scholarly journals A qualitative exploratory study of selected physicians’ perceptions of the management of non-communicable diseases at a referral hospital in Zimbabwe

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Alexander Cheza ◽  
Boikhutso Tlou
Keyword(s):  
General Practitioners ◽  
Exploratory Study ◽  
Clinical Symptoms ◽  
Care Delivery ◽  
Clinical Care ◽  
Hospital Setting ◽  
Communicable Diseases ◽  
The Other ◽  
Non Communicable Diseases ◽  
Public Health Burden

Abstract Introduction Non-communicable diseases (NCDs) have recently become a global public health burden and a leading cause of premature death, mainly in low- and middle-income countries (LMICs). The aim of the study was to explore physicians’ perceptions on the availability and quality of clinical care for the management of NCDs. Methods This was a qualitative exploratory study meant to obtain expert perceptions on clinical care delivery for NCDs in one Zimbabwean central hospital setting. Data was collected from participants who consented and was analyzed using Stata version 13. A four-point Likert scale was used to categorize different levels of perceived satisfaction. Findings Twenty-three doctors participated in the study: four female doctors and nineteen males. Nineteen of the doctors were general practitioners, whilst four were specialists. The findings indicated that both categories perceived some shortfalls in clinical care for NCDs. Moreover, the perceptions of general practitioners and specialists were not significantly different. Participants perceived cancer care to be lagging far behind the other three NCDs under study. Care of cardiovascular diseases (CVDs) and diabetes showed mixed perceptions amongst participants, with positive perceptions almost equaling negative perceptions. Furthermore, hypertension was perceived to be clinically cared for better than the other NCDs under consideration. Reasons for the gaps in NCD clinical care were attributed by 33% of the participants to financial challenges; a further 27% to patient behavioral challenges; and 21% to communication challenges. Conclusions The article concludes that care delivery for the selected NCDs under study at CCH need to be improved. Furthermore, it is crucial to diagnose NCDs before patients show clinical symptoms. This helps disease prognosis to yield better care results. The evaluation of doctors’ perceptions indicates the need to improve NCD care at the institution in order to control NCD co-morbidities that may increase mortality.

scholarly journals Cost of care of chronic non-communicable diseases in Jamaican patients: the role of obesity

2016 ◽  
Vol 17 (2) ◽  
pp. 81-95
Author(s):  
Christine M. Fray-Aiken ◽  
Rainford J. Wilks ◽  
Abdullahi O. Abdulkadri ◽  
Affette M. McCaw-Binns
Keyword(s):  
Cost Of Illness ◽  
Hospital Setting ◽  
Indirect Costs ◽  
Communicable Diseases ◽  
Cost Of Care ◽  
Total Direct Cost ◽  
Non Communicable Diseases ◽  
Female Patients ◽  
Per Capita ◽  
The Cost

OBJECTIVE: To estimate the economic cost of Chronic Non-Communicable Diseases (CNCDs) and the portion attributable to obesity among patients in Jamaica.METHODS: The cost-of-illness approach was used to estimate the cost of care in a hospital setting in Jamaica for type 2 diabetes mellitus, hypertension, coronary heart disease, stroke, gallbladder disease, breast cancer, colon cancer, osteoarthritis, and high cholesterol. Cost and service utilization data were collected from the hospital records of all patients with these diseases who visited the University Hospital of the West Indies (UHWI) during 2006. Patients were included in the study if they were between15 and 74 years of age and if female, were not pregnant during that year. Costs were categorized as direct or indirect. Direct costs included costs for prescription drugs, consultation visits (emergency and clinic visits), hospitalizations, allied health services, diagnostic and treatment procedures. Indirect costs included costs attributed to premature mortality, disability (permanent and temporary), and absenteeism. Indirect costs were discounted at 3% rate.RESULTS: The sample consisted of 554 patients (40%) males (60%) females. The economic burden of the nine diseases was estimated at US$ 5,672,618 (males 37%; females 63%) and the portion attributable to obesity amounted to US$ 1,157,173 (males 23%; females 77%). Total direct cost was estimated at US$ 3,740,377 with female patients accounting for 69.9% of this cost. Total indirect cost was estimated at US$ 1,932,241 with female patients accounting for 50.6% of this cost. The greater cost among women was not found to be statistically significant. Overall, on a per capita basis, males and females accrued similar costs-of-illness (US$ 9,451.75 vs. US$ 10,758.18).CONCLUSIONS: In a country with per capita GDP of less than US$ 5,300, a per capita annual cost of illness of US$ 10,239 for CNCDs is excessive and has detrimental implications for the health and development of Jamaica.

