scholarly journals Headache in General Practice: Frequency, Management, and Results of Encounter

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Thomas Frese ◽  
Henriette Druckrey ◽  
Hagen Sandholzer
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Drug Prescription ◽  
Spinal Column ◽  
Primary Headache ◽  
Secondary Headache ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Frequency Management ◽  
Tract Infections

Objective. Headache is a common reason for consulting the general practitioner. The goal of the investigation was to characterize the headache consultation rates, the associated symptoms, the frequency of diagnostic and therapeutic procedures, and the results of the encounter of patients with headache. Methods. Cross-sectional data were collected from randomly selected patients during the German SESAM 2 study and compared with unpublished but publicly available data from the Dutch Transition Project. Results. Headache accounts for up to five percent of all general practice consultations. Women consult the general practitioner for headache twice as often as men. Physical examination and drug prescription are the most frequent procedures. Most of the patients suffer from primary headache; secondary headache is due to upper respiratory tract infections or problems of the spinal column. Dangerous courses occur in very rare cases. Conclusion. This work confirms the findings of earlier studies regarding the management of patients that consult the general practitioner for headache. It broadens the preexisting database since cross-sectional data regarding headache in general practice was rarely published.

Headache in Children in Dutch General Practice

Cephalalgia ◽  
1999 ◽  
Vol 19 (3) ◽  
pp. 147-150 ◽  
Author(s):  
JC van der Wouden ◽  
P van der Pas ◽  
MA Bruijnzeels ◽  
JA Brienen ◽  
LWA van Suijlekom-Smit
Keyword(s):  
Infectious Disease ◽  
General Practice ◽  
General Practitioner ◽  
Psychosocial Problems ◽  
Upper Respiratory Tract ◽  
School Problems ◽  
Reason For Encounter ◽  
Practice Population ◽  
Tract Infections ◽  
Made In

Aim: To describe the occurrence of headache in general practice, the diagnoses made in general practice, and the management. Method: Data from the Dutch national survey of morbidity and interventions in general practice were used. The practice population (103 practices) comprised 63753 children aged 0-14 years. Results: In 634 episodes, headache was a reason for encounter. The incidence of headache presented to the general practitioner was 40.2 per 1000 person years. More than half of the episodes were related to an infectious disease, among which upper respiratory tract infections predominated. The incidence rate of the diagnosis idiopathic headache was 7.3 episodes per 1000 person years. The incidence increased with age and was higher in girls than in boys. In only 12% of cases of idiopathic headache were special investigations carried out, mostly blood examinations. Medication was prescribed in 27% of all episodes of idiopathic headache. In the absence of an infectious disease, many headache episodes were associated with psychosocial problems. Family problems and school problems were mentioned most often. Conclusion: Headache in children as reason for encounter is a common problem in general practice, often associated with an infectious disease. When confronted with a child with idiopathic headache, the general practitioner should be aware of a possible psychosocial component.

scholarly journals Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sewunet Admasu Belachew ◽  
Lisa Hall ◽  
Linda A. Selvey
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Acute Diarrhoea ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Retail Outlets ◽  
Sub Saharan ◽  
Tract Infections ◽  
Ssa Countries

Abstract Background The development of antimicrobial resistance, which is partially attributable to the overuse and/or misuse of antibiotics in health care, is one of the greatest global public health challenges. In Sub-Saharan African (SSA) countries, non-prescribed dispensing of antibiotics in community drug retail outlets (CDROs) has been flagged as one of the contributing factors for the widespread misuse of antibiotics in the community. Objective The current review aimed to estimate the proportion of non-prescription antibiotics requests or consultations that resulted in provision of antibiotics without a valid prescription among CDROs in SSA region, and describe the type of antibiotics dispensed. Methods A literature search was conducted using PubMed, CINAHL, Scopus and Google Scholar. We also searched reference lists of relevant articles. Random effect model meta-analysis was employed to determine the pooled proportion of over the counter sale of antibiotics. Subgroup and meta-regression was undertaken to explore the potential cause of heterogeneity in effect size across studies. Results Of 671 total citations retrieved, 23 met the inclusion criteria (seven cross-sectional questionnaire-based surveys and 16 cross-sectional client-based studies). The overall pooled proportion of non-prescription antibiotics requests or consultations that resulted in supply of antibiotics without prescription was 69% (95% CI 58–80). Upper respiratory tract infections and/or acute diarrhoea were the most frequently presented case scenarios, and amoxicillin and co-trimoxazole were the most frequently dispensed antibiotics to treat those symptoms. Conclusions Non-prescribed dispensing of antibiotics was found to be a common practice among CDROs in several SSA countries. Ease of access to and overuse of antibiotics can potentially accelerate the emergence of resistance to antibiotics available in the region. Our review highlights the need for a stringent enforcement of existing policies and/or enacting new regulatory frameworks that would regulate antibiotic supply, and training and educational support for pharmacy personnel (e.g. pharmacists, pharmacy assistants) regarding judicious use of antibiotics and the importance of antimicrobial stewardship.

