Medication Use During Pregnancy and Lactation in a Dutch Population

Background: Medication use during pregnancy and lactation can be unavoidable, but knowledge on safety for the fetus or breastfed infant is limited among patients and healthcare providers. Research aim: This study aimed to determine (a) the prevalence of medication use in pregnant and lactating women in a tertiary academic center, (b) the types and safety of these medicines, and (c) the influence of medication use on initiation of breastfeeding. Methods: This study used a cross-sectional survey among women ( N = 292) who underwent high-risk or low-risk deliveries. Data about their use of prescribed, over-the-counter, and homeopathic medication during pregnancy were obtained through a structured interview, followed by a questionnaire during lactation. Safety was classified according to the risk classification system from the Dutch Teratological Information Service. Results: Overall, 95.5% of participants used medication. One third of participants used at least one medicine with an unknown risk for the fetus. Teratogenic medication was used by 6.5% of participants, whereas 29.5% used medication with a (suspected) pharmacological effect on the fetus. Lactation was initiated by 258 (88.7%) participants, of which 84.2% used medication while breastfeeding. In 3.8% of participants, this medication was classified unsafe, but none used medication with an unknown risk. One-third of the nonlactating participants decided not to initiate breastfeeding because of medication use. In 70% of participants, this decision was appropriate. Conclusion: The prevalence of overall use of medication in Dutch pregnant and lactating women admitted to a tertiary center was high. There is an urgent need for pharmacometric studies for determination of the safe use of the most frequently used medicines during pregnancy or lactation.

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Knowledge and Communication of the National Core Standards Tool

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/3659 ◽

2018 ◽

Vol 20 (2) ◽

Author(s):

Winnie Thembisile Maphumulo ◽

Busisiwe Bhengu

Keyword(s):

Pearson Correlation ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Sampling Technique ◽

Quality Of Healthcare ◽

Survey Study ◽

Public Healthcare ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Professional Nurses

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.

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Preventable adverse drug events causing hospitalisation: identifying root causes and developing a surveillance and learning system at an urban community hospital, a cross-sectional observational study

BMJ Open Quality ◽

10.1136/bmjoq-2020-001161 ◽

2021 ◽

Vol 10 (1) ◽

pp. e001161

Author(s):

Jane de Lemos ◽

Peter Loewen ◽

Cheryl Nagle ◽

Robert McKenzie ◽

Yong Dong You ◽

...

Keyword(s):

Observational Study ◽

Adverse Drug Events ◽

Healthcare Providers ◽

Medication Use ◽

Learning System ◽

Chronic Obstructive ◽

Action Plans ◽

Medical Conditions ◽

Cross Sectional ◽

Medication Changes

ObjectivesTo identify root causes of preventable adverse drug events (pADEs) contributing to hospital admission; to develop key messages which identify actions patients/families and healthcare providers can take to prevent common pADEs found; to develop a surveillance learning system for the community.MethodsCross-sectional observational study; 120 patients and families, 61 associated healthcare providers were interviewed then root cause analysis was performed to develop key learning messages and an electronic reporting tool was designed. Most common pADE-related medical conditions and their root causes and most common pADE root causes of entire cohort are reported.ResultsMost common pADE-related medical conditions: chronic obstructive pulmonary disease/asthma (13.3%), bleeding (12.5%), hypotension (12%), heart failure (10%), acute kidney injury (5%) and pneumonia (5%). Most common root causes were: providers not confirming that the patient/family understands information given (29.2%), can identify how a medication helps them/have their concerns addressed (16.7%), can identify if a medication is working (14.1%) or causing a side effect (23.3%); can enact medication changes (7.5%); absence of a sick day management plan (12.5%), and other action plans to help patients respond to changes in their clinical status (10.8%); providers not assessing medication use and monitoring competency (19.2%). Ten key learning messages were developed and a pADE surveillance learning system was implemented.ConclusionsTo prevent pADEs, providers need to confirm that patients/families understand information given, how a medication helps them, how to recognise and respond to side effects, how to enact medication changes and follow action plans; providers should assess patient’s/families’ medication use and monitoring competency.

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Pre-Exposure Prophylaxis Training among Medical Schools in the United States

Journal of Primary Care & Community Health ◽

10.1177/21501327211028713 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110287

Author(s):

Robert L. Cooper ◽

Mohammad Tabatabai ◽

Paul D. Juarez ◽

Aramandla Ramesh ◽

Matthew C. Morris ◽

...

