scholarly journals The study on knowledge-attitude-practice of primary care physician toward anticoagulants therapy in Non-valvular atrial fibrillation patients in Shanghai of China

2020 ◽  
Author(s):  
Shasha Ye ◽  
Tianhao Wang ◽  
Arthur Liu ◽  
Ying Yu ◽  
Zhigang Pan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Work Experience ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Bachelor's Degree ◽  
Cluster Sampling ◽  
Primary Role ◽  
Cross Sectional ◽  
Positive Attitudes

Abstract Background As the large number of CHS centers in China face the majority of NVAF patients, primary care physicians (PCPs) play the primary role in the prevention of embolization. Therefore, an awareness of anticoagulant management in NVAF patients must be brought into focus among PCPs in China. This study will help primary care physicians (PCPs) increase their awareness of oral anticoagulant (OAC) therapy for non-valvular atrial fibrillation (NVAF) to prevent embolization.Method This was a cross-sectional observational study of 462 PCPs in community health service (CHS) centers across Shanghai. We used a self-administered questionnaire to collect data from September to December 2017. A stratified random cluster sampling was adopted in the 90 CHS centers with the family medicine residency program.Result Among 462 participants, 69.3% (320/462) of females with a medical bachelor’s degree and more than 10 years of work experience predominated in the 30 to 49 years of age group. The mean score for “knowledge,” “attitude” and “practices” of OAC therapy in NVAF patients among PCPs was 3.68±2.752, 53.62±7.148, and 37.63±10.336, respectively. The level of knowledge of OAC therapy in NVAF patients among PCPs was insufficient in over half (75.8%) of participants. The majority (89.8%) of PCPs had a positive attitude and 68.0% had modest performance in the anticoagulant management of NVAF patients.Conclusion The knowledge and behaviors of PCPs were insufficient in OAC therapy to prevent embolization in NVAF patients. The study also revealed the positive attitudes of participants, and their desire to learn the latest knowledge of OAC therapy.

scholarly journals A study of knowledge, attitudes, and practices of primary care physicians toward anticoagulant therapy in patients with non-valvular atrial fibrillation in Shanghai, China

2020 ◽  
Author(s):  
Shasha Ye ◽  
Tianhao Wang ◽  
Arthur Liu ◽  
Ying Yu ◽  
Zhigang Pan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Anticoagulant Therapy ◽  
Work Experience ◽  
Primary Care Physicians ◽  
Educational Interventions ◽  
Cluster Sampling ◽  
Primary Role ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

Abstract Background:As a large number of Community Health Service (CHS) centers in China face the majority of patients with non-valvular atrial fibrillation (NVAF), primary care physicians (PCPs) play a primary role in the prevention of embolization. Therefore, an awareness of anticoagulant management in patients with NVAF must be brought into focus among PCPs in China. This study investigated PCPs’ knowledge, attitudes, and practices toward anticoagulant therapy in patients with NVAF, to help them understand their shortcomings regarding oral anticoagulant (OAC) therapy in preventing embolization.Method:This was a cross-sectional observational study of 462 PCPs in CHS centers across Shanghai. We used a self-administered questionnaire to collect data from September to December 2017. A stratified random cluster sampling was adopted in the 90 CHS centers with the family medicine residency program.Result:Among 462 participants, 69.3% (320/462) of females received a medical bachelor’s degree and over 50% of participants had more than 10 years of work experience. Each section for knowledge, attitude, and practice were categorized as poor (≤39.0%), fair (40.0%–69.0%), and good (≥70.0%). The level of knowledge of OAC therapy for patients with NVAF among PCPs was insufficient in over half (75.8%) of the participants. The majority (89.8%) of PCPs had a positive attitude and 68.0% had modest performance in the anticoagulant management of patients with NVAF.Conclusions: The knowledge and behaviors of PCPs were insufficient for OAC therapy to prevent embolization in patients with NVAF. The study also revealed that there is good potential for PCPs’ educational interventions to positively impact the care of patients with NVAF.

scholarly journals The study on knowledge - attitude - practice of primarycare physician toward anticoagulant therapy in patients with Non-valvular atrial fibrillation in Shanghai of China

