Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020–2021
BackgroundClinical practice guidelines were continually changing during the COVID-19 pandemic to reflect the best available evidence for a novel virus. In Kazakhstan, the national clinical guidelines for COVID-19 patient care were regularly modified and it was not known if and to what extent these g...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1248959/full |
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| author | Saya Gazezova Saya Gazezova Dilyara Nabirova Dilyara Nabirova Dilyara Nabirova Ariana Detmar Manar Smagul Manar Smagul Lena Kasabekova Lena Kasabekova Sanam Zikriyarova Roberta Horth Roberta Horth |
| author_facet | Saya Gazezova Saya Gazezova Dilyara Nabirova Dilyara Nabirova Dilyara Nabirova Ariana Detmar Manar Smagul Manar Smagul Lena Kasabekova Lena Kasabekova Sanam Zikriyarova Roberta Horth Roberta Horth |
| author_sort | Saya Gazezova |
| collection | DOAJ |
| description | BackgroundClinical practice guidelines were continually changing during the COVID-19 pandemic to reflect the best available evidence for a novel virus. In Kazakhstan, the national clinical guidelines for COVID-19 patient care were regularly modified and it was not known if and to what extent these guidelines were being followed in practice.MethodsWe conducted a sub-analysis of data collected from an observational study among people hospitalized with COVID-19 in a large infectious disease hospital in Almaty in four cross-sections of increased COVID-19 incidence: T1 (1 June–30 August 2020); T2 (1 October–31 December 2020); T3 (1 April–31 May 2021); and T4 (1 July–26 October 2021). Modifications to the national COVID-19 treatment guidelines were identified and clinical data were abstracted from electronic medical records. We assessed frequency of antibiotic, glucocorticoid, anticoagulant, and antiviral administered in each period and determined if these aligned with national clinical guidelines. We used multivariable logistic regression to compare practices across periods.ResultsSix modifications were made to national COVID-19 treatment guidelines during this study. Of 1,146 people hospitalized with COVID-19, 14% were in T1, 14% in T2, 22% in T3, and 50% in T4. Anticoagulant treatment was administered to 87% (range: 56%–95%), antibiotic treatment to 60% (range: 58%–64%), glucocorticoid to 55% (range: 43%–64%) and antiviral therapy 15% (range: 7%–22%). Majority of treatments were not aligned with national guidelines, including 98% of anticoagulant use, 95% of antibiotic use, 56% of glucocorticoid use, and 56% of antiviral use. There were no significant changes in practice following changes in guidelines for antibiotic use (64% in T1 to 58% in T2, p = 0.30). There was significant increase in use of anticoagulant (84% in T2 vs. 95% in T3, p < 0.01), glucocorticoid (43% in T2 vs. 64% in T3, p < 0.01), and antiviral treatment (7% in T3 vs. 15% in T4, p < 0.01) after guidelines updates.ConclusionThe majority of treatments administered to people hospitalized with COVID-19 in four periods of high incidence in Almaty were not aligned with updated clinical guidelines. Antibiotic misuse was markedly high throughout. Increased awareness and training on clinical practice guidelines as updates are released may help improve adoption of evidence-based practices. |
| first_indexed | 2024-03-11T21:19:16Z |
| format | Article |
| id | doaj.art-bc502b37ebca4035aaa65173a65fc429 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-11T21:19:16Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-bc502b37ebca4035aaa65173a65fc4292023-09-28T10:53:48ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-09-011010.3389/fmed.2023.12489591248959Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020–2021Saya Gazezova0Saya Gazezova1Dilyara Nabirova2Dilyara Nabirova3Dilyara Nabirova4Ariana Detmar5Manar Smagul6Manar Smagul7Lena Kasabekova8Lena Kasabekova9Sanam Zikriyarova10Roberta Horth11Roberta Horth12Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, KazakhstanScientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring, Almaty, KazakhstanCentral Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, KazakhstanDivision of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, KazakhstanHealth Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, FinlandDivision of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United StatesCentral Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, KazakhstanScientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring, Almaty, KazakhstanCentral Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, KazakhstanScientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring, Almaty, KazakhstanCentral Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, KazakhstanCentral Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, KazakhstanDivision of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, KazakhstanBackgroundClinical practice guidelines were continually changing during the COVID-19 pandemic to reflect the best available evidence for a novel virus. In Kazakhstan, the national clinical guidelines for COVID-19 patient care were regularly modified and it was not known if and to what extent these guidelines were being followed in practice.MethodsWe conducted a sub-analysis of data collected from an observational study among people hospitalized with COVID-19 in a large infectious disease hospital in Almaty in four cross-sections of increased COVID-19 incidence: T1 (1 June–30 August 2020); T2 (1 October–31 December 2020); T3 (1 April–31 May 2021); and T4 (1 July–26 October 2021). Modifications to the national COVID-19 treatment guidelines were identified and clinical data were abstracted from electronic medical records. We assessed frequency of antibiotic, glucocorticoid, anticoagulant, and antiviral administered in each period and determined if these aligned with national clinical guidelines. We used multivariable logistic regression to compare practices across periods.ResultsSix modifications were made to national COVID-19 treatment guidelines during this study. Of 1,146 people hospitalized with COVID-19, 14% were in T1, 14% in T2, 22% in T3, and 50% in T4. Anticoagulant treatment was administered to 87% (range: 56%–95%), antibiotic treatment to 60% (range: 58%–64%), glucocorticoid to 55% (range: 43%–64%) and antiviral therapy 15% (range: 7%–22%). Majority of treatments were not aligned with national guidelines, including 98% of anticoagulant use, 95% of antibiotic use, 56% of glucocorticoid use, and 56% of antiviral use. There were no significant changes in practice following changes in guidelines for antibiotic use (64% in T1 to 58% in T2, p = 0.30). There was significant increase in use of anticoagulant (84% in T2 vs. 95% in T3, p < 0.01), glucocorticoid (43% in T2 vs. 64% in T3, p < 0.01), and antiviral treatment (7% in T3 vs. 15% in T4, p < 0.01) after guidelines updates.ConclusionThe majority of treatments administered to people hospitalized with COVID-19 in four periods of high incidence in Almaty were not aligned with updated clinical guidelines. Antibiotic misuse was markedly high throughout. Increased awareness and training on clinical practice guidelines as updates are released may help improve adoption of evidence-based practices.https://www.frontiersin.org/articles/10.3389/fmed.2023.1248959/fullCOVID-19coronavirus infectionclinical guidanceKazakhstanantibiotic use |
| spellingShingle | Saya Gazezova Saya Gazezova Dilyara Nabirova Dilyara Nabirova Dilyara Nabirova Ariana Detmar Manar Smagul Manar Smagul Lena Kasabekova Lena Kasabekova Sanam Zikriyarova Roberta Horth Roberta Horth Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020–2021 Frontiers in Medicine COVID-19 coronavirus infection clinical guidance Kazakhstan antibiotic use |
| title | Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020–2021 |
| title_full | Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020–2021 |
| title_fullStr | Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020–2021 |
| title_full_unstemmed | Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020–2021 |
| title_short | Therapies for people hospitalized with COVID-19 and alignment with national clinical guidelines in a large hospital, Almaty, Kazakhstan, 2020–2021 |
| title_sort | therapies for people hospitalized with covid 19 and alignment with national clinical guidelines in a large hospital almaty kazakhstan 2020 2021 |
| topic | COVID-19 coronavirus infection clinical guidance Kazakhstan antibiotic use |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1248959/full |
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