Keyword(s):

United States ◽

Hiv Prevention ◽

Injection Drug Users ◽

Drug Users ◽

Healthcare Providers ◽

Medical Schools ◽

The United States ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

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Healthcare Providers’ Attitudes, Knowledge, and Practice Behaviors for Educating Patients About Advance Directives: A National Survey

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118813720 ◽

2018 ◽

Vol 36 (5) ◽

pp. 387-395 ◽

Cited By ~ 5

Author(s):

Frances R. Nedjat-Haiem ◽

Tamara J. Cadet ◽

Anup Amatya ◽

Shiraz I. Mishra

Keyword(s):

Online Survey ◽

Survey Design ◽

Healthcare Providers ◽

Medical Decision ◽

Cross Sectional Survey ◽

Patient Centered ◽

Cross Sectional ◽

Practice Behaviors ◽

Centered Care ◽

Seriously Ill Patients

Background: Advance care planning for end-of-life care emerged in the mid-1970’s to address the need for tools, such as the advance directive (AD) legal document, to guide medical decision-making among seriously ill patients, their families, and healthcare providers. Objective: Study aims examine providers’ perspectives on AD education that involve examining (1) a range of attitudes about educating patients, (2) whether prior knowledge was associated with practice behaviors in educating patients, and (3) specific factors among healthcare providers such as characteristics of work setting, knowledge, attitudes, and behaviors that may influence AD education and documentation. Design: To examine providers’ views, we conducted a cross-sectional, online survey questionnaire of healthcare providers using social media outreach methods for recruitment. Methods: This study used a cross-sectional survey design to examine the proposed aims. Healthcare providers, recruited through a broad approach using snowball methods, were invited to participate in an online survey. Logistic regression analyses were used to examine providers’ views toward AD education. Results: Of 520 participants, findings indicate that most healthcare providers said that they were knowledgeable about AD education. They also viewed providing education as beneficial to their practice. These findings suggest that having a positive attitude toward AD education and experiencing less organizational barriers indicate a higher likelihood that providers will educate patients regarding ADs. Conclusion: Various disciplines are represented in this study, which indicates that attitudes and knowledge influence AD discussions. The importance of AD discussions initiated by healthcare providers is critical to providing optimal patient-centered care.

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IMPACT AND SATISFACTION WITH E-CONSULTATION: A PERCEPTION OF ALLIED HEALTH PROFESSIONALS

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.10.2/005 ◽

2021 ◽

Vol 10 (2) ◽

pp. 19-24

Author(s):

Mubashir Siddiqui

Keyword(s):

Health Professionals ◽

Allied Health ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Cross Sectional Survey ◽

Allied Health Professionals ◽

Cross Sectional ◽

Google Docs ◽

Consultation Services ◽

Good Substitute

BACKGROUND AND AIMS The havoc caused by COVID-19 leads to have an adverse impact on medical priorities for consultation however e-consultation has been used widely by practitioners to aid the patient and healthcare providers. METHODOLOGY A cross-sectional survey was conducted on allied health professionals, considering physical and occupational therapists. A self-administered questionnaire regarding impact assessment and level of attained satisfaction was distributed to participants in Google Docs via email or Whatsapp groups. RESULTS A total number of 109 responses obtained from the participants showed (34.9%) were agreed to understand the completed condition of the patient, (38.5%) but (41.3%) disagreed to treat the patient same as physical appointment and (35.58%) disagreed to work more productively. Only (32.1%) were agreed to be satisfied during their consultation, (49.5%) agreed that e-consultation can never be adopted as a good substitute of physical appointments. CONCLUSION It was concluded that limited number of therapists were satisfied with their e-consultation services while majority were agreed that the service cannot be a good substitute for a physical appointment. Therefore, further trials needs to be conducted to evaluate the factors causing hindrance in healthcare delivery.

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The Psychological Impact of COVID-19 on Healthcare Providers in Obstetrics: A Cross-Sectional Survey Study

Frontiers in Psychology ◽

10.3389/fpsyg.2021.632999 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lidia Del Piccolo ◽

Valeria Donisi ◽

Ricciarda Raffaelli ◽

Simone Garzon ◽

Cinzia Perlini ◽

...

Keyword(s):

Psychological Distress ◽

General Health Questionnaire ◽

Healthcare Providers ◽

Organizational Level ◽

Survey Study ◽

University Hospitals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Gynecology And Obstetrics ◽

