260-261. doi: 10.35434/rcmhnaaa.2021.143.1249

World Health Organization. Clinical management Clinical management Living guidance COVID-19. World Heal Organ [Internet]. Geneva: WHO; 2021 [cited Apr 10, 2024]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1

National Institutes of Health. Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) [Internet]. United Stated: NIH; 2021 [cited Apr 10, 2024]. Available from: https://www.covid19treatmentguidelines.nih.gov/

Silva SCN, Alencar BR, Viduedo AFS, Ribeiro LM, Ponce de Leon CGRM, Schardosim JM. Management of severe preeclampsia in the puerperium: development and scenario validation for clinical simulation. Rev Bras Enferm. 2021;74(6):e20200445. doi: 10.1590/0034-7167-2020-0445

National Council of Medical Residency. Nomenclature of Specialties and Subspecialties of the National Medical Residency System [Internet]. Lima: CONAREME; 2018 [cited Aug 10, 2024]. Available from: https://www.conareme.org.pe/web/

Ministry of Health of Peru. Services and Categories of the Primary Level of Healthcare [Internet]. Lima: MINSA; 2024 [cited Aug 10, 2024]. Available from: https://www.gob.pe/16728-servicios-y-categorias-del-primer-nivel-de-atencion-de-salud

Cotrina-Rodas ML, Cusquisiban-Cusquisiban, FE. Evaluación del uso de receta médica en la dispensación de medicamentos en el tratamiento de la enfermedad por coronavirus (COVID-19), Cajamarca, 2021 [Thesis]. Cajamarca: Universidad Privada Antonio Guillermo Urrelu; 2022 [cited Apr 10, 2024]. Available from: http://repositorio.upagu.edu.pe/handle/UPAGU/2064

Pacheco-Pacahuala, VK, Casaverde-Torres, M. Relación entre los errores de prescripción y tratamiento para el Covid-19 en usuarios atendidos en Boticas Mifarma SJL-Lima 2021 [Thesis]. Junin: Universidad Privada de Huancayo “Franklin Roosevelt”; 2021 [cited Apr 10, 2024]. Available from: https://repositorio.uroosevelt.edu.pe/handle/20.500.14140/385?show=full

Zavala-Flores E, Salcedo-Matienzo J. Pre-hospitalary medication in COVID-19 patients from a public hospital in Lima-Peru. Acta Med Peru. 2020;37(3). doi: 10.35663/amp.2020.373.1277

Melody Milagros AC, Romina NM. Conocimiento de los Médicos sobre efectos adversos de medicamentos más usados en el primer nivel de atención en establecimientos de salud del MINSA Chiclayo 2018 [Thesis]. Lambayeque: Universidad San Martin de Porres; 2020 [cited Apr 10, 2024]. Available from: http://repositorio.usmp.edu.pe/bitstream/handle/20.500.12727/6009/arias_cmm.pdf?sequence=1&isAllowed=y

Aguilar Pérez A, López Ulfe RJ. Nivel de conocimiento de los médicos del Servicio de Hospitalización del Hospital II EsSalud Cajamarca sobre el uso de ivermectina e hidroxicloroquina para COVID-19 [Thesis]. Cajamarca: Universidad Privada Antonio Guillermo Urrelo; 2021 [cited Apr 10, 2024]. Available from: http://repositorio.upagu.edu.pe/handle/UPAGU/1461

Mendoza-Chuctaya G, Calla-Torres M, Ramos KR, Mejia CR. Examen Nacional de Medicina (ENAM): Análisis de la última década de evaluaciones teóricas en los futuros médicos del Perú. Acta méd. Peru. 2021; 38(3):169-76. doi: 10.35663/amp.2021.383.2164.

National Superintendency of Higher University Education. II Informe Bienal sobre la realidad universitaria en el Perú [Internet]. Perú: SUNEDU; 2020. [cited 10 Apr 2024]. Available from: https://www.gob.pe/institucion/sunedu/informes-publicaciones/1093280-ii-informe-bienal-sobre-la-realidad-universitaria-en-el-peru

Espinoza-Portilla E, Gil-Quevedo W, Agurto-Távara E. Principales problemas en la gestión de establecimientos de salud en el Perú. Revista Cubana de Salud Pública. 2020;46(4):e2146.

Downloads

Published

2024-11-19

How to Cite

1.
Wong K, Taipe K, Tapia-Bullón WA, Tapia-Sequeiros G, Soriano-Moreno AN. Physician Adherence to Guideline Recommendations for Mild COVID-19 in Peru: A Cross-sectional Study. Rev. Cuerpo Med. HNAAA [Internet]. 2024 Nov. 19 [cited 2024 Nov. 21];17(3). Available from: https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/2523