Tables
- Table 1. Equipment required for practical approach to lung health strategy implementation#
First-level health facilities Sputum containers Peak flow meters with mouthpieces Inhalation chamber with masks (for children) Pulse oximeter Oxygen sources (cylinder and/or concentrators and accessories) Nebuliser with mask (manual at least) District referral outpatient services or laboratories Binocular microscope Centrifuge and incubator (if cultures for TB are performed) Basic radiology equipment Spirometer Pulse oximeter Equipment for tracheal aspiration Oxygen sources Equipment for pleural drainage Needles and instruments for transthoracic pleural biopsy Blood gas analyser Second referral level Bronchoscope (if there is a chest specialist trained to use it) TB: tuberculosis. #: according to the World Health Organization practical approach to lung health implementation guideline [8].
- Table 2. Practical approach to lung health (PAL) reported results on clinical outcomes
Outcomes Clinical outcomes Countries Diagnosis of chronic respiratory diseases# Increase in diagnosis of CRD Algeria, Chile, Jordan, Morocco, Kyrgyzstan, South Africa, Tunisia, Syria Quality of care of asthma and COPD patients Improvement of patients' management
Improvement of patients' quality of lifeSouth Africa, El Salvador Chile, Nepal Tuberculosis Improvement in the quality of the diagnostic process of TB
Improvement in TB case detectionAlgeria, Bolivia, Morocco, South Africa, Syria, Tunisia South Africa, Algeria Treatment Antibiotics Decrease in drug prescription, particularly antibiotics and adjuvant drugs Algeria, Bolivia, El Salvador, Jordan, Kyrgyzstan, Morocco, Nepal, Syria, Tunisia CRD drugs PAL improves the quality of drug prescription for CRD patients
Increase in inhaled steroid prescription
Decrease in oral steroid prescriptionAlgeria, Chile, Jordan, Kyrgyzstan, Morocco, South Africa, Syria, Tunisia COPD: chronic obstructive pulmonary disease; CRD: chronic respiratory diseases; TB: tuberculosis. #: asthma and COPD.
- Table 3. Practical approach to lung health (PAL) reported results on managerial and economic outcomes
Outcomes Clinical outcomes Countries Managerial Referral Increase in respiratory disease management in primary healthcare
Decrease in referral to upper health levelBolivia, El Salvador, Guinea, Jordan, Kyrgyzstan, South Africa Strengthening health services Strengthening of health workers' self confidence
Upgrading of health workers' skillsSouth Africa Economic Cost Reduction in the average cost of drug prescription per respiratory patient Algeria, Bolivia, Jordan, Kyrgyzstan, Morocco, Syria, Tunisia Patient out-of-pocket expense Decrease in direct and indirect costs Nepal Cost effectiveness of PAL Relatively cost effective Nepal, South Africa - Table 4. Impact of practical approach to lung health on drug prescription in seven countries
Algeria Morocco Kyrgyzstan Tunisia Jordan Bolivia Syria Number of drugs per patient -10.1*** -15*** -11.1*** -18.8*** -12.2*** -17.0*** -14.3*** Patients with antibiotic prescription -10.0** -25*** -22.0*** -21.1*** -15.9*** -12.3** -33.3*** Drug prescription cost per patient -13.6*** -18*** -32.4*** -19.3*** -8.7* -17.7*** -26.2*** Data are presented as %. *: p<0.05; **: p<0.01; ***: p<0.001.