CLINICAL GUIDELINES FOR CONSTIPATION IN CHILDREN - ARE PRIMARY CARE PHYSICIANS TAKING NOTE?

In view of the high prevalence of hypertension (HTN) among Russian population, it becomes extremely important to meet the criteria for the medical care quality within the periodic examinations for this group of patients.Aim. To assess the quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension (RH), by primary care physicians in different Russian regions.Materials and methods. As part of working visits of the expert group from the National Medical Research Center for Therapy and Preventive Medicine in 38 Russian regions in the period from February 1, 2020 to December 15, 2020, an analysis of ambulatory records of patients with grade 1-3 hypertension was carried out. A total of 3614 ambulatory medical records (AMRs) were analyzed, of which the grade 1-3 hypertension, with the exception of RH, was revealed in 764 ones. The analysis of records was carried out using an original checklist. Statistical processing was carried out using the software package IBM SPSS Statistics 20 (USA) and Microsoft Office Excel 2016 (USA).Results. An analysis of 764 AMRs was performed. The mean age of patients was 63,9-11,2 (women, 64,7-11,3 years; men, 62,7-10,9 years). The majority (58,9%) of participants were women. Follow-up monitoring was established in a timely manner in 450 people (58,9%) of patients, of which there were 189 men (42%) and 261 women (58%). In 87,9% (n=672) of cases, the diagnosis formulation met the established clinical guidelines criteria. In 36 cases (4,7%), there was no evidence in favor of hypertension according to the current clinical guidelines. In 21,1% (n=161) of cases, the minimum recommended periodicity of visits was not observed. In last visits of 323 patients, the blood pressure did not reach the target values. AMRs did not contain information on low-density lipoprotein cholesterol (LDL-C) in 91б4% of cases (n=698). Among patients with a known level of LDL-C, the target values were achieved only in 15,2% of cases (n=10).Conclusion. Our analysis revealed the insufficient quality of outpatient medical care to hypertensive patients within the periodic examinations. Proposals are created for monitoring and measures to improve the quality of care for this category of patients.

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Sources of Information on Medicinal Products Among Physicians – A Survey Conducted Among Primary Care Physicians in Poland

Frontiers in Pharmacology ◽

10.3389/fphar.2021.801845 ◽

2022 ◽

Vol 12 ◽

Author(s):

Magdalena Zielińska ◽

Tomasz Hermanowski

Keyword(s):

Primary Care ◽

Clinical Guidelines ◽

Primary Care Physicians ◽

Demographic Data ◽

Sources Of Information ◽

Medicinal Products ◽

Using Data ◽

Credible Information ◽

Source Of Information ◽

Credible Source

Introduction: Primary care physicians need to have access to up-to-date knowledge in various fields of medicine and high-quality information sources, but little is known about the use and credibility of sources of information on medicinal products among Polish doctors. The main goal of this study was to analyze the sources of information on medicinal products among primary care physicians in Poland.Methods: A survey was conducted among 316 primary care physicians in Poland. The following information was collected: demographic data of participants, type and frequency of using data sources on medicinal products, barriers to access credible information, assessment of the credibility of the sources used, impact of a given source and other factors on prescription decisions.Results: The most frequently mentioned sources of information were medical representatives (79%), medical journals (78%) and congresses, conventions, conferences, and training (76%). The greatest difficulty in finding the latest information about medicinal products was the lack of time. The surveyed doctors considered clinical guidelines to be the most credible source of information, and this source also had the greatest impact on the choice of prescribed medicinal products.Conclusion: The study showed that clinicians consider clinical guidelines as the most credible source of information with the greatest impact on prescribing medicinal products. However, it is not the source most often mentioned by doctors for obtaining knowledge about medicinal products. There is a need to develop strategies and tools to provide physicians with credible sources of information.

