Patients perspectives on drug shortages in six European hospital settings – a cross sectional study

Abstract Background It is known that drug shortages represent a major challenge for all stakeholders involved in the process, but there is little evidence regarding insights into patients′ awareness and perspectives. This study aimed to investigate the patients-perceived drug shortages experience and their view on outcomes in different European hospital settings. Furthermore, we wanted to explore information preferences on drug shortages. Methods A retrospective, cross sectional, a mixed method study was conducted in six European hospital settings. One hospital (H) from each of this country agreed to participate: Bosnia and Herzegovina (H-BiH), Croatia (H-CR), Germany (H-GE), Greece (H-GR), Serbia (H-SE) and Poland (H-PO). Recruitment and data collection was conducted over 27 months from November 2017 until January 2020. Overall, we surveyed 607 patients which completed paper-based questionnaire. Questions related to: general information (demographic data), basic knowledge on drug shortages, drug shortages experienced during hospitalization and information preferences on drug shortage. Differences between hospital settings were analyzed using Chi-squared test or Fisher’s exact test. For more complex contingency tables, Monte Carlo simulations (N = 2000) were applied for Fisher’s test. Post-hoc hospital-wise analyses were performed using Fisher’s exact tests. False discovery rate was controlled using the Bonferroni method. Analyses were performed using R: a language and environment for statistical computing (v 3.6.3). Results 6 % of patients reported experiences with drug shortages while hospitalized which led to a deterioration of their health. The majority of affected patients were hospitalized at hematology and/or oncology wards in H-BiH, H-PO and H-GE. H-BiH had the highest number of affected patients (18.1 %, N = 19/105, p < 0.001) while the fewest patients were in H-SE (1 %, N = 1/100, p = 0.001). In addition, 82.5 %, (N = 501/607) of respondents wanted to be informed of alternative treatment options if there was a drug shortage without a generic substitute available. Majority of these patients (66.4 %, N = 386/501) prefer to be informed by a healthcare professional. Conclusions Although drug shortages led to serious medical consequences, our findings show that most of the patients did not perceive shortages as a problem. One possible interpretation is that good hospital management practices by healthcare professionals helped to mitigate the perceived impact of shortages. Our study highlights the importance of a good communication especially between patients and healthcare professionals in whom our patients have the greatest trust.

Download Full-text

Knowledge, attitude and practices regarding malaria among residents of rural Mangalore, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20185386 ◽

2018 ◽

Vol 7 (1) ◽

pp. 231

Author(s):

Animesh Gupta ◽

Aishwarya Bhat

Keyword(s):

Preventive Measures ◽

Demographic Data ◽

Cross Sectional Study ◽

Control Measures ◽

Basic Knowledge ◽

Parasitic Diseases ◽

Health Seeking ◽

Community Based ◽

Cross Sectional ◽

Structured Questionnaire

Background: Malaria is one of the most prevalent parasitic diseases worldwide and India has fourth highest number of malaria cases and deaths in the world. Prevention of the disease through better knowledge and awareness is the appropriate way to keep the disease away and remain healthy. Thus, the present study was aimed to assess the knowledge, attitude and practices regarding malaria among residents of Mangalore.Methods: Community based cross sectional study was conducted among residents in Mangalore. The data was collected by using pre-tested semi-structured questionnaire which include socio-demographic data, basic knowledge about malaria, transmission and preventive measures and health seeking behaviour regarding malaria through interview method.Results: Almost 98.4% respondents heard of malaria disease and 96% respondents had knowledge that malaria is caused by mosquito bite. Even, majority (72%) of respondents knew that malaria can be fatal. Regarding the symptoms of malaria, 52.4% respondents mentioned fever with chills and 11.6% respondents don’t know about malarial symptoms.Conclusions: Majority of the respondents were familiar with the malaria symptoms, mode of transmission and vector control measures. They had good knowledge of malaria disease and good practices of malaria control measures.

