scholarly journals Time intervals and routes to diagnosis for lung cancer in 10 jurisdictions: cross-sectional study findings from the International Cancer Benchmarking Partnership (ICBP)

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e025895 ◽  
Author(s):  
Usha Menon ◽  
Peter Vedsted ◽  
Alina Zalounina Falborg ◽  
Henry Jensen ◽  
Samantha Harrison ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Northern Ireland ◽  
Symptom Onset ◽  
Primary Care Physicians ◽  
Cancer Registries ◽  
Secondary Outcome ◽  
Newly Diagnosed ◽  
Time Intervals ◽  
Cross Sectional

ObjectiveDifferences in time intervals to diagnosis and treatment between jurisdictions may contribute to previously reported differences in stage at diagnosis and survival. The International Cancer Benchmarking Partnership Module 4 reports the first international comparison of routes to diagnosis and time intervals from symptom onset until treatment start for patients with lung cancer.DesignNewly diagnosed patients with lung cancer, their primary care physicians (PCPs) and cancer treatment specialists (CTSs) were surveyed in Victoria (Australia), Manitoba and Ontario (Canada), Northern Ireland, England, Scotland and Wales (UK), Denmark, Norway and Sweden. Using Wales as the reference jurisdiction, the 50th, 75th and 90th percentiles for intervals were compared using quantile regression adjusted for age, gender and comorbidity.ParticipantsConsecutive newly diagnosed patients with lung cancer, aged ≥40 years, diagnosed between October 2012 and March 2015 were identified through cancer registries. Of 10 203 eligible symptomatic patients contacted, 2631 (27.5%) responded and 2143 (21.0%) were included in the analysis. Data were also available from 1211 (56.6%) of their PCPs and 643 (37.0%) of their CTS.Primary and secondary outcome measuresInterval lengths (days; primary), routes to diagnosis and symptoms (secondary).ResultsWith the exception of Denmark (−49 days), in all other jurisdictions, the median adjusted total interval from symptom onset to treatment, for respondents diagnosed in 2012–2015, was similar to that of Wales (116 days). Denmark had shorter median adjusted primary care interval (−11 days) than Wales (20 days); Sweden had shorter (−20) and Manitoba longer (+40) median adjusted diagnostic intervals compared with Wales (45 days). Denmark (−13), Manitoba (−11), England (−9) and Northern Ireland (−4) had shorter median adjusted treatment intervals than Wales (43 days). The differences were greater for the 10% of patients who waited the longest. Based on overall trends, jurisdictions could be grouped into those with trends of reduced, longer and similar intervals to Wales. The proportion of patients diagnosed following presentation to the PCP ranged from 35% to 75%.ConclusionThere are differences between jurisdictions in interval to treatment, which are magnified in patients with lung cancer who wait the longest. The data could help jurisdictions develop more focused lung cancer policy and targeted clinical initiatives. Future analysis will explore if these differences in intervals impact on stage or survival.

scholarly journals Diagnostic routes and time intervals for patients with colorectal cancer in 10 international jurisdictions; findings from a cross-sectional study from the International Cancer Benchmarking Partnership (ICBP)

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023870 ◽  
Author(s):  
David Weller ◽  
Usha Menon ◽  
Alina Zalounina Falborg ◽  
Henry Jensen ◽  
Andriana Barisic ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Cancer Registries ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Time Intervals ◽  
Cross Sectional ◽  
Treatment Data ◽  
The Uk

ObjectiveInternational differences in colorectal cancer (CRC) survival and stage at diagnosis have been reported previously. They may be linked to differences in time intervals and routes to diagnosis. The International Cancer Benchmarking Partnership Module 4 (ICBP M4) reports the first international comparison of routes to diagnosis for patients with CRC and the time intervals from symptom onset until the start of treatment. Data came from patients in 10 jurisdictions across six countries (Canada, the UK, Norway, Sweden, Denmark and Australia).DesignPatients with CRC were identified via cancer registries. Data on symptomatic and screened patients were collected; questionnaire data from patients’ primary care physicians and specialists, as well as information from treatment records or databases, supplemented patient data from the questionnaires. Routes to diagnosis and the key time intervals were described, as were between-jurisdiction differences in time intervals, using quantile regression.ParticipantsA total of 14 664 eligible patients with CRC diagnosed between 2013 and 2015 were identified, of which 2866 were included in the analyses.Primary and secondary outcome measuresInterval lengths in days (primary), reported patient symptoms (secondary).ResultsThe main route to diagnosis for patients was symptomatic presentation and the most commonly reported symptom was ‘bleeding/blood in stool’. The median intervals between jurisdictions ranged from: 21 to 49 days (patient); 0 to 12 days (primary care); 27 to 76 days (diagnostic); and 77 to 168 days (total, from first symptom to treatment start). Including screen-detected cases did not significantly alter the overall results.ConclusionICBP M4 demonstrates important differences in time intervals between 10 jurisdictions internationally. The differences may justify efforts to reduce intervals in some jurisdictions.

