scholarly journals Need of guidance in disabling and chronic migraine identification in the primary care setting, results from the european MyLife anamnesis survey

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Angel L. Guerrero ◽  
Andrea Negro ◽  
Philippe Ryvlin ◽  
Kirill Skorobogatykh ◽  
Rainel Sanchez-De La Rosa ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Migraine ◽  
Western Europe ◽  
Online Survey ◽  
Care Setting ◽  
Preventive Treatment ◽  
Societal Burden ◽  
Patient Diary ◽  
Preventive Medication ◽  
The Uk

Abstract Background Migraine affects 80.8 million people in Western Europe and is the first cause of disability among people between ages 15 and 49 worldwide. Despite being a highly prevalent and disabling condition, migraine remains under-diagnosed and poorly managed. Methods An international, online survey was conducted among 201 general practitioners (GPs) from 5 European countries (France, Germany, Italy, Spain and the UK) who are experienced in the management of headache disorders. Results The majority of GPs (82%) did not refer patients with chronic migraine (CM) to migraine specialists. Among those patients, the participants estimated that around 55% received preventive medication. Some differences between countries were observed regarding referral rate and prescription of preventive treatment. Most GPs (87%) reported a lack of training or the need to be updated on CM management. Accordingly, 95% of GPs considered that a migraine anamnesis guide could be of use. Overall, more than 95% of GPs favoured the use of a patient diary, a validated diagnostic tool and a validated scale to assess impact of migraine on patients’ daily life. Similarly, 96% of the GPs considered that the inclusion of warning features (red flags) in an anamnesis guide would be useful and 90% favoured inclusion of referral recommendations. Conclusions The results from this survey indicate that more education on diagnosis and management of CM is needed in primary care. Better knowledge on the recognition and management of migraine in primary care would improve both prognosis and diagnosis and reduce impact of migraine on patients’ lives, healthcare utilization and societal burden.

scholarly journals Current clinical practice in disabling and chronic migraine in the primary care setting: results from the European My-LIFE anamnesis survey

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Philippe Ryvlin ◽  
Kirill Skorobogatykh ◽  
Andrea Negro ◽  
Rainel Sanchez- De La Rosa ◽  
Heike Israel-Willner ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Migraine ◽  
Primary Care Physicians ◽  
Care Setting ◽  
Primary Care Setting ◽  
Headache Disorder ◽  
Episodic Migraine ◽  
Patient Diary ◽  
The Uk

Abstract Background Migraine is a prevalent and disabling headache disorder that affects more than 1.04 billion individuals world-wide. It can result in reduction in quality of life, increased disability, and high socio-economic burden. Nevertheless, and despite the availability of evidence-based national and international guidelines, the management of migraine patients often remains suboptimal, especially for chronic migraine (CM) patients. Methods My-LIFE anamnesis project surveyed 201 General practitioners (GPs) from 5 European countries (France, Germany, Italy, Spain, and the UK) with the aim of understanding chronic migraine (CM) patients’ management in the primary care setting. Results In our survey, GPs diagnosed episodic migraine (EM) more often than CM (87% vs 61%, p < 0.001). We found that many CM patients were not properly managed or referred to specialists, in contrast to guidelines recommendations. The main tools used by primary-care physicians included clinical interview, anamnesis guide, and patient diary. Tools used at the first visit differed from those used at follow-up visits. Up to 82% of GPs reported being responsible for management of patients diagnosed with disabling or CM and did not refer them to a specialist. Even when the GP had reported referring CM patients to a specialist, 97% of them were responsible for their follow-up. Moreover, the treatment prescribed, both acute and preventive, was not in accordance with local and international recommendations. GPs reported that they evaluated the efficacy of the treatment prescribed mainly through patient perception, and the frequency of follow-up visits was not clearly established in the primary care setting. These results suggest that CM is underdiagnosed and undertreated; thereby its management is suboptimal in the primary care. Conclusions There is a need of guidance in the primary care setting to both leverage the management of CM patients and earlier referral to specialists, when appropriate.

scholarly journals Professional education among haemophilia nurses: a survey of current practices

