scholarly journals A Cross-Sectional Survey on Medication Management Practices for Noncommunicable Diseases in Europe During the Second Wave of the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Tamás Ágh ◽  
Job FM van Boven ◽  
Björn Wettermark ◽  
Enrica Menditto ◽  
Hilary Pinnock ◽  
...  
Keyword(s):  
Management Practices ◽  
Medication Management ◽  
Nonparametric Tests ◽  
European Countries ◽  
Noncommunicable Diseases ◽  
Public Healthcare ◽  
National Guidelines ◽  
Cross Sectional ◽  
The Impact ◽  
Second Wave

Maintaining healthcare for noncommunicable diseases (NCDs) is particularly important during the COVID-19 pandemic; however, diversion of resources to acute care, and physical distancing restrictions markedly affected management of NCDs. We aimed to assess the medication management practices in place for NCDs during the second wave of the COVID-19 pandemic across European countries. In December 2020, the European Network to Advance Best practices & technoLogy on medication adherencE (ENABLE) conducted a cross-sectional, web-based survey in 38 European and one non-European countries. Besides descriptive statistics of responses, nonparametric tests and generalized linear models were used to evaluate the impact on available NCD services of the number of COVID-19 cases and deaths per 100,000 inhabitants, and gross domestic product (GDP) per capita. Fifty-three collaborators from 39 countries completed the survey. In 35 (90%) countries face-to-face primary-care, and out-patient consultations were reduced during the COVID-19 pandemic. The mean ± SD number of available forms of teleconsultation services in the public healthcare system was 3 ± 1.3. Electronic prescriptions were available in 36 (92%) countries. Online ordering and home delivery of prescription medication (avoiding pharmacy visits) were available in 18 (46%) and 26 (67%) countries, respectively. In 20 (51%) countries our respondents were unaware of any national guidelines regarding maintaining medication availability for NCDs, nor advice for patients on how to ensure access to medication and adherence during the pandemic. Our results point to an urgent need for a paradigm shift in NCD-related healthcare services to assure the maintenance of chronic pharmacological treatments during COVID-19 outbreaks, as well as possible future disasters.

A Cross Sectional Study on the Psychological Impact of Covid-19 Pandemic on Schoolteachers in Andhra Pradesh

2021 ◽  
Vol 8 (32) ◽  
pp. 2938-2942
Author(s):  
Ganga Raju Godasi ◽  
Abdul Salaam Mohammed ◽  
Raj Kiran Donthu ◽  
Jaya Prakash Nunna
Keyword(s):  
Andhra Pradesh ◽  
Psychological Impact ◽  
Cross Sectional Study ◽  
Nonparametric Tests ◽  
Cross Sectional ◽  
Urban Background ◽  
Equal Distribution ◽  
R Language ◽  
Rural And Urban ◽  
The Impact

BACKGROUND COVID-19 is a novel disease caused by Coronavirus. It was declared a pandemic by WHO in March 2020. To reduce the impact of the disease lockdown was imposed by various governments. This has a psychological impact on various groups of people. Schoolteachers are no less affected. There is scarcity in our understanding of the psychological impact among schoolteachers. This study is an attempt to understand the psychological impact among schoolteachers. We wanted to study the psychological impact of the COVID-19 pandemic on schoolteachers. METHODS The study was a cross-sectional one and conducted using online Google forms. A total of seventy-nine schoolteachers were included in the study analysis. The data were analysed using R language; nonparametric tests like Mann Whitney U and Kruskal Wallis test were used. The data obtained were tabulated and discussed. RESULTS Nearly half the sample belongs to 46 to 55 years, males constitute 57 %, majority of the participants were married, there was an equal distribution from a rural and urban background and teachers working in Government setup were 86 %. Females had significantly higher levels of depression and stress. Married had significantly higher levels of depression. Moderate to severe levels of depression, anxiety and stress were seen in 2.6 %, 10 %, and 2.5 % of the participants. CONCLUSIONS The study has found an increase in psychological impact among the schoolteachers. But the reported increase is less than that observed during the peak of the pandemic. Females have more depression and stress compared to males. KEYWORDS COVID-19, Mental Disorders, Pandemic, Schoolteachers

scholarly journals A call for harmonization of European kidney care: dialysis reimbursement and distribution of kidney replacement therapies

