scholarly journals Lessons learned in the provision NCD primary care to Syrian refugee and host communities in Lebanon: the need to ‘act locally and think globally’

2019 ◽  
Vol 42 (3) ◽  
pp. e361-e368 ◽  
Author(s):  
Abla M Sibai ◽  
Martine Najem Kteily ◽  
Rana Barazi ◽  
Mia Chartouni ◽  
Maguy Ghanem ◽  
...  
Keyword(s):  
Primary Care ◽  
Intervention Program ◽  
Diabetes Management ◽  
Healthcare Providers ◽  
Monitoring And Evaluation ◽  
Study Groups ◽  
Lessons Learned ◽  
Host Community ◽  
Conflict Situations ◽  
And Control

ABSTRACT Background Prevention and control of non-communicable diseases (NCDs) remain inadequate in resource-scarce countries, particularly in conflict situations. This paper describes a multicomponent intervention for management of hypertension and diabetes among older adult Syrian refugees and the Lebanese host community and reflects on challenges for scaling up NCD integration into primary care in humanitarian situations. Methods Using a mixed method approach, the study focused on monitoring and evaluation of the three components of the intervention: healthcare physical facilities and documentation processes, provider knowledge and guideline-concordant performance, and refugee and host community awareness. Results Findings revealed overall high compliance of healthcare workers with completing data collection forms. Their knowledge of basic aspects of hypertension/diabetes management was adequate, but diagnosis knowledge was low. Patients and healthcare providers voiced satisfaction with the program. Yet, interruptions in medicines’ supplies and lapses in care were perceived by all study groups alike as the most problematic aspect of the program. Conclusions Our intervention program was aligned with internationally agreed-upon practices, yet, our experiences in the field point to the need for more ‘local testing’ of modified interventions within such contexts. This can then inform ‘thinking globally’ on guidelines for the delivery of NCD care in crisis settings.

scholarly journals A cluster-randomized trial of the effectiveness of a triple-faceted intervention promoting adherence to primary care physician visits by diabetes patients: J-DOIT2 large-scale trial (J-DOIT2-LT)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mitsuhiko Noda ◽  
Yasuaki Hayashino ◽  
Katsuya Yamazaki ◽  
Hikari Suzuki ◽  
Atsushi Goto ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Education ◽  
Primary Care Physician ◽  
Intervention Program ◽  
Primary Outcome ◽  
Care Physician ◽  
Controlled Study ◽  
Cluster Randomized ◽  
And Control ◽  
Diabetes Patients

Abstract We aimed to assess whether a triple-faceted intervention program administered in the primary care setting could decrease the risk of insufficient adherence to primary care physician (PCP) appointments among this patient population. We conducted a cluster-randomized controlled study to assess the effects of a 1-year intervention. The primary outcome was insufficient adherence to regular PCP attendance for diabetes treatment, defined as failure to visit a PCP within 2 months of an original appointment date. The intervention consisted of mailing patient reminders of their PCP appointments, providing patients with health education aimed at lifestyle modification and benchmarking PCP procedures. Eleven municipal level district medical associations employing 192 PCPs were divided into two subregions for assignment to intervention and control clusters, with 971 and 1,265 patients assigned to the intervention and control groups, respectively. Primary outcome data were available for 2,200 patients. The intervention reduced insufficient adherence to regular PCP appointments by 63% (hazard ratio, 0.37; 95% confidence interval [CI], 0.23–0.58). In conclusion, a triple-faceted intervention program consisting of health education, appointment reminders, and physician benchmarking may decrease the risk of incomplete adherence to regular PCP appointments by diabetes patients.

scholarly journals Intersectoral Collaborations for the Prevention and Control of Vector Borne Diseases: A Scoping Review

2019 ◽  
Vol 53 (4) ◽  
Author(s):  
Ma. Sophia Graciela L. Reyes ◽  
Chelseah Denise H. Torres ◽  
Amiel Nazer C. Bermudez ◽  
Kim L. Cochon ◽  
Evalyn A. Roxas ◽  
...  
Keyword(s):  
Yellow Fever ◽  
Scoping Review ◽  
Prevention And Control ◽  
Monitoring And Evaluation ◽  
Lessons Learned ◽  
Vector Borne Diseases ◽  
Vector Borne ◽  
Comprehensive Framework ◽  
And Control ◽  
And Training

