scholarly journals General Practitioners' Propensity to Cooperate With Other Health Professionals in the Management of Patients With Multimorbidity and Polypharmacy: A Cross-sectional Study.

2020 ◽  
Author(s):  
Helene Carrier ◽  
Anna Zaytseva ◽  
Aurélie Bocquier ◽  
Patrick Villani ◽  
Martin Fortin ◽  
...  

Abstract Background. Cooperation between general practitioners (GPs) and other health professionals appears to help reduce the risk of adverse events linked to polypharmacy for patients with multimorbidity. We investigated the existence of different GP profiles according to their opinions and behaviors about such cooperation and studied the association between these profiles and the GPs’ characteristics and deprescribing behaviors.Methods. Between May and July 2016, we performed a cross-sectional survey in a panel of French GPsabout their management of patients with multimorbidity and polypharmacy, focusing specifically on their opinions of healthcare professionals’ roles and interprofessional cooperation. We used an agglomerative hierarchical cluster analysis to identify GP profiles and then multivariable logistic regression models to study their associations with these doctors' characteristics and deprescribing behaviors.Results. We identified four profiles of GPs according to their cooperation propensities: GPs from the “intensive” profile (14%) were favorable to cooperating with various health professionals, including delegating some prescribing tasks to pharmacists; GPs from the "moderate" profile (47%) had favorable opinions about health professionals’ roles, except for this specific task delegation; GPs from the "selective" profile (27%) tended to work only with physicians; GPs from the "low cooperation" profile (12%) didn’t appeared interested in cooperation. These profiles were associated with different professional characteristics.Conclusions. Current health policies encourage interprofessional cooperation for the management of patients with multimorbidity. Our study provides information for understanding disparities among GPs regarding working with other professionals who deal with their patients and suggests possible ways to improve cooperation.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariam John Munyogwa ◽  
Kaloli Sayi Ntalima ◽  
Secilia Ng’weshemi Kapalata

Abstract Background Obesity at the workplace has been associated with symptoms of lower self-esteem, increased individual and employer healthcare costs, increased absenteeism and presenteeism and reduced productivity. Therefore, this study was designed to study the prevalence and correlates of central obesity among formal sector employees in Dodoma City. Methods Study design was a cross-sectional survey conducted from March to June, 2019. Participants were employees from formal sector employment defined as those paid regular monthly wage and with either a secured permanent or temporary contract. Simple random sampling was used to select four out of fifteen large buildings hosting various establishments. Respondents were obtained conveniently and interviewed face to face. Central obesity was defined as a waist circumference greater than 102 cm for males and greater than 88 cm for females. Chi-square test was conducted to assess the differences among the groups. Simple and multiple logistic regression models were fitted to identify the correlates of central obesity. Results A total of 392 respondents (98% response rate) agreed and participated in the study. The overall prevalence of central obesity was found to be 41.8% (164/392). The prevalence of central obesity was significantly higher among females (67.4% p < 0.001), respondents aged ≥51 years (60%, p = < 0.001), administrators (55.1% p = < 0.05), respondents with salary of > 1,000,000 Tanzanian Shilling (TSh.) per month (54.4%, p = < 0.05), respondents who eat homemade meals at the workplace (64.2%, p = < 0.05) and respondents with hypertension (62.5%, p = < 0.05). Correlates of central obesity were found to be female sex (AOR = 9.53; 95% CI: 5.49, 16.78), increased age, eating homemade meals at the workplace (AOR = 2.32; 95% CI: 1.04, 4.19) and hypertension (AOR = 3.15; 95% CI: 1.41, 6.91). Conclusions The present study revealed high prevalence of central obesity among formal sector employees in Dodoma City. Scholars and stakeholders are urged to generate more evidences and design appropriate interventions to curb the situation.