2020 ◽  
Author(s):  
Shasha Ye ◽  
Tianhao Wang ◽  
Arthur Liu ◽  
Ying Yu ◽  
Zhigang Pan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Work Experience ◽  
Primary Care Physicians ◽  
Educational Interventions ◽  
Cluster Sampling ◽  
Primary Role ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Abstract Background: As the large number of Community Health Service (CHS) centers in China face the majority of non-valvular atrial fibrillation (NVAF) patients, primary care physicians (PCPs) play the primary role in the prevention of embolization. Therefore，an awareness of anticoagulant management in NVAF patients must be brought into focus among PCPs in China. This study will investigate PCPs’ Knowledge, Attitude and Practice toward anticoagulant therapy in patients with NVAF and help PCPs increase their awareness of oral anticoagulant (OAC) therapy for NVAF to prevent embolization. Method: This was a cross-sectional observational study of 462 PCPs in CHS centers across Shanghai. We used a self-administered questionnaire to collect data from September to December 2017. A stratified random cluster sampling was adopted in the 90 CHS centers with the family medicine residency program. Result: Among 462 participants, 69.3% (320/462) of females got a medical bachelor’s degree and over 50% participants had more than 10 years of work experience. According to similar study, each section for knowledge, attitude, and practice were categorized as poor (≤39.0%), fair (40.0%–69.0%), and good (≥70.0%) [18] . The level of knowledge of OAC therapy in patients with NVAF among PCPs was insufficient in over half (75.8%) of participants. The majority (89.8%) of PCPs had a positive attitude and 68.0% had modest performance in the anticoagulant management of patients with NVAF. Conclusion: The knowledge and behaviors of PCPs were insufficient in OAC therapy to prevent embolization in patients with NVAF. The study also revealed there is good potential for PCPs’ educational interventions to positively impact on the care of patients with NVAF.

scholarly journals The study on knowledge-attitude-practice of primary care physician toward anticoagulant therapy in patients with Non-valvular atrial fibrillation in Shanghai of China

2020 ◽  
Author(s):  
Shasha Ye ◽  
Tianhao Wang ◽  
Arthur Liu ◽  
Ying Yu ◽  
Zhigang Pan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Anticoagulant Therapy ◽  
Work Experience ◽  
Primary Care Physicians ◽  
Educational Interventions ◽  
Cluster Sampling ◽  
Primary Role ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Abstract Background: As the large number of Community Health Service (CHS) centers in China face the majority of non-valvular atrial fibrillation (NVAF) patients, primary care physicians (PCPs) play the primary role in the prevention of embolization. Therefore，an awareness of anticoagulant management in NVAF patients must be brought into focus among PCPs in China. This study will investigate PCPs’ Knowledge, Attitude and Practice toward anticoagulant therapy in patients with NVAF and help PCPs increase their awareness of oral anticoagulant (OAC) therapy for NVAF to prevent embolization.Method: This was a cross-sectional observational study of 462 PCPs in CHS centers across Shanghai. We used a self-administered questionnaire to collect data from September to December 2017. A stratified random cluster sampling was adopted in the 90 CHS centers with the family medicine residency program. Result: Among 462 participants, 69.3% (320/462) of females got a medical bachelor’s degree and over 50% participants had more than 10 years of work experience. According to similar study, each section for knowledge, attitude, and practice were categorized as poor (≤39.0%), fair (40.0%–69.0%), and good (≥70.0%)[18]. The level of knowledge of OAC therapy in patients with NVAF among PCPs was insufficient in over half (75.8%) of participants. The majority (89.8%) of PCPs had a positive attitude and 68.0% had modest performance in the anticoagulant management of patients with NVAF. Conclusion: The knowledge and behaviors of PCPs were insufficient in OAC therapy to prevent embolization in patients with NVAF. The study also revealed there is good potential for PCPs’ educational interventions to positively impact on the care of patients with NVAF.

scholarly journals General practitioner attitudes and confidence to deprescribing for elderly patients

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Pier Riccardo Rossi ◽  
Sarah E. Hegarty ◽  
Vittorio Maio ◽  
Marco Lombardi ◽  
Andrea Pizzini ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Real Life ◽  
Care Physician ◽  
Local Health Authority ◽  
Local Health ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Factors Affecting

