Current Practice of Imaging-Guided Interventional Procedures in Rheumatic and Musculoskeletal Diseases: Results of a Multinational Multidisciplinary Survey

Objectives: To investigate opinion and routine practice of specialists from different disciplines on imaging techniques for interventional procedures related to rheumatic and musculoskeletal diseases (RMDs).Methods: An English-language questionnaire was developed by an international working group and distributed to health care providers of various disciplines involved in the care of people with RMDs via an online survey tool (SoSci Survey®) from December 2019 to May 2020.Results: A total of 1,105 respondents from 56 countries completed the survey, over 60% of participants were rheumatologists. The majority of respondents (88%) performed interventional procedures in RMDs patients and 90% of them used imaging guidance. Ultrasonography was the most frequently used technique, particularly among rheumatologists. X-ray and computed tomography were mainly used by radiologists. A discrepancy emerged between the importance assigned to certain items such as the availability of a second operator and their actual implementation in clinical practice. Local barriers, lack of resources and facilities were mentioned as the most relevant obstacles in this regard. Lack of training on imaging and/or imaging guided procedures did not emerge as a barrier to perform such interventions; in fact, 19% of respondents performing the procedures indicated not to have received adequate training in this field.Conclusions: This is the first multinational multidisciplinary survey exploring in detail the opinions and practice on imaging guidance for interventional procedures in RMDs. A harmonization of protocols based on international guidelines, along with adequate training programmes and interventions on barriers at national/local levels are the main unmet needs requiring attention.

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Influence of COVID-19 pandemic on decisions for the management of people with inflammatory rheumatic and musculoskeletal diseases: a survey among EULAR countries

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-218697 ◽

2020 ◽

pp. annrheumdis-2020-218697

Author(s):

Christian Dejaco ◽

Alessia Alunno ◽

Johannes WJ Bijlsma ◽

Annelies Boonen ◽

Bernard Combe ◽

...

Keyword(s):

Symptom Onset ◽

Working Group ◽

Online Survey ◽

English Language ◽

Musculoskeletal Diseases ◽

Treatment Decisions ◽

Treat To Target ◽

Remote Consultation ◽

Survey Tool ◽

Containment Measures

ObjectivesTo investigate how the first wave of COVID-19 pandemic influenced decisions of rheumatologists and health professionals in rheumatology regarding the management of patients with inflammatory rheumatic and musculoskeletal diseases (RMDs).MethodsAn English-language questionnaire was developed by a EULAR working group and distributed via national rheumatology societies of EULAR countries, EMEUNET and individual working group members. Responses were collected using an online survey tool. Descriptive statistics were calculated.ResultsWe analysed 1286 responses from 35/45 EULAR countries. Due to containment measures, 82% of respondents indicated cancellation/postponement of face-to-face visits of new patients (84% of them offering remote consultation) and 91% of follow-up visits (96% with remote consultation). The majority of respondents (58%) perceived that the interval between symptom onset and first rheumatological consultations was longer during containment restrictions than before. Treatment decisions were frequently postponed (34%), and the majority (74%) of respondents stated that it was less likely to start a biological disease modifying anti-rheumatic drug (DMARD)/targeted synthetic DMARD during the pandemic, mainly because of patients’ fear, limited availability of screening procedures and decreased availability of rheumatological services. Use of (hydroxy)chloroquine (HCQ) and tocilizumab (TCZ) for the COVID-19 indication was reported by 47% and 42% of respondents, respectively, leading to a shortage of these drugs for RMDs indications according to 49% and 14% of respondents, respectively.ConclusionMeasures related to containment of COVID-19 pandemic led to a perceived delay between symptom onset and a first rheumatological visit, postponement of treatment decisions, and shortage of HCQ and TCZ, thereby negatively impacting early treatment and treat-to-target strategies.