scholarly journals Knowledge, Attitude, and Prescription Practice on Antimicrobials Use Among Physicians: A Cross-Sectional Study in Eastern China

2021 ◽  
Vol 58 ◽  
pp. 004695802110599
Author(s):  
Rixiang Xu ◽  
Tingyu Mu ◽  
Wang Jian ◽  
Caiming Xu ◽  
Jing Shi
Keyword(s):  
Bacterial Resistance ◽  
Eastern China ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Prescription Practices ◽  
Adequate Knowledge ◽  
Determining Factors ◽  
Tract Infections ◽  
Prescription Practice

Over-prescription of antimicrobials for patients is a major driver of bacterial resistance. The aim of the present study was to assess the knowledge, attitude, and prescription practices regarding antimicrobials among physicians in the Zhejiang province in China, and identify the determining factors. A total of 600 physicians in public county hospitals and township health institutions were surveyed cross-sectionally using a structured electronic questionnaire. The questionnaire was completed by 580 physicians and the response rate was 96.67%. The mean score of 11 terms related to antimicrobial knowledge was 6.81, and an average of 32.1% of patients with upper respiratory tract infections (URTIs) were prescribed antimicrobials. Multivariate analysis indicated that young general practitioners with less training are more likely to contribute to more frequent antimicrobial prescriptions ( P < .05). In contrast, older physicians with more training are more willing to provide patients with the correct knowledge regarding antimicrobials and less likely to prescribe antimicrobials for URTIs. Correlation analysis showed that the level of physician's knowledge, attitude, and prescription practice is related ( P < .05). In conclusion, proper prescription of antimicrobials depends on adequate knowledge and regular training programs for physicians.

scholarly journals A cross sectional study on prescription pattern of drugs in upper respiratory tract infections in a tertiary care hospital

2020 ◽  
Vol 9 (2) ◽  
pp. 271
Author(s):  
Divya Bade ◽  
Shivashankaramurthy K. G. ◽  
Kiran L. J. ◽  
Raghuprasada M. S. ◽  
Harishkumar V. S. ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Essential Medicines ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Upper Respiratory ◽  
Tract Infections

Background: Upper respiratory tract infections are one of the leading causes of hospital visits worldwide. Judicious use of antibiotics is challenging for upper respiratory tract infections (URTIs) in developing countries like India. This leads to inappropriate use of antibiotics causing many dreaded conditions like antibacterial resistance among other things. Hence rational use of drugs, mainly antibacterial, is a priority to reduce the burden of treatment failure. The objective of this study is to study the prescribing patterns and rationality of drugs prescribed in the management of URTIs.Methods: This was a cross-sectional study. Data was collected from records of 300 outpatients clinically diagnosed as URTIs from SSIMS and RC Hospital, Davangere between January 2015 and June 2016. The prescribing patterns, approval status and listing of drugs in World Health Organization (WHO) essential medicines list/ National List of Essential Medicines (NLEM) were analysed. The data was presented as percentages, mean and standard deviations.Results: A total of 300 cases were studied. Among these, acute pharyngitis (29%) and acute sinusitis (26%) are the most common infections. Of the 300 cases studied, 283 (94.3%) were prescribed antimicrobials. Of the total 740 medications prescribed, 393 (53.1%) were fixed-dose combinations (FDCs). A total of 724 medications (97.8%) were approved by Drugs Controller General of India and 248 (33.5%) by Food and Drug Administration. Only 5.8% of the prescribed drugs have been listed in WHO’s and NLEM. The most common class of antibacterials prescribed was Beta-lactams.Conclusions: Oral formulations were preferred over parenteral formulations and FDCs were preferred over single drug formulations. Beta-lactams comprised the major class of antibacterial prescribed.

scholarly journals Perioperative Respiratory Adverse Events in General Anesthesia Among Pediatric Surgical Patients in Comprehensive Specialized Hospitals in Northwest Ethiopia, 2020; A Cross-Sectional Follow-Up

