Primary care and emergency physician attitudes and beliefs related to patients with psychogenic nonepileptic spells

IntroductionDeprescribing is the process of tapering or stopping medications aiming at improving patient outcomes and optimising current therapy. Some studies have tried to identify which patients will have inappropriate medication deprescribed, but none have found any association with sociodemographic and clinical characteristics, number of prescribed medications or duration of medication. Our aim was to determine Portuguese elderly patients’ attitudes and beliefs regarding medication use and their willingness to have regular medications deprescribed.Material and methodsWe conducted a cross-sectional study in triangulation in primary care centres from mainland Portugal and its autonomous regions. We used a random sample of 386 polymedicated older adult patients who answered the questionnaire between October 2018 and February 2019. For the quantitative analysis, we used sociodemographic characteristics, clinical profile and medication. For the qualitative analysis, we studied an included open question by coding participants’ answers; common codes were grouped together. A convergent mixed methods design was used.Results74.0% expressed the belief that medicines were generally beneficial. 19.9% reported a strong belief that medicines were harmful and 33.4% that they were overused. 61.8% were against the idea of deprescribing and 24.6% were in favour of deprescription. Those against the idea had a lower education level (p = 0.006) and a higher number of self-perceived morbidities (p = 0.001) than those not against it.ConclusionsMedication benefits were accepted by the majority of patients who also were against the idea of deprescribing. It is important that doctors are aware of this reality, namely in the primary care setting, addressing the patients’ fears and beliefs and making the deprescribing process possible.

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Comparison of attitudes and beliefs of physical therapists and primary care physicians regarding low back pain management: A cross-sectional study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200295 ◽

2021 ◽

pp. 1-7

Author(s):

Ahmed Alhowimel ◽

Faris Alodibi ◽

Mazad Alotaibi ◽

Dalyah Alamam ◽

Julie Fritz

Keyword(s):

Primary Care ◽

Saudi Arabia ◽

Physical Therapists ◽

Attitudes And Beliefs ◽

Low Back ◽

Line Contact ◽

First Line ◽

Cross Sectional ◽

Biopsychosocial Approach ◽

Beliefs And Attitudes

BACKGROUND: The first-line contact for patients seeking care for low back pain (LBP) can potentially change the disease course. The beliefs and attitudes of healthcare providers (HCPs) can influence LBP management. Although referring patients with LBP to physical therapy is common, the first-line contact for patients with LBP in Saudi Arabia is the primary care physician (PCP). Physical therapy will soon be integrated into primary care; therefore, it is rational to compare physical therapists’ (PTs) beliefs and attitudes regarding LBP with those of PCPs. OBJECTIVE: We compared PCPs’ and PTs’ attitudes and beliefs regarding LBP management. METHODS: We employed a cross-sectional, voluntary response sample research design using the Pain Attitudes and Beliefs Scale (PABS). Participants were PTs and PCPs practicing in Saudi Arabia. RESULTS: In total, 153 participants completed the PABS (111 PTs and 52 PCPs). PCPs demonstrated significantly higher PABS biomedical subscale scores than did the PTs. CONCLUSIONS: HCPs in Saudi Arabia should receive additional training to adopt a biopsychosocial approach to managing LBP. In this study, the HCPs’ treatment recommendations may not correspond with contemporary clinical guidelines. Research to facilitate the implementation of optimal professional education and training to adopt a biopsychosocial approach is an urgent priority.

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