Gaps in patient-centered follow-up cancer care: a cross sectional study

Author(s):  
Breanne Hobden ◽  
Heidi Turon ◽  
Amy Waller ◽  
Mariko Carey ◽  
Anthony Proietto ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rana Abu Farha ◽  
Eman Elayeh ◽  
Needa Zalloum ◽  
Tareq Mukattash ◽  
Eman Alefishat ◽  
...  

Abstract Background The fact that pharmacists are in the front line of patients’ care gives a great responsibility to focus on education and training of pharmacy students to build a ‘patient-centered’ clinicians. Unfortunately, pharmacy education in the developing countries, have been lagging behind actual practice delivered by pharmacists. This highlighted the need to evaluate the perceptions of undergraduate pharmacy students regarding their current pharmacy training practices and experiences. Methods This is a cross-sectional study that was conducted in Jordan during the period from August 2018 to October 2018. During the study period, a questionnaire was distributed to pharmacy students to collect information regarding 1) pharmaceutical care services provided by them during their experiential training, 2) their perceptions towards training sites, 3) their perceptions of the outcomes of their training experience, 4) information about their training site and 5) their demographics characteristics. Results A total of 202 pharmacy students responded to the questionnaire. The majority of them reported having the opportunity to dispense refill or new prescriptions (73.8%, n = 149), and conduct patient interviews (69.8%, n = 141, but they were not provided good opportunities to create electronic patient profiles using the information obtained (53.0%, n = 107), perform required dose calculations based on patient information (37.6%, n = 76), and interact with other healthcare professionals (34.6%, n = 70). In addition, students showed positive attitudes toward training sites, positive feedback about the outcomes of their training experience (median scores range between 4 and 5 for all statements (IQR = 1 for all)). Conclusion Students showed positive feedback about the outcomes of their training experience, but they felt that the selected training sites do not have adequate resources to meet their training competencies. Memorandums of understanding development is needed to specify the purpose of training and define the responsibility for both parties of the training process.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e040352
Author(s):  
Avinash Sharma ◽  
Olusegun Isaac Alatise ◽  
Kelli O'Connell ◽  
Samson Gbenga Ogunleye ◽  
Adewale Abdulwasiu Aderounmu ◽  
...  

Background/aimsCancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria.MethodsIn April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ~130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history.ResultsWe enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists.ConclusionsDespite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.


2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Desalew Tilahun ◽  
Abebe Abera ◽  
Gugsa Nemera

Abstract Background Health literacy plays a prominent role in empowering individuals for prevention as well as management of non-communicable diseases (NCDs). However, there is paucity of information on the health literacy of patients with non-communicable diseases in Ethiopia. Therefore, this study aimed to assess communicative health literacy and associated factors in patients with NCDs on follow-up at Jimma Medical Center (JMC), Ethiopia. Methods A cross-sectional study was conducted from 4 May 2020 to 4 July 2020 with 408 randomly selected adult patients, attending outpatient department of JMC in Ethiopia. The final sample size was obtained by using single population proportion formula. All patients with NCDs who were on follow-up at chronic illness clinic, JMC, were used as a source population. All eligible patients with NCDs who fulfilled the inclusion criteria were included in this study. A simple random sampling technique was used to recruit study participants. Data were collected through structured interviewer administered questionnaires on the six of nine health literacy domains using Health Literacy Questionnaire (HLQ) containing 30 items, socio-demographic and socio-economic characteristics, disease-related factors, and health information sources. Multivariable logistic regression was executed to determine the associations. Result Descriptive analysis shows more than half of the respondents in four of the six health literacy domains had high communicative health literacy level (CHLL). The proportion of people with high CHLL across each of the domains was as follows: health care provider support (56.1%), social support for health (53.7%), active engagement with a healthcare provider (56.1%), and navigating healthcare system (53.4%). We found educational status was significantly associated with five of six health literacy domains whereas number of sources was associated with four of six health literacy domains. Conclusion The overall findings of the current study indicate that health literacy levels vary according to socio-demographic and disease characteristics of patients. Thus, healthcare professionals should assess patients’ health literacy level and tailor information and support to the health literacy skills and personal context of their patients.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S120-S120
Author(s):  
G O Yeabyo

Abstract Introduction/Objective Cancer is one of a great public health problem in developing countries like Ethiopia and scarcity of histopathology laboratory is another burden for diagnosis and follow up of cancer diseases. The main purpose of this study is to evaluate the accessibility of histopathology services in Ethiopia. Methods Cross sectional study design were used to analyze the status of histopathology services in Ethiopia. Results There are 13 histopathology laboratories in the nation and a survey was conducted at these institutions. Out of these 13 Histopathology services seven are located in the capital, Addis Ababa and six found out of the capital located in four different regions. About 40,239,100 habitants have no histopathology service around their catchment area. Conclusion There are very limited histopathology laboratories, as a result diagnosis and prevention of cancer diseases are inadequate throughout the country.