scholarly journals Public subsidies and the recommendation of child vaccines among primary care physicians: a nationwide cross-sectional study in Japan

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020923
Author(s):  
Yuta Sakanishi ◽  
Yosuke Yamamoto ◽  
Megumi Hara ◽  
Norio Fukumori ◽  
Yoshihito Goto ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Multiple Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Childhood Vaccination ◽  
Secondary Outcome ◽  
Hpv Vaccines ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public Subsidies

ObjectiveAlthough public subsidies and physician recommendations for vaccination play key roles in increasing childhood vaccination coverage, the association between them remains uncertain. This study aimed to identify the association between awareness of public subsidies and recommendations forHaemophilus influenzaetype b (Hib),Streptococcus pneumoniae(pneumococcal conjugate vaccine (PCV)) and human papillomavirus (HPV) vaccinations among primary care physicians in Japan.DesignThis is a cross-sectional study.SettingIn 2012, a questionnaire was distributed among 3000 randomly selected physicians who were members of the Japan Primary Care Association.ParticipantsFrom the questionnaire, participants were limited to physicians who administered childhood vaccinations.Primary and secondary outcome measuresThe primary measures were participants’ awareness of public subsidies and their recommendation levels for Hib, PCV and HPV vaccines. Multiple logistic regression analysis was performed to investigate the association between awareness and recommendation, with adjustment for possible confounders.ResultsThe response rate was 25.8% (743/2880). Of 743 physician respondents, 434 were included as analysis subjects. The proportions of those who recommended vaccinations were 57.1% for Hib, 54.1% for PCV and 58.1% for HPV. For each vaccine, multivariable analyses showed physicians who were aware of the subsidy were more likely to recommend vaccination than those who were not aware: the adjusted ORs were 4.21 (95% CI 2.47 to 7.15) for Hib, 4.96 (95% CI 2.89 to 8.53) for PCV and 4.17 (95% CI 2.00 to 8.70) for HPV.ConclusionsPrimary care physicians’ awareness of public subsidies was found to be associated with their recommendations for the Hib, PCV and HPV vaccines. Provision of information about public subsidies to these physicians may increase their likelihood to recommend vaccination.

scholarly journals Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044372
Author(s):  
Mat Nawi Zanaridah ◽  
Mohd Noor Norhayati ◽  
Zakaria Rosnani
Keyword(s):  
Primary Care ◽  
Evidence Based Medicine ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Sectional Study ◽  
Primary Care Practitioner ◽  
Cross Sectional ◽  
Primary Care Practitioners ◽  
Based Medicine

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.

scholarly journals Prepared and highly committed despite the risk of COVID-19 infection: a cross-sectional survey of primary care physicians’ concerns and coping strategies in Singapore

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jerrald Lau ◽  
David Hsien-Yung Tan ◽  
Gretel Jianlin Wong ◽  
Yii-Jen Lew ◽  
Ying-Xian Chua ◽  
...  
Keyword(s):  
Primary Care ◽  
Coping Strategies ◽  
Stress Management ◽  
Primary Care Physicians ◽  
Well Being ◽  
Pandemic Preparedness ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Accessible Information ◽  
And Coping

Abstract Background Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs’ concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak. Methods Two hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19. Results A total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors. Conclusions PCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.

scholarly journals Managing the Return to Football During the COVID-19 Pandemic: A Survey of the Head Team Physicians of the Football Bowl Subdivision Programs

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712199204
Author(s):  
Alexander D. Slabaugh ◽  
John W. Belk ◽  
Jonathan C. Jackson ◽  
Richard J. Robins ◽  
Eric C. McCarty ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
National Collegiate Athletic Association ◽  
College Football ◽  
Cross Sectional Study ◽  
Return To Play ◽  
World Health ◽  
Cross Sectional ◽  
Football Bowl Subdivision ◽  
Health Organization