2021 ◽  
Author(s):  
Yophtahe Woldegerima ◽  
Desalegn Muche ◽  
Wubie Birlie ◽  
Habtu Adane ◽  
Misganaw Mengie
Keyword(s):  
Adverse Events ◽  
Respiratory Tract Infections ◽  
Northwest Ethiopia ◽  
Surgical Patients ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Upper Respiratory ◽  
Tract Infections

Abstract Introduction: Perioperative respiratory adverse events (PRAEs) are the most frequent complications in pediatrics which frequently result in morbidity and mortality. They are accountable for 75% of perioperative critical incidents and 33% of cardiac arrests. The occurrence and severity of PRAEs depends on the natures of surgery, anesthesia & patient’s status.Objective: To assess the incidence and factors associated with PRAEs in general anesthesia among pediatric surgical patients at the University of Gondar and Tibebe-Ghion Comprehensive Hospital and Specialized Hospitals, Northwest Ethiopia, 2020.Methods: After obtaining the ethical approval, a hospital-based prospective cross-sectional follow-up study was conducted among pediatric surgical patients who underwent variety of surgical operations. A total of 225 patients were included. The associations between independent variables and the outcome variables were determined at 95% CI with the Chi-squared test, Fisher–exact test, bivariate, and multivariate logistic regression. Hosmer-Lemeshow test was used to assess the goodness of fit. Variables with a p-value < 0.05 were considered significant.Results: The incidence of PRAEs among 210 (93.3% response rate) pediatrics surgical patients was 26.2% (95% CI: 20.5, 30.9). A total of 129 episodes of PRAEs were observed. Most of the adverse events (89 (69.0%)) were occurred postoperatively. Desaturation was found to be the predominant adverse event which was occurred 61 (47.3%) times. Age < 1 year (AOR: 3.6, 95% CI: 1.3, 10.0), ASA ≥ 3 (AOR: 5.2, 95% CI: 1.9, 22.9), upper respiratory tract infections (AOR: 7.6, 95% CI: 1.9, 30.2), presence of secretions in the upper airway (AOR: 4.8, 95% CI: 1.4, 15.9) and airway related procedures (AOR: 6.0, 95% CI: 1.5, 24.1) were significantly associated PRAEs.Conclusions: The incidence of PRAEs among pediatric surgical patients was relatively high (26.2%). Especially, the postoperative phase is the most critical time for the occurrence of PRAEs and desaturation was the predominant adverse event. Age less than a year, presence of upper respiratory tract infections, presence of secretions in the upper airways, ASA ≥ 3 and airway related procedures were associated with PRAEs. Clinicians should carry out effective risk assessment, optimization and adequate preparation for the management of perioperative respiratory adverse events.

scholarly journals The Relationship Of The Utilization Of Sanitation Clinic With The Prevention Of Upper Respiratory Tract Infection Disease In Majasem Public Health Center Working Area Cirebon City 2019

2019 ◽  
Vol 6 (2) ◽  
pp. 22-26
Author(s):  
Dina Aulya Wahab ◽  
Mitha Erlisya Puspandhani ◽  
Shella Febiana
Keyword(s):  
Public Health ◽  
Respiratory Tract ◽  
Personal Hygiene ◽  
P Value ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Indirect Contact ◽  
Public Health Office ◽  
Upper Respiratory ◽  
Tract Infections

Utilization of clinical sanitation is where people use clinical sanitation room and follow activity in clinical saanitation. Efforts to prevent diseases of the upper respiratory tract, namely to prevent direct or indirect contact with patients with upper respiratory tract infections and using PPE, maintaining environmental cleanliness, maintaining personal hygiene with clean and healthy living behaviors in the household order. Depend on data of Public Health Office Cirebon at 2018, achievement program clinical sanitation just reach clinical sanitation is 30%, number of ISPA cases reach number 26.142 people. This research uses correlation descriptive, approach with cross sectional. Population is all of people in Puskesmas Working Area Cirebon as much 2.506 people. Sample technic which use is purposiv sampling technic as much 97 people. Instrumen which uses this research is questionare. Result of research shows 97 responden total responden which utilize clinical sanitation as much 88 responden or 90,7% more than which not utilize clinical sanitation as much 9,3%. P value which is got as bis as 0,00 and smller of value a = 0,05. This result shows that there is relation utilization of clinical sanitation which prevent ISPA disease in Puskesmas Working Area Majasem Cirebon.  Be expected that the agency more improve clinical sanitation program and educate the public related importance to maintain environmental health.

scholarly journals Challenges in antibiotics prescription in pediatrics: A national survey among Lebanese pediatricians