2020 ◽  
Vol 35 (6) ◽  
pp. 979-986 ◽  
Author(s):  
Arjan van der Tol ◽  
Vianda S Stel ◽  
Kitty J Jager ◽  
Norbert Lameire ◽  
Rachael L Morton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Expenditure ◽  
European Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Expenditure ◽  
Home Dialysis ◽  
Kidney Replacement Therapy ◽  
The Cost ◽  
The Impact

Abstract Background We compare reimbursement for haemodialysis (HD) and peritoneal dialysis (PD) in European countries to assess the impact on government healthcare budgets. We discuss strategies to reduce costs by promoting sustainable dialysis and kidney transplantation. Methods This was a cross-sectional survey among nephrologists conducted online July–December 2016. European countries were categorized by tertiles of gross domestic product per capita (GDP). Reimbursement data were matched to kidney replacement therapy (KRT) data. Results The prevalence per million population of patients being treated with long-term dialysis was not significantly different across tertiles of GDP (P = 0.22). The percentage of PD increased with GDP across tertiles (4.9, 8.2, 13.4%; P < 0.001). The HD-to-PD reimbursement ratio was higher in countries with the highest tertile of GDP (0.7, 1.0 versus 1.7; P = 0.007). Home HD was mainly reimbursed in countries with the highest tertile of GDP (15, 15 versus 69%; P = 0.005). The percentage of public health expenditure for reimbursement of dialysis decreased across tertiles of GDP (3.3, 1.5, 0.7%; P < 0.001). Transplantation as a proportion of all KRT increased across tertiles of GDP (18.5, 39.5, 56.0%; P < 0.001). Conclusions In Europe, dialysis has a disproportionately high impact on public health expenditure, especially in countries with a lower GDP. In these countries, the cost difference between PD and HD is smaller, and home dialysis and transplantation are less frequently provided than in countries with a higher GDP. In-depth evaluation and analysis of influential economic and political measures are needed to steer optimized reimbursement strategies for KRT.

scholarly journals General practitioners’ and out-of-hours doctors’ role as gatekeeper in emergency admissions to somatic hospitals in Norway: registry-based observational study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jesper Blinkenberg ◽  
Sahar Pahlavanyali ◽  
Øystein Hetlevik ◽  
Hogne Sandvik ◽  
Steinar Hunskaar
Keyword(s):  
General Practitioners ◽  
Hospital Admissions ◽  
Significant Proportion ◽  
Emergency Admission ◽  
Public Healthcare ◽  
Malignant Neoplasms ◽  
Cross Sectional ◽  
Out Of Hours ◽  
Emergency Admissions ◽  
The Impact

Abstract Background Primary care doctors have a gatekeeper function in many healthcare systems, and strategies to reduce emergency hospital admissions often focus on general practitioners’ (GPs’) and out-of-hours (OOH) doctors’ role. The aim of the present study was to investigate these doctors’ role in emergency admissions to somatic hospitals in the Norwegian public healthcare system, where GPs and OOH doctors have a distinct gatekeeper function. Methods A cross-sectional analysis was performed by linking data from the Norwegian Patient Registry (NPR) and the physicians’ claims database. The referring doctor was defined as the physician who had sent a claim for a consultation with the patient within 24 h prior to an emergency admission. If there was no claim registered prior to hospital arrival, the admission was defined as direct, representing admissions from ambulance services, referrals from nursing home doctors, and admissions initiated by in-hospital doctors. Results In 2014 there were 497,587 emergency admissions to somatic hospitals in Norway after excluding birth related conditions. Direct admissions were most frequent (43%), 31% were referred by OOH doctors, 25% were referred by GPs, whereas only 2% were referred from outpatient clinics or private specialists with public contract. Direct admissions were more common in central areas (52%), here GPs’ referrals constituted only 16%. The prehospital paths varied with the hospital discharge diagnosis. For anaemias, 46–49% were referred by GPs, for acute appendicitis and mental/alcohol related disorders 52 and 49% were referred by OOH doctors, respectively. For both malignant neoplasms and cardiac arrest 63% were direct admissions. Conclusions GPs or OOH doctors referred many emergencies to somatic hospitals, and for some clinical conditions GPs’ and OOH doctors’ gatekeeping role was substantial. However, a significant proportion of the emergency admissions was direct, and this reduces the impact of the GPs’ and OOH doctors’ gatekeeper roles, even in a strict gatekeeping system.

scholarly journals Causal impact of social care, public health and healthcare expenditure on mortality in England: cross-sectional evidence for 2013/2014

