Improving prescribing practices with rapid diagnostic tests (RDTs): synthesis of 10 studies to explore reasons for variation in malaria RDT uptake and adherence (original) (raw)

The overuse of antimalarial drugs is widespread. Effective methods to improve prescribing practice remain unclear. We evaluated the impact of 10 interventions that introduced rapid diagnostic tests for malaria (mRDTs) on the use of tests and adherence to results in different contexts. A comparative case study approach, analysing variation in outcomes across different settings. Studies from the ACT Consortium evaluating mRDTs with a range of supporting interventions in 6 malaria endemic countries. Providers were governmental or non-governmental healthcare workers, private retail sector workers or community volunteers. Each study arm in a distinct setting was considered a case. 28 cases from 10 studies were included, representing 148 461 patients seeking care for suspected malaria. The interventions included different mRDT training packages, supervision, supplies and community sensitisation. Analysis explored variation in: (1) uptake of mRDTs (% febrile patients tested); (2) provider ...