Background: COVID-19 is a severe respiratory virus that spreads via person-to-person contact through respiratory droplets. Since being declared a pandemic in early March 2020, the World Health Organization had yet to release guidelines regarding the return of college or professional sports for the 2020-2021 season. Purpose: To survey the head orthopedic surgeons and primary care team physicians for the National Collegiate Athletic Association (NCAA) Football Bowl Subdivision (FBS) football teams so as to gauge the management of common COVID-19 issues for the fall 2020 college football season. Study Design: Cross-sectional study. Methods: The head team orthopaedic surgeons and primary care physicians for all 130 FBS football teams were surveyed regarding their opinions on the management of college football during the COVID-19 pandemic. A total of 30 questions regarding testing, return-to-play protocol, isolating athletes, and other management issues were posed via email survey sent on June 5, 2020. Results: Of the 210 team physicians surveyed, 103 (49%) completed the questionnaire. Overall, 36.9% of respondents felt that it was unsafe for college athletes to return to playing football during fall 2020. While the majority of football programs (96.1%) were testing athletes for COVID-19 as they returned to campus, only 78.6% of programs required athletes to undergo a mandatory quarantine period before resuming involvement in athletic department activities. Of the programs that were quarantining their players upon return to campus, 20% did so for 1 week, 20% for 2 weeks, and 32.9% quarantined their athletes until they had a negative COVID-19 test. Conclusion: While US Centers for Disease Control and Prevention guidelines evolve and geographic regions experience a range of COVID-19 infections, determining a universal strategy for return to socialization and participation in sports remains a challenge. The current study highlighted areas of consensus and strong agreement, but the results also demonstrated a need for clarity and consistency in operations, leadership, and guidance for medical professionals in multiple areas as they attempt to safely mitigate risk for college football players amid the COVID-19 pandemic.

scholarly journals Determinants of Timing of Presentation of Neurotrauma Patients to a Neurosurgical Center in a Developing Country

2018 ◽  
Vol 09 (04) ◽  
pp. 545-550 ◽  
Author(s):  
Toluyemi Adefolarin Malomo ◽  
Toyin Ayofe Oyemolade ◽  
Amos Olufemi Adeleye
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Late Presentation ◽  
Neurological Deficits ◽  
Delayed Presentation ◽  
Long Distance ◽  
College Hospital ◽  
Cross Sectional ◽  
Initial Care ◽  
Cord Injury

ABSTRACT Background: A major goal in neurotrauma management is the prevention of secondary neuronal injuries. This goal is time bound as neurological deficits once established are usually irreversible. Late presentation is the norm in most neurotrauma patients in developing countries. Aims: The aim of the study was to review the timing of presentation of neurotrauma patients and the possible causes of their late presentation for neurosurgical care in our practice. Methods: A cross-sectional study of a 4-month prospective database of neurotrauma patients presenting to the University College Hospital, Ibadan, was done. The participants’ biodata, injury characteristics, initial-care details before referral, and information on timing and causes of delay were analyzed. Results: The study subjects included 111 patients, 80.2% (89/111) were males, and 52.8% aged 21–40 years. Head injury (HI), spinal cord injury (SCI), and combined HI and SCI occurred, respectively, in 80.2%, 14.4%, and 5.4%. Road accidents followed by falls were seen in 73.9% and 14.4% (16), respectively. Just 46.8% (52/111) cases presented within 12 h of injury and only 37 (33.3%) within 4 h. Majority, 83.8% (93/111) were referrals from primary care. These referrals were delayed in 81.7% (76/93) of these. The referring health facilities were located intracity with our center in 54%. Other causes of delayed presentation of these study participants included long-distance travel to our center, lack of funds, or a combination of the above factors. Eighty-nine patients (80.2%) were brought in by family members and the remaining minority by passers-by and road safety personnel. Conclusions: Delayed referral from primary care features prominently in timing of presentation of neurotrauma patients in Nigeria. There is a need for collaboration as well as continuing medical education between the neurotrauma specialists and primary care physicians.

scholarly journals The Differences in the Prevalence of Cardiovascular Disease, Its Risk Factors, and Achievement of Therapeutic Goals among Urban and Rural Primary Care Patients in Poland: Results from the LIPIDOGRAM 2015 Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5656
Author(s):  
Krzysztof Studziński ◽  
Tomasz Tomasik ◽  
Adam Windak ◽  
Maciej Banach ◽  
Ewa Wójtowicz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Primary Care Physicians ◽  
Primary Care Patient ◽  
Care Patient ◽  
Cross Sectional ◽  
Therapeutic Goals ◽  
Rural Primary Care