2018 ◽  
Vol 4 (4) ◽  
pp. 00155-2018 ◽  
Author(s):  
Julia Hansen ◽  
Reiner Hanewinkel ◽  
Matthis Morgenstern

The aim of this study was to investigate the association between exposure to electronic cigarette (e-cigarette) advertisements and use of e-cigarettes, combustible cigarettes and hookahs.A cross-sectional survey of 6902 German students (mean age 13.1 years, 51.3% male) recruited in six German states was performed. Exposure to e-cigarette advertisements was measured with self-rated contact frequency to three advertising images. Multilevel mixed-effect logistic regression models were used to assess associations between exposure to e-cigarette advertisement and use of e-cigarettes, combustible cigarettes and hookahs (ever and past 30 days).Overall, 38.8% of the students were exposed to e-cigarette advertisements; ever-use of e-cigarettes was 21.7%, of combustible cigarettes was 21.8% and of hookahs was 23.2%, and poly-use of all three products was 12.4%. Exposure to e-cigarette advertisements was positively related to ever and past 30-day use of e-cigarettes, combustible cigarettes, hookahs and combined use.We concluded that a considerable number of German teenagers are exposed to e-cigarette advertisement. There was a clear exposure–behaviour link, indicating that advertising contact was associated with different kinds of “vaping” and also smoking behaviour. Although causal interpretation is not possible due to the cross-sectional design, findings raise concerns about the current tobacco control policies.


2021 ◽  
Author(s):  
Morrison Asiamah ◽  
Kwadwo Owusu Akuffo ◽  
Pricillia Nortey ◽  
Nina Donkor ◽  
Anthony Danso-Appiah

Abstract Background: Spontaneous reporting of adverse drug reactions (ADR) is an effective means of ensuring postmarketing surveillance of drugs, and health professionals play a cardinal role through voluntary reporting of ADR. However, the pharmacovigilance system in Ghana is plagued with under-reporting issues, which is of public health concern. Method: A questionnaire-based cross-sectional study involving 268 health professionals at Kpone-Katamanso District was carried out. Data on spontaneous reporting of ADR, demographics of participants, knowledge, and attitudes of professionals towards reporting and factors that may influence ADR reporting were collected. Logistic regression models were used to examine the association of the independent variables with spontaneous reporting of ADR.Result: Overall, 77.6% (208) of the 268 respondents had witnessed ADR; however, only 17.3% of the respondents have ever reported an ADR to the FDA. Health professionals who had adequate knowledge on spontaneous reporting of ADR were 51.9%, while 30.3% had very good knowledge of spontaneous reporting of ADR. After statistical adjustment, Age (AOR=2.26, 95%CI= 1.25–4.10), Fear of Legal Consequences (AOR=0.15, 95%CI=0.41–0.51), Time Constraint (AOR=0.3, 95%CI=0.10–0.91), Pharmacovigilance training (AOR= 18.78, 95%CI= 5.46–64.59) and Unavailability of Reporting form (AOR=0.28, 95%CI=0.09– 0.88) were found to be significantly associated spontaneous reporting of ADR. Conclusion: The proportion of health professionals in the Kpone-Katamanso District who spontaneously report observed ADR is low. Our findings underscore the need for the FDA to intensify awareness through media sensitization and engage all relevant stakeholders on the need for the entire population to report ADR.


