Knowledge and attitudes of Australian general practitioners towards medicinal cannabis: a cross-sectional survey

ObjectivesTo examine the knowledge and attitudes of Australian general practitioners (GP) towards medicinal cannabis, including patient demand, GP perceptions of therapeutic effects and potential harms, perceived knowledge and willingness to prescribe.Design, setting and participantsA cross-sectional survey completed by 640 GPs (response rate=37%) attending multiple-topic educational seminars in five major Australian cities between August and November 2017.Main outcome measuresNumber of patients enquiring about medicinal cannabis, perceived knowledge of GPs, conditions where GPs perceived it to be beneficial, willingness to prescribe, preferred models of access, perceived adverse effects and safety relative to other prescription drugs.ResultsThe majority of GPs (61.5%) reported one or more patient enquiries about medicinal cannabis in the last three months. Most felt that their own knowledge was inadequate and only 28.8% felt comfortable discussing medicinal cannabis with patients. Over half (56.5%) supported availability on prescription, with the preferred access model involving trained GPs prescribing independently of specialists. Support for use of medicinal cannabis was condition-specific, with strong support for use in cancer pain, palliative care and epilepsy, and much lower support for use in depression and anxiety.ConclusionsThe majority of GPs are supportive or neutral with regards to medicinal cannabis use. Our results highlight the need for improved training of GPs around medicinal cannabis, and the discrepancy between GP-preferred models of access and the current specialist-led models.

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Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries

Primary Health Care Research & Development ◽

10.1017/s1463423621000657 ◽

2021 ◽

Vol 22 ◽

Author(s):

Peter P. Groenewegen ◽

Wienke G. W. Boerma ◽

Peter Spreeuwenberg ◽

Bohumil Seifert ◽

Willemijn Schäfer ◽

...

Keyword(s):

Primary Care ◽

General Practitioners ◽

Professional Training ◽

Institutional Development ◽

Task Shifting ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Independent Variables ◽

Nurse Prescribing ◽

Number Of Patients

Abstract Aim: To describe variation in task shifting from general practitioners (GPs) to practice assistants/nurses in 34 countries, and to explain differences by analysing associations with characteristics of the GPs, their practices and features of the health care systems. Background: Redistribution of tasks and responsibilities in primary care are driven by changes in demand for care, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill mix of primary care teams. However, these developments are hampered by barriers between professional domains, which can be rigid as a result of strict regulation, traditional attitudes and lack of trust. Methods: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7200 GPs in 34 countries. The dependent variable ‘task shifting’ is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are: institutional development of primary care; demand for and supply of care; nurse prescribing as an indicator for professional boundaries; professionalisation of practice assistants/nurses (indicated by professional training, professional associations and journals). Multilevel analysis is used to account for the clustering of GPs in countries. Findings: Countries vary in the degree of task shifting by GPs. Regarding GP and practice characteristics, use of electronic health record applications (as an indicator for innovativeness) and age of the GPs are significantly related to task shifting. These variables explain only little variance at the level of GPs. Two country variables are positively related to task shifting: nurse prescribing and professionalisation of primary care nursing. Professionalisation has the strongest relationship, explaining 21% of the country variation.

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Ultrasonography in assessing suspected bone fractures: a cross-sectional survey amongst German general practitioners

10.21203/rs.2.14811/v2 ◽

2019 ◽

Author(s):

Gordian Lukas Schmid ◽

Beatrice Kühnast ◽

Marcus Heise ◽

Tobias Deutsch ◽

Thomas Frese

Keyword(s):

General Practitioners ◽

Bone Fractures ◽

Routine Care ◽

X Rays ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Knowledge And Attitudes ◽