Download Full-text

Children’s Nurses’ Knowledge and Attitudes on Paediatric Pain: A Descriptive Cross-Sectional Survey in a Developing Country

Nurse Media Journal of Nursing ◽

10.14710/nmjn.v10i3.32457 ◽

2020 ◽

Vol 10 (3) ◽

pp. 222-233

Author(s):

Evans Oduro ◽

Abigail Kusi-Amponsah Diji ◽

Grace Kusi ◽

Albert Amagyei ◽

Joana Kyei-Dompim ◽

...

Keyword(s):

Professional Education ◽

Management Practices ◽

Demographic Data ◽

Pediatric Pain ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Knowledge And Attitudes ◽

Hospital Facility ◽

Pain Knowledge ◽

Nurses Knowledge

Background: Children’s nurses’ knowledge of pain affects their pain management practices. Even though poor knowledge and attitudes have been reported in several studies, most were carried out in developed settings. However, little has been reported on the management of paediatric pain by nurses in resource-limited settings such as in sub-Saharan Africa.Purpose: This study sought to assess the knowledge and perceptions of children’s nurses regarding paediatric pain in a Ghanaian context.Methodology: A descriptive cross-sectional survey was carried out among 65 nurses at eight hospitals at various levels of healthcare in Ghana. Over three months, participants’ demographic data and responses on the Pediatric Nurses Knowledge and Attitude Survey Regarding Pain (PNKAS) instrument were collected. Data were analyzed and presented using descriptive and inferential statistics.Results: Participants’ average (SD) knowledge and attitudes regarding paeditric pain was 36.7% (6.9%) and ranged from 21.4% to 57.1%. Pediatric pain knowledge and attitudes (PPKA) of the nurses differed based on working years in the children’s unit and the hospital type they worked in (p<0.05). Nevertheless, the type of hospital facility was the only independent predictor of their PPKA (R2=0.181, p<0.001).Conclusion: Children nurses in this setting generally had insufficient knowledge and attitudes on paediatric pain. They should be motivated to undertake self-directed learning and regular continuing professional education to update their knowledge, attitude and skills on evidence-based pediatric pain assessment and management.

Download Full-text

Prevalence of chronic kidney disease in Bhuj district: a cross sectional study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20174294 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1412

Author(s):

Vinayak Chauhan ◽

Kashyap Buch

Keyword(s):

Blood Test ◽

Serum Uric Acid Level ◽

Demographic Data ◽

Simple Random Sampling ◽

Cross Sectional Study ◽

Basic Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

The Mean

Background: In order to control any disease basic knowledge about the prevalence and risk factors of the particular disease is required.Methods: In this cross-sectional study, 2600 individuals aged between 25 and 70 years old were recruited. Participants were selected from the general population residing in Bhuj, Gujarat, India via simple random sampling. Demographic data were collected. Urine and blood test were performed, and the glomerular filtration rate was estimated.Results: One hundred and thirty participants (10%) had CKD. The mean age was significantly higher in the CKD group. Hypertension and diabetes mellitus were significantly more prevalent among the participants with CKD than those without CKD (P < 0.001 for both). Proteinuria was significantly associated with CKD, whereas a history of urinary tract infection, a history of nephrolithiasis, smoking, serum uric acid level, lipid profile, and blood glucose level were not.Conclusions: Overall, it seems that CKD is a common health problem in Gujarat, but further studies in other parts of this country is recommended for the better estimation of CKD prevalence. This study shows the importance of screening for CKD.

Download Full-text

The influence of Occupation and Teamwork on the Successful Use of the WHO Surgical Checklist: Experiences of Swedish Healthcare Professionals

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20211205 ◽

2021 ◽

Vol 11 (12) ◽

pp. 31-41

Author(s):

Krupic F

Keyword(s):