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e046417
Author(s):  
Stephen Martin ◽  
Francesco Longo ◽  
James Lomas ◽  
Karl Claxton
Keyword(s):  
Public Health ◽  
Social Care ◽  
Healthcare Expenditure ◽  
Least Squares Method ◽  
Total Mortality ◽  
Public Healthcare ◽  
Cross Sectional ◽  
Local Public Health ◽  
Spending Growth ◽  
The Impact

ObjectivesThe first objective is to estimate the joint impact of social care, public health and healthcare expenditure on mortality in England. The second objective is to use these results to estimate the impact of spending constraints in 2010/2011–2014/2015 on total mortality.MethodsThe impact of social care, healthcare and public health expenditure on mortality is analysed by applying the two-stage least squares method to local authority data for 2013/2014. Next, we compare the growth in healthcare and social care expenditure pre-2010 and post-2010. We use the difference between these growth rates and the responsiveness of mortality to changes in expenditure taken from the 2013/2014 cross-sectional analysis to estimate the additional mortality generated by post-2010 spending constraints.ResultsOur most conservative results suggest that (1) a 1% increase in healthcare expenditure reduces mortality by 0.532%; (2) a 1% increase in social care expenditure reduces mortality by 0.336%; and (3) a 1% increase in local public health spending reduces mortality by 0.019%. Using the first two of these elasticities and data on the change in spending growth between 2001/2002–2009/2010 and 2010/2011–2014/2015, we find that there were 57 550 (CI 3075 to 111 955) more deaths in the latter period than would have been observed had spending growth during this period matched that in 2001/2002–2009/2010.ConclusionsAll three forms of public healthcare-related expenditure save lives and there is evidence that additional social care expenditure is more than twice as productive as additional healthcare expenditure. Our results are consistent with the hypothesis that the slowdown in the rate of improvement in life expectancy in England and Wales since 2010 is attributable to spending constraints in the healthcare and social care sectors.

scholarly journals Consumption of healthy and unhealthy foods in adults according to binge drinking and sex - Brazil 2016

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
AM Pita Ruiz ◽  
D de Assumpção ◽  
P M Stolses ◽  
Bergamo Francisco
Keyword(s):  
Binge Drinking ◽  
Food Consumption ◽  
Alcohol Intake ◽  
Negative Impact ◽  
Red Meat ◽  
Soft Drinks ◽  
Noncommunicable Diseases ◽  
Public Healthcare ◽  
Cross Sectional ◽  
Regular Consumption

Abstract Background Abusive alcohol intake is associated with noncommunicable diseases that exert a financial impact on public healthcare systems throughout the world. Alcohol affects the absorption of nutrients and plasma levels of fatty acids and exerts a negative impact on food consumption. Objective Determine the regular consumption (≥ 5 days/week) of healthy and unhealthy foods in adults (≥ 20 years) according to binge drinking and sex. Methods A cross-sectional study was conducted with data from the Surveillance System of Risk and Protection Factors for Chronic Diseases of the 2016 Vigitel telephone survey conducted by the Brazilian Health Ministry. Multiple logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI). Results Information from 32,195 women and 19,490 men was analyzed, with binge drinking reported in 11.95% and 27.85%, respectively. Lower regular consumption of fruit (OR: 0.80; 95%CI: 0.69-0.92) and milk (OR: 0.82; 95%CI: 0.72-0.94) as well as greater consumption of red meat (OR: 1.27; 95%CI: 1.10-1.46) were found among the men who reported binge drinking. Lower regular consumption of natural juice (OR: 0.79; 95%CI: 0.67-0.93), fruit (OR: 0.64; 95%CI: 0.55-0.75) and milk (OR: 0.70; 95%CI: 0.60-0.82) as well as greater consumption of red meat (OR: 1.35; 95%CI: 1.14-1.59) and soft drinks/artificial juice (OR: 1.55; 95%CI: 1.24-1.94) were found among the women who reported binge drinking. Regarding sex, women consumed more raw vegetables (OR: 1.50; 95%CI: 1.24-1.82), cooked vegetables (OR: 1.79; 95%CI: 1.44-2.21), fruit (OR: 1.28; 95%CI: 1.07-1.55) and sweets (OR: 1.35; 95%CI: 1.05-1.72) as well as less red meat (OR: 0.71; 95%CI: 0.59-0.86) than men who also engaged in binge drinking. Conclusions Binge drinking was associated with a lower frequency of the regular consumption of healthy foods, such as fruit, vegetables and milk, as well as a greater consumption of red meat, soft drinks and sweets. Key messages Alcohol exerts a negative impact on food consumption. Abusive alcohol intake is associated with noncommunicable diseases.

