Factors Associated With Provision of Long-Acting Reversible Contraception Among Adolescent Health Care Providers

Abstract Background: Reduction of maternal mortality and morbidity is a major global health priority. However, much remains unknown regarding factors associated with postpartum hemorrhage (PPH) among childbearing women in the Rwandan context. The aim of this study is to explore the influencing factors for prevention of PPH and early detection of women at risk as perceived by beneficiaries and health workers in the Northern Province of Rwanda. Methods: A qualitative descriptive exploratory study was drawn from a larger sequential exploratory‐mixed methods study. Semi‐structured interviews were conducted with 11 women who experienced PPH within the 6 months prior to interview. In addition, focus group discussions were conducted with: women’s partners or close relatives (2 focus groups), community health workers (CHWs) in charge of maternal health (2 focus groups) and health care providers (3 focus groups). A socio ecological model was used to develop interview guides to describe factors related to early detection and prevention of PPH in consideration of individual attributes, interpersonal, family and peer influences, intermediary determinants of health and structural determinants. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board. Results: We generated four interrelated themes: (1) Meaning of PPH: beliefs, knowledge and understanding of PPH: (2) Organizational factors; (3) Caring and family involvement and (4) Perceived risk factors and barriers to PPH prevention. The findings from this study indicate that PPH was poorly understood by women and their partners. Family members and CHWs feel that their role for the prevention of PPH is to get the woman to the health facility on time. The main factors associated with PPH as described by participants were multiparty and retained placenta. Low socioeconomic status and delays to access health care were identified as the main barriers for the prevention of PPH. Conclusions: Addressing the identified factors could enhance early prevention of PPH among childbearing women. Placing emphasis on developing strategies for early detection of women at higher risk of developing PPH, continuous professional development of health care providers, developing educational materials for CHWs and family members could improve the prevention of PPH. Involvement of all levels of the health system was recommended for a proactive prevention of PPH. Further quantitative research, using case control design is warranted to develop a screening tool for early detection of PPH risk factors for a proactive prevention.

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Treatment Persistence Among Insured Patients Newly Starting Buprenorphine/Naloxone for Opioid Use Disorder

Annals of Pharmacotherapy ◽

10.1177/1060028017751913 ◽

2018 ◽

Vol 52 (5) ◽

pp. 405-414 ◽

Cited By ~ 11

Author(s):

Natalia Shcherbakova ◽

Gary Tereso ◽

Jacqueline Spain ◽

Robert J. Roose

Keyword(s):

Health Care ◽

Health Care Providers ◽

Care Delivery ◽

Opioid Use Disorder ◽

Prescription Opioid ◽

Care Providers ◽

Opioid Use ◽

Treatment Persistence ◽

Factors Associated ◽

Insured Patients

Background: Persistence with medication-assisted therapy among patients with opioid use disorder has been associated with reduced likelihood of illicit opioid use. Objective: We aimed to describe treatment persistence and identify factors associated with 1-year persistence among insured patients newly initiating buprenorphine-containing pharmacotherapy. Methods: The retrospective observational cohort included employer-sponsored and managed Medicaid patients newly started on buprenorphine-containing therapy between June 30, 2010, and January 1, 2015. Persistence was measured as both a continuous and dichotomous variable (proportion of patients persistent for 1 year). Multivariable logistic regression analysis was used to identify factors associated with 1-year persistence. Results: A total of 302 patients met inclusion criteria. The median [range] number of treatment episodes was 1 [1-4]. Mean number of days on therapy during the first episode was 206 (SD = 152) days, with 40.4% (n = 122) of patients persisting for 1 year. Presence of concomitant fills of prescription opioid analgesics (odds ratio [OR] = 0.25; 95% CI = 0.12-0.51), being in care of an addiction specialist (OR = 0.40; 95% CI = 0.21-0.76), and Medicaid insurance coverage (OR = 0.33; 95% CI = 0.13-0.84) were significantly and negatively associated with 1-year persistence. There was also a strong inverse relationship between persistence and inpatient hospitalization (OR = 0.30; 95% CI = 0.12-0.76). Conclusions: Several health care delivery and use variables were significantly associated with nonpersistence. Concomitant use of prescription opioids is the most easily modifiable risk factor that health care providers and policy makers may act on to improve treatment continuation.