The Individual

Objective: To assess the psychological distress of healthcare providers (HCPs) working in the field of obstetrics during the coronavirus disease 2019 (COVID-19) pandemic and to identify factors associated with psychological distress at the individual, interpersonal, and organizational level.Design: Cross-sectional survey study.Setting: Four University hospitals in Italy.Participants: HCPs working in obstetrics, including gynecologists, residents in gynecology and obstetrics, and midwives.Methods: The 104-item survey Impatto PSIcologico COVID-19 in Ostetricia (IPSICO) was created by a multidisciplinary expert panel and administered to HCPs in obstetrics in May 2020 via a web-based platform.Main Outcome Measures: Psychological distress assessed by the General Health Questionnaire-12 (GHQ-12) included in the IPSICO survey.Results: The response rate to the IPSICO survey was 88.2% (503/570), and that for GHQ-12 was 84.4% (481/570). Just over half (51.1%; 246/481) of the GHQ-12 respondents reported a clinically significant level of psychological distress (GHQ-12 ≥3). Psychological distress was associated with either individual (i.e., female gender, stressful experience related to COVID-19, exhaustion, and the use of dysfunctional coping strategies), interpersonal (i.e., lower family support, limitations in interactions with colleagues), and organizational (i.e., reduced perception of protection by personal protective equipment, perceived delays on updates and gaps in information on the pandemic) factors in dealing with the pandemic.Conclusions: Results confirm the need for monitoring and assessing the psychological distress for HCPs in obstetrics. Interventions at the individual, interpersonal, and organizational level may relieve the psychological distress during the COVID-19 pandemic and foster resilience skills in facing emotional distress.

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Association Between Dietary Quality and Postpartum Depression in Lactating Women: A Cross-Sectional Survey in Urban China

Frontiers in Nutrition ◽

10.3389/fnut.2021.705353 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chenlu Yang ◽

Ai Zhao ◽

Hanglian Lan ◽

Zhongxia Ren ◽

Jian Zhang ◽

...

Keyword(s):

Postpartum Depression ◽

Depression Scale ◽

Prevalence Ratio ◽

Urban China ◽

Dietary Quality ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Lactating Women ◽

Dietary Recall ◽

Food Variety

Background: Evidence on the effects of dietary quality on the risk of postpartum depression in the Chinese population is limited. This study aimed to examine the association between dietary quality and postpartum depression in Chinses lactating women.Methods: A total of 939 participants from 10 cities were included in this analysis. A one-time 24-h dietary recall was used to obtain the data on food consumption and dietary quality was assessed based on Diet Balance Index. The Edinburgh postnatal depression scale was considered at a cutoff point of 10 to detect postpartum depression. Poisson regression models were used to explore the association of dietary quality with postpartum depression.Results: Depressed women tended to have a more inadequate intake of vegetables and have more insufficient food variety. The median (25th, 75th) of the overall high bound score (HBS), low bound score (LBS), and diet quality distance (DQD) was 9 (5, 14), 30 (25, 37), and 40 (34, 47), respectively. Compared with subjects with the lowest quartile of LBS, those with the highest quartile of LBS had a higher risk of postpartum depression [adjusted prevalence ratio (aPR), 1.08; 95% confidence interval (95% CI), 1.01, 1.15; P for trend, 0.043]. We also observed a significant association between DQD and postpartum depression (Q4 vs. Q1: aPR, 1.07; 95% CI: 1.00, 1.14; P for trend, 0.036).Conclusion: Poor dietary quality was associated with postpartum depression in Chinese lactating women.

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Lack of Awareness of the Impact of Improperly Disposed Of Medications and Associated Factors: A Cross-Sectional Survey in Indonesian Households

Frontiers in Pharmacology ◽

10.3389/fphar.2021.630434 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sofa D. Alfian ◽

Widya N. Insani ◽

Eli Halimah ◽

Nabilla A. Qonita ◽

Siti S. Jannah ◽

...

Keyword(s):

Healthcare Providers ◽

Binary Logistic Regression ◽

Cross Sectional Survey ◽

Related Factors ◽

Cross Sectional ◽

Public Places ◽

Validated Questionnaire ◽

Unused Medications ◽

Medication Disposal ◽

The Impact

Introduction: Disposal of unused medications through environmentally unsafe routes is common in Indonesia. The lack of awareness of the impact of improperly disposed of medications is a significant contributing factor. The objectives of this study were to identify factors associated with lack of awareness of the impact of improperly disposed of unused medications and to assess the associations of awareness with medication disposal practices among the general population in Indonesia.Patients and methods: An observational cross-sectional survey was conducted using nonprobability sampling in Bandung, Indonesia, from November 2017 to January 2018 among respondents who were older than 18 years, had used any medication in the past, were literate, and had signed an informed consent document. Disposal practices and awareness regarding the impact of improperly disposed of unused medications were collected using an online- and a paper-based pre-validated questionnaire. The paper-based questionnaires were distributed to respondents in public places such as city center, markets, and religious places. Binary logistic regression was performed to assess associations of sociodemographic and other related factors with a lack of awareness. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported.Results: Of 497 participating respondents, 433 and 64 respondents filled an online- or a paper-based questionnaire, respectively. Most respondents were female, aged between 18 and 30 years, and students/university students. Of 497 respondents, more than half (53.1%) were not aware that improper medication disposal could harm the environment and population health. Most respondents (79.5%) had never received information about proper medication disposal practices. The education level, the number of stored medications at home, and previous education about medication disposal practices were significantly associated with awareness of proper practices. In the multivariate analysis, only those with previous education about medication disposal practices were less likely to report a lack of awareness (OR: 0.043; 95% CI: 0.02–0.09). Respondents with a lack of awareness tended to dispose of their unused medications in the garbage or shared them with friends or relatives.Conclusion: There is a clear need to increase awareness of the importance of proper medication disposal practices, in particular among the student population of Bandung city, Indonesia. Healthcare providers can play an important role by educating this specific population on the proper disposal of unused medications.