2021 ◽  
Vol 6 ◽  
Author(s):  
Emmanuel Nii-Boye Quarshie

Background: A growing body of evidence from high-income contexts suggests a strong association between sexual violence victimisation and self-harm and eventual suicide. However, both sexual violence and self-harm among adolescents are still less researched in sub-Saharan African countries, including Ghana.Objectives: To estimate the 12-month prevalence of self-harm, and to describe the associated factors and reported reasons for self-harm among school-going adolescent survivors of sexual violence victimisation during the previous 12 months in urban Ghana.Methods: Analytic data came from a regional-based representative cross-sectional survey including in-school youth (N = 1,723) conducted in 2017 within the Greater Accra Region of Ghana. Of these, 297 (17.2%) self-reported sexual violence victimisation in the previous 12 months; this proportion of the participants (n = 297) was the focus of the current study. Items measuring sexual violence victimisation, self-harm, and correlates were adopted from the 2012 Ghana WHO–Global School-based Student Health Survey and the Child and Adolescent Self-harm in Europe Study. Data analysis involved multivariable logistic regression models.Results: The estimate of self-harm ideation during the previous 12 months was 45.8% (95% CI: 40–52), whereas the estimate of self-harm behaviour was 38.7% (95% CI: 33–44). About two in five of the participants who reported self-harm wanted to die by their last episode of the behaviour. While bullying victimisation was associated with increased odds of self-harm ideation (aOR = 1.97, 95% CI 1.17, 3.31, p = 0.010) and behaviour (aOR = 2.76, 95% CI 1.59, 4.80, p &lt; 0.001), weekly alcohol use (aOR = 2.56, 95% CI 1.32, 4.93, p = 0.005), conflict with parents (aOR = 2.30, 95% CI 1.28, 4.12, p = 0.005), and physical abuse victimisation (aOR = 1.80, 95% CI 1.03, 3.15, p = 0.037) showed strong associations with increased odds of self-harm behaviour in the past 12 months.Conclusions: The evidence underscores the need for both universal and targeted multi-level intervention and prevention programmes to mitigate the offence of sexual violence and reduce the chances of self-harm among adolescent survivors of sexual violence in urban Ghana.


2014 ◽  
Vol 04 (04) ◽  
pp. 028-032
Author(s):  
K.S Sharath ◽  
Manavi Prabhu ◽  
Biju Thomas ◽  
Shamila Shetty

Abstract Objective: The purpose of the study is to estimate the knowledge, attitude and practise of the oral hygiene,and dental treatment, and its correlation with everyday oral hygiene practices among the health care professionals of south canara district ( Karnataka) Methods: A cross sectional survey was conducted on 200 health care professionals between Jan 20th to Feb 20th 2013.Two hundred health professionals were asked to answer a questionnaire containing 15 questions.Data once collected was analysed using SPSS software. Results: 56.3% health professionals visited the dentist once in six months. 26% health professionals felt that unavailability of time is the main factor influencing dental visits. Main cause of taking a dental appointment in 33% subjects was found to be dental caries. 54.6% obtained information on oral hygiene practices through mass media followed by 22.3 % who obtained it directly from the dentist.59.2% brushed their teeth twice daily.50% used medium bristle tooth brush.48.5 % had a brushing time of 3-5 min. 41.5% did not use any other oral hygiene aid.28.64% got scaling done in the last 3-6 months. 56% did not have an habit of using a tooth pick. 43.3% used combination of circular, vertical and horizontal method of brushing.45.5% felt that scaling caused loss of enamel. Conclusion: It appears that knowledge, attitude, and behaviour attitude, practice and knowledge of oral hygiene practices and dental treatment in health care professionals in South Canara district is gud.Though more information needs to be provided about other oral hygiene aids.


2017 ◽  
Vol 21 (6) ◽  
pp. 1065-1074 ◽  
Author(s):  
Rachel C Brown ◽  
Andrew R Gray ◽  
Lee Ching Yong ◽  
Alex Chisholm ◽  
Sook Ling Leong ◽  
...  