Fracture Diagnosis ◽

Outpatient Settings ◽

Rule Out

Abstract Background: Over the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the integration of this application of US into routine care and outpatient settings needs to be explored. In this study, we surveyed German general practitioners (GPs) to assess their knowledge, attitudes, and utilization of US for the diagnosis of suspected fractures. Methods: Notification of the study, a self-designed questionnaire, and a reminder were mailed to 600 randomly selected GPs in Saxony and Saxony-Anhalt. Results: The response rate was 47.7% ( n = 286), and respondents did not differ from the population of all GPs in respect to sex and practice type. Among GPs surveyed, 48.6% used an US device in their practice. On average, GPs diagnosed six patients with suspected fractures per month, yet only 39.3% knew about the possibility of ultrasonographic fracture diagnosis, and only 4.3% of GPs using US applied it for this purpose. Among participants, 71.9% believed that US is inferior to conventional X-rays for the diagnosis of bony injuries. Users of US were better informed of and more commonly used US for fracture diagnosis compared to non-users. Conclusion: The need to rule out possible fractures frequently arises in general practice, and US devices are broadly available. Further efforts are needed to improve the knowledge and attitudes of GPs regarding the accuracy of US for fracture diagnosis. Multicenter controlled trials could explore the safety, usefulness, and effectiveness of this still seldom used diagnostic approach for suspected fractures.

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Knowledge, Attitudes and associated factors to Use District Health Information System (DHIS2 data) for decision making among health professionals in a Resource limited settings: Cross-sectional Survey (Preprint)

10.2196/preprints.25712 ◽

2020 ◽

Author(s):

Shuma Gosha Kanfe ◽

Nebyu Demeke Mengiste ◽

Mohammedjud Hassen Ahmed ◽

Gebiso Roba Debele ◽

Berhanu Fikadie Endehabtu

Keyword(s):

Decision Making ◽

Health Professionals ◽

Associated Factors ◽

Good Knowledge ◽

Cross Sectional Survey ◽

District Health ◽

Cross Sectional ◽

Determinant Factors ◽

Knowledge And Attitudes ◽

Health Need

BACKGROUND Evidence based practice is a key to increase effectiveness and efficiency of quality health services. To achieve this, utilization of health facility data (DHIS2 data) is required which is determined by knowledge and attitudes of health professionals. Thus, this study aimed to assess knowledge and attitudes of health professionals to use DHIS2 data for decision making. OBJECTIVE This study aimed to assess the knowledge, attitudes and its associated factors among health professionals to use DHIS2 data for decision making at South west of Ethiopia 2020 METHODS Cross sectional quantitative study methods was conducted to assess Knowledge and Attitudes of health professionals to use DHIS2 data. A total of 264 participants were approached. SPSS version 22 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done RESULTS Overall 130(49.2%) of the respondents had good knowledge to use DHIS2 data (95% CI: [43, 55.3]), whereas over 149 (56.4%) of the respondents had favorable attitudes towards the use of DHIS2 data for decision making purpose (95% CI: [53.2, 59.8]). Skills [AOR=2.20,95% CI:(1.16, 4.19)], Age [AOR= 1.92, 95% CI: (1.03, 3.59)] ,Resources[AOR=2.56, 95% CI:(1.35,4.86)], Staffing[AOR= 2.85, 95% CI : (1.49, 5.48)] and Experiences[AOR= 4.66, 95% CI: (1.94, 5.78)] were variables associated with knowledge to use DHIS2 data whereas Training [AOR= 5.59, 95% CI: (2.48, 5.42)], Feedback [AOR= 4.08, 95% CI: (1.87, 8.91)], Motivation [AOR=2.87, 95% CI: (1.36, 6.06)] and Health need [AOR=2.32, 95% CI: (1.10-4.92)] were variables associated with attitudes of health professionals to use DHIS2 data CONCLUSIONS In general, about half of the study participants had good knowledge of DHIS2 data utilization whereas more than half of respondents had favorable attitudes. Skills, resources, ages, staffing and experiences were the most determinant factors for the knowledge to use DHIS2 data whereas health need, motivation, feedback and training were determinant factors for attitudes to use DHIS2 data

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A Cross-sectional Survey of the North American Skull Base Society: Current Practice Patterns of Vestibular Schwannoma Evaluation and Management in North America

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0037-1607319 ◽

2017 ◽

Vol 79 (03) ◽

pp. 289-296 ◽

Cited By ~ 5

Author(s):

Jamie Van Gompel ◽

R. Wiet ◽

Nicole Tombers ◽

Anand Devaiah ◽

Devyani Lal ◽

...