scholarly journals Where did all the other non-communicable diseases go?

BMJ ◽  
2011 ◽  
Vol 343 (sep13 2) ◽  
pp. d5785-d5785 ◽  
Author(s):  
G. L. Birbeck
Keyword(s):  
Communicable Diseases ◽  
The Other ◽  
Non Communicable Diseases

scholarly journals The Effectiveness of Health Services Delivered by Community Health Workers on Outcomes Related to Non-Communicable Diseases among Elderly People in Rural Areas: A Systematic Review

2021 ◽  
Author(s):  
Vita Widyasari ◽  
Ferry Fadzlul Rahman ◽  
Kuan-Han Lin ◽  
Jiun-Yi Wang
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
Community Health ◽  
Elderly People ◽  
Rural Areas ◽  
Health Workers ◽  
Intervention Group ◽  
Communicable Diseases ◽  
The Other ◽  
Non Communicable Diseases

Background: The number of elderly and the burden of non-communicable diseases increase with time. Community involvement is expected to be an important prevention agent for their neighbors. This study aimed to determine the effectiveness of health services delivered by community health workers (CHWs) which focus on physiological indices related to non-communicable diseases among elderly people and to explain the health services or interventions carried out by CHWs.   Methods: This systematic review was conducted based on the PRISMA guidelines. PubMed, ProQuest Science Database, Scopus, EBSCOhost CINAHL, and Web of Science were taken as the source of databases. Manual search was also conducted for articles published before March 2019 without time restriction. The quality of each study was assessed using Critical Checklist by Joanna Briggs Institute. Results: Of the 3,275 initial studies retrieved, 4 studies were included in qualitative synthesis analysis. Three studies arranged a face-to-face interview, while the other study was conducted over the phone. All the 4 studies were intervention studies. Three of them showed a significant improvement in mean systolic blood pressure for the intervention group compared to the control group. The other study showed a significant improvement in weight loss for the intervention group. Conclusion: Health services delivered by CHWs was beneficial to elderly people in rural areas on some physiological indices. It suggested that health services delivered CHWs could contribute toward secondary prevention programs.

scholarly journals The outpatient medical care in patients with chronic diseases under dispensary supervision in the conditions of the COVID-19 pandemic. Temporary guidelines. Version 2

2022 ◽  
Vol 20 (8) ◽  
pp. 3172
Author(s):  
O. M. Drapkina ◽  
L. Y. Drozdova ◽  
S. N. Avdeev ◽  
S. A. Boytsov ◽  
E. S. Ivanova ◽  
...  
Keyword(s):  
General Practitioners ◽  
Primary Care Physicians ◽  
Communicable Diseases ◽  
Clinical Aspects ◽  
Non Communicable Diseases ◽  
Family Doctors ◽  
National Medical ◽  
Coronavirus Infection ◽  
Overall Mortality

Guidelines were approved at the meeting of the academic council of the National Medical Research Center for Therapy and Preventive Medicine, Moscow (Protocol No. 10 of 19.10.2021).The aim of these guidelines is to provide primary care physicians with scientifically based algorithms for the implementation of dispensary monitoring in patients with chronic non-communicable diseases in the conditions of the new coronavirus infection (COVID-19) pandemic, including the use of telemedicine technologies.The organization and conduct of high-quality medical follow-up are the most important tasks aimed at both reducing the risks of developing complications of chronic non-communicable diseases and reducing overall mortality, especially in the current conditions of the COVID-19 pandemic. The guidelines contain clinical aspects of dispensary follow-up, general principles of tactics for managing patients with various chronic non-communicable diseases in COVID-19 conditions, in addition, brief checklists with options for interviewing patients with various chronic non-communicable diseases are presented, topical aspects of the interaction of drugs used in the treatment of chronic non-communicable diseases with antiviral drugs are considered.The guidelines are intended for general practitioners, district therapists, general practitioners (family doctors), as well as doctors of other specialties providing primary health care.

