scholarly journals Development and Evaluation of a Mobile Decision Support System for Hypertension Management in the Primary Care Setting in Brazil: Mixed-Methods Field Study on Usability, Feasibility, and Utility (Preprint)

2018 ◽  
Author(s):  
Daniel Vitório Silveira ◽  
Milena Soriano Marcolino ◽  
Elaine Leandro Machado ◽  
Camila Gonçalves Ferreira ◽  
Maria Beatriz Moreira Alkmim ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Cardiovascular Risk ◽  
Care Setting ◽  
Primary Care Setting ◽  
Middle Income Country ◽  
Income Country ◽  
Daily Routine ◽  
Evidence Based ◽  
Middle Income

BACKGROUND Despite being an important cardiovascular risk factor, hypertension has low control levels worldwide. Computerized clinical decision support systems (CDSSs) might be effective in reducing blood pressure with a potential impact in reducing cardiovascular risk. OBJECTIVE The goal of the research was to evaluate the feasibility, usability, and utility of a CDSS, TeleHAS (tele–hipertensão arterial sistêmica, or arterial hypertension system), in the care of patients with hypertension in the context of a primary care setting in a middle-income country. METHODS The TeleHAS app consists of a platform integrating clinical and laboratory data on a particular patient, from which it performs cardiovascular risk calculation and provides evidence-based recommendations derived from Brazilian and international guidelines for the management of hypertension and cardiovascular risk. Ten family physicians from different primary care units in the city of Montes Claros, Brazil, were randomly selected to use the CDSS for the care of hypertensive patients for 6 months. After 3 and 6 months, the feasibility, usability, and utility of the CDSS in the routine care of the health team was evaluated through a standardized questionnaire and semistructured interviews. RESULTS Throughout the study, clinicians registered 535 patients with hypertension, at an average of 1.24 consultations per patient. Women accounted for 80% (8/10) of participant doctors, median age was 31.5 years (interquartile range 27 to 59 years). As for feasibility, 100% of medical users claimed it was possible to use the app in the primary care setting, and for 80% (8/10) of them it was easy to incorporate its use into the daily routine and home visits. Nevertheless, 70% (7/10) of physicians claimed that the time taken to fill out the CDSS causes significant delays in service. Clinicians evaluated TeleHAS as good (8/10, 80% of users), with easy completion and friendly interface (10/10, 100%) and the potential to improve patients’ treatment (10/10, 100%). A total of 90% (9/10) of physicians had access to new knowledge about cardiovascular risk and hypertension through the app recommendations and found it useful to promote prevention and optimize treatment. CONCLUSIONS In this study, a CDSS developed to assist the management of patients with hypertension was feasible in the context of a primary health care setting in a middle-income country, with good user satisfaction and the potential to improve adherence to evidence-based practices.

scholarly journals Engaging primary care providers in managing pediatric eating disorders: a mixed methods study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jocelyn Lebow ◽  
Cassandra Narr ◽  
Angela Mattke ◽  
Janna R. Gewirtz O’Brien ◽  
Marcie Billings ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Mixed Methods ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Care Providers ◽  
Evidence Based Treatment

Abstract Background The primary care setting offers an attractive opportunity for, not only the identification of pediatric eating disorders, but also the delivery of evidence-based treatment. However, constraints of this setting pose barriers for implementing treatment. For interventions to be successful, they need to take into consideration the perspectives of stakeholders. As such, the purpose of this study was to examine in-depth primary care providers’ perspective of challenges to identifying and managing eating disorders in the primary care setting. Methods This mixed methods study surveyed 60 Pediatric and Family Medicine providers across 6 primary care practices. Sixteen of these providers were further interviewed using a qualitative, semi-structured interview. Results Providers (n = 60, response rate of 45%) acknowledged the potential of primary care as a point of contact for early identification and treatment of pediatric eating disorders. They also expressed that this was an area of need in their practices. They identified numerous barriers to successful implementation of evidence-based treatment in this setting including scarcity of time, knowledge, and resources. Conclusions Investigations seeking to build capacities in primary care settings to address eating disorders must address these barriers.

MENSTRUAL PROBLEMS AMONG ADOLESCENT GIRLS (10-19YEARS) IN THE PRIMARY CARE SETTING

2021 ◽  
pp. 40-42
Author(s):  
Manjula M ◽  
M.K.C. Nair ◽  
Babu George ◽  
Leena M L ◽  
Preeja B
Keyword(s):  
Primary Care ◽  
Reproductive Health ◽  
Adolescent Girls ◽  
Premenstrual Syndrome ◽  
Social Life ◽  
Care Setting ◽  
Primary Care Setting ◽  
Premenstrual Dysphoric Disorder ◽  
Primary Data ◽  
Daily Routine

Background: Menstrual problems are common among adolescent girls which can affect their daily routine and quality of life. Early detection and intervention for the menstrual problems can improve future reproductive health. Aims: To nd the prevalence and type of menstrual disorders, premenstrual syndrome and premenstrual dysphoric disorder among adolescents in the primary care setting. This was a community based cross sectional survey done covering Materials and methods: the whole of Thiruvananthapuram district, Kerala..Anganwadis were the primary data collecting units, selected by systematic random sampling. Data was collected using pretested structured questionnaire and validated premenstrual symptoms screening tool. Mean, standard deviation and simple percentage were used. Chi square test was used for nding associations and signicance level. P value <0.05 was taken as signicant. The most common reported Results: problems during menstruation were dysmenorrhoea (73.6%), moderate to severe premenstrual syndrome (13.5%), oligomenorrhoea (12.5%), menorrhagia (8.4%) and premenstrual dysphoric disorder (6.2%).The prevalence of menstrual problems increased as the age increased Conclusions: Majority of adolescents suffer from one or other menstrual problem which can affect their academic and social life. It can also affect their future reproductive health. So school health programs should give emphasis on adolescent menstrual health for a healthy future generation.

scholarly journals Multiple cardiovascular risk factors in adolescents from a middle-income country: Prevalence and associated factors

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0200075
Author(s):  
Thiago Veiga Jardim ◽  
Thomas A. Gaziano ◽  
Flávia Miquetichuc Nascente ◽  
Carolina de Souza Carneiro ◽  
Polyana Morais ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Associated Factors ◽  
Middle Income Country ◽  
Income Country ◽  
Middle Income

scholarly journals Clinical Decision Support Technology to Increase Advance Care Planning in the Primary Care Setting

2010 ◽  
Vol 28 (4) ◽  
pp. 230-235 ◽  
Author(s):  
Ericka E. Tung ◽  
Kristin S. Vickers ◽  
Kandace Lackore ◽  
Rosa Cabanela ◽  
Julie Hathaway ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Advance Care Planning ◽  
Care Setting ◽  
Primary Care Setting ◽  
Clinical Decision ◽  
Care Planning ◽  
Advance Care ◽  
Decision Support Technology

248 Underestimation of Cardiovascular Risk in Patients With Elevated Cardiometabolic Risk in the Canadian Primary Care Setting

2012 ◽  
Vol 28 (5) ◽  
pp. S183-S184
Author(s):  
H. Teoh ◽  
J.P. Després ◽  
D.H. Fitchett ◽  
A. Galluzzi ◽  
L. Goldin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cardiovascular Risk ◽  
Care Setting ◽  
Cardiometabolic Risk ◽  
Primary Care Setting
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