scholarly journals A study of metabolic syndrome in patients of HIV on ART in India

2021 ◽  
Author(s):  
V K Sashindran ◽  
Anchit Raj Singh
Keyword(s):  
Metabolic Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Noncommunicable Diseases ◽  
Care Hospital ◽  
Cross Sectional ◽  
High Prevalence ◽  
Hiv Morbidity ◽  
The Impact

AbstractMetabolic syndrome is a risk factor for cardiovascular disease. With improvement in therapy for HIV, morbidity related to metabolic syndrome becomes a focus of interest. Change in nutritional status and introduction of newer regimens of ART are changing the impact of metabolic syndrome on patients of HIV. Few studies in recent times from developing countries have addressed this question. This is a cross sectional study to study the prevalence of Metabolic Syndrome in patients of HIV on ART from clinics in a tertiary care hospital in India. Data from 1208 patients of HIV on ART was analyzed and metabolic syndrome was seen in 257(21.3%) patients.The high prevalence of metabolic syndrome in patients of HIV in India found in this study gives an insight on the morbidity of noncommunicable diseases in patients with HIV in India in recent times.

scholarly journals Physiotherapists perceived role in managing anxiety in patients with Relapsing-Remitting Multiple Sclerosis: a mixed-methods study.

2021 ◽  
Author(s):  
Lauren Lucas ◽  
Jack Parker
Keyword(s):  
Mixed Methods ◽  
Clinical Supervision ◽  
Management Practices ◽  
Training Needs ◽  
Outpatient Rehabilitation ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physiotherapy Practice ◽  
The Impact

ABSTRACT Objectives: To explore how physiotherapists manage anxiety in patients with RRMS in community and outpatient settings. To identify further training and research to better develop physiotherapy practice. Design: A mixed-methods design, combining a cross-sectional survey and semi-structured interviews with UK-physiotherapists. Participants: Sixteen UK-registered physiotherapists: 11 in the survey, 5 in the interviews. Methods: To inform the qualitative study, a cross-sectional survey collected data from physiotherapists working in neurology to understand the impact and management of anxiety in people with MS (PwMS) during rehabilitation. Analysis used descriptive statistics and the findings formed the interview guide. Semi-structured interviews with specialist physiotherapists explored barriers and facilitators to managing anxiety, physiotherapy training needs and offered suggestions to develop physiotherapy research and practice. Themes were derived inductively. Results: The survey suggested how PwMS present with anxiety, its impact during rehabilitation, physiotherapy management practices, and physiotherapist skills and training needs. Five semi-structured interviews with specialist physiotherapists expanded on the survey findings and identified five main themes: Understanding the MS journey, modifying assessment and treatment, anxiety management toolbox, lagging behind Musculoskeletal Physiotherapy, and gaining knowledge and skills. Conclusion: Physiotherapists encounter anxiety in PwMS in community and outpatient rehabilitation and perceive they have a role in managing it as it presents. Facilitators included communication, listening skills and opportunities to develop strong therapeutic relationships. Poor training and support, lack of clinical guidelines and limited research evidence were considered barriers. Clinically relevant learning opportunities, interprofessional working, and greater support through clinical supervision is recommended to better develop physiotherapy practice.

scholarly journals Residents' practice and perceptions during the COVID-19 pandemic

2020 ◽  
Author(s):  
Miao Fang ◽  
Shunju Xiang ◽  
Yang Si
Keyword(s):  
Internal Medicine ◽  
Clinical Practice ◽  
Online Courses ◽  
Medical Residents ◽  
Basic Information ◽  
Continuous Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact ◽  
Second Wave

Rationale, aims and objectives: This study aimed to determine the residents’ perspectives on clinical practice during the pandemic of coronavirus disease 2019 (COVID-19). Methods: A cross-sectional survey was carried out online among medical residents in our hospital. The survey covered basic information, condition of clinical practice, and perspectives related to the COVID-19. Results: total 174 (26.8%) residents responded and completed the survey. Nearly half of the residents (51.7%) expressed willingness of going to the frontline to fight against the virus and 62.3% of the residents showed good morale. Online courses were delivered to 87.9% of the residents with satisfaction at 89.7%. Approximate one third of the residents concerned the impact of the epidemic on graduation (34.0%) and taking up an occupation (32.8 %). Majorities (79.3%) determined to be a doctor after the pandemic. Notablely 40.2% of the residents thought they were underpaid. 21.8% of the residents reported to be unfairly treated in clinical practice. Overall no statistical differences were revealed between internal medicine and surgery residents, and between those married and singles, regarding the perceptions related to the COVID-19. Conclusion: Administrators should take cognizance of perspective of the residents and formulate corresponding strategies to reassure trainees’ safety and continuous training, address the residents’ concerns and get prepared for the second wave of COVID-19.

