[Application of clinical audit to the evaluation of prescription of interferon-alpha in a teaching hospital].
Aim of this study was to evaluate through an audit tool the appropriateness of interferon-alpha (IFN-alpha) prescribing in a teaching hospital. The records of all patients (n.665) treated with IFN-alpha since 1991 were reviewed and the data concerning diagnosis and treatment collected using a standardized from. The data were submitted for peer review to a panel which included the representatives of the different medical specialties which actually prescribed the drug, external experts and members of the health management board of the hospital. The following points were discussed:-adherence to accepted therapeutic indications:-accuracy of the diagnosis prior to treatment:-scheduled doses:-criteria defining non-responders;-length of treatment and criteria for discontinuation. At the end of the study a questionnaire for evaluation of the audit was submitted to all participants. Most patients were treated according to a diagnosis of chronic hepatitis (HCV, n.448; HBV, n.54; HDV, n.22); other indications were chronic myeloid leukemia, thrombocythemia, polycythemia vera, Kaposi's sarcoma, condylomata, melanoma and mycosis fungoides. All indications were approved by the panel: no patient was treated outside established indications (85.6%) or a clinical trial protocol (14.4%). Standard schedules were initially applied to each indication, and were adjusted if needed according to the clinical response. In conclusion, the audit showed that IFN-alpha was correctly prescribed in our teaching hospital; the procedure was well accepted and its application may be useful in modifying prescribing attitudes.
Privitera
G
G
Istituto di Igiene e Medicina Preventiva, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano.
Auxilia
F
F
Bosisio
C
C
Castaldi
S
S
Pagano
A
A
D004363:Drug Utilization; D006784:Hospitals, Teaching; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D007558:Italy; D008485:Medical Audit
D016898:Interferon-alpha