Deprescribing is a patient-centered process of medication withdrawal intended to achieve improved health outcomes through discontinuation of one or more medications that are either potentially harmful or no longer required. The objective of this study was to assess the perceptions of primary care physicians on deprescribing and potential barriers to deprescribing in the Local Health Authority (LHA) of Turin, Piedmont, Italy. Secondary objective was to evaluate educational needs of primary care physician. Cross sectional survey of primary care physicians working in the LHA of Turin, Piedmont, Italy. 439 GPs (71.3% of the total number of primary care physicians) attended an educational session related to deprescribing and were asked to anonymously answer a paper survey. Participants were asked to complete a previously published questionnaire about deprescribing and potential factors affecting the deprescribing process. A correlation coefficient was calculated to assess the association between physicians’ confidence in deprescribing and attitudes or barriers associated with deprescribing. Many GPs (71%) reported general confidence in their ability to deprescribe. Most respondents (83%) reported they were comfortable deprescribing preventive medications, however almost half expressed doubts regarding deprescribing when medication was initially prescribed by a colleague (45%) or when patient and/or caregiver supported the opportunity to continue the assumption (49%). Around a third of doctors maintain that the absence of strong evidence supporting deprescribing prevents them from considering it (38%), that they do not have the necessary time to effectively go through the process of deprescribing (29%), and that fear of possible effects due on withdrawal prevents them from deprescribing (31%). There was no strong correlation between physicians’ confidence and attitudes or barriers associated with deprescribing. The present study confirms that general practitioners sense the importance of deprescribing and feel prepared to face it managing communication with patients and caregivers, but find barriers when enacting the practice in a real-life context.

scholarly journals Knowledge, Attitudes, and Practices towards Diabetic Retinopathy among Primary Care Physicians of Saudi Arabia: A Multicenter Cross-Sectional Study

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1697
Author(s):  
Ashokkumar Thirunavukkarasu ◽  
Abdulmohsen Khaled Almulhim ◽  
Faisal Ahmed Albalawi ◽  
Ziyad Muharib Alruwaili ◽  
Ola Ali Almajed ◽  
...  
Keyword(s):  
Primary Care ◽  
Saudi Arabia ◽  
Diabetic Retinopathy ◽  
Work Experience ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Attitudes And Practices

Primary care physicians play a vital role in preventing the progression of diabetic retinopathy (DR) from the initial stages to the late stages. This questionnaire-based analytical cross-sectional study was carried out to assess the knowledge, attitude, practices, and their correlation among 274 randomly selected primary care physicians in Saudi Arabia. Among the studied population, high knowledge, attitudes, and practice scores were observed in 21.5%, 15%, and 29.2% of the physicians, respectively. The mean knowledge score was significantly higher among the age group of less than 30 years (p = 0.031) and the female gender (p = 0.012). The attitude scores were significantly higher among the Saudi physicians (p = 0.027) and those with PHC work experience of less than five years (p < 0.001). Regarding the practices, a significant association was found among the age group of less than 30 years (p = 0.019) and Saudi physicians (p = 0.003). There was a significant positive correlation between knowledge (correlation coefficient (r) = 0.739, p < 0.001) and attitude (r = 0.479, p = 0.007) with the practice scores. It is recommended that targeted continuous medical education, workshops, and seminars are conducted on the prevention and care of DR among primary care physicians. Furthermore, an exploratory multicenter study that involves primary care physicians belonging to all ministries and private sectors is warranted.

scholarly journals Communication between health professionals and their influence on the coordination of care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M F M Mendes ◽  
I C Samico ◽  
Z M A Hartz
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Diagnostic Errors ◽  
Care Physician ◽  
Primary Role ◽  
Coordination Of Care ◽  
Levels Of Care ◽  
Specialized Care