Objectives. This scoping review aimed to support a landscape analysis to identify lessons learned about intersectoral collaborations (ISCs) by describing their existing models in the context of dengue, malaria and yellow fever. Methods. A scoping review following the methodology of Joanna Briggs Institute was performed using the following inclusion criteria: studies involving humans; studies discussing intersectoral collaborations, malaria/dengue/yellow fever, and prevention or control at any level; and studies in countries endemic for the aforementioned diseases. Studies were screened using Covidence, while data were extracted using NVivo. Results. Of the 7,535 records retrieved, 69 were included in the qualitative analysis. Most ISCs were initiated by multilateral organizations and ministries of health, and none by communities. Strategies included advocacy, health education, research, public health measures, resource mobilization, service delivery and training; mostly employed on a community level. Monitoring and evaluation were mostly formative, ongoing, and participatory. Gaps included administrative and policy barriers, resource shortages, and inadequate research and training. Conclusions. Multiple models of ISC exist in the literature. There is a need to develop a comprehensive framework for an effective and sustainable multisectoral approach for the prevention and control of VBDs ensuring adequate resources, active stakeholders, and strategies that span the entire socio-ecological spectrum.

scholarly journals Implementation of HPV-based screening in Burkina Faso: lessons learned from the PARACAO hybrid-effectiveness study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keitly Mensah ◽  
Charles Kaboré ◽  
Salifou Zeba ◽  
Magali Bouchon ◽  
Véronique Duchesne ◽  
...  
Keyword(s):  
Primary Care ◽  
Burkina Faso ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Real Life ◽  
Limited Resource ◽  
Lessons Learned ◽  
Promising Alternative ◽  
Logistic Regression Models ◽  
Primary Healthcare Centers

Abstract Background Cervical cancer screening in sub-Saharan countries relies on primary visual inspection with acetic acid (VIA). Primary human papillomavirus (HPV)-based screening is considered a promising alternative. However, the implementation and real-life effectiveness of this strategy at the primary-care level in limited-resource contexts remain under explored. In Ouagadougou, Burkina Faso, free HPV-based screening was implemented in 2019 in two primary healthcare centers. We carried out a process and effectiveness evaluation of this intervention. Methods Effectiveness outcomes and implementation indicators were assessed through a cohort study of screened women, observations in participating centers, individual interviews with women and healthcare providers and monitoring reports. Effectiveness outcomes were screening completeness and women’s satisfaction. Logistic regression models and concurrent qualitative analysis explored how implementation variability, acceptability by women and the context affected effectiveness outcomes. Results After a 3-month implementation period, of the 350 women included in the cohort, 94% completed the screening, although only 26% had their screening completed in a single visit as planned in the protocol. The proportion of highly satisfied women was higher after result disclosure (95%) than after sampling (65%). A good understanding of the screening results and recommendations increased screening completeness and women’s satisfaction, while time to result disclosure decreased satisfaction. Adaptations were made to fit healthcare workers’ workload. Conclusion Free HPV-based screening was successfully integrated within primary care in Ouagadougou, Burkina Faso, leading to a high level of screening completeness despite the frequent use of multiple visits. Future implementation in primary healthcare centers needs to improve counseling and reduce wait times at the various steps of the screening sequence.

scholarly journals Nurses’ knowledge of chronic disease management

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Saloshni Naidoo ◽  
Ozayr H. Mahomed ◽  
Shaidah Asmall ◽  
Myra Taylor
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Diseases ◽  
Chronic Disease Management ◽  
Diabetes Management ◽  
T Test ◽  
And Control ◽  
The Impact ◽  
Nurses Knowledge