Healthcare Professionals ◽

University Hospital ◽

Categorical Variables ◽

Cross Sectional ◽

Good Communication ◽

Emergency Situations ◽

Who Checklist ◽

Questionnaire Research ◽

Surgical Checklist ◽

Self Administered Questionnaire

Background: Every year, some 300 million operations are performed around the world, with approximately 700,000 in Sweden. This represents about one surgical procedure per 25 people. All these operations are not free of risk. The safety of patients can be enhanced by teamwork, good communication and checklists ensuring adherence to safety routines. The aim of the present study was to describe the experience of Swedish healthcare professionals of using the WHO surgical checklist, with special emphasis on different occupations and teamwork. Methods:A descriptive cross-sectional statistical study, including healthcare professionals from two departments at a university hospital in the western part of Sweden, was conducted. Data were collected from one hundred and ninety-six healthcare professionals, using a self-administered questionnaire that contained 12 questions. The Mantel-Haenszel and Pearson χ2 tests were used for ordered and unordered categorical variables. Results: One hundred and ninety-six healthcare professionals, aged 21-73, and 6 different categories with 5-25 years experiences participated. Regarding the usage of the checklist at different departments, the biggest different was about responsibility to implementation of the checklist (p=0,001), using the checklist in the emergency situations (p=0.04), if the checklist improve patient’s safety (p=0.04), and if the list has been completed correctly (p=0,006). Regarding the training for using the checklist, anaesthetist nurses were most negative with 75,5%, and the operating nurses were most positive with 39.2 %. 66,0 % of nurse anaesthetists, the checklist was adapted to the department. Majority of all the occupations thought that the checklist improved patients safety, and that the checklist had been correctly completed. Conclusion: Different departments and different occupations experience difficulties using the checklist in the Swedish healthcare system. More research is needed to investigate the experiences of healthcare professionals, whether different occupations report differently about using the checklist and whether teamwork is influenced by using the checklist. A further understanding of the checklist and its importance, as well as its content, could increase the safety of patients due to improved compliance. Key words: WHO checklist, surgery, occupation, teamwork questionnaire, research .

Download Full-text

Characteristics and functionalities of mobile apps aimed at patients diagnosed with immune-mediated inflammatory diseases: systematic app search (Preprint)

10.2196/preprints.31016 ◽

2021 ◽

Author(s):

Rosa Romero-Jimenez ◽

Vicente Escudero-Vilaplana ◽

Esther Chamorro-De-Vega ◽

Arantza Ais ◽

Elena Lobato-Matilla ◽

...

Keyword(s):

Healthcare Professionals ◽

Inflammatory Diseases ◽

Mobile Apps ◽

Well Being ◽

Health Impact ◽

General Information ◽

Specific Information ◽

Cross Sectional ◽

Immune Mediated ◽

Patient Reported

BACKGROUND Immune-mediated inflammatory diseases (IMIDs) are systemic conditions associated with a high social and health impact. New treatments have changed the prognosis of IMIDs and have increased patient autonomy in disease management. Mobile apps have enormous potential to improve health outcomes in IMID patients. While a large number of IMID apps are available, the app market is not regulated, and functionality and reliability remain uncertain. OBJECTIVE Our objectives were to review available apps for IMID patients and/or caregivers and to identify and describe the main characteristics and functionalities of these apps. METHODS We performed an observational, cross-sectional, descriptive study of all apps for IMID patients. Between April 5 and 14, 2021, we conducted a search of the App Store (iOS) and Play Store (Android) platforms. The search terms used were “ankylosing spondylitis”, “Crohn's disease”, “IBD”, “inflammatory bowel disease”, “immune-mediated inflammatory diseases”, “immune-mediated inflammatory disorders”, “psoriasis”, “psoriatic arthritis”, “rheumatoid arthritis”, and “ulcerative colitis”. The inclusion criteria were as follows: 1) content related to IMIDs, 2) English or Spanish language, 3) user population consisting of patients and healthcare consumers, including family and caregivers. The variables analyzed were as follows: app name, type of IMID, platform (Android or iOS), country of origin, language, category of the app, cost, date of the last update, size, downloads, author affiliation, and functionalities. RESULTS We identified 713 apps in the initial search, and 243 apps met the criteria and were analyzed. Of these, 37.0% (90/243) were on Android, 27.2% (66/243) on iOS, and 35.8% (87/243) on both platforms. The most frequent categories were health and well-being/fitness apps (188/243 [48.5%]) and medicine (82/243 [37.9%]). A total of 211 apps (82.3%) were free. The mean time between the date of the analysis and the date of the most recent update was 18.5 months (SD = 19.3). Healthcare professionals were involved in the development of 100 apps (41.1%). We found differences between Android and iOS in the time since the last update (16.2 [SD=14.7] months vs. 30.3 [SD=25.7] months) and in free apps (85.6% vs. 75.8%; respectively). The functionalities were as follows: general information about lifestyles, nutrition, or exercises (135/243 apps [55.6%]); specific information about the disease or treatment (102/243 apps [42.0%]); recording of symptoms or adverse events (51/243 apps [21.0%]); agenda/calendar (44/243 apps [18.1%]); reminder medication (41/243 apps [16.9%]); and recording of patient-reported outcomes (41/243 apps [16.9%]). A total of 147 apps (60.5%) had more than one functionality. CONCLUSIONS IMID-related apps are heterogeneous in terms of functionality and reliability. Apps may be a useful complement to IMID care, especially in patient education (their most frequent functionality). However, more than half of the IMID apps had not been developed by healthcare professionals or updated in the last year. Doubts over author affiliations and the lack of updates lead to significant uncertainties concerning their quality and safety.