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.

scholarly journals The study on knowledge-attitude-practice of primary care physician toward anticoagulants therapy in Non-valvular atrial fibrillation patients in Shanghai of China

2020 ◽  
Author(s):  
Shasha Ye ◽  
Tianhao Wang ◽  
Arthur Liu ◽  
Ying Yu ◽  
Zhigang Pan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Work Experience ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Bachelor's Degree ◽  
Cluster Sampling ◽  
Primary Role ◽  
Cross Sectional ◽  
Positive Attitudes

Abstract Background As the large number of CHS centers in China face the majority of NVAF patients, primary care physicians (PCPs) play the primary role in the prevention of embolization. Therefore, an awareness of anticoagulant management in NVAF patients must be brought into focus among PCPs in China. This study will help primary care physicians (PCPs) increase their awareness of oral anticoagulant (OAC) therapy for non-valvular atrial fibrillation (NVAF) to prevent embolization.Method This was a cross-sectional observational study of 462 PCPs in community health service (CHS) centers across Shanghai. We used a self-administered questionnaire to collect data from September to December 2017. A stratified random cluster sampling was adopted in the 90 CHS centers with the family medicine residency program.Result Among 462 participants, 69.3% (320/462) of females with a medical bachelor’s degree and more than 10 years of work experience predominated in the 30 to 49 years of age group. The mean score for “knowledge,” “attitude” and “practices” of OAC therapy in NVAF patients among PCPs was 3.68±2.752, 53.62±7.148, and 37.63±10.336, respectively. The level of knowledge of OAC therapy in NVAF patients among PCPs was insufficient in over half (75.8%) of participants. The majority (89.8%) of PCPs had a positive attitude and 68.0% had modest performance in the anticoagulant management of NVAF patients.Conclusion The knowledge and behaviors of PCPs were insufficient in OAC therapy to prevent embolization in NVAF patients. The study also revealed the positive attitudes of participants, and their desire to learn the latest knowledge of OAC therapy.

scholarly journals Sources of psychological distress among primary care physicians during the COVID-19 pandemic’s first wave in Spain: a cross-sectional study

2021 ◽  
Vol 22 ◽  
Author(s):  
Ana Cebrián-Cuenca ◽  
José Joaquín Mira ◽  
Elena Caride-Miana ◽  
Antonio Fernández-Jiménez ◽  
Domingo Orozco-Beltrán
Keyword(s):  
Primary Care ◽  
Psychological Distress ◽  
Primary Care Physicians ◽  
Linear Regression Analysis ◽  
Cross Sectional Study ◽  
Multivariate Linear Regression Analysis ◽  
Sectional Study ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Protective Measures

Abstract Background: The COVID-19 pandemic is affecting people worldwide. In Spain, the first wave was especially severe. Objectives: This study aimed to identify sources and levels of distress among Spanish primary care physicians (PCPs) during the first wave of the pandemic (April 2020). Methods: A cross-sectional study was conducted using a survey that included sociodemographic data, a description of working conditions related to distress [such as gaps in training in protective measures, cleaning, and hygiene procedures in work setting, unavailability of personal protective equipments (PPEs) and COVID-19 RT-PCR test, and lack of staff due to be infected] and a validated scale, the ‘Self-applied Acute Stress Scale’ (EASE). The survey was answered by a non-probability sampling of PCPs working in family healthcare centres from different regions of Spain. Analysis of variance and multivariate linear regression analysis were performed. Results: In all, out of 518 PCP participants, 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of PPE. PCP characteristics associated with higher levels of distress include female gender [1.69; 95% confidence interval (CI) 0.54, 2.84]; lack of training in protective measures (1.96; 95% CI 0.94, 2.99); unavailable COVID-19 RT-PCR for health care workers after quarantine or COVID-19 treatment (−0.77 (−1.52, −0.02). Reinforcing disinfection of the work environment (P < 0.05), availability of PPEs (P < 0.05), and no healthcare professional was infected (P < 0.05) were related to the lowest distress score. Conclusions: A better understanding of the sources of distress among PCPs could prevent its effect on future outbreaks.

Sign in / Sign up

Export Citation Format

Share Document