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Patient and Health Care Provider Perspectives on Long Acting Injectable Antipsychotics in Schizophrenia and the Introduction of Olanzapine Long-Acting Injection

Journal of Central Nervous System Disease ◽

10.4137/jcnsd.s4091 ◽

2011 ◽

Vol 3 ◽

pp. JCNSD.S4091 ◽

Cited By ~ 3

Author(s):

Heidi J. Wehring ◽

Sheryl Thedford ◽

Maju Koola ◽

Deanna L. Kelly

Keyword(s):

Health Care ◽

Health Care Provider ◽

Health Care Providers ◽

Care Provider ◽

Treatment Options ◽

Care Providers ◽

Provider Attitudes ◽

Provider Perspectives ◽

Long Acting ◽

Acting Agent

Olanzapine long acting injection has joined risperidone and paliperidone as the second generation long acting antipsychotic injection options for treatment of patients with schizophrenia. Long acting injections are important alternatives to oral medications for patients who have difficulty adhering to daily or multiple daily medication administrations, yet may be underutilized or not well understood. Patient perceptions, adherence, and preferences are important issues for health care providers to address when discussing treatment options with their patients. Reviewed here are overall patient and health care provider attitudes and perceptions regarding long acting injections and the details of olanzapine long acting injectable, the newest agent, and how it will fit in the marketplace. In addition, efficacy, safety, dosing and use data regarding this newest long acting agent are reviewed and compared to other available long acting agents.

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Knowledge, attitudes and practices on influenza vaccination during pregnancy in Quito, Ecuador

10.21203/rs.3.rs-46051/v4 ◽

2020 ◽

Author(s):

Carlos E. Erazo ◽

Carlos V. Erazo ◽

Mario J. Grijalva ◽

Ana L. Moncayo

Keyword(s):

Health Care ◽

Antenatal Care ◽

Influenza Vaccination ◽

Pregnant Women ◽

Health Care Providers ◽

Influenza Viruses ◽

Care Providers ◽

Factors Associated ◽

Attitudes And Practices ◽

Knowledge Attitudes And Practices

Abstract Background: Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes, and practices (KAP) of pregnant women toward influenza vaccination in Quito-Ecuador.Methods: A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models.Results: A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62-26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03-2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01-1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%).Conclusions: Health educational programs aimed at pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.

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Factors associated with health care providers speaking with older patients about being subjected to abuse

Journal of Elder Abuse & Neglect ◽

10.1080/08946566.2021.2014378 ◽

2021 ◽

pp. 1-18

Author(s):

Atbin Motamedi ◽

Mikael Ludvigsson ◽

Johanna Simmons

Keyword(s):

Health Care ◽

Health Care Providers ◽

Older Patients ◽

Care Providers ◽

Factors Associated

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CONTRACEPTIVE USE DYNAMICS IN INDIA: AN OVERVIEW

10.36106/ijsr/8315251 ◽

2021 ◽

pp. 23-25

Author(s):

Rajalakshmi R ◽

Renuka K

Keyword(s):

Health Care ◽

Health Care Providers ◽

Subcutaneous Injection ◽

Contraceptive Use ◽

Care Providers ◽

Effective Form ◽

Long Acting

Injectable contraception, or the shot: is an extensively used form of productive contraception worldwide. Currently new forms of injectable contraception have been advanced which admit for subcutaneous injection (under the skin), rather than IM injection. These new formulations may admit women to prefer self-injecting contraception more easily as it don't require a provider to inject them, this is the point to be noted as injectable contraception must be taken every 3 months once. Few people using injectable contraception may choose to self-inject for reasons of their privacy or convenience, and in the places where there are not adequate health care providers to administer reinjections, this has the ability to develop access to this safe and effective form of long-acting contraception.

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