Download Full-text

How common are Chinese patients with multimorbidity involved in decision making and having a treatment plan? a cross-sectional study

10.21203/rs.2.16804/v1 ◽

2019 ◽

Cited By ~ 1

Author(s):

Kam Pui Lee ◽

Samuel Yeung Shan Wong ◽

Benjamin Hon Kei Yip ◽

Eliza Lai Yi Wong ◽

Dicken Chan ◽

...

Keyword(s):

Decision Making ◽

Outpatient Clinic ◽

Healthcare Professionals ◽

Treatment Plan ◽

Demographic Data ◽

Cross Sectional Study ◽

Chinese Patients ◽

Sectional Study ◽

Cross Sectional ◽

Specialist Outpatient Clinic

Abstract Background Creating a treatment plan (TP) through shared decision making (SDM) with healthcare professionals, is of paramount importance for patients with multimorbidity. This study aims to estimate the prevalence of SDM and TP in patients with multimorbidity, and study the association between SDM/TP with demographics and patients’ confidence to manage their diseases.Method This cross-sectional study used an internationally recognized survey. 1,032 patients aged 60 or above with multimorbidity, were recruited from a specialist outpatient clinic, general outpatient clinic (GOPC) and a geriatric day hospital. The proportion of patients reported to have SDM and TP were estimated. Associations between the presence of SDM/TP and patients’ demographic data, and the confidence level to manage their illnesses, were then studied using logistic regression.Results The prevalence of SDM and TP were 35.8% and 82.1%, respectively. The presence of TP was associated with receiving healthcare from the same doctor or in the same facilities, and being recruited from GOPC. Presence of SDM (OR 1.381, p=0.054) and TP(OR 2.195, p<0.0001) were associated with enhanced confidence in dealing with diseases.Conclusion Most people with multimorbidity had TP in Hong Kong, but fewer patients had SDM.Practice implications: Ways to promote SDM in HK are needed.

Download Full-text

To burn-out or not to burn-out: a cross-sectional study in healthcare professionals in Spain during COVID-19 pandemic

BMJ Open ◽

10.1136/bmjopen-2020-044945 ◽

2021 ◽

Vol 11 (2) ◽

pp. e044945

Author(s):

Maria Torrente ◽

Pedro AC Sousa ◽

Ana Sánchez-Ramos ◽

Joao Pimentao ◽

Ana Royuela ◽

...

