scholarly journals Does early identification of high work related stress affect pharmacological treatment of primary care patients? - analysis of Swedish pharmacy dispensing data in a randomised control study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Pernilla J. Bjerkeli ◽  
Ingmarie Skoglund ◽  
Kristina Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Work Related ◽  
Primary Health ◽  
Related Stress ◽  
Pharmacy Dispensing Data ◽  
Dispensing Data

Abstract Background The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. Methods The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care centres (PHCCs) were eligible participants. The intervention included early identification of work-related stress by the WSQ, general practitioner (GP) training and GP feedback at consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for a period of 12 months following the intervention was used. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Data was analysed using Mann Whitney U tests and chi-square tests. Results The study population included 271 individuals (132 in the intervention group and 139 in the control group). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). Conclusion Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. In this randomised control trial, analysis of pharmacy dispensing data show that patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics. Trial registration ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.

scholarly journals Does early identification of work-related stress in primary health care effect pharmacy dispensing?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Bjerkeli ◽  
I M Skoglund ◽  
K Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Pharmacological Treatment ◽  
Early Identification ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. Methods The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care were eligible participants. The intervention included general practitionerś (GP) training to use the WSQ, early identification of patientś work-related stress by the WSQ, and GPś feedback on the WSQ results during the consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for 12 months following the intervention were analysed using Mann Whitney U tests and chi-square tests. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Results The study population included 271 individuals (132 in the intervention group and 139 in the control group). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). Conclusions Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. Key messages Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. Patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics than controls.

scholarly journals Self-reported sick leave following a brief preventive intervention on work-related stress

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
A-M Hultén ◽  
P Bjerkeli ◽  
K Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Brief Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Work Related Stress ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background General practitioners (GPs) play an important role for early identification and prevention of sick leave among patients perceiving ill health due to work-relates stress. In order to fulfil the role, they need adequate methodologies and tools. This study aimed to evaluate the effectiveness of a brief intervention in primary health care including early identification of work-related stress combined with feedback at consultation on the number of self-reported sick leave days. Methods A randomised controlled trial was performed at seven primary health care centres in western Sweden. Self-reported sick leave data collected between November 2015 and January 2017 were analysed prospectively. The study included 271 employed, non-sick-listed patients aged 18-64 years seeking care for mental and/or physical health complaints. The intervention group received a brief intervention about work-related stress, including training for GPs, screening of patients' work-related stress, feedback to patients on screening results and discussion of measures at GP consultation. The control group received treatment as usual. Results At 6-month follow-up 59/105 (56%) in the intervention group and 61/115 (53%) in the control group reported no sick leave. At 12-month follow-up the corresponding numbers were 61/119 (51%) and 57/122 (47%) respectively. There were no statistically significant differences between the intervention group and the control group in the median number of self-reported sick leave days. Conclusions The brief intervention showed no effect on the numbers of self-reported sick leave days. However, using sick leave as an outcome measure was difficult, as sick leave is multifactorial and the data has a non-normal distribution. In addition, sick leave might be used as an indicator as well as a possible treatment of ill health. Other actions and interventions to address patients perceiving ill health due to work-related stress should be explored. Key messages Sick leave is used as an indicator and as a treatment of ill health, which can complicate the evaluation of studies. The complexity of primary health care trials calls for other evaluation methods.

scholarly journals Does a brief work-stress intervention prevent sick-leave during the following 24 months? A randomized controlled trial in Swedish primary care

Work ◽  
2021 ◽  
pp. 1-10
Author(s):  
Jenny Hultqvist ◽  
Pernilla Bjerkeli ◽  
Gunnel Hensing ◽  
Kristina Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Early Identification ◽  
Controlled Trial ◽  
Intervention Group ◽  
Training Session ◽  
Control Group ◽  
Treatment As Usual ◽  
Primary Health

BACKGROUND: Work-related stress (WRS) presents a risk for sick leave. However, effective methods to identify people at risk for sick leave due to WRS at an early stage are lacking in primary health care. OBJECTIVE: To evaluate whether a systematic early identification of WRS can prevent sick leave over 24 months after the intervention. METHODS: Study participants (n = 132 intervention; n = 139 control) were employed, non-sick-listed persons seeking care at primary health care centres. The intervention included early identification of WRS by a validated instrument, general practitioner (GP) awareness supported by a brief training session, patients’ self-reflection by instrument completion, GP giving the patient feedback at consultation and GP identifying preventive measures. The control group received treatment as usual. Outcome data were retrieved from the Swedish Social Insurance Agency. RESULTS: The intervention group had less registered median sick leave days (n = 56) than the control group (n = 65) but the difference was not statistically significant. CONCLUSIONS: The brief intervention was not proven effective in preventing sick leave in the following 24 months compared to treatment as usual. Further research on how to identify, advice and treat those at high risk for sick leave in primary health care is needed.