2021 ◽  
Author(s):  
Amale ISSA ◽  
Nadine SALEH ◽  
Mira HLEYHE ◽  
Rouba Karen ZEIDAN ◽  
Sara ASSAF ◽  
...  
Keyword(s):  
Secondary Infection ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Special Focus ◽  
Upper Respiratory Tract ◽  
National Guidelines ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
National Campaigns ◽  
Tract Infections

Abstract Background Antibiotics are the most prescribed drugs especially in pediatrics and for Upper Respiratory tract Infections (URI). Physicians are facing many challenges in their practice regarding antibiotics prescription. The aim of this study, the first of its kind in Lebanon, is to evaluate attitudes and practices of Lebanese pediatricians towards antibiotics prescription with a special focus on URI in order to identify challenges facing physicians. Methods This is a cross-sectional study conducted in 2018 among pediatricians registered in the Orders of Physicians. A 63-item questionnaire in English was sent by e-mail or by message to the mobile phone of all pediatricians with subsequent reminders. Data was collected from May 1st through July 2nd 2018. Statistical analysis was done using SPSS 21.0. The analysis involved descriptive quantitative statistics (means and standard deviations, frequencies and percentages). Results From a total of 1213 physicians approached, 117 agreed to participate in the study giving a response rate of ~ 10%. A high proportion of Lebanese pediatricians replied correctly on avoiding antibiotics in cases of cough (86.3%), URI (74.4%), tympanic membrane dysfunction (64.1%) and prevention of secondary infection (63%). Eighty percent of physicians prescribed antibiotics for pharyngitis without requesting a throat culture. The majority of physicians admitted that antibiotic use is considerable in their community and that antibiotic resistance is a threat on the national and international level. Forty percent of pediatricians agreed and strongly agreed that giving advice to parents reduces their antibiotic demand. The same percentage disapproved that they might prescribe antibiotics in order to gain parents’ trust. Conclusion National campaigns are required to increase parents’ education and promote judicious antimicrobials use. Implementing national guidelines, ensuring continuing medical education for doctors and regulating over the counter sale of antibiotics are highly recommended.

scholarly journals Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shan Wang ◽  
Lihua Liu ◽  
Jianchao Liu ◽  
Likun Miao ◽  
Qian Zhuang ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Pediatric Patients ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Sectional Study ◽  
Cross Sectional ◽  
Short Supply ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Clinical Records

Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

scholarly journals Off-label drug prescriptions in French general practice: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026076 ◽  
Author(s):  
François Drogou ◽  
Allison Netboute ◽  
Joris Giai ◽  
Xavier Dode ◽  
David Darmon ◽  
...  
Keyword(s):  
General Practice ◽  
Drug Prescription ◽  
Low Frequency ◽  
Cross Sectional Study ◽  
Drug Prescriptions ◽  
Off Label Use ◽  
Sectional Study ◽  
Cross Sectional ◽  
Off Label ◽  
Label Use

ObjectivesOff-label drug prescribing is a public health and economic issue. The aim of this study was to describe off-label prescription in general practice in France, in terms of frequency and nature, and to identify its main determining factors.DesignMulticentre cross-sectional studySettingTwenty-three training general practice officesParticipantsAll the voluntary patients coming for a medical consultation or visited at home over a cumulative period of 5 days per office between November 2015 and January 2016.MethodsEleven interns, acting as observers, collected data. Two reviewers analysed the drugs prescribed by the trainers, in order to identify those prescribed off-label in terms of their indication or the age of the patient. We used a univariate, then a multivariate model, based on hierarchical mixed-effects logistic regression.ResultsAmong the 4932 drug prescriptions registered, 911 (18.5%[95% CI17.4% to 19.6%]) were off-label, of which 865 (17.6%) due to the indication of the drug and 58 (1.2%) due to the age of the patient. The prescription never mentioned the off-label use, neither was the patient informed of it, as required by the French law. With the multivariate analysis, variables contributing to off-label prescription were the number of drugs (OR=1.05 for each additional drug), the initiation of new drug therapy (OR=1.26) and the non-specific goal of the prescription (OR=1.43); the age of the patient ≤14 years (OR=1.42); the rural location of the physician’s practice (OR=1.38) and the low frequency of the visits of national health insurance representatives (OR=0.93).ConclusionAlmost one out of five drugs prescribed in French general practice was off-label. It seems necessary to better train physicians in clinical pharmacology, to provide them with more effective drug prescription software, to reinforce postmarketing surveillance and to clearly define off-label use by consensus.

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