scholarly journals Qualitative Evaluation of the General Practitioner Chronic Non-Communicable Diseases Training Programme

2020 ◽  
Author(s):  
Chunyu Zhang ◽  
Fang Fang ◽  
Mingqiang Peng ◽  
Ying Zhao ◽  
Ruixue Liu ◽  
...  
Keyword(s):  
General Practitioner ◽  
General Practitioners ◽  
Outpatient Clinic ◽  
Qualitative Evaluation ◽  
Training Programme ◽  
Communicable Diseases ◽  
Interview Data ◽  
Structured Interviews ◽  
Non Communicable Diseases ◽  
Practitioner Training

Abstract Background: In China, general practitioners have limited ability to provide care for common chronic non-communicable diseases because they lack postgraduate training. In an attempt to improve general practitioners’ skills in this regard, the present authors previously launched the Chronic Non-Communicable Diseases Training Programme. The present study aims to evaluate the effectiveness of this programme.Methods: Thirty-nine trainee general practitioners who participated in the programme underwent semi-structured interviews, which explored how they performed the training, what they achieved from the programme, and their suggestions for future programmes. The interview data were analysed using a thematic analysis approach.Results: Under the guidance of supervisors, the thirty-nine trainee general practitioners completed the structured but individualised training plan, which comprised a four-day basic theory class, three months practicing in a ward, and six months assisting in an outpatient clinic. They reported an improvement in their ability to provide care for chronic non-communicable diseases and perform two-way referral, as well as their communication with patients. They also reported that, since returning to their communities, they had become more confident, were building better relationships with their patients, and had changed their clinic behaviours from copying prescriptions to making medical decisions independently. Their principal suggestion for the training programme was to alter the order of the training, as they preferred to practice in the ward before assisting in the outpatient clinic.Conclusion: The course comprised a learner-centred, practice- and apprenticeship-based, general-practitioner training programme. Given the participants’ progress and the beneficial effects of the programme reported in the interview data, it appears to be worthwhile to extend the General Practitioner Chronic Non-Communicable Diseases Training Programme.

scholarly journals Qualitative evaluation of the general practitioner chronic non-communicable diseases training programme

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chunyu Zhang ◽  
Fang Fang ◽  
Mingqiang Peng ◽  
Ying Zhao ◽  
Ruixue Liu ◽  
...  
Keyword(s):  
General Practitioner ◽  
General Practitioners ◽  
Outpatient Clinic ◽  
Qualitative Evaluation ◽  
Training Programme ◽  
Communicable Diseases ◽  
Interview Data ◽  
Structured Interviews ◽  
Non Communicable Diseases ◽  
Practitioner Training

Abstract Background In China, general practitioners have limited ability to provide care for common chronic non-communicable diseases because they lack postgraduate training. In an attempt to improve general practitioners’ skills in this regard, the present authors previously launched the Chronic Non-Communicable Diseases Training Programme. The present study aims to evaluate the effectiveness of this programme. Methods Thirty-nine trainee general practitioners who participated in the programme underwent semi-structured interviews, which explored how they performed the training, what they achieved from the programme, and their suggestions for future programmes. The interview data were analysed using a thematic analysis approach. Results Under the guidance of supervisors, the thirty-nine trainee general practitioners completed the structured but individualised training plan, which comprised a four-day basic theory class, 3 months practising in a ward, and 6 months assisting in an outpatient clinic. They reported an improvement in their ability to provide care for chronic non-communicable diseases and perform two-way referral, as well as their communication with patients. They also reported that, since returning to their communities, they had become more confident, were building better relationships with their patients, and had changed their clinic behaviours from copying prescriptions to making medical decisions independently. Their principal suggestion for the training programme was to alter the order of the training, as they preferred to practice in the ward before assisting in the outpatient clinic. Conclusion The course comprised a learner-centred, practice- and apprenticeship-based, general-practitioner training programme. Given the participants’ progress and the beneficial effects of the programme reported in the interview data, it appears to be worthwhile to extend the General Practitioner Chronic Non-Communicable Diseases Training Programme.