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Opinions of healthcare providers on the design of a smartphone application for asthma treatment in the Kingdom of Saudi Arabia

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2020.508 ◽

2020 ◽

Vol 15 ◽

Author(s):

Hajed M. Al-Otaibi ◽

Khalid A. Ansari ◽

Osama Hamad ◽

Turki M. Alanzi

Keyword(s):

Saudi Arabia ◽

Therapeutic Process ◽

Healthcare Providers ◽

Smartphone Application ◽

Asthma Treatment ◽

Cross Sectional Survey ◽

Kingdom Of Saudi Arabia ◽

Cross Sectional ◽

Primary Physician ◽

Global Initiative

Introduction: In several countries of the world, smartphone applications have been designed to contribute to the treatment of asthma. However, none of these applications has been developed in Saudi Arabia. Therefore, the objective of this article is to design a smartphone application for the treatment of asthma based on the opinions of healthcare providers from the Kingdom of Saudi Arabia. Methods: In order to know the opinion of the healthcare providers from Saudi Arabia about the design of an asthmaApp, we used a purposive sampling method and conducted a cross sectional survey employing a questionnaire which was distributed through the QuestionPro.com website to all healthcare providers working in this country. The questionnaire was sent to 376 healthcare providers and the response rate was 25%. Results: The data indicated that the majority of the respondents opined that the following features were important or very important in the design of a smartphone application for asthma treatment in Saudi Arabia: information about. patient diagnosis (98%), primary physician access information(83%), patient satisfaction with the therapeutic process (91%), push notifications about reminder for drugs (95%), push notification for treatment of inhaler and other drugs (92%), push notifications about reminders of clinic visits and therapy sections (81%), push notifications to ask for help sending SMS to primary physician about patients’ attacks (89%), pathophysiology of asthma (82%), asthma triggers (98%), drug guidelines (94%), drug side effects (93%), number of asthma attacks (98%), medication statistics (88%), visual inputs such as peak flow (91%), data to link patients to healthcare providers and to healthcare centers (82%), and Global Initiative for Asthma (GINA) references (72%). Conclusions: According to the opinion of the majority of healthcare providers (92%), the proposed smartphone application designed based on medical guidelines will contribute to improve the treatment of patients with asthma in the Kingdom of Saudi Arabia, and will help to reduce the number of asthma cases that need hospitalization, and the number of asthma cases in the emergency departments of the hospitals of the Kingdom.

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Preferences for Advance Directives in Korea

Nursing Research and Practice ◽

10.1155/2012/873892 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

So-Sun Kim ◽

Won-Hee Lee ◽

JooYoung Cheon ◽

Jung-Eun Lee ◽

KiSun Yeo ◽

...

Keyword(s):

End Of Life ◽

Advance Directives ◽

End Of Life Care ◽

Healthcare Providers ◽

Tube Feeding ◽

Life Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Korean People ◽

End Stage

Background. The goal of advance directives is to help patients retain their dignity and autonomy by making their own decisions regarding end-stage medical treatment. The purpose of this study was to examine preferences of advance directives among general population in Korea.Method. A descriptive cross-sectional survey was performed from October 2007 to June 2008 in Seoul, Korea. A total of 336 city-dwelling adults self-administered the questionnaire and returned it via mail. Data analyses were conducted using SPSS 17.0.Results. Subjects reported the need for healthcare providers' detailed explanations and recommendations regarding end-of-life care. When there is no hope of recovery and death is imminent, most subjects did not want to receive cardiopulmonary resuscitation nor an IV or tube feeding. However, most of the subjects wanted pain management care.Conclusions. The present study showed that many Korean people have an interest in advance directives. The results show that the autonomy and dignity of patient have increased in importance. To provide better end-of-life care, there is a need to educate patients on the definition and intent of an advance directive. Additional proactive communication between patients and their caregivers should be educated to healthcare providers.

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