Background: Chronic diseases of lifestyle are detrimentally affecting South Africans. National Health Insurance, which is intended to improve care, requires capacity building for nurses at primary care clinics to ensure appropriate service provision.Objective: This study’s objective was to evaluate the impact of the ‘Primary Care 101’ chronic disease management guideline and training on nurses’ knowledge of chronic diseases management.Method: A population-based, unblinded, stratifid cluster randomised controlled trialwith intervention (n = 20) and control clinics (n = 10) in three South African districts was conducted over six months in 2012. Nurses in the clinics participated in surveying knowledge on management of tuberculosis, human immunodefiiency virus infection, mental health, epilepsy, diabetes, hypertension and asthma and chronic obstructive pulmonary disease (COPD). All nurses were surveyed at baseline and six months later. Intervention clinic nurses were also surveyed immediately after training and three months post-training. Data were analysed using SPSS version 19 (SPSS Inc., Chicago, IL).Total mean knowledge percentage scores were calculated for each chronic disease. Mean knowledge percentage score changes between baseline and six months amongst all nurses and between intervention and control clinic nurses were compared using the paired samples t-test and independent samples t-test respectively.Results: There were signifiant improvements in nurses’ knowledge of hypertension and diabetes management over six months. Knowledge about asthma and COPD management decreased in all districts and nurse categories.Conclusion: The improvements in nurses’ knowledge can ensure improved patientmanagement, but attention to asthma and COPD management is required.Agtergrond: Chroniese lewenstylsiektes beïnvloed Suid-Afrikaners nadelig. Die nasionale gesondheidsversekering, wat ten doel het om sorg te verbeter, vereis kapasiteitsbou vir verpleegsters by primêre-sorg-klinieke om sodoende toepaslike dienslewering te verseker.Doelwitte: Hierdie studie se doel was te evalueer wat die impak van die ‘Primary Care 101’ chroniese siekte bestuursriglyn, asook opleiding is op verpleegsters se kennis van hoe om chroniese siektes te bestuur.Metode: ’n Bevolkingsgebaseerde, onverblinde, ewekansige gekontroleerde trossteekproef met ingrypings- (n = 20) en kontrole-klinieke (n = 10) is oor ’n tydperk van ses maande in 2012 in drie Suid-Afrikaanse distrikte uitgevoer. Verpleegsters in hierdie klinieke het deelgeneem aan ’n opname oor hul kennis oor die bestuur van tuberkulose, menslike immuniteitsgebreksvirus-infeksie, geestesgesondheid, epilepsie, diabetes, hoë bloeddruk, asook asma en chroniese obstruktiewe longsiekte (COPD). Alle verpleegsters is by die basislyn ondervra en ses maande later. Intervensie kliniekverpleegsters is ook ondervra onmiddellik na die opleiding en drie maande post-opleiding. Data is ontleed met behulp van SPSS, weergawe 19 (SPSS Inc, Chicago, IL). Totale gemiddelde kennis persentasietellings isvir elke chroniese siekte bereken. Veranderinge in die gemiddelde kennis persentasietellings tussen die basislyn en ses maande later is onder alle verpleegsters, asook tussen ingrypingsen kontrole-kliniekverpleegsters vergelyk met behulp van die gepaarde steekproef t-toets en die onafhanklike steekproef t-toets onderskeidelik.Resultate: Daar was ’n aansienlike verbetering in verpleegsters se kennis oor die bestuur van hoë bloeddruk en diabetes na ses maande. Kennis oor die bestuur van asma en COPD het in alle distrikte en verpleegster-kategorieë afgeneem.Gevoltrekking: Die verbetering in die verpleegsters se kennis kan verbeterde pasiëntbestuur verseker, maar die bestuur van asma en COPD vereis verdere aandag.

scholarly journals Clinical management of Type II Diabetes among the unstably housed: a qualitative study of primary care physicians

2019 ◽  
Vol 37 (3) ◽  
pp. 418-423
Author(s):  
Mariana L Henry ◽  
Judith H Lichtman ◽  
Kendra Hanlon ◽  
Danya E Keene
Keyword(s):  
Primary Care ◽  
Type Ii Diabetes ◽  
Primary Care Physicians ◽  
Diabetes Management ◽  
Standard Of Care ◽  
Type Ii ◽  
Structured Interviews ◽  
Individualized Care ◽  
Primary Care Clinicians ◽  
And Control