AbstractObjectiveDespite evidence linking regular nut consumption with reduced chronic disease risk, population-level intakes remain low. Research suggests nut-promoting advice from doctors facilitates regular nut consumption. However, there is no information on current nut recommendation practices of health professionals. The aim of the present study was to examine the advice provided by health professionals regarding nut consumption.DesignIn this cross-sectional study, participants were invited to complete a survey including questions about their nut recommendation practices.SettingNew Zealand (NZ).SubjectsThe NZ Electoral Roll was used to identify dietitians, general practitioners and practice nurses.ResultsIn total 318 dietitians, 292 general practitioners and 149 practice nurses responded. Dietitians were more likely (82·7 %) to recommend patients increase consumption of nuts than general practitioners (55·5 %) and practice nurses (63·1 %; both P<0·001). The most popular nuts recommended were almonds, Brazil nuts and walnuts, with most health professionals recommending raw nuts. The most common recommendation for frequency of consumption by dietitians and practice nurses was to eat nuts every day, while general practitioners most frequently recommended 2–4 times weekly, although not statistically significantly different between professions. Dietitians recommended a significantly greater amount of nuts (median 30 g/d) than both general practitioners and practice nurses (20 g/d; both P<0·001).ConclusionsDietitians were most likely to recommend consumption of nuts in accordance with current guidelines, but there are opportunities to improve the adoption of nut consumption recommendations for all professions. This may be a viable strategy for increasing population-level nut intakes to reduce chronic disease.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Willemijn L. A. Schäfer ◽  
Michael J. van den Berg ◽  
Peter P. Groenewegen

Abstract Background The workload of general practitioners (GPs) and dissatisfaction with work have been increasing in various Western countries over the past decades. In this study, we evaluate the relation between the workload of GPs and patients’ experiences with care. Methods We collected data through a cross-sectional survey among 7031 GPs and 67,873 patients in 33 countries. Dependent variables are the patient experiences on doctor-patient communication, accessibility, continuity, and comprehensiveness of care. Independent variables concern the workload measured as the GP-reported work hours per week, average consultation times, job satisfaction (an indicator of subjective workload), and the difference between the workload measures of every GP and the average in their own country. Finally, we evaluated interaction effects between workload measures and what patients find important in a country and the presence of a patient-list system. Relationships were determined through multilevel regression models. Results Patients of GPs who are happier with their work were found to experience better communication, continuity, access, and comprehensiveness. When GPs are more satisfied compared to others in their country, patients also experience better quality. When GPs work more hours per week, patients also experience better quality of care, but not in the area of accessibility. A longer consultation time, also when compared to the national average, is only related to more comprehensive care. There are no differences in the relationships between countries with and without a patient list system and in countries where patients find the different quality aspects more important. Conclusions Patients experience better care when their GP has more work hours, longer consultation times, and especially, a higher job satisfaction.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Babar Irfan ◽  
Ibrahim Zahid ◽  
Muhammad Sharjeel Khan ◽  
Omar Abdul Aziz Khan ◽  
Shayan Zaidi ◽  
...  

Abstract Background Basic Life Support (BLS) is the recognition of sudden cardiac arrest and activation of the emergency response system, followed by resuscitation, and rapid defibrillation. According to WHO, Pakistan has one of the highest mortality rates from accidental deaths therefore assessment and comparison of BLS knowledge in health professionals is crucial. We thereby aim to assess and compare the knowledge of BLS in doctors, dentists and nurses. Methods A multi-centric cross-sectional survey was conducted in Karachi at different institutions belonging to the private as well as government sector from January to March 2018. We used a structured questionnaire which was adapted from pretested questionnaires that have been used previously in similar studies. Descriptive statistics were analyzed using SPSS v22.0, where adequate knowledge was taken as a score of at least 50%. P < 0.05 was considered as significant. Logistic regression was used to identify the factors affecting the knowledge regarding BLS in health care professionals. Results The responders consisted of 140 doctors, nurses and dentists each. Only one individual (dentist) received a full score of 100%. In total, 58.3% of the population had inadequate knowledge. Average scores of doctors, dentists and nurses were 53.5, 43.3 and 38.4% respectively. Doctors, participants with prior training in BLS and those with 6 to 10 years after graduation were found to be a significant predictor of adequate knowledge, on multivariate analysis. Conclusion Even though knowledge of BLS in doctors is better than that of dentists and nurses, overall knowledge of health care professionals is extremely poor. Present study highlights the need for a structured training of BLS for health care workers.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029357
Author(s):  
Hannelore Storms ◽  
Bert Aertgeerts ◽  
Frank Vandenabeele ◽  
Neree Claes