Abstract Background Problems linked to the coordination of care may represent a lack of communication between levels of care and reflect diagnostic errors, duplication of tests and unnecessary hospitalizations. This study aims to understand the role of communicational relationships between professionals and their influence on coordination between levels of care. Methods An evaluative and qualitative nature research. 24 interviews were carried out, with primary care physicians and specialists, institutional supporters and managers of a public health network in Pernambuco, Brazil. The content thematic analysis worked out sought to identify synergies and contradictions in the relationships between the actors. Results Knowledge about the role of primary care was incomplete, not being understood its primary role as a care provider. The primary care physician was not recognized as the responsible physician by most professionals. The specialists considered the references poorly filled out and showed a lack of confidence in the primary care physician, who in turn revealed that he did not receive any counter-reference and difficulty in contacting a specialist. Few articulation mechanisms have been reported between levels and the use of informal communication mechanisms. The managers acknowledged the existence of problems, but highlighted the commitment of management in the actions for organizing the network. The “goodwill” of the professionals was considered an articulation facilitator, but not a sufficient practice. Conclusions The results allowed to deepen the look at the complexity of the relationships between the actors and how they can influence coordination. Since is perceived the communicational tensions and weaknesses, it is urgent to think of strategies that establish institutionalized spaces for meetings and dialogues that allow articulation among professionals. Key messages The study analyzes communicational relationships between primary and specialized care professionals and their influence on the coordination of care. Strategies for mutual collaboration are mandatory.

scholarly journals Exploring emergency department visits: factors influencing individuals’ decisions, knowledge of triage systems and waiting times, and experiences during visits to a tertiary hospital in Saudi Arabia

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Nawaf Alhabdan ◽  
Faisal Alhusain ◽  
Abdulkareem Alharbi ◽  
Muatassem Alsadhan ◽  
Moath Hakami ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Physicians ◽  
Waiting Times ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Physician ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Validated Questionnaire

Abstract Background In recent years, there has been an increased utilization of emergency departments (EDs) in many countries. Additionally, it is reported that there are major delays in delivering care to ED patients. Longer waiting times are associated with poor patient satisfaction, whereas an understanding of the triage process increases satisfaction. This study aimed to assess ED visitor’s awareness of the triage procedure and their preferences regarding delayed communication. Methods Cross-sectional study of King Abdulaziz Medical City – Emergency Department visitors using a previously validated questionnaire (Seibert 2014) which was translated to Arabic, piloted, and then used for this study. Results A total of 334 questionnaires were returned. The mean age of respondents was 33 years. Regarding primary care physicians, only 16% of respondents said that they have one. About 21% of those tried to communicate with them before coming to the ED. Even though only 11% of respondents knew exactly what triage is, 51% were able to correctly explain why some patients are seen before others. Statistical analysis did not show any factors that are associated with increased knowledge of triage. Most respondents (75%) want to hear updates regarding delays with 69% of them preferring to be updated every 30 min. Conclusions This study showed that the majority of patients do not know what triage means and that most of them want to know how the ED works. Moreover, a lot of respondents said that they do not have a primary care physician. These results support increasing patient awareness by education and involving them if any delay happens.

scholarly journals Atrial fibrillation care in rural communities: a mixed methods study of physician and patient perspectives

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Kathy L. Rush ◽  
Lindsay Burton ◽  
Fransien Van Der Merwe ◽  
Linda Hatt ◽  
Camille Galloway
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Mixed Methods ◽  
Rural Communities ◽  
Primary Care Physicians ◽  
Weight Maintenance ◽  
Care Physician ◽  
Patient Perspectives ◽  
Exercise Intolerance ◽  
Rural Patient

Abstract Background Atrial fibrillation (AF) is a serious heart arrhythmia associated with devastating outcomes such as stroke. Inequitable rural AF care may put patients at risk. Virtually delivered specialty AF care offers a viable option, but stakeholder perceptions of this option within the context of rural AF care is unknown. The study purpose was to obtain patient and primary care physician perspectives of rural AF care and virtually delivered AF care as a potential option. Methods Using a mixed methods design, AF patients (n = 101) and physicians (n = 15) from three rural communities participated in focus groups and/or surveys. Focus group data were thematically analyzed, survey data were descriptively analyzed, and data were triangulated. Results Findings captured patients’ and physicians’ perceptions of prioritized, needs, concerns and problems in AF management, available/unavailable services, and their ideas about virtual AF care. Patients and physicians identified eclectic problems in managing AF. Overall, patients felt ill informed about managing their AF and their most salient problems related to fatigue, exercise intolerance, weight maintenance, sleep apnea, and worry about stroke and bleeding. Physicians found treating patients with co-morbidities and cognitive decline problematic and balancing risks related to anticoagulation challenging. Patients and physicians identified education as a pressing need, which physicians lacked time and resources to meet. Despite available rural services, access to primary and cardiology care was a recurring challenge, and emergency department (ED) use highly contentious but often the only option for accessing care. Physicians’ managed AF care and varied in the referrals they made, often reserving them for complex situations to avoid patient travel. Patients and providers supported a broad approach to virtual AF care, tailored to an inclusive rural patient demographic. Conclusions The study offered valuable physician and patient perspectives on AF care in rural communities including diverse management challenges, gaps in access to primary and specialty services that made ED an often used but contentious option. Findings point to the potential value of virtual care designed to reach patients with AF across the spectrum and geared to local contexts that preserve the vital role of primary care physicians in AF care in their communities.