Keyword(s):

Healthcare Workers ◽

Online Survey ◽

Healthcare Professionals ◽

Demographic Data ◽

Maslach Burnout Inventory ◽

Well Being ◽

Survey Study ◽

Multivariable Logistic Regression Analysis ◽

Cross Sectional ◽

Burn Out

ObjectiveTo assess the prevalence of burn-out syndrome in healthcare workers working on the front line (FL) in Spain during COVID-19.DesignCross-sectional, online survey-based study.SettingsSampling was performed between 21st April and 3rd May 2020. The survey collected demographic data and questions regarding participants’ working position since pandemic outbreak.ParticipantsSpanish healthcare workers working on the FL or usual ward were eligible. A total of 674 healthcare professionals answered the survey.Main outcomes and measuresBurn-out syndrome was assessed by the Maslach Burnout Inventory-Medical Personnel.ResultsOf the 643 eligible responding participants, 408 (63.5%) were physicians, 172 (26.8%) were nurses and 63 (9.8%) other technical occupations. 377 (58.6%) worked on the FL. Most participants were women (472 (73.4%)), aged 31–40 years (163 (25.3%)) and worked in tertiary hospitals (>600 beds) (260 (40.4%)). Prevalence of burn-out syndrome was 43.4% (95% CI 39.5% to 47.2%), higher in COVID-19 FL workers (49.6%, p<0.001) than in non- COVID-19 FL workers (34.6%, p<0.001). Women felt more burn-out (60.8%, p=0.016), were more afraid of self-infection (61.9%, p=0.021) and of their performance and quality of care provided to the patients (75.8%, p=0.015) than men. More burn-out were those between 20 and 30 years old (65.2%, p=0.026) and those with more than 15 years of experience (53.7%, p=0.035).Multivariable logistic regression analysis revealed that, working on COVID-19 FL (OR 1.93; 95% CI 1.37 to 2.71, p<0.001), being a woman (OR 1.56; 95% CI 1.06 to 2.29, p=0.022), being under 30 years old (OR 1.75; 95% CI 1.06 to 2.89, p=0.028) and being a physician (OR 1.64; 95% CI 1.11 to 2.41, p=0.011) were associated with high risk of burn-out syndrome.ConclusionsThis survey study of healthcare professionals reported high rates of burn-out syndrome. Interventions to promote mental well-being in healthcare workers exposed to COVID-19 need to be immediately implemented.

Download Full-text

Seroprevalence of Leptospira in Racehorses and Broodmares in New Zealand

Animals ◽

10.3390/ani10111952 ◽

2020 ◽

Vol 10 (11) ◽

pp. 1952

Author(s):

Charlotte F. Bolwell ◽

Chris W. Rogers ◽

Jackie Benschop ◽

Julie M. Collins-Emerson ◽

Brooke Adams ◽

...

Keyword(s):

Risk Factors ◽

New Zealand ◽

Management Practices ◽

Demographic Data ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Level Information ◽

Potential Risk Factors ◽

Thoroughbred Racing

A cross-sectional survey was conducted to determine the seroprevalence of Leptospira in a cohort of horses and to evaluate potential risk factors for Leptospira seropositivity in horses in New Zealand. The convenience sample included 499 Thoroughbred racing and breeding horses from 25 commercial properties in North Island, New Zealand. A questionnaire was used to collect demographic data on horses and property-level information on grazing and management practices, pest (rodent) management, access to natural waterways, other livestock on the property, and possible contact with wildlife. The microscopic agglutination test was used to test sera for serovars Ballum, Copenhageni, Hardjo (bovis), Pomona, and Tarassovi. Logistic regression was used to investigate the risk factors for Leptospira seropositivity to at least one serovar and for each serovar individually. A total of 124 (25%, 95% confidence interval (CI) 21–29%) horses had positive titres to any one of the five serovars. The seroprevalence of Ballum, Copenhageni, Hardjo (bovis), Pomona, and Tarassovi was 5% (95% CI 3–7%), 9% (95% CI 7–12%), 6% (95% CI 4–8%), 6% (95% CI 4–8%), and 6% (95% CI 4–8%), respectively. Broodmares, compared to racehorses and alternately grazing horses with sheep, increased the odds of exposure to any one serovar, whilst grazing the same time as sheep and alternately grazing horses with cattle increased the odds of exposure to Ballum and Hardjo (bovis), respectively. Historical exposure to Leptospira in racing and breeding horses was identified, and risk factors were consistent with pasture-based exposure.