Keyword(s):

North America ◽

Skull Base ◽

Vestibular Schwannoma ◽

North American ◽

Management Practices ◽

Current Practice ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Number Of Patients ◽

Wide Range

Background Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America. Methods This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Results A total of 57 completed surveys were returned. Most respondents claimed to have over 20 years of experience and the majority reported working in an academic practice with an affiliated otolaryngology and/or neurosurgery residency program. Sixty-three percent of respondents claimed to evaluate VS patients in clinic with both an otolaryngologist and neurosurgeon involved. Eighty-six percent of respondents claimed to operate on VS with both an otolaryngologist and neurosurgeon involved, while only 18% of neurosurgeons and 9% of otolaryngologists performed surgery alone. There was a wide range in the number of cases evaluated at each center annually. Similarly, there was wide variation in the number of patients treated with microsurgery and radiation at each center. Additional details regarding management preferences for microsurgery, stereotactic radiosurgery, stereotactic radiotherapy, and conservative observation are presented. Conclusion VS management practices vary between providers and centers. Overall, most centers employ a multidisciplinary approach to management with collaboration between otolaryngology and neurosurgery. Overall, survey responses concur with previous studies suggesting a shift toward conservatism in management.

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Satisfaction of Postoperative Patients on Pain Management Program its Relationship to the Knowledge and Attitudes of Chinese Nurses: A Cross-Sectional Survey

Tobacco Regulatory Science ◽

10.18001/trs.7.6.134 ◽

2021 ◽

Vol 7 (6) ◽

pp. 6609-6626

Author(s):

Shuyuan Li

Keyword(s):

Pain Management ◽

Optimal Level ◽

Management Program ◽

Chinese Patients ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Knowledge And Attitudes ◽

Pain Management Program ◽

Before And After ◽

Knowledge And Attitude

This study is a cross-sectional survey of the satisfaction of postoperative patients its relationship to the knowledge and attitudes of Chinese nurses on pain management. Data were sourced out from two groups of respondents participated in the study, 75 post-operative patients and 97 in-service nurses from the health institutions China. The study was conducted for five-months. Ethics protocols were observed before and after the conduct of the study. Findings showed that post-operative pain management program among the participating medical institutions in China were assessed to have moderate level of satiation by the patients. All the components namely pain relief experience, care provided by the nurses, education provided as to pain management, and therapeutic dialogue provided by the nurses were all assessed by postoperative Chinese patients at a fair level. Meanwhile, gender and education of post-operative patients can be considered as factors in the planning and implementation of pain management program. Consequently, similar to studies conducted worldwide, Chinese nurses do not establish yet an optimal level of knowledge and attitude towards pain management. Meanwhile age, experience, education are factors on the knowledge and attitude on pain management among nurses. Finally, positive moderate relationship is established between patient satisfaction and knowledge and attitudes of nursing staff towards pain management. The findings of these study call for action and reform in the implementation of pain management program focusing on the major role and development of 21st century nurses. Practical implications of the study are discussed.

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US-based cross-sectional survey of clinicians’ knowledge and attitudes about shared decision-making across healthcare professions and specialties

BMJ Open ◽

10.1136/bmjopen-2018-022730 ◽

2018 ◽

Vol 8 (10) ◽

pp. e022730 ◽

Cited By ~ 3

Author(s):

Rachel C Forcino ◽

Renata West Yen ◽

Maya Aboumrad ◽

Paul J Barr ◽

Danielle Schubbe ◽

...

Keyword(s):

Decision Making ◽

Family Medicine ◽

Shared Decision Making ◽

Nurse Practitioners ◽

Physician Assistants ◽

Shared Decision ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Knowledge And Attitudes ◽

Positive Attitudes

ObjectiveIn this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties.SettingWe administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017.Participants272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US.ResultsWe found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making.ConclusionsRecent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.