scholarly journals Person-Centered Interactive Self-Management Support in Primary Health Care for People with Type 2 Diabetes: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Ulrika Öberg ◽  
Ulf Isaksson ◽  
Lena Jutterström ◽  
Carljohan Orre ◽  
Åsa Hörnsten
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Management Support ◽  
Randomized Controlled ◽  
Primary Health

BACKGROUND Type 2 diabetes (T2D) is increasing as the population ages. The development of new medical treatments is promising and important, but the basic treatment remains self-management, even if adherence to lifestyle advice is low. Electronic health (eHealth) or mHealth interventions can increase empowerment among people living with T2D and may compensate for the lack of professional resources and geographical distances. The interactive self-management support (iSMS) project aims at including digital tools to support people living with T2D in their self-management and facilitating their interaction with diabetes specialist nurses (DSNs). This protocol outlines a study with the purpose of developing and evaluating an intervention where people living with T2D can increase self-efficacy and empowerment through digital self-monitoring and interaction with DSNs. OBJECTIVE To develop and evaluate a person-centered iSMS intervention in primary health care for people with T2D in addition to their usual diabetes care. METHODS This study is a 12-month, 3-armed, nonblinded randomized controlled trial (RCT), which will be conducted in 6 primary health care centers (HCCs) in northern Sweden. Eligible participants will be randomized to either an intervention group (n=46), a control group (n=46), or an external group (n=46) for comparison. The intervention group will receive the mobile app, and the control group will receive a minimal intervention (diabetes brochure) and the usual standard of care. Changes in glycated hemoglobin (HbA1c) will be the primary outcome measure. RESULTS This trial is currently open for recruitment. The first results are expected to be submitted for publication in Autumn 2019. CONCLUSIONS This study, with its focus on iSMS, will provide insights regarding suitable ways to promote and develop a person-centered intervention. If successful, the intervention has the potential to become a model for the provision of self-management support to people with T2D.

Manajemen Diri (Self Management) Perilaku Sehat pada Pasien Hipertensi

2021 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Vera Kurnia ◽  
Desti Nataria
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Intervention Group ◽  
Sampling Technique ◽  
Healthy Diet ◽  
Rank Test ◽  
Control Group ◽  
Healthy Behavior ◽  
Education Management ◽  
Primary Health

Hypertension is one of the most common causes of morbidity and mortality  all over the world, also known as “the silent killer” because people with hypertension are without symptoms. West Sumatera Province reported that the prevalence of hypertension at the age 18 years has increased from 25,8% in 2013 to 31,7% in 2018. Successful strategies to manage the blood preasure depends on patients self-care management or the ability and willingness of the patient to change and maintain certain behavior.The purpose of this research is to determine the effect of self-education management of hypertension patients in the working area of primary health care in Bukittinggi.Design of this research is a quasi experimental design with pretest-posttest with control group. The sample which used were 62 respondents consist of 31 people in the intervention group and 31 people in the group control. Sampling was done by consecutive sampling technique. Data was analyzed Wilcoxon signed rank test and Mann Whitney test. The result of this research shows that there isn’t any effect of self education management to healthy behavior which includes exercise and healthy diet of the intervention group and the control group at community health center in Bukittinggi (mean rank after the intervention < 10; p> 0,05). Based on the result of this research it can be concluded that the habits of respondents who carry out light and medium activities every day and also education provided by primary health care  have given big impact to respondent’s habits where they always do exercise and healthy diet in their daily life.The result of this research can be used as an input for primary health care to maintain and improve education of healthy behavior for hypertension patients.

scholarly journals Effect of implementation intention on walking in people with diabetes

2020 ◽  
Vol 54 ◽  
pp. 103
Author(s):  
Marco Antonio Vieira da Silva ◽  
Thaís Moreira São-João ◽  
Marilia Estevam Cornelio ◽  
Fábio Luiz Mialhe
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Leisure Time Physical Activity ◽  
Intervention Strategy ◽  
Intervention Group ◽  
Implementation Intention ◽  
Control Group ◽  
Primary Health ◽  
Significant Difference