2021 ◽  
pp. 095646242110240
Author(s):  
Genesis S Huerta-Vera ◽  
Manuel A Amarista ◽  
Fernando A Mejía ◽  
Ana B Graña ◽  
Elsa V Gonzalez-Lagos ◽  
...  

Due to a huge crisis extensive to health services many Venezuelan people living with HIV (PLWH) had migrated abroad, including Peru where favorable laws were in place until June 2019. We describe the health status and epidemiological trends of PLWH from Venezuela at an HIV program in Lima. We analyzed baseline and follow-up data of all Venezuelan PLWH enrolled in our HIV program from January 2017 to December 2019. A cross-sectional study in a subsample served to describe ARV adherence and context of migration. Between 2017-2019 our HIV Program registered 398 Venezuelan PLWH, representing 20% of the 2018 annual enrollments; numbers decreased since mid-2019. The median age was 30 years (IQR 26;37) and 90.5% were men. Between 2017 and 2019, the proportion with diagnosis in Peru increased from 14.3% to 60.9%; of AIDS stage at entry, from 8.8% to 27.2%. By December 2019, 182/250 (72.8%) were still in care, and 43 (10.8%) had not started ART. Viral suppression evaluated in 195, was achieved in 71.8%. From 2017 to 2019, migrant PLWH arrived in worsened clinical conditions, with increasing diagnosis in Peru; the flow of migrant PLWH entering care diminished with less favorable laws. Viral suppression rates were suboptimal.


2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Oliver Okoth Achila ◽  
Millen Ghebretinsae ◽  
Abraham Kidane ◽  
Michael Simon ◽  
Shewit Makonen ◽  
...  

Objective. There is a dearth of relevant research on the rapidly evolving epidemic of diabetes mellitus (particularly Type 2 diabetes mellitus) in sub-Saharan Africa. To address some of these issues in the Eritrean context, we conducted a cross-sectional study on glycemic and lipid profiles and associated risk factors. Methods. A total of 309 patients with diabetes mellitus on regular follow-up at the Diabetic and Hypertensive Department at Halibet Regional Referral Hospital, Asmara, were enrolled for the study. Data on specific clinical chemistry and anthropomorphic parameters was collected. Chi-squared (χ2) test or Fischer’s exact test was used to evaluate the relationship between specific variables. Multivariate logistic regression (backward: conditional) was undertaken to identify the factors associated with increased odds of suboptimal values in glucose and specific lipid panel subfractions. Results. High proportions of patients (76.7%) had suboptimal levels of HbA1c with a mean±SD of 8.6%±1.36, respectively. In multivariate regression analysis, the likelihood of HbA1c≥7% was higher in patients with abnormal WHR (AOR=3.01, 95% CI, 3.01 (1.15–7.92=0.024)) and in patients without hypertension (AOR=1.97, 95% CI (1.06–3.56), p=0.021). A unit reduction in eGFR was also associated with HbA1c≥7% (AOR=0.99, 95% CI (0.98–1=0.031)). In a separate analysis, the data shows that 80.9% of the patients had dyslipidemia. In particular, 62.1% of the patients had TC≥200 mg/dL (risk factors: sex, hypertension, and HbA1c concentration), 81.6% had LDL‐C≥100 mg/dL (risk factors: sex and hypertension), 56.3% had TG≥150 (risk factors: sex, HbA1c, and waist circumference), 62.8% had abnormal HDL-C (risk factors: waist circumference), 78.3% had non‐HDL<130 mg/dL (risk factors: duration of disease, reduced estimated glomerular filtration rate, and HbA1c), and 45.3% had abnormal TG/HDL (risk factors: sex, age of patient, FPG, and waist circumference). Conclusions. The quality of care, as measured by glycemic and specific lipid targets, in this setting is suboptimal. Therefore, there is an urgent need for simultaneous improvements in both indicators. This will require evidence-based optimization of pharmacological and lifestyle interventions. Therefore, additional studies, preferably longitudinal studies with long follow-up, are required on multiple aspects of DM.


PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 834-838 ◽  
Author(s):  
Richard C. Wasserman ◽  
Candace A. Croft ◽  
Sarah E. Brotherton

In this cross-sectional study, the vision-screening process is described for 8417 children aged 3 to 5 seen for health supervision in a group of 102 pediatric practices in 23 states and Puerto Rico. Three hundred forty children who failed screening (63% of those who failed) were followed up 2 months after initial screening. The sample was 52% male, 86% white, 9% black, 3% Hispanic, and 1% Asian. Vision screening was attempted on 66% of children overall. Pediatricians' reasons for not screening were "not routine" (44%), "too young" (40%), and "screening done previously" (17%). Younger children were less likely to be screened than older children (39% of those aged 3), and Hispanics were less likely to be screened than other ethnic groups (P &lt; .001). Thirty-three percent of children received no screening for latent strabismus. Two months later, 50% of parents whose child had failed a vision test were unaware of this fact on questionnaire follow-up. Eighty-five percent of children referred to an eye specialist had made or kept an appointment. It is concluded that pediatricians need to increase vision screening among younger preschool children and communicate more effectively to parents the results of screening failure.


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