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Awareness, management, and practice patterns of pediatric NAFLD by primary care physicians

Paediatrics & Child Health ◽

10.1093/pch/pxab057 ◽

2021 ◽

Author(s):

Victoria Lee-Kim ◽

Rachael Morkem ◽

David Barber ◽

Jennifer A Flemming ◽

Mohit Kehar

Keyword(s):

Primary Care ◽

Liver Disease ◽

Clinical Guidelines ◽

Primary Care Physicians ◽

Practice Patterns ◽

Dissemination And Implementation ◽

Lifestyle Modifications ◽

Nonalcoholic Fatty Liver ◽

The North ◽

Specialist Referral

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children. Primary-care physicians (PCPs) play a key role in identifying patients requiring specialist referral. In this study, we aim to determine PCPs’ practice patterns for paediatric NAFLD, as knowledge gaps have been reported for adult NAFLD. Methods A survey was sent to 60 PCPs in the Eastern Ontario Network from July 2019 to January 2020. Results Thirty-seven (62%) PCPs responded to the survey. Twenty-one incorrectly considered the prevalence of paediatric NAFLD to be ≤10%. The majority (35/36) cared for less than five paediatric NAFLD patients. Thirty-four (92%) were only ‘slightly familiar’ or ‘not familiar at all’ with paediatric NAFLD. Only one PCP routinely screens for NAFLD. Only one PCP was aware of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) clinical guidelines for paediatric NAFLD. Twenty-five (68%) correctly selected lifestyle modifications as a treatment option. Lack of confidence in the knowledge of NAFLD was the most common barrier for managing paediatric cases. Conclusion The majority of PCPs are not screening for paediatric NAFLD and are not familiar with its clinical spectrum, citing a lack of knowledge regarding NAFLD as the greatest barrier. This may cause delays in diagnosis and a presentation with advanced fibrosis at the time of specialist referral. Dissemination and implementation of clinical guidelines have the potential to improve knowledge and screening rates for NAFLD in children at the primary-care level.

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Compliance with the clinical guidelines for managing asthma by primary care physicians: An ambispective observational study

Revista Clínica Española (English Edition) ◽

10.1016/j.rceng.2019.11.006 ◽

2020 ◽

Author(s):

M. Roman-Rodriguez ◽

J. Molina-Paris ◽

A. Fernandez-Sanchez ◽

Mohsen Abedianzadeh Timar ◽

Jesús Acha Domínguez ◽

...

Keyword(s):

Primary Care ◽

Observational Study ◽

Clinical Guidelines ◽

Primary Care Physicians

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Referral Practices for Spinal Surgery are Poorly Predicted by Clinical Guidelines and Opinions of Primary Care Physicians

Medical Care ◽

10.1097/mlr.0b013e3181e3588b ◽

2010 ◽

Vol 48 (9) ◽

pp. 852-858 ◽

Cited By ~ 9

Author(s):

S. Samuel Bederman ◽

Warren J. McIsaac ◽

Peter C. Coyte ◽

Hans J. Kreder ◽

Nizar N. Mahomed ◽

...

Keyword(s):

Primary Care ◽

Clinical Guidelines ◽

Spinal Surgery ◽

Primary Care Physicians ◽

Referral Practices

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To screen or not to screen, when clinical guidelines disagree: primary care physicians' use of the PSA test

Preventive Medicine ◽

10.1016/j.ypmed.2003.09.035 ◽

2004 ◽

Vol 38 (2) ◽

pp. 182-191 ◽

Cited By ~ 52

Author(s):

Crystale Purvis Cooper ◽

Tracie L Merritt ◽

Louie E Ross ◽

Lisa V John ◽

Cynthia M Jorgensen

Keyword(s):

Primary Care ◽

Clinical Guidelines ◽

Primary Care Physicians ◽

Psa Test

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Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

American Journal of Law & Medicine ◽

10.1017/s0098858800002586 ◽

2003 ◽

Vol 29 (4) ◽

pp. 489-524

Author(s):

Brent Pollitt

Keyword(s):

Primary Care ◽

Mental Illness ◽

Nurse Practitioners ◽

Primary Care Physicians ◽

American Psychological Association ◽

The United States ◽

Psychotropic Medications ◽

American Psychological ◽

Training Requirements ◽

Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

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