Psychiatric Morbidity in Primary Health Care in Santiago, Chile Preliminary Findings

1994 ◽  
Vol 165 (4) ◽  
pp. 530-533 ◽  
Author(s):  
Ricardo Araya ◽  
Robert Wynn ◽  
Richard Leonard ◽  
Glyn Lewis

BackgroundThe aims were to determine the prevalence of psychiatric morbidity among primary care attenders in a poor suburb of Santiago and to study the relationship with health service use.MethodA cross-sectional survey was made of 163 consecutive attenders to a primary care clinic.ResultsEleven per cent of the sample gave a psychological reason for consultation and the prevalence of psychiatric morbidity was 53%, defined using the revised Clinical Interview Schedule. Women and those of lower socio-economic status were at higher risk. Physicians recognised 14% of the psychiatric morbidity. Attenders with psychiatric morbidity consulted more frequently.ConclusionsThere is a need to improve the recognition and management of psychiatric morbidity in primary care in Chile and other less developed countries. This could lead to the more efficient use of scarce health care resources in primary care.

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Tan CE ◽  
Mohd Roozi AH ◽  
Wong WHR ◽  
Sabaruddin SAH ◽  
Ghani NI ◽  
...  

Introduction: The common cold is the commonest reason for primary care encounters worldwide. This paper aims to describe the reasons that influence patients to seek medical consultation for the common cold. Methods: This was a cross-sectional survey conducted among adult patients of an urban teaching primary care clinic. An adapted bilingual survey form was administered by the researchers to obtain data regarding their decision to seek medical consultation for a cold and the reasons for their decision. Quantitative analyses were done to describe the close-ended responses. Open-ended responses were analysed using a qualitative approach and the frequencies of the themes were reported. Results: A total of 320 respondents participated in this study, with a response rate of 91.4%. They were predominantly females (59.4%), Malay (70.9%), and had tertiary education (65.9%). More than half of the patients (52.5%) said they would seek consultation for cold symptoms. Fever was the commonest symptom (57-61%) which compelled them to seek consultation. The commonest reason for seeking consultation was to get medications (41.7%), whereas the commonest reason not to seek consultation was the practice of self-medication (44.2%). Ethnicity was found to be significantly associated with the decision to seek doctor’s consultation. Conclusion: Colds are usually self-limiting and do not result in complications. Empowering patients by providing appropriate self-care knowledge can help to reduce the burden of primary care services. Patients should be taught about red flag symptoms as well as drug safety for medications commonly taken for colds.


BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023731 ◽  
Author(s):  
Dee Mangin ◽  
Jenna Parascandalo ◽  
Olga Khudoyarova ◽  
Gina Agarwal ◽  
Verdah Bismah ◽  
...  

ObjectiveThere is increasing awareness of the burden of medical care experienced by those with multimorbidity. There is also increasing interest and activity in engaging patients with chronic disease in technology-based health-related activities (‘eHealth’) in family practice. Little is known about patients’ access to, and interest in eHealth, in particular those with a higher burden of care associated with multimorbidity. We examined access and attitudes towards eHealth among patients attending family medicine clinics with a focus on older adults and those with polypharmacy as a marker for multimorbidity.DesignCross-sectional survey of consecutive adult patients attending consultations with family physicians in the McMaster University Sentinel and Information Collaboration practice-based research network. We used univariate and multivariate analyses for quantitative data, and thematic analysis for free text responses.SettingPrimary care clinics.Participants693 patients participated (response rate 70%). Inclusion criteria: Attending primary care clinic. Exclusions: Too ill to complete survey, cannot speak English.ResultsThe majority of participants reported access to the internet at home, although this decreased with age. Participants 70 years and older were less comfortable using the internet compared with participants under 70. Univariate analyses showed age, multimorbidity, home internet access, comfort using the internet, privacy concerns and self-rated health all predicted significantly less interest in eHealth. In the multivariate analysis, home internet access and multimorbidity were significant predictors of disinterest in eHealth. Privacy and loss of relational connection were themes in the qualitative analysis.ConclusionThere is a significant negative association between multimorbidity and interest in eHealth. This is independent of age, computer use and comfort with using the internet. These findings have important implications, particularly the potential to further increase health inequity.