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

scholarly journals Health TAPESTRY Ontario: Protocol for a Randomized Controlled Trial to Test Reproducibility and Implementation

2020 ◽  
Author(s):  
Dee Mangin ◽  
Larkin Lamarche ◽  
Sivan Bomze ◽  
Sayem Borhan ◽  
Tracy Browne ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Randomized Controlled Trial ◽  
Primary Health Care ◽  
Controlled Trial ◽  
Care Team ◽  
Control Group ◽  
Randomized Controlled ◽  
Primary Health ◽  
Diverse Communities

Abstract Background: Health TAPESTRY (Health Teams Advancing Patient Experience: STRengthening qualitY) aims to help people stay healthier for longer where they live by providing person-focused care through the integration of four key program components: 1) trained volunteers who visit clients in their homes, 2) an interprofessional primary health care team, 3) use of technology to collect and share information, and 4) improved connections to community health and social services. The initial randomized controlled trial of Health TAPESTRY found promising results in terms of health care use and patient outcomes, indicating a shift from reactive to preventive care. The trial was based on one clinical academic centre, thus limiting generalizability. The study objectives are: 1) to test reproducibility of the established effectiveness of Health TAPESTRY on physical activity and hospitalizations, 2) to test the feasibility of, and understand the contributing factors to, the implementation of Health TAPESTRY in six diverse communities across Ontario, Canada, and 3) to determine the value for money of implementing Health TAPESTRY. Methods : This planned study is a pragmatic parallel randomized controlled trial with a delayed intervention for control participants at six months. This trial will simultaneously assess effectiveness and implementation in a real world setting (Type II hybrid) in six diverse communities across Ontario. Participants 70 years of age and older will be randomized into the Health TAPESTRY intervention or the control group (usual care). Intervention clients will receive an individualized plan of care from an interprofessional care team. The plan will be based on a client’s goals and current health risks identified through volunteer visits. The study’s outcomes are mapped onto the RE-AIM framework, with levels of physical activity and number of hospitalizations as the co-primary outcomes. The main analysis will be a comparison at six months. Discussion: It is important to evaluate the effectiveness and implementation of Health TAPESTRY in multiple communities prior to scaling or widespread adoption. Trial registration: ClinicalTrials.gov: NCT03397836 (posted January 12, 2018). Keywords: Primary health care, Randomized controlled trial, Integrated care, Interdisciplinary health care teams, Health care volunteers, Older adults, Implementation

The effect of pillbox use and education by pharmacist toward medication adherence in diabetes mellitus patients in a Primary Health Care Center in Mataram

2021 ◽  
Vol 32 (4) ◽  
pp. 577-582
Author(s):  
Mahacita Andanalusia ◽  
Yunita Nita ◽  
Umi Athiyah
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Primary Health Care ◽  
Medication Adherence ◽  
Care Center ◽  
Intervention Group ◽  
Primary Health Care Center ◽  
Control Group ◽  
Health Care Center ◽  
Primary Health

Abstract Objectives Nonadherence to a long-term therapy, including diabetes mellitus, is one of the global problems that need to be overcome. This study aims to determine the effect of pillbox use and education by pharmacists toward medication adherence in patients with diabetes mellitus in a Primary Health Care Center in Mataram. Methods This research was an experimental research design with pretest-posttest with control group design. The study was conducted from October to December 2019 at Tanjung Karang Primary Health Care Center, Mataram. Measurement of adherence was done using the Adherence to Refill and Medication Scale questionnaire. The higher the score, the more nonadherence the patients. Patients were divided into three groups, which were the control group, educational intervention group, and pillbox and educational intervention group. Each group consisted of 11 patients. Results Patients’ medication adherence increased from 19.54 (SD 4.37) to 15.18 (SD 2.64) in the education and pillbox intervention group (p=0.004). Whereas, in the education and control group, the adherence did not provide a significant change (p>0.05). Based on the difference in adherence scores, it was known that what contributed to changes in compliance was refilling medicine and intentional nonadherence in taking medicine subscale (p=0.024). Conclusions Providing education and pillbox done by pharmacists at the Primary Health Care Center can increase adherence to the therapy of diabetes mellitus patients. Pharmacists at the Primary Health Care Center can use the intervention model to improve the level of adherence of patients with chronic illness.

Sign in / Sign up

Export Citation Format

Share Document