scholarly journals Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review

Pharmaceutics ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 809
Author(s):  
Emiliene B. Tata ◽  
Melvin A. Ambele ◽  
Michael S. Pepper
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Ethical Issues ◽  
Care Delivery ◽  
Clinical Care ◽  
Cost Effective ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Successful Implementation ◽  
Sub Saharan

Clinical research in high-income countries is increasingly demonstrating the cost- effectiveness of clinical pharmacogenetic (PGx) testing in reducing the incidence of adverse drug reactions and improving overall patient care. Medications are prescribed based on an individual’s genotype (pharmacogenes), which underlies a specific phenotypic drug response. The advent of cost-effective high-throughput genotyping techniques coupled with the existence of Clinical Pharmacogenetics Implementation Consortium (CPIC) dosing guidelines for pharmacogenetic “actionable variants” have increased the clinical applicability of PGx testing. The implementation of clinical PGx testing in sub-Saharan African (SSA) countries can significantly improve health care delivery, considering the high incidence of communicable diseases, the increasing incidence of non-communicable diseases, and the high degree of genetic diversity in these populations. However, the implementation of PGx testing has been sluggish in SSA, prompting this review, the aim of which is to document the existing barriers. These include under-resourced clinical care logistics, a paucity of pharmacogenetics clinical trials, scientific and technical barriers to genotyping pharmacogene variants, and socio-cultural as well as ethical issues regarding health-care stakeholders, among other barriers. Investing in large-scale SSA PGx research and governance, establishing biobanks/bio-databases coupled with clinical electronic health systems, and encouraging the uptake of PGx knowledge by health-care stakeholders, will ensure the successful implementation of pharmacogenetically guided treatment in SSA.

scholarly journals Prevalence and Determinants of Communicable and Non-Communicable Diseases in India

2019 ◽  
Vol 8 (1) ◽  
pp. 34-41
Author(s):  
Pugalenthi . ◽  
Ndanyuzwe Aime
Keyword(s):  
Family Health ◽  
Principal Component ◽  
Component Analysis ◽  
Communicable Diseases ◽  
Married Women ◽  
The Body ◽  
The Other ◽  
Accurate Information ◽  
Non Communicable Diseases ◽  
National Family

The parts and organs communicate with each other to ensure function of the body properly. Communication among various regions of the body is essential for enabling the organism to respond appropriately to find any changes in the internal and external environments. Communicable and non-communicable disorders are often quite complex involving a mixed picture of hypo secretion and hyper secretion. The objectives are to study the regional variations of communicable and non-communicable diseases among the currently married women; to examine the communicable and non-communicable diseases and the various socio-economic and demographic characteristics and to study predictors of communicable and non-communicable diseases with Principal component analysis (PCA). The present study is being made to analyze from National Family Health Survey (NFHS- III) conducted during 2005-06. Total number of sample was 4102 from the collected sample sizes and particularly those who were answered for the above questions were taken for the analysis to find accurate information. To find the predictors of Diabetics, Asthma and Thyroid, Principle Component Analysis (PCA) was used. The analysis part represents that of the communicable and non-communicable diseases like Asthma was experienced by those who do not use LPG/Electricity. It was about 62 percent of respondents were experienced Asthma than the other two diseases (Thyroid and Diabetics). But those diseases were in higher proportion among those who had the level of education was secondary and higher secondary. It indicates that of the communicable and non-communicable diseases Asthma was experienced by 48.6 percent compared to the other two diseases such as Thyroid and diabetics among the respondents.

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