scholarly journals Oncology Guidelines Usage in a Low- and Middle-Income Country

2018 ◽  
pp. 1-6 ◽  
Author(s):  
Nofisat Ismaila ◽  
Omolola Salako ◽  
Jimoh Mutiu ◽  
Oladeji Adebayo
Keyword(s):  
Treatment Guidelines ◽  
Guideline Implementation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Patients With Cancer ◽  
Radiation Oncologists ◽  
Local Setting ◽  
American Society ◽  
Low And Middle Income

Purpose There is a paucity of data about current usage of oncology guidelines in low- and middle-income countries (LMICs), specifically in terms of the availability and quality of those guidelines. Our objective was to determine usage of oncology guidelines and the barriers and facilitators to their usage among radiation oncologists in LMICs. Methods An online cross-sectional survey was conducted among practicing radiation oncologists in Nigeria via e-mail and the social media database of the Association of Radiation and Clinical Oncologists of Nigeria. In addition, paper questionnaires were administered at regional clinical meetings. Results The survey response rate was 53.4% in a sample of 101 radiation oncologists from the database. Sixty-nine percent of respondents were consultants and 30% were residents. Approximately 43% had < 5 years’ experience. All of the respondents were involved in administering chemotherapy during the treatment of patients with cancer, whereas approximately half were involved in diagnosing cancer. Ninety-three percent reported using guidelines in treating patients, the top two guidelines being those from the National Comprehensive Cancer Network (90%) and the American Society of Clinical Oncology (50%). The two major barriers to guideline usage were that facilities were inadequate for proper guideline implementation and that the information in guidelines were too complex to understand. Potential facilitators included providing adequate facilities, developing local guidelines, and increasing awareness of guideline usage. Conclusion Our study shows that clinicians involved in the treatment of patients with cancer in LMICs are aware of cancer treatment guidelines. However, implementation of these guidelines hinders their usage because the facilities are inadequate, guidelines are not applicable to the local setting, and the information in the guidelines is too complex.

scholarly journals Oncology guidelines usage in a low and middle-income country.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18211-e18211
Author(s):  
Nofisat Ismaila ◽  
Omolola Salako ◽  
Adebayo Oladeji
Keyword(s):  
Cancer Patients ◽  
Treatment Guidelines ◽  
Guideline Implementation ◽  
Healthcare Providers ◽  
Developed Countries ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Middle Income ◽  
Low And Middle Income

e18211 Background: Healthcare providers often rely on clinical practice guidelines to help inform and optimize patient care. However, most of these guidelines are from reputable organizations that are based in developed countries. There is a paucity of data about the status of guidelines in low and middle-income countries (LMIC), specifically in terms of their availability, usage and quality. Objective: To determine utilization of oncology guideline and potential barriers to usage in a LMIC among clinical and radiation oncologist (RADONCS) Methods: A cross-sectional survey was conducted with the use of an online questionnaire that was administered to practicing RADONCS in Nigeria via the Association’s email and social media database. In addition, paper questionnaires were administered in person at regional clinical meetings. Results: Survey response rate was 53.4% in a sample of 101 RADONCS from the database. Sixty-nine percent of respondents were consultants and 30% were residents. About 17% had greater than ten years’ experience managing cancer patients, while 43% had less than five years’ experience. All of the respondents are involved in the chemotherapy administration while only about half are involved in the screening and diagnosis of cancer patients. Ninety-three percent report using guidelines in managing patients and the top 3 guidelines used were National Comprehensive Cancer Network (90%), American Society of Clinical Oncology (50%) and European Society of Medical Oncology (46%). The major three barriers to guideline utilization were inadequate facilities for proper guideline implementation, the guideline is not applicable to setting and information in guideline is overwhelming. Potential facilitators include providing adequate facilities, developing local guidelines and increase awareness on the use of guidelines. Almost all respondents are in favour of using guidelines that are adapted to their practice setting. Conclusions: Our study shows that clinicians involved in the management of cancer patients in a LMIC are aware of cancer treatment guidelines. However, issues like inadequate facilities, inapplicability of guideline to local setting and complexity of information in guidelines hinder their usage.

scholarly journals Implementing treatment guidelines for ambulance services in a low- and middle income setting

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Carlsson ◽  
V Blaku ◽  
H Lidberg ◽  
R Hodza-Beganovic ◽  
P Berggren
Keyword(s):  
Treatment Guidelines ◽  
Implementation Process ◽  
Service Organizations ◽  
Hospital Treatment ◽  
Organizational Decision Making ◽  
Local Conditions ◽  
Middle Income ◽  
Daily Work ◽  
Local Setting ◽  
Low And Middle Income

Abstract Background The use of clinical practice guidelines in clinical and organizational decision-making improves the care of patients and patient safety. Guidelines make healthcare consistent and efficient. In many low- and middle income countries healthcare workers depend on guidelines developed in higher income countries. For these to be useful and accepted they need to be adapted to the local setting. The aim of the study was to implement pre-hospital treatment guidelines into an organization that was not currently using guidelines. The study was partnership between a Swedish pre-hospital training organization and local ambulance service organizations in Kosovo. Methods An iterative process of implementing the guidelines was used: Identify guidelines appropriate for the local organization.In sets of five, have the guidelines translated into Albanian.Adapt the guidelines to the local conditions and context.Approval of guidelines by an expert group.Begin using the guidelines within the target organization. Results The first set of five guidelines was translated, approved, and implemented into the organizations. To improve acceptance, both practitioners and decision-makers were involved in the process. Seven workshops were held, with a total of 104 participants. In follow-up discussions participants said they accepted the guidelines and that they would be useful in their daily work. Conclusions It is important to evaluate to what extent the guidelines have been accepted, understood, and used. The success and acceptance is due to the flexible procedure managing the full implementation process. Adapting guidelines to fit with local needs and requirements using local experts made the guidelines accessible and useful. The workshop discussions established justification and approval. Key messages Involve local experts in contextualising guidelines to increase acceptance from the start. Support building a robust local implementation organization to assist and administer change.