2020 ◽  
Vol 7 (1) ◽  
pp. 1-7
Author(s):  
Simon Fletcher ◽  
Steve Chaplin ◽  
Cathy Harrison ◽  
Kristian Juusola ◽  
Norma Collins
Keyword(s):  
New Media ◽  
Professional Education ◽  
Western Europe ◽  
Online Survey ◽  
The Philippines ◽  
Hard Copy ◽  
Traditional Use ◽  
Face To Face ◽  
The Uk ◽  
Almost All

AbstractBackground:Guidance from the European Association for Haemophilia and Allied Disorders (EAHAD) sets out the educational milestones haemophilia nurses should aim to achieve. However, little is known about the resources nurses use for education and current awareness.Aims:To assess the current educational level of haemophilia nurses, how and where they access ongoing education, where they feel they need extra support, and how best this teaching could be delivered.Methods:Haemophilia nurses in the Haemnet Horizons group devised and piloted a questionnaire. This was distributed in hard copy to nurses attending the 2019 EAHAD Congress and promoted as an online survey hosted by Survey Monkey.Results:Seventy-five replies were received from nurses in Europe (46 in the UK), and two from nurses in Chile and the Philippines. Most described their role as ‘specialist nurse’, with the majority having worked in haemophilia care for up to ten years. Half had a nursing degree and one quarter had a nursing diploma. Three quarters had attended at least one course specifically related to haemophilia nursing. Almost all used academic sources, study days and the websites of health profession organisations as information sources. Most also used Google or Wikipedia, but fewer used Twitter. Patient association websites were more popular among non-UK nurses. About half attended sponsored professional meetings and three quarters reported that educational meetings were available in their workplace. A clear majority preferred interactive and face-to-face activities using patient-focused content.Conclusions:The study shows that nurses, predominantly in Western Europe, access a range of educational resources, most of which are ‘traditional’. Use of online sources is high, but social media are less popular than Google or Wikipedia. Further research is needed to explore the potential of new media for haemophilia nurse education, and whether the current educational levels and needs highlighted in the survey remains the same across the whole of Europe.

scholarly journals Exploring primary care responses to domestic violence and abuse (DVA): operationalisation of a national initiative

2019 ◽  
Vol 21 (2) ◽  
pp. 144-154 ◽  
Author(s):  
Julie McGarry ◽  
Basharat Hussain ◽  
Kim Watts
Keyword(s):  
Primary Care ◽  
Domestic Violence ◽  
Care Setting ◽  
Primary Care Setting ◽  
Local Level ◽  
Team Approach ◽  
Content Type ◽  
The Uk ◽  
The Impact ◽  
Domestic Violence And Abuse

Purpose In the UK, the Identification and Referral to Improve Safety (IRIS) initiative has been developed for use within primary care to support women survivors of domestic violence and abuse (DVA). However, while evaluated nationally, less is known regarding impact of implementation at a local level. The purpose of this paper is to explore the effectiveness of IRIS within one locality in the UK. Design/methodology/approach A qualitative study using interviews/focus groups with primary care teams and women who had experienced DVA in one primary care setting in the UK. Interviews with 18 participants from five professional categories including: general practitioners, practice nurses, practice managers, assistant practice managers and practice receptionists. Focus group discussion/interview with seven women who had accessed IRIS. Data were collected between November 2016 and March 2017. Findings Five main themes were identified for professionals: Team role approach to training, Professional confidence, Clear pathway for referral and support, Focussed support, Somewhere to meet that is a “safe haven”. For women the following themes were identified: Longevity of DVA; Lifeline; Face to face talking to someone; Support and understood where I was coming from; A place of safety. Practical implications IRIS played a significant role in helping primary care professionals to respond effectively. For women IRIS was more proactive and holistic than traditional approaches. Originality/value This study was designed to assess the impact that a local level implementation of the national IRIS initiative had on both providers and users of the service simultaneously. The study identifies that a “whole team approach” in the primary care setting is critical to the effectiveness of DVA initiatives.

scholarly journals Pediatric nurses in pediatricians’ offices: a survey for primary care pediatricians