scholarly journals Influence of workshop attendance on management of pediatric fecal incontinence in Nigeria

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Taiwo Akeem Lawal
Keyword(s):  
Fecal Incontinence ◽  
Management Practices ◽  
Postgraduate Training ◽  
Surgical Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Past ◽  
The Impact ◽  
Training Opportunities ◽  
And Training

Abstract Background The care of children with fecal incontinence is suboptimal with inadequate support and training opportunities. The postgraduate training of pediatric surgeons on the management of fecal incontinence is inadequate since each training center is not likely to see enough number of cases yearly. Supplemental training through workshops on fecal incontinence may help to bridge the gap. The aim of this cross sectional study was to evaluate the impact of previous attendance of a workshop on fecal incontinence management practices among pediatric surgeons. Results A total of 41 respondents participated. Eleven (26.8%) respondents had attended a workshop in the past and seven (17.1%) had done a Malone antegrade continent enema (MACE) on patients. A higher proportion of respondents who had practiced for over 15 years had attended a workshop on fecal incontinence compared to those who had not attended one (90.9% vs. 33.3%, p = 0.001). The proportion of respondents who had attended a workshop on fecal incontinence and had performed a MACE (18.2%) was higher than the proportion of those who had not attended a workshop and had performed a similar procedure on patients (3.3%), p = 0.047. Conclusions One quarter of pediatric surgeons in the country surveyed had attended a workshop on fecal incontinence. Prior attendance of a workshop on fecal incontinence is significantly related to experience and significantly influenced the performance of a MACE procedure. Supplementation of the training of pediatric surgeons through workshops on fecal incontinence will help to improve capacity in pediatric colorectal surgical care.

scholarly journals Impacts of Community Pharmacists on Self-medication Management among Rural Dwellers, Kwara State Central, Nigeria

2013 ◽  
Vol 12 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Shakirat I Bello ◽  
Ibrahim K Bello
Keyword(s):  
Blood Pressure ◽  
Rural Communities ◽  
Descriptive Analysis ◽  
Medication Management ◽  
Community Pharmacists ◽  
Cross Sectional Study ◽  
Direct Patient Care ◽  
Self Medication ◽  
Cross Sectional ◽  
The Impact

The role of pharmacist has not only advanced from medication dispensing but also to direct patient care and pharmaceutical interventions aiming at enhancing the populace wellbeing. The objective of this research was to assess the impact of rural community pharmacist interventions on self-medications and disease prevalence among rural settings in the Kwara State Central, Nigeria. A descriptive, cross-sectional study was conducted in eight rural communities with a pre-piloted questionnaire. Data obtained from respondents were computed with Statistical Package for Social Sciences (SPSS) Version 16 using descriptive analysis procedures, and relationships between variables were tested using the chi square. Respondents between the age of 40 and 50 years dominated with 42.3% and majority (88.1%) of the rural residents were illiterates. Farming was the major occupation of the respondents and survived on less than ten thousand naira Nigeria money ($63) per month. Among the combinations of drugs abused by the respondents, the regimen containing combination of prednisolone, diclofenac and paracetamol had the highest users. The least used combination was ibuprofen, diclofenac plus prednisolone. These combinations were taken twice daily by the majority participants. The most common reasons given for self-medications were osteoarthritis (31.1%), poverty (17.4%), general body pain (14.3%), inadequate of health facilities (4.6%), ignorance (4.3%) among others. The intervention offered by the pharmacists had reduced the mean systolic blood pressure significantly (P < 0.05) from 161 mmHg to 129 mmHg and diastolic blood pressure from 104 mmHg at baseline to 86 mmHg. Postintervention evaluation revealed the impact of the pharmacists, as the respondents with dyspepsia at baseline significantly (P < 0.05) reduced from 220 to 53 participants. Dhaka Univ. J. Pharm. Sci. 12(1): 1-9, 2013 (June) DOI: http://dx.doi.org/10.3329/dujps.v12i1.16294

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