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SEPTICEMIA;

The Professional Medical Journal ◽

10.29309/tpmj/2012.19.06.2465 ◽

2012 ◽

Vol 19 (06) ◽

pp. 808-811

Author(s):

SAEMA TEHSEEN ◽

AFIFA WAHEED ◽

NABEELA SHAMI

Keyword(s):

Study Design ◽

Teaching Hospital ◽

Public Awareness ◽

Developed Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Number Of Patients ◽

Elective Termination ◽

Complete History ◽

Definite Role

Induced Miscarriage is defined as the elective termination of pregnancy before 24 weeks of gestation. Objectives: To determinethe frequency of sepsis associated with induced Miscarriage. Study Design: Cross-sectional survey. Setting: Department of Obstetrics andGynaecology, Unit-II, Ghurki Trust Teaching Hospital, Lahore. Duration of Study: Six months from 25-12-08 to 24-06-09. Materials andMethods: Total 110 cases were taken. Complete history including parity and mode of admission was taken. All information was recorded onspecially designed proforma. Results: A large number of patients turned out to be para 3-4 i.e. 87 (79%), 15 cases (13.7%) had the paritybetween 5-7 and only 8 cases (7.3%) were para 1-2 (Table-I).On analyzing the mode of admission it was found that 50 (45.4%) patients wereadmitted through out-patient department. 60 cases (54.6%) were admitted through emergency (Table-II). Finally the frequency of sepsisamongst women presenting with Miscarriage was calculated and it was found to be 25 (22.7%). 85 (77.3%) cases did not show any evidence ofsepsis (Table-III). Conclusions: Illegal Miscarriages are a major contribution to septic morbidity leading to a large number of maternal deathswhich is a dilemma in under developed countries like ours. Better public awareness and access to contraceptive measures has a definite role toplay in improving the outcome.

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Perceived Knowledge of Scheme Members and Their Satisfaction with Their Medical Schemes: A Cross-Sectional Study in South Africa.

10.21203/rs.3.rs-951531/v1 ◽

2021 ◽

Author(s):

Francis M’bouaffou ◽

Eric Buch ◽

Evelyn Thsehla ◽

Steve Olorunju

Keyword(s):

South Africa ◽

Service Providers ◽

Primary Source ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Perceived Knowledge ◽

Cross Sectional ◽

Perceived Satisfaction ◽

Private And Public ◽

The Cost

Abstract Background: South Africa has a dual healthcare system comprised of private and public sectors covering 16% and 84% of the population, respectively. Medical schemes are the primary source of health insurance in the private sector. The aim of this study was to assess the perceived knowledge and satisfaction of open medical schemes members. Methods: A cross-sectional survey was conducted using a stratified systematic sample of members from 22 open medical schemes. Nine hundred and sixty members were requested to complete an online semi-structured questionnaire to determine their perceived knowledge and satisfaction with their schemes. We tested to see if variables such as age, gender, years of membership, education, income or having a chronic disease were associated with better-perceived knowledge or satisfaction. We calculated a composite perceived knowledge and satisfaction score, for which a score above 60th percentile for perceived knowledge and 60th for perceived satisfaction were considered good perceived knowledge and good perceived satisfaction with their schemes.Results: Respondents, generally perceived themselves to have good knowledge and were satisfied with their schemes except for accessibility to doctors under the designated service providers arrangement. Overall, members were satisfied, especially with the quality of service from their designated service providers (DSPs) and their schemes. However, only 9% were satisfied with accessibility to doctors under their DSP arrangement, 25% were satisfied with the cost of scheme membership and only 46% were satisfied with the prescribed minimum benefit package. The test for association showed that years of medical schemes membership, perceived knowledge of the prescribed minimum benefits, better income and laying a complaint were associated with better-perceived knowledge. Conclusion: Medical schemes remain a key element of private healthcare in South Africa. The analysis shows that medical schemes, should put more effort into the accessibility of general practitioner under their designated service providers. Furthermore, the PMBS should be reviewed to provide a comprehensive benefits basket without co-payment for members as recommended by the Medical Schemes Act Amendment Bill of 2018.

