Adherence to clinical guidelines in integration of mental health services into primary health care in Mbarara, southwestern Uganda: a medical records review

Abstract Background The Ugandan Ministry of Health decentralized mental healthcare to the district level; developed Uganda Clinical Guidelines (UCG); and trained primary health care (PHC) providers in identification, management, referral individuals with common disorders. This was intended promote integration services into PHC country. ‘Common disorders’ here refers mental, neurological substance use conditions as indicated UCG. However, extent general remains unknown. study aimed establish level adherence UCG identification management Methods a prospective medical record review patient information collected November December 2018, March April 2019 at two centers (III IV) southwestern Uganda. Data (health facility sex age patient; disorder diagnosis, management) using checklist. Continuous data analyzed means standard deviation while categorical Chi-square. Multivariable logistic regression analysis performed predictors provider clinical guidelines on PHC. conducted 95% significance. Results Of 6093 records patients facilities during period, 146 (2.4%) had or diagnosis. commonly diagnosed disorders were epilepsy 91 (1.5%) bipolar 25 (0.4%). most prescribed medications carbamazepine 65 (44.5%), phenobarbital 26 (17.8%). medicines inappropriately center III for diagnosis included chlorpromazine 3 (2.1%) haloperidol 1 (0.7%). Female gender (aOR: 0.52, CI 0.39–0.69) 61+ years 3.02, 1.40–6.49) entry HMIS register. Conclusion There noticeable change practice by integrating routine reflected rise number treated entered modified paper based registers.