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Immacolata Dall’Oglio ◽  
Giovanni Vitali Rosati ◽  
Valentina Biagioli ◽  
Emanuela Tiozzo ◽  
Orsola Gawronski ◽  
...  
Keyword(s):  
Primary Care ◽  
Disease Prevention ◽  
Online Survey ◽  
Care Setting ◽  
Clinical Care ◽  
Professional Activity ◽  
Healthcare Education ◽  
Pediatric Nurses ◽  
Pediatric Nurse ◽  
Primary Care Pediatricians

Abstract Background The role played by nurses in caring for children in pediatricians’ officies in the community is crucial to ensure integrated care. In Italy, pediatricians are responsible for the health of children aged 0–14 years living in the community. This study aimed to describe Italian primary care pediatricians’ opinions about the usefulness of several nursing activities that pediatric nurses could perform in pediatricians’ offices. Methods An online survey with pediatricians working in primary care in Italy was conducted between April–December 2018. A 40-item questionnaire was used to assess four types of nursing activities: clinical care, healthcare education, disease prevention, and organizational activities. The answers ranged from 1 (not useful at all) to 6 (very useful). Moreover, three open-ended questions completed the questionnaire. Results Overall, 707 pediatricians completed the online survey. Participants were mainly female (63%), with a mean age of 57.74 (SD = 6.42). The presence of a pediatric nurse within the pediatrician’s office was considered very useful, especially for healthcare education (Mean 4.90; SD 1.12) and disease prevention (Mean 4.82; SD 1.11). Multivariate analysis confirmed that pediatricians ‘with less working experience’, ‘having their office in a small town’, and ‘collaborating with a secretary and other workers in the office’ rated the nurse’s activities significantly more useful. Conclusions A pediatric nurse in the pediatrician’s office can significantly contribute to many activities for children and their families in the community. These activities include clinical care, healthcare education, disease prevention, and the organizational processes of the office. Synergic professional activity between pediatricians and pediatric nurses could ensure higher health care standards in the primary care setting.

scholarly journals Prerequisites for providing effective support to family caregivers within the primary care setting – results of a study series in Germany

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Family Caregivers ◽  
Support Services ◽  
Online Survey ◽  
Care Setting ◽  
Primary Care Setting ◽  
Psychological Needs ◽  
Care Recipient ◽  
Current Status ◽  
Good Time

Abstract Background General Practitioners are considered to be well placed to monitor home-care settings and to respond specifically to family caregivers. To do this, they must be sensitive to the needs and expectations of caregivers. In order to determine the current status of GP care in terms of the support given to family caregivers, a series of studies were conducted to gather the perspectives of both caregivers and GPs. The results are used to derive starting points as to which measures would be sensible and useful to strengthen support offered to family caregivers in the primary care setting. Methods Between 2020 and 2021, three sub-studies were conducted: a) an online survey of 612 family caregivers; b) qualitative interviews with 37 family caregivers; c) an online survey of 3556 GPs. Results Family caregivers see GPs as a highly skilled and trustworthy central point of contact; there are many different reasons for consulting them on the subject of care. In the perception of caregivers, particular weaknesses in GP support are the absence of signposting to advisory and assistance services and, in many cases, the failure to involve family caregivers in good time. At the same time, GPs do not always have sufficient attention to the physical and psychological needs of family caregivers. The doctors interviewed consider the GP practice to be well suited to being a primary point of contact for caregivers, but recognise that various challenges exist. These relate, among other things, to the timely organisation of appropriate respite services, targeted referral to support services or the early identification of informal caregivers. Conclusions GP practices can play a central role in supporting family caregivers. Caregivers should be approached by the practice team at an early stage and consistently signposted to help and support services. In order to support care settings successfully, it is important to consider the triadic constellation of needs, wishes and stresses of both the caregiver and the care recipient. More training and greater involvement of practice staff in the support and identification of caregivers seems advisable.

scholarly journals Treatment Evolution after COPD Diagnosis in the UK Primary Care Setting

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e105296 ◽  
Author(s):  
Keele E. Wurst ◽  
Yogesh Suresh Punekar ◽  
Amit Shukla
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
The Uk ◽  
Copd Diagnosis
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