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Increase in the proportion of Plasmodium falciparum with kelch13 C580Y mutation and decline in pfcrt and pfmdr1 mutant alleles in Papua New Guinea

Malaria Journal ◽

10.1186/s12936-021-03933-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Naoko Yoshida ◽

Masato Yamauchi ◽

Ryosuke Morikawa ◽

Francis Hombhanje ◽

Toshihiro Mita

Keyword(s):

Plasmodium Falciparum ◽

Papua New Guinea ◽

New Guinea ◽

Therapeutic Effects ◽

Cross Sectional Survey ◽

Cross Sectional ◽

In The Wild ◽

Nationwide Surveillance ◽

Greater Mekong Subregion ◽

C580y Mutation

Abstract Background The C580Y mutation in the Plasmodium falciparum kelch13 gene is the most commonly observed variant in artemisinin-resistant isolates in the Greater Mekong Subregion (GMS). Until 2017, it had not been identified outside the GMS, except for Guyana/Amazonia. In 2017, three parasites carrying the C580Y mutation were identified in Papua New Guinea (PNG). As the C580Y allele rapidly spread in the GMS, there is concern that this mutant is now spreading in PNG. Methods In 2020, a cross-sectional survey was conducted at two clinics in Wewak, PNG. Symptomatic patients infected with P. falciparum were treated with artemether plus lumefantrine following a national treatment policy. Blood samples were obtained before treatment, and polymorphisms in kelch13, pfcrt, and pfmdr1 were determined. Parasite positivity was examined on day 3. The results were compared with those of previous studies conducted in 2002, 2003, and 2016–2018. Results A total of 94 patients were included in this analysis. The proportion of C580Y was significantly increased (2.2% in 2017, 5.7% in 2018, and 6.4% in 2020; p = 4.2 × 10–3). A significant upward trend was observed in the wild-type proportion for pfcrt (1.9% in 2016 to 46.7% in 2020; p = 8.9 × 10–16) and pfmdr1 (59.5% in 2016 to 91.4% in 2020; p = 2.3 × 10–6). Among 27 patients successfully followed on day 3, including three with C580Y infections, none showed positive parasitaemia. Conclusions Under the conditions of significant increases in pfcrt K76 and pfmdr1 N86 alleles in PNG, the increase in kelch13 C580Y mutants may be a warning indicator of the emergence of parasites resistant to the currently used first-line treatment regimen of artemether plus lumefantrine. Therefore, nationwide surveillance of molecular markers for drug resistance and assessment of its therapeutic effects are important.

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Stockpiled personal protective equipment and knowledge of pandemic plans as predictors of perceived pandemic preparedness among German general practitioners

PLoS ONE ◽

10.1371/journal.pone.0255986 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255986

Author(s):

Arno Stöcker ◽

Ibrahim Demirer ◽

Sophie Gunkel ◽

Jan Hoffmann ◽

Laura Mause ◽

...

Keyword(s):

General Practitioners ◽

Personal Protective Equipment ◽

Explanatory Power ◽

Vital Role ◽

Protective Equipment ◽

Linear Regression Models ◽

Pandemic Preparedness ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Determining Factor

Background The COVID-19 pandemic significantly changed the work of general practitioners (GPs). At the onset of the pandemic in March 2020, German outpatient practices had to adapt quickly. Pandemic preparedness (PP) of GPs may play a vital role in their management of a pandemic. Objectives The study aimed to examine the association in the stock of seven personal protective equipment (PPE) items and knowledge of pandemic plans on perceived PP among GPs. Methods Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March–April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age. Results In total, 508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP; the association of the knowledge of a pandemic plan was significant but small. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP. Conclusion The stock of PPE seems to be the determining factor for PP among German GPs; for COVID-19, sufficient masks are the determining factor. Knowledge of a pandemic plans play a secondary role in PP.

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