scholarly journals Abdominal obesity in primary care

2017 ◽  
Vol 4 (4) ◽  
pp. 915 ◽  
Author(s):  
Sethu Prabhu Shankar ◽  
Golepu Kartikeya
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Abdominal Obesity ◽  
Primary Care Physicians ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Care Physician ◽  
Abdominal Circumference ◽  
Age Group ◽  
Cross Sectional

Background: Obesity is one of the important challenge in primary care. Abdominal obesity is associated with future cardiovascular disease when compared to non-obese individuals. The objective was to study the prevalence of abdominal obesity in patients attending primary care physician and to analyse abdominal obesity across different age groups and gender.Methods: The study was done as cross-sectional study at primary care centres in and around Pondicherry. Patients visiting primary care physician were included in the study. All adult patients of age more than 18 years, of both sexes visiting the primary care physician were included in study. Pregnant women, patients with abdomen diseases and patients those who are not willing to give written consent for participation in the study were excluded from the study. Demographic profile, anthropometric measurements were recorded. Abdominal circumference of all patients were recorded using a standard measuring tape. Abdominal obesity was diagnosed when the abdominal circumference was more than 90 centimetres in male and more than 80 centimetres in female.Results: A total number of 1030 patients were included in the study. There were 189 patients in age group 60-69. Females 535 outnumbered males 484. In the age group 50-59, 33 (40%) of males and 45 (44%) of females had increased abdominal circumference more than 90 centimetres in males and 80 centimetres in females. Across all age groups 121 (24%) males had abdominal circumference more than 90 centimetres in the study and 147 (28%) females had abdominal circumference more than 80 centimetres.Conclusions: Abdominal obesity is common at primary care level. The prevalence of abdominal obesity is more in females when compared with males. Hence all primary care physicians have to be stressed about the importance of abdominal obesity. 

Factors Associated With Discussions Regarding Place of Death Preferences Among Older Japanese: A JAGES Cross-Sectional Study

2020 ◽  
Vol 38 (1) ◽  
pp. 54-61
Author(s):  
Yuki Moriki ◽  
Maho Haseda ◽  
Naoki Kondo ◽  
Toshiyuki Ojima ◽  
Katsunori Kondo ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Place Of Death ◽  
Multivariable Logistic Regression Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Community Factors ◽  
Factors Associated

In Japan, many adults prefer to die at home; however, few have their preferences actually come true. While discussions regarding place of death preferences (DPDPs) are important for older adults, they are poorly documented. Therefore, we investigated the factors associated with older Japanese men and women having DPDPs. We used cross-sectional survey data collected for the Japan Gerontological Evaluation Study (JAGES). We applied multivariable logistic regression analysis to calculate the odds ratio (ORs) of having DPDPs separately between men (n = 2,770) and women (n = 3,038) aged ≥ 75 years. We considered 17 potential factors associated with having DPDPs, which were classified as either demographic, healthcare, family, or community factors. Among participants, 50.1% had DPDPs: 1,288 men (44.3%) and 1,619 women (55.7%). Older adults, DPDPs were associated with 5 additional factors; e.g. having a primary care physician (ORs = 1.47 [men] and 1.45 [women]), as were those who gave family and friends advice (ORs = 1.26 [men] and 1.62 [women]), and having people who listened to their concerns (ORs = 1.70 [men] and 1.81 [women]). Among men, DPDPs were associated with 3 additional factors; e.g. humorous conversations with their spouse (OR = 1.60). Among women, only one factor—reading newspapers (OR = 1.43) was associated with having DPDPs. Social networks with primary care physicians, family members, and friends may be important factors in promoting DPDPs. These gender-based differences in older adults relating to DPDPs should be considered when developing interventions to promote advance care planning that includes DPDPs.

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