2021 ◽  
Vol 12 ◽  
pp. 215013272110350
Author(s):  
Pasitpon Vatcharavongvan ◽  
Viwat Puttawanchai

Background Most older adults with comorbidities in primary care clinics use multiple medications and are at risk of potentially inappropriate medications (PIMs) prescription. Objective This study examined the prevalence of polypharmacy and PIMs using Thai criteria for PIMs. Methods This study was a retrospective cross-sectional study. Data were collected from electronic medical records in a primary care clinic in 2018. Samples were patients aged ≥65 years old with at least 1 prescription. Variables included age, gender, comorbidities, and medications. The list of risk drugs for Thai elderly version 2 was the criteria for PIMs. The prevalence of polypharmacy and PIMs were calculated, and multiple logistic regression was conducted to examine associations between variables and PIMs. Results Of 2806 patients, 27.5% and 43.7% used ≥5 medications and PIMs, respectively. Of 10 290 prescriptions, 47% had at least 1 PIM. The top 3 PIMs were anticholinergics, proton-pump inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). Polypharmacy and dyspepsia were associated with PIM prescriptions (adjusted odds ratio 2.48 [95% confident interval or 95% CI 2.07-2.96] and 3.88 [95% CI 2.65-5.68], respectively). Conclusion Prescriptions with PIMs were high in the primary care clinic. Describing unnecessary medications is crucial to prevent negative health outcomes from PIMs. Computer-based clinical decision support, pharmacy-led interventions, and patient-specific drug recommendations are promising interventions to reduce PIMs in a primary care setting.


2016 ◽  
Vol 7 (6) ◽  
pp. 106-109
Author(s):  
Leeberk Raja Inbaraj ◽  
Carolin Elizabeth Georg ◽  
Nan Lin Kham ◽  
Gift Norman

Background: Adherence to diet and drugs, blood glucose monitoring, foot care, exercise and early recognition of the complications, are the crucial elements for tertiary prevention of Diabetes Mellitus. Non compliance can lead to poor glycemic control which can eventually aggravate complications and lead to disability and mortality. This study aimed  at estimating prevalence of non-adherence and identify perceptions and practices associated with non-adherence.Materials and Methods: A cross sectional study was conducted in a primary care clinic in a disadvantaged community Hundred patients with Diabetes were recruited and interviewed using a semi-structured questionnaire.Results: Non adherence rate was 30%. Those who are unable to remember multiple doses (37.5%) were 2.77 (95% CI: 0.94-8.15) times more likely to non-adhere to the treatment than those who are able to remember multiple doses (16.7%).Similarly Patients who often discontinued medications and switched over to alternative system medicines tended to be non- adherent 8.5 (95% CI:1.6- 45.0) times more than those who continued treatment without interruption. Non adherence was not associated with age, gender, education level, and cost of medication and duration of diabetes. People who were illiterate and elderly did not know the consequences of missing doses and stopped medications when they felt better as well as resorted to traditional medicinesConclusions: Counselling sessions should focus on perceptions and ideas about diabetes. Innovative health education modalities have to be developed for illiterate and elderly people.Asian Journal of Medical Sciences Vol.7(5) 2016 106-109


AIDS ◽  
1996 ◽  
Vol 10 (9) ◽  
pp. 1033-1039 ◽  
Author(s):  
Constantine G. Lyketsos ◽  
Heidi Hutton ◽  
Marc Fishman ◽  
Joseph Schwartz ◽  
Glenn J. Treisman

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Anak Kelak Johny ◽  
Whye Lian Cheah ◽  
Safii Razitasham

The decision by the patients to disclose traditional and complementary medicine (TCM) use to their doctor is an important area to be explored. This study aimed to determine the disclosure of TCM use and its associated factors to medical doctor among primary care clinic attendees in Kuching Division, Sarawak. It was a cross-sectional study using questionnaire, interviewer administered questionnaire. A total of 1130 patients were screened with 80.2% reporting using TCM. Logistic regression analysis revealed that being female (AOR = 3.219, 95% CI: 1.385, 7.481), perceived benefits that TCM can prevent complication of illness (AOR = 3.999, 95% CI: 1.850, 8.644) and that TCM is more gentle and safer (AOR = 4.537, 95% CI: 2.332, 8.828), perceived barriers of not having enough knowledge about TCM (AOR = 0.530, 95% CI: 0.309, 0.910), patient dissatisfaction towards healthcare providers being too business-like and impersonal (AOR = 0.365, 95% CI: 0.199, 0.669) and paying more for healthcare than one can afford (AOR = 0.413, 95% CI: 0.250, 0.680), and accessibility of doctors (AOR = 3.971, 95% CI: 2.245, 7.023) are the predictors of disclosure of TCM use. An open communication between patients and doctor is important to ensure safe implementation and integration of both TCM and medical treatment.


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