ObjectivesTo support patients in their disease management, providing information that is adjusted to patients’ knowledge and ability to process health information (ie, health literacy) is crucial. To ensure effective health communication, general practitioners (GPs) should be able to identify people with limited health literacy. To this end, (dis)agreement between patients’ health literacy and GPs’ estimations thereof was examined. Also, characteristics impacting health literacy (dis)agreement were studied.DesignCross-sectional survey of general practice patients and GPs undertaken in 2016–17.SettingForty-one general practices in two Dutch-speaking provinces in Belgium.ParticipantsPatients (18 years of age and older) visiting general practices. Patients were excluded when having severe impairments (physical, mental, sensory).Main outcome measuresPatients’ health literacy was assessed with 16-item European Health Literacy Survey Questionnaire. GPs indicated estimations on patients’ health literacy using a simple scale (inadequate; problematic; adequate). (Dis)agreement between patients’ health literacy and GPs’ estimations thereof (GPs’ estimations being equal to/higher/lower than patients’ health literacy) was measured using Kappa statistics. The impact of patient and GP characteristics, including duration of GP–patient relationships, on this (dis)agreement was examined using generalised linear logit model.ResultsHealth literacy of patients (n=1375) was inadequate (n=201; 14.6%), problematic (n=299; 21.7%), adequate (n=875; 63.6%). GPs overestimated the proportion patients with adequate health literacy: adequate (n=1241; 90.3%), problematic (n=130; 9.5%) and inadequate (n=4; 0.3%). Overall, GPs’ correct; over-/underestimations of health literacy occurred for, respectively, 60.9%; 34.2%; 4.9% patients, resulting in a slight agreement (κ=0.033). The likelihood for GPs to over-/underestimate patients’ health literacy increases with decreasing educational level of patients; and decreasing number of years patients have been consulting with their GP.ConclusionsIntuitively assessing health literacy is difficult. Patients’ education, the duration of GP–patient relationships and GPs’ gender impact GPs’ perceptions of patients’ health literacy.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Mariam John Munyogwa ◽  
Abdalla Hussein Mtumwa

Introduction. Overweight and obesity are a threat to the public health following their association with noncommunicable diseases, such as type 2 diabetes mellitus, cardiovascular disease, and some cancers. Despite this fact, the information on overweight and obesity, particularly in most developing countries, is still scarce to address the problem. This article partly addresses the gap through the findings of a cross-sectional survey that was conducted in Dodoma Region, Central Tanzania, to determine the prevalence and correlates of abdominal obesity among adults. Methods. Using a community-based cross-sectional survey, data were generated from the participants who aged 18 years and above. Simple random sampling and Kish selection table techniques were used to get the sample who responded through a face-to-face-administered questionnaire. Waist circumference was measured using the guideline of the WHO protocol of measuring waist and hip circumference. Abdominal obesity is defined as a condition with waist circumference >102 cm for men and >88 cm for women. Prevalence was computed with a 95% confidence interval. Simple and multiple logistic regression models were fitted to identify the risk factors associated with abdominal obesity. Results. A total of 840 respondents took part in the study. The overall prevalence of abdominal obesity was found to be 24.88% (209/840). The prevalence of abdominal obesity was significantly higher among women than men (35.14% vs. 6.89%, p<0.0001) and higher among urban dwellers (33.56%) than their rural counterparts (15.56%). Correlates of abdominal obesity was found to be gender, marital status, place of residence, age, education level, and the time used in watching television. Conclusion. This study revealed a high prevalence of abdominal obesity among the people living in the Dodoma Region. Increased age, urban residence, more time spent on television, less walking per day, and being ever married were all associated with having abdominal obesity in this population.


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