Abstract Background Housing is a growing challenge for US adults in an increasingly unaffordable housing market. These housing challenges can create barriers to effective management and control of Type II Diabetes. However, little is known about how housing challenges are perceived and navigated by clinicians who care for patients with Type II Diabetes. Objective To examine how primary care clinicians perceive and navigate their patients’ housing challenges in the context of Type II Diabetes management. Methods We conducted semi-structured interviews with 18 primary care clinicians practising in four clinical settings in New Haven, Connecticut. Two investigators systematically coded the interviews. Analysis of coded data was used to determine themes. Results Participants considered housing as significant to their patients’ health and a potential barrier to optimal diabetes management. Participants sought to improve their patients’ housing through advocacy, referrals and interdisciplinary collaborations. They also adjusted clinical decisions to adapt to patients’ housing challenges. In making clinical adjustments, participants struggled to find a balance between what they perceived to be feasible for unstably housed patients and maintaining a standard of care. Some participants navigated this balanced by employing creative strategies and individualized care. Conclusion In highlighting the challenges that clinicians face in maintaining a standard of care for unstably housed diabetes patients, our findings speak to the need for more guidance, resources and support to address housing in a clinical setting.

scholarly journals Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: From Key Lessons to a Framework for Implementation

2021 ◽  
Author(s):  
Edmond C Li ◽  
Rosy Tsopra ◽  
Geronimo Larrain Gimenez ◽  
Alice Serafini ◽  
Gustavo Gusso ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Lessons Learned ◽  
Free Text ◽  
Online Questionnaire ◽  
Face To Face ◽  
Need To Evaluate ◽  
Barriers And Challenges ◽  
Remote Care

Background: With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. Objective: We explored GPs' perspectives on the main benefits and challenges of using digital remote care. Methods: GPs across 20 countries completed an online questionnaire between June - September 2020. GPs' perceptions on main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. Results: 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and the accompanying legal frameworks. Main challenges included patient's preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. Conclusion: At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how. Lessons learned during the emergency phase can be used to inform the stable adoption of virtual care solutions, and co-design processes and platforms that are technologically robust, secure, and supported by a strategic long-term plan.

Lessons Learned From a Pilot Project on Telemedicine Advance Care Planning in an Urban Geriatric Primary Care Office

2021 ◽  
pp. 104990912110369
Author(s):  
Olivia M. Seecof ◽  
Molly Allanoff ◽  
John Liantonio ◽  
Susan Parks
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Medical Record ◽  
Advance Care Planning ◽  
Pilot Project ◽  
Lessons Learned ◽  
Care Planning ◽  
Geriatric Population ◽  
Advance Care ◽  
Primary Care Office

Purpose: There is a dearth of literature regarding the documentation of advance care planning (ACP) in the geriatric population, despite the controversial, yet well-studied need for ACP. The purpose of this pilot study was to provide an update to a prior study from our institution that outlined the need for increased documentation of advance care planning (ACP) in an urban geriatric population. Methods: Our study involved using telemedicine to conduct dedicated ACP visits and an electronic medical record (EMR) note-template specifically designed for these visits in an attempt to increase the amount of documented ACP in the EMR in this population. Results: The study did not yield significant results due to the inability to schedule enough patients for these dedicated visits. Discussion: While our study was ultimately unsuccessful, 3 crucial lessons were identified that will inform and fuel future interventions by the authors to further the study of documentation of ACP.

scholarly journals Monitoring and Evaluation of COVID-19 response in the WHO African Region: challenges and lessons learned

2021 ◽  
pp. 1-14
Author(s):  
Benido Impouma ◽  
Caitlin M. Wolfe ◽  
Franck Mboussou ◽  
Bridget Farham ◽  
Tessa Saturday ◽  
...  
Keyword(s):  
Monitoring And Evaluation ◽  
Lessons Learned ◽  
African Region
Sign in / Sign up

Export Citation Format

Share Document