scholarly journals Sources of Information on Medicinal Products Among Physicians – A Survey Conducted Among Primary Care Physicians