Adherence of Physicians-in-Training to the 2009 International Standards for Tuberculosis Care (ISTC) at the University of the Philippines- Philippine General Hospital

Abstract

Introduction: The international standards for tuberculosis care (ISTC) was published to provide widely accepted level of care that all practitioners should follow in managing confirmed TB or suspected TB patients. Various initiatives were started in order to reinforce the standards embodied in the ISTC since 2006. Hence the investigators would like to evaluate the adherence of third year residents - in - training (Internal Medicine and Family Medicine from University of the Philippines, Philippine General Hospital (UP-PGH), 2012-2013) to the ISTC 2009 guidelines. Methodology: This study was done through review of randomly selected 59 outpatient records from January 2012 to December 2013 of TB patients seen by all third year residents from Internal Medicine and Family Medicine in UP-PGH. Outcome variables were the number of residents-in-training following the selected ISTC core standards: Standards for: Diagnosis (2,3); Treatment (8,10,13); HIV Infection and other Co-morbid Conditions (14); and Public Health and Prevention (21). Results: Standards 2 (at least 2 sputum specimens), 17 (thorough assessment of co-morbidities), and 8 (use of 1st line treatment regimen) were noted with higher number of residents adhering with 88.1% (52/59), 76.3% (45/59) and 64.4% (38/59) respectively. Standard 14 (HIV testing among TB patients) was only documented in 15.2% (9/59) residents. Conclusion: Standards 2, 17, and 8 were the most adhered ISTC guideline while standard 14 was least adhered to. Reinforcements are needed to provide updates to scale up TB management of residents-in-training based on international standard through regular continuing medical educations (CMEs), forums and/or seminars and feedbacks. Mechanisms and infrastructures should be in place to facilitate adherence to the ISTC.