scholarly journals Gaps in Capacity in Primary Care in Low-Resource Settings for Implementation of Essential Noncommunicable Disease Interventions

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
S. Mendis ◽  
Igbal Al Bashir ◽  
Lanka Dissanayake ◽  
Cherian Varghese ◽  
Ibtihal Fadhil ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Information ◽  
Health Financing ◽  
Noncommunicable Disease ◽  
Noncommunicable Diseases ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Objective.The objective was to evaluate the capacity of primary care (PC) facilities to implement basic interventions for prevention and management of major noncommunicable diseases (NCDs), including cardiovascular diseases and diabetes.Methods.A cross-sectional survey was done in eight low- and middle-income countries (Benin, Bhutan, Eritrea, Sri Lanka, Sudan, Suriname, Syria, and Vietnam) in 90 PC facilities randomly selected. The survey included questions on the availability of human resources, equipment, infrastructure, medicines, utilization of services, financing, medical information, and referral systems.Results and Conclusions.Major deficits were identified in health financing, access to basic technologies and medicines, medical information systems, and the health workforce. The study has provided the foundation for strengthening PC to address noncommunicable diseases. There are important implications of the findings of this study for all low- and middle-income countries as capacity of PC is fundamental for equitable prevention and control of NCDs.

scholarly journals What Caused My Cancer? Cancer Patients’ Perceptions on What May Have Contributed to the Development of Their Cancer: A Cross-Sectional, Cross-Country Comparison Study

2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986378 ◽  
Author(s):  
Alix Hall ◽  
Sang Minh Nguyen ◽  
Lisa Mackenzie ◽  
Rob Sanson-Fisher ◽  
Ian Olver ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cancer Patients ◽  
Public Awareness ◽  
Sun Exposure ◽  
Evidence Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Patients With Cancer ◽  
Awareness Campaigns

Accurate public perceptions on the risk factors associated with cancer are important in promoting primary, secondary, and tertiary prevention. Limited studies have explored this topic among patients with cancer in non-western, low-to-middle-income countries. A cross-sectional survey to compare Australian and Vietnamese cancer patients’ perceptions of what caused their cancer was undertaken. Adult, patients with cancer from both countries, receiving radiotherapy treatment completed a standardized survey, which included a 25-item module assessing their beliefs on the causes of their cancer. Items ranged from known evidence-based causes (eg, smoking, sun exposure) to non-evidence-based beliefs (eg, stress or anxiety, physical injury, or trauma). Country-specific logistic regression analyses were conducted to identify differences in the determinants of patients’ top perceived causes. A total of 585 patient surveys were completed (75% response rate; 285 from Australia, and 300 from Vietnam). Most patients were male (58%) and aged 60 years and older (55%). The most frequently reported risk factor overall and for the Australian sample was “getting older” (overall = 42%, Australia = 49%, and Vietnam = 35%). While the most frequently reported risk factor for the Vietnamese sample was “poor diet” (overall = 39%, Australia = 11%, and Vietnam = 64%). There were differences in the characteristics associated with the top causes of cancer identified by Australian and Vietnamese patients. Patients’ beliefs about what may have caused their cancer are complex and likely to be impacted by multiple factors, including the country from which they reside. Developing public awareness campaigns that are accurate and tailored to address the specific beliefs and possible misconceptions held by the target community are needed.

scholarly journals Cannabis use and suicide attempts among 86,254 adolescents aged 12–15 years from 21 low- and middle-income countries

2018 ◽  
Vol 56 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Andre F. Carvalho ◽  
Brendon Stubbs ◽  
Davy Vancampfort ◽  
Stefan Kloiber ◽  
Michael Maes ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Cannabis Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Public Health Policies ◽  
Middle Income Countries ◽  
School Based ◽  
Confounding Variables ◽  
Low And Middle Income

AbstractBackground: Evidence suggests that cannabis use may be associated with suicidality in adolescence. Nevertheless, very few studies have assessed this association in low- and middle-income countries (LMICs). In this cross-sectional survey, we investigated the association of cannabis use and suicidal attempts in adolescents from 21 LMICs, adjusting for potential confounders.Method: Data from the Global school-based Student Health Survey was analyzed in 86,254 adolescents from 21 countries [mean (SD) age = 13.7 (0.9) years; 49.0% girls]. Suicide attempts during past year and cannabis during past month and lifetime were assessed. Multivariable logistic regression analyses were conducted.Results: The overall prevalence of past 30-day cannabis use was 2.8% and the age-sex adjusted prevalence varied from 0.5% (Laos) to 37.6% (Samoa), while the overall prevalence of lifetime cannabis use was 3.9% (range 0.5%–44.9%). The overall prevalence of suicide attempts during the past year was 10.5%. Following multivariable adjustment to potential confounding variables, past 30-day cannabis use was significantly associated with suicide attempts (OR = 2.03; 95% CI: 1.42–2.91). Lifetime cannabis use was also independently associated with suicide attempts (OR = 2.30; 95% CI: 1.74–3.04).Conclusion: Our data indicate that cannabis use is associated with a greater likelihood for suicide attempts in adolescents living in LMICs. The causality of this association should be confirmed/refuted in prospective studies to further inform public health policies for suicide prevention in LMICs.

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