Appropiated drug means
drug of choice or the best drug for patient in specific conditions.
ExampleIn baby, drug of choice for fever is paracetamol.
In Diabetic nephropathy or Chronic Kidney Disease, drug of choice for protects kidney is ACEI drug group such as enalapril.
Sometimes appropiated drugs depend on clinical practice guideline.
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searchA medical guideline (also called a clinical guideline, clinical protocol or clinical practice guideline) is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of
healthcare. Such documents have been in use for thousands of years during the entire
history of medicine. However, in contrast to previous approaches, which were often based on tradition or authority, modern medical guidelines are based on an examination of current evidence within the paradigm of
evidence-based medicine. They usually include summarized
consensus statements, but unlike the latter, they also address practical issues.
Modern clinical guidelines briefly identify, summarize and evaluate the best evidence and most current data about
prevention,
diagnosis,
prognosis, therapy including dosage of medications,
risk/benefit and
cost-effectiveness. Then they define the most important questions related to clinical practice and identify all possible
decision options and their
outcomes. Some guidelines contain decision or computation
algorithms to be followed. Thus, they integrate the identified decision points and respective courses of action to the clinical judgment and experience of practitioners. Many guidelines place the treatment alternatives into classes to help providers in deciding which treatment to use.
Additional objectives of clinical guidelines are to
standardize medical care, to raise quality of care, to reduce several kinds of risk (to the patient, to the healthcare provider, to
medical insurers and health plans) and to achieve the best balance between cost and medical parameters such as
effectiveness,
specificity,
sensitivity, resolutiveness, etc. It has been demonstrated repeatedly that the use of guidelines by healthcare providers such as
hospitals is an effective way of achieving the objectives listed above, although they are not the only ones.
Special
computer software packages known as
guideline execution engines have been developed to facilitate the use of medical guidelines in concert with an
electronic medical record system. The Guideline Interchange Format (GLIF) is a computer representation format for clinical guidelines that can be used with such engines.
[1]It has been found
[2] that some simple clinical practice guidelines are not routinely followed to the extent they might be. It has been found that providing a
nurse or other medical assistant with a
checklist of recommended procedures can result in the attending physician being reminded in a timely manner regarding procedures that might have been overlooked.
The guideline-based approach to healthcare is a relatively recent one and has originated in the United States in the 1990s. Guidelines are usually produced at national or international levels by medical associations or governmental bodies, such as the US Agency for Healthcare Research and Quality. Local healthcare providers may produce their own set of guidelines or adapt them from existing top-level guidelines.
The USA and other countries maintain medical guideline
clearinghouses. In the USA, the
National Guideline Clearinghouse maintains a catalog of high-quality guidelines published by various organizations (mostly professional physician organizations). In the United Kingdom, clinical practice guidelines are published primarily by the
National Institute for Health and Clinical Excellence (NICE). In The Netherlands, two bodies (CBO and NHG) publish specialist and primary care guidelines, respectively. In Germany, the
German Agency for Quality in Medicine (ÄZQ) coordinates a national program for disease management guidelines. All these organisations are now members of the
Guidelines International Network, an international not-for-profit association of organisations and individuals involved in clinical practice guidelines. G-I-N is owner of the International Guideline Library - the largest web based data base of medical guidelines worldwide.
