UCG  and  EMHSLU  2016  

Appropriate Medicine Use unit

Pharmacy Department
October 2017
 Need  for  UCG  

Changes  in    
New  epidemics  
Guidelines  

New  drugs  

NEW  
TECHNOLOGIES  

New  treatment    
policies   New  diagnosDc  tests  
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 How  are  UCG  produced/reviewed  
Socio-­‐cultural   Expert     Health  system  
  ScienDfic  
Evidence    factors  
InternaDonal  
knowledge    resources  
NaDonal     Cost    
    guidelines  
     guidelines  
  effecDveness  
 
 
 
Discussion  
Consensus  

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 GOALS OF UCG
q OPTIMIZE q COST EFFECTIVE AND
PATIENTS’CARE EFFICIENT USE OF
RESOURCES

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 History  of  UCG    

1993   2003  

2010  

2012   5  
UCG  AND  EMHSLU  2016  

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 Process  
1.  EXPERTS’  REVIEW  
2.  STAKEHOLDERS’  
WORKSHOP  
3.  COMPILATION  
4.  QUALITY  CONTROL  
(harmonizaDon,  peer  review,  
clarificaDons,  re-­‐consultaDon)  

5.  EDITING/LAYOUT  

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 WHAT  IS  NEW  
q CHAPTERS  REORGANIZED  
⇒  Emergencies: Common emergencies, trauma and
injuries, poisoning
NEW!  
⇒  Infections, HIV and STDs
⇒  Medical chapters: cardiovascular, respiratory,
gastrointestinal and hepatic, renal and urinary,
endocrino, mental, neurological and substance abuse,
muscoloskeletal and joint, blood, oncology and
palliative care
⇒  MCH chapters: gynaecology, family planning,
obstetrics, childhood illnesses, immunization, nutrition
⇒  Specialist chapters: eye, ENT, skin, oro-dental,
surgery, radiology and anaesthesia
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 WHAT  IS  NEW  
⇒  DETAILED TABLE
OF CONTENTS
for easier
consultation

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 WHAT  IS  NEW  
⇒  Haemorrhagic fevers, yellow fever, chronic hepatitis
B, stroke, COPD, anaemia, sickle cell disease, atrial
fibrillation, headache, Nodding disease,
menopause, prostate diseases etc added
⇒  sections on non-communicable diseases expanded
(diabetes, hypertension, asthma etc) and diagnostic
criteria included

⇒  New IMCI and MCH guidelines – updated,

expanded

⇒  Management of side effects of FP methods and

vaccines added
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 WHAT  IS  NEW  
q Very  prac3cal  layout:  
⇒  Tables  for  management,  clearly  demarcated  
⇒  Non  pharmacological  to  pharmacological  
treatment  
⇒  From  first  line  to  second  line  
⇒  From  lower  to  higher  level  of  care  
⇒  Cross-­‐references  
⇒  NOTA  BENE:  Limited  informa3on  for  higher  levels  
(RR  and  above)  
q ICD10  classifica3on  
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Example:  febrile  convulsions  

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Example:  type  2  DM  

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 New guidelines included
MOH guidelines
q  Palliative care guidelines
2014
q  New HIV guidelines 2016
q  New TB guidelines 2016
q  Integrated Malaria
Management 2015
q  Nutrition Guidelines 2016
q  Management of chronic
hepatitis B 2016
WHO guidelines
q  Integrated management
of pregnancy and
Childbirth 2015
q  Integrated Management
of Childhood Illnesses
2014
q  Mental health GAP
intervention guide 2010
q  Other guidelines
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 AnDmicrobials
 in
 UCG
 
q Input/Sources
 of
 informaDon
 
⇒  Guidance from microbiology expert (Dr. Najjuka)
⇒  Situation analysis/recommendations, 2015
by UNAS
⇒  MOH and WHO guidelines and publications
⇒  Experts’ opinion
q Challenges
 
⇒  Insufficient information on causes of diseases and
antimicrobial resistance patterns
q Principles
 
⇒  Access
⇒  Clinical effectiveness
⇒  “parsimony”
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 Annexes
 
q Standard
 Infec3on
 Control
 Precau3ons
 
q Pharmacovigilance
 and
 Adverse
 Drug
 
reac3on
 
q Essen3al
 Medicine
 List
 2016
 
q Na3onal
 Laboratory
 Test
 Menu
 

 

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UCG  Pdf  -­‐  Xodo  
 What  can  I  use  it  for?  
IN  THE  DIAGNOSTIC  PROCESS  
q E.g.  I  think  it  could  be  typhoid  fever:    
⇒ are the symptoms and signs of my
patient consistent with what it is in the
manual?
⇒ What are the differentials?
⇒ Which test should I do to confirm?
⇒ What are the diagnostic criteria?
 
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 What  can  I  use  it  for?  
IN  THE  PRESCRIBING  PROCESS  
q Which  is  the  first  line  treatment?  
q Which  dosages  and  route  and  dura3on  of  
medicines?  
q Which  other  measures  are  necessary  besides  
medicines?  
q At  which  level  is  this  condi3on  managed?  
Should  I  refer  this  pa3ent?  And  to  which  level?  
q What  is  the  second  line  treatment  if  the  1st  line  
fails  or  is  not  available  or  is  not  tolerated?  
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 EMHSLU  2016  
q Reorganiza3on  to  align  with  WHO  EML  2015    
q Specialist  medicines  presented  within  each  
therapeu3c  category  
q Some  changes  
⇒  Amoxicillin 250 mg dispersible tablets
introduced
⇒  Ceftriaxone to HC3 (for MCH conditions)
⇒  Ergometrine and nalidixic acid removed
⇒  Atorvastatin introduced
⇒  Hydroxyurea introduced
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 Way  forward  
q Capillary  distribu3on  copies  through  NMS/JMS  
q Dissemina3on  
⇒  Ensure guidelines are available at prescribing
points
⇒  Ensure HWs understand the rational and aims
of UCG
⇒  Ensure HWs know how to use UCG
⇒  Monitor use and compliance with guidelines
 

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