Download Full-text

Drug shortage management: A qualitative assessment of a collaborative approach

PLoS ONE ◽

10.1371/journal.pone.0243870 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0243870

Author(s):

Emily Chen ◽

Susan Goold ◽

Sam Harrison ◽

Iman Ali ◽

Ibtihal Makki ◽

...

Keyword(s):

Management Practices ◽

Qualitative Assessment ◽

Collaborative Approach ◽

Ethical Challenges ◽

Structured Interviews ◽

Drug Shortage ◽

Shared Resource ◽

Drug Shortages ◽

The Impact ◽

Institutional Engagement

Drug shortages frequently and persistently affect healthcare institutions, posing formidable financial, logistical, and ethical challenges. Despite plentiful evidence characterizing the impact of drug shortages, there is a remarkable dearth of data describing current shortage management practices. Hospitals within the same state or region may not only take different approaches to shortages but may be unaware of shortages proximate facilities are facing. Our goal is to explore how hospitals in Michigan handle drug shortages to assess potential need for comprehensive drug shortage management resources. We conducted semi-structured interviews with diverse stakeholders throughout the state to describe experiences managing drug shortages, approaches to recent shortages, openness to inter-institutional engagement, ideas for a shared resource, and potential obstacles to implementation. To solicit additional feedback on ideas for a shared resource gathered from the interviews, we held focus groups with pharmacists, physicians, ethicists, and community representatives. Among participants representing a heterogeneous sample of institutions, three themes were consistent: (1) numerous drug shortage strategies occurring simultaneously; (2) inadequate resources and lead time to proactively manage shortages; and (3) interest in, but varied attitudes toward, a collaborative approach. These data provide insight to help develop and test a shared drug shortage management resource for enhancing fair allocation of scarce drugs. A shared resource may help institutions adopt accepted best practices and more efficiently access or share finite resources in times of shortage.

Download Full-text

From one side to the other: what is essential? Perception of oncology patients and their caregivers in the beginning of oncology treatment and in palliative care

Einstein (São Paulo) ◽

10.1590/s1679-45082014rc3091 ◽

2014 ◽

Vol 12 (4) ◽

pp. 485-491 ◽

Cited By ~ 6

Author(s):

Bruna Antenussi Munhoz ◽

Henrique Soares Paiva ◽

Beatrice Martinez Zugaib Abdalla ◽

Guilherme Zaremba ◽

Andressa Macedo Paiva Rodrigues ◽

...

Keyword(s):

Palliative Care ◽

Demographic Data ◽

Cross Sectional Study ◽

Medical Team ◽

Oncology Patients ◽

Cross Sectional ◽

Care Clinic ◽

Good Communication ◽

Oncology Treatment ◽

In The Beginning

Objective To evaluate the perception of oncology patients and their caregivers upon diagnosis and beginning of the therapy and during palliative care.Methods A cross-sectional study at the oncology and palliative care outpatients clinics of the Faculdade de Medicina do ABC. Clinical and demographic data from patients and their caregivers were collected and questionnaires regarding the elements considered important in relation to the treatment were applied.Results We enrolled 32 patients and 23 caregivers that were initiating treatment at the oncology outpatient clinic, as well as 20 patients and 20 caregivers at the palliative care clinic. Regarding the patients treated at the oncology clinic, the issues considered most important were a physician available to discuss the disease and answer questions (84%), trust in the physician (81%), and a physician with accessible language (81%). For their caregivers, the following issues were considered extremely important: trust in the medical team that treats the patients (96%), and the same medical team taking care of their relatives (87%). As to patients treated at the palliative care clinic, trust in the physician (83%), to be with people considered important to them (78%), and to be treated preserving their dignity (72%) were considered extremely important. For their caregivers, to receive adequate information about the disease and the treatment’s risks and benefits (84%), and sincere communication of information about the disease (79%) were considered extremely relevant.Conclusion Confidence through good communication and consistency in care were fundamental values to achieve satisfaction among caregivers and patients with cancer during all the course of disease development.

Download Full-text