title: Doctors' compliance with national guidelines and clinical pathway on the treatment of tuberculosis inpatients in Hubei, China.
abstract: OBJECTIVE
  The Ministry of Health in China has enacted a revised National Tuberculosis Control Program (NTP) guidelines and clinical pathway (CP) on new smear-positive pulmonary tuberculosis (TB) inpatients to improve the quality of TB care and asked doctors' compliance to them on the treatment of TB inpatients. However, it remains unknown whether doctors adhere to them well. So this study focuses on evaluating the doctors' compliance with them in one representative TB hospital for medical quality improvement.
  
  
  METHODS
  A hospital-based retrospective study involving all medical records of newly diagnosed smear-positive pulmonary TB inpatients from July 2011 to July 2013. Analysis indicators including adequate drug regimens rate, adequate drug dosages rate and adequate length of hospital stay rate were chosen to assess doctors' compliance with NTP guidelines and CP on the treatment of new smear-positive pulmonary TB inpatients. The optimal value of these indicators is 100%.
  
  
  RESULTS
  Of the 334 inpatients selected, the rate of adequate drug regimens prescribed is 26.95% (90/334), and the rate of adequate drug dosages is 0% (0/90). For the dosage of single drug, the rates of adequate dosage of isoniazid, rifampicin, pyrazinamide and ethambutol are 24.44% (22/90), 85.56% (77/90), 70% (63/90) and 13.33% (12/90). Moreover, 75.56% (68/90) of isoniazid was prescribed too high and 83.34% (75/90) of ethambutol was prescribed too low. The rate of adequate length of hospital stay provided is 28.44% (95/334).
  
  
  CONCLUSIONS
  Doctors' compliance with NTP guidelines and CP on new smear-positive pulmonary TB inpatients is depressed and needs improvement.
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Zheng
authors.forename: Fangying
authors.initials: F
authors.lastname: Zhong
authors.forename: Xinping
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage*; D002681:China; D019091:Critical Pathways / Q000592:standards; D019983:Guideline Adherence; D006760:Hospitalization; D006801:Humans; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents
keywords: compliance; doctors; drug dosages; drug regimens; length of hospital stay; tuberculosis