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Reopening Oral Health Services during the COVID-19 Pandemic through a Knowledge Exchange Coalition

JDR Clinical & Translational Research ◽

10.1177/23800844211011985 ◽

2021 ◽

pp. 238008442110119

Author(s):

M. McNally ◽

L. Rock ◽

M. Gillis ◽

S. Bryan ◽

C. Boyd ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Services ◽

Return To Work ◽

Health Care Providers ◽

Online Survey ◽

Knowledge Exchange ◽

Oral Health Care ◽

Care Providers ◽

Oral Health Services

Background: The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work. Methods: Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic. Results: Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic. Conclusions: A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings. Knowledge Transfer Statement: The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.

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The Use of and Attitude Towards Telehealth in Rural Communities

Australian Journal of Primary Health ◽

10.1071/py07035 ◽

2007 ◽

Vol 13 (3) ◽

pp. 29 ◽

Cited By ~ 4

Author(s):

Emily Mauldon

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Routine Practice ◽

Care Providers ◽

Urban Hospital ◽

Primary Health ◽

The Impact ◽

Rural Patients

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.

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An Evaluation of the Self-Reported Knowledge Base of Disaster Management Core Competencies of Australian Paramedics

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19002814 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s129-s130

Author(s):

Peter Horrocks ◽

Vivienne Tippett ◽

Peter Aitken

Keyword(s):

Health Care ◽

Disaster Management ◽

Health Care Providers ◽

Health Care Professionals ◽

Disaster Response ◽

Online Survey ◽

Core Competencies ◽

Ambulance Service ◽

Care Providers ◽

Extensive Experience

Introduction:Evidence-based training and curriculum are seen as vital in order to be successful in preparing paramedics for an effective disaster response. The creation of broadly recognized standard core competencies to support the development of disaster response education and training courses for general health care providers and specific health care professionals will help to ensure that medical personnel are truly prepared to care for victims of mass casualty events.Aim:To identify current Australian operational paramedic’s specific disaster management education and knowledge as it relates to disaster management core competencies identified throughout the literature and the frequency of measures/techniques which these paramedics use to maintain competency and currency.Methods:Paramedics from all states of Australia were invited to complete an anonymous online survey. Two professional bodies distributed the survey via social media and a major ambulance service was surveyed via email.Results:The study population includes 130 respondents who self-identified as a currently practicing Australian paramedic. Paramedics from all states except South Australia responded, with the majority coming from Queensland Ambulance Service (N= 81%). In terms of experience, 81.54% of respondents report being qualified for greater than 5 years. Initial analysis shows that despite the extensive experience of the practitioners surveyed when asked to rate from high to low their level of knowledge of specific disaster management core competencies a number of gaps exist.Discussion:Core competencies are a defined level of expertise that is essential or fundamental to a particular job, and serve to form the foundation of education, training, and practice for operational service delivery. While more research is needed, these results may help inform industry, government, and education providers to better understand and to more efficiently provide education and ongoing training to paramedics who are responsible for the management of disaster within the Australian community.

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P003 INFLAMMATORY BOWEL DISEASE PATIENTS’ PERSPECTIVES OF CLINICAL TRIALS

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.133 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S53-S53

Author(s):

David Rubin ◽

Laurent Peyrin-Biroulet ◽

Walter Reinisch ◽

Swati Tole ◽

Laura Sullivan ◽

...

Keyword(s):

Health Care ◽

Clinical Trial ◽

Clinical Trials ◽

Health Care Providers ◽

Online Survey ◽

The United States ◽

Trial Participation ◽

Pharmaceutical Manufacturer ◽

Care Providers ◽

Inflammatory Bowel

Abstract Background Despite recent progress in treatment for inflammatory bowel diseases (IBD), there is a need for therapies with long-term efficacy and improved safety. Clinical trials in IBD face challenges with patient recruitment because of study designs, competitive or overlapping trials, and a limited number of eligible patients. We sought to better understand patients’ motivations, awareness of, and experience with IBD clinical trials. Methods We conducted an international survey of adult patients with IBD consisting of 2 components. The quantitative component, a 15-minute online survey, was completed by all patients. A qualitative component, a 30-minute telephone interview, was completed by a subset of patients from the United States (US). All percentages indicate results from the online survey. Results 226 patients (mean age, 41.9 y) completed the online survey. Survey respondents included patients with ulcerative colitis (52%) and Crohn’s disease (48%) from the US (n=100, 21 of whom underwent a phone interview), Brazil (n=26), Canada (n=25), France (n=25), Germany (n=25), and Spain (n=25). Ninety-six percent of respondents reported at least a basic understanding of clinical trials, and 34 (15%) were current or past clinical trial participants. Patients reported learning about trials through 1 or more sources (could select as many as applied): health care providers (42%), pharmaceutical manufacturer websites (31%), social media (30%), online support groups (28%), and foundations (18%-23%). In the survey, patients rated conversations with health care providers most helpful, but patients who were interviewed revealed that most physicians often do not initiate conversations about clinical trials, and patients typically do not ask. Primary motivators for trial participation (rated from “does not encourage me at all” to “encourages me very much”) included altruistic goals of advancing medicine (67%), potentially mitigating risks of uncontrolled IBD such as colon cancer (59%), and access to treatment options that could improve quality of life (59%) or would otherwise be unaffordable (52%). Major barriers to participation (rated from “does not discourage me at all” to “discourages me very much”) included invasive screening and monitoring (35%), concern over receiving placebo (35%), or suboptimal treatment (33%), and concerns about posttrial access to study medication (27%). The majority (68%) reported that being in a clinical trial means being a “guinea pig” for an experimental treatment. Conclusion Opportunities to improve patients’ clinical trial experience in IBD include better communication with health care providers and improved patient education about clinical trial design and ethics. Ultimately, a better understanding of the patient perspective will be important for more informed patients and potentially higher recruitment and enrollment.

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Development of an Instrument to Measure Community Acceptance of Nurse Practictioners and Physician Assistants

Journal of Nursing Measurement ◽

10.1891/1061-3749.7.1.63 ◽

1999 ◽

Vol 7 (1) ◽

pp. 63-77 ◽

Cited By ~ 3

Author(s):

Lynn C. Baer ◽

Kathleen A. Baldwin ◽

Rebecca J. Sisk ◽

Parris Watts ◽

Margaret S. Grinslade ◽

...

Keyword(s):

Factor Analysis ◽

Rural Communities ◽

Health Care Providers ◽

Nurse Practitioners ◽

Methodological Approach ◽

Physician Assistants ◽

Care Providers ◽

Oblique Rotation ◽

Survey Tool ◽

Community Acceptance

The purpose of this study was to identify the significant dimensions of the concept of community acceptance of nurse practitioners/physician’s assistants and to construct areliable and valid instrument which would reflect these dimensions. The methodological approach included: conceptualization of categories, development of items for each category, development of the tool, administration of the tool, and psychometric analysis of results. Community input through focus-group interviews and post-administration questions provided qualitative data. The survey tool, consisting of items in four conceptualized categories (knowledge, access, competence, and trust), was administered in five rural communities. The responses of 967 residents were analyzed through factor analysis. The criterion, eigenvalue > 1.0, resulted in seven factors. Oblique rotation was applied to the seven factors and marker variables (loadings > .70) facilitated the identification of the underlying dimensions of each factor. Overall, 98% of the items assigned to the original categories were maintained after factor analysis. The identification of these dimensions helped to simplify the description and understanding of community acceptance of nurse practitioners and physicians’ assistants. Community acceptance of these advanced health care providers is a necessary precursor to use of services.

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Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz

Canadian Journal of Infectious Diseases ◽

10.1155/2001/645147 ◽

2001 ◽

Vol 12 (suppl c) ◽

pp. 20C-30C ◽

Cited By ~ 3

Author(s):

M John Gill ◽

Anita Rachlis ◽

Sharon Walmsley ◽

Mark Halman ◽

The Efavirenz Consensus Working Group

Keyword(s):

Side Effects ◽

Adverse Effects ◽

Health Care Providers ◽

Highly Active Antiretroviral Therapy ◽

Primary Care Physicians ◽

Sleep Disturbances ◽

Present Report ◽

Management Strategies ◽

Routine Practice ◽

Care Providers

Efavirenz is a potent antiretroviral agent used in combination with other antiretroviral agents as part of highly active antiretroviral therapy. Efavirenz is generally well tolerated because the majority of its adverse effects are self-limiting, with central nervous symptoms and rash being the most frequent. In routine practice, the discontinuation rate of efavirenz due to adverse effects appears higher than that described in clinical trials. To minimize early treatment interruption and maximize the benefit of long term viral suppression that can be achieved with efavirenz therapy, health care providers and patients have identified that there is a need for information, education about and practical tools for the management of efavirenz-related side effects. To this end, a panel of experts in the care of HIV patients consisting of primary care physicians, infectious disease specialists, psychiatrists and pharmacists was convened. Through the evaluation of current literature and discussion among the group, the panel arrived at consensus recommendations. The present report outlines general management recommendations that apply to adverse effects related to efavirenz initiation, as well as specific management strategies for central nervous system symptoms such as agitation, sleep disturbances, dreams, dizziness, impaired concentration and depression. It is hoped that these practical recommendations will aid clinicians in minimizing and improving patient tolerance of side effects, thereby achieving improved adherence and patient outcomes.

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Knowledge, Attitudes and Practices of Health Care Providers in the Philippine General Hospital towards In-Patient Hypoglycemia and its Management

Acta Medica Philippina ◽

10.47895/amp.v55i1.2926 ◽

2021 ◽

Vol 55 (1) ◽

Author(s):

Sarah-Laida J. Isnani ◽

Anna Macalalad-Josue ◽

Cecilia A. Jimeno

Keyword(s):

Health Care ◽

General Hospital ◽

Health Care Providers ◽

Care Providers ◽

Knowledge Domain ◽

Cross Sectional ◽

Survey Tool ◽

Attitudes And Practices ◽

Kap Survey ◽

Knowledge Attitudes And Practices

Objectives. To determine the knowledge, attitudes and practices (KAP) of health care providers at the Philippine General Hospital towards hypoglycemia among non-critically ill patients using a validated, self-administered survey tool. Methods. This study covered two phases out of a three-phased project: (1) development and validation of a 43- item KAP survey tool and (2) assessment of KAP among nurses and residents using the tool. Phases 1 and 2 are analytic cross-sectional studies. Data for the KAP survey was collected using the developed tool and focused group discussions (FGDs). Results of this study will be the framework for Phase 3, which is the development of an in-patient hypoglycemia protocol. Results. The validated KAP survey tool yielded a low overall mean score of 12.56 ± 2.11 in the knowledge domain although high scores (4.88 ± 1) were noted for knowledge on management of hypoglycemia. In terms of attitude, majority (99.31%) of respondents believed that fewer hypoglycemia events correlates to better clinical outcomes and are willing to adopt a nurse-driven protocol. Most respondents (52.8%) employed correct practices in hypoglycemia management. The FGDs identified the perceived facilitators and barriers to hypoglycemia management. Conclusion. There is a gap in knowledge and practices in managing hypoglycemia among health care providers which needs to be addressed further with education and training. Nevertheless, health care providers have a positive attitude towards having a standard hypoglycemia protocol that will contribute greatly to its implementation in the clinical area.

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Effect of Health Care Providers’ Focused Discussion and Proactive Education About Relapse Management on Patient Reporting of Multiple Sclerosis Relapse

International Journal of MS Care ◽

10.7224/1537-2073.2020-018 ◽

2021 ◽

Author(s):

Royce W. Waltrip ◽

Nancy Mahler ◽

Alina Ahsan ◽

Leslie B. Herbert

Keyword(s):

Multiple Sclerosis ◽

Health Care ◽

Health Care Providers ◽

Online Survey ◽

Care Providers ◽

Patient Reporting ◽

Multiple Sclerosis Relapse ◽

The Past ◽

Disease Modifying Therapy

Abstract Background: Treatments for multiple sclerosis (MS) relapse include intravenous corticosteroids and repository corticotropin injection. Despite available treatment, in the Multiple Sclerosis in America 2017 survey, only 47% of patients reported always/often contacting their MS health care provider (HCP) during relapse. In this study, the Multiple Sclerosis in America 2017 survey participants who received intravenous corticosteroids or repository corticotropin injection for treatment of past relapses completed a follow-up survey to understand how patients characterize relapse severity and to explore predictors of patients contacting their HCP during a relapse. Methods: Patients were18 years and older, diagnosed as having MS by an HCP, and currently using disease-modifying therapy. Patients completed an online survey assessing relapse characteristics and interactions with the HCP treating the patient’s MS. Regression analysis identified predictors of patients contacting their HCP during relapse. Results: Mean age of the 126 respondents was 49.2 years, 81.0% were female, and most (80.2%) had one or more relapses in the past 2 years. Patients estimated that 38.3% of their relapses were mild; 45.1%, moderate; and 16.6%, severe. Number and frequency of symptoms increased with relapse severity. Less than half (46.0%) reported they were extremely likely to contact their HCP during a relapse. The best predictors of being likely to contact the HCP during relapse were the HCP having previously discussed the importance of immediately communicating a relapse and patients’ willingness to accept the HCP’s recommendation for relapse treatment. Conclusions: Findings highlight the importance of HCPs’ advance discussions with patients with MS regarding relapse management to increase the likelihood patients will contact their HCP during relapse.

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Assessing the knowledge, attitude and perception on workplace readiness regarding COVID-19 among health care providers in Ethiopia—An internet-based survey

PLoS ONE ◽

10.1371/journal.pone.0247848 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247848

Author(s):

Agazi Fitsum Gebreselassie ◽

Abebe Bekele ◽

Heaven Yeshaneh Tatere ◽

Rex Wong

Keyword(s):

Health Care ◽

Health Care Providers ◽

Disease Transmission ◽

Online Survey ◽

Care Providers ◽

Healthcare Facilities ◽

Workplace Readiness ◽

Medical Supplies ◽

Level Of Knowledge ◽

Novel Coronavirus

Background Healthcare facilities in Ethiopia are responsible for collecting samples for testing and treating COVID-19 patients, providing COVID-19 information to staff, establishment of response teams, and provision of adequate personal protective equipment (PPE). Working at the frontlines against the pandemic, health care providers’ level of knowledge about COVID-19, attitude towards their work, and confidence in the preparedness of their facilities are essential factors in mounting a successful response. Objectives This study investigated the knowledge level of HCP in Ethiopia on this novel coronavirus, and their perspectives on whether their workplaces have sufficient preparedness to handle this disease. Methods A self-administered online survey was conducted. Results The knowledge related to COVID-19 among HCPs was high, with an overall average of 91.5%. The majority of our respondents were supportive to the government’s measures to minimize disease transmission, but most of them were also frustrated by how COVID affected their day to day lives. The majority of them were worried about contracting COVID at work and transmitting the infection to their families. Most respondents did not feel safe going to work (P<0.001). Apart from providing adequate information on COVID-19, most workplaces did not have sufficient PPE (P<000.1) and medical supplies (P<0.001). Close to 50% of respondents agreed and disagreed that their workplaces had clear protocols for handling COVID-19 (P = 0.144). Those who handled known COVID patients were more likely to agree their workplaces had clear protocols (OR = 2.69, P<0.001). Conclusion Improving supplies of PPEs and establishing a clear communicating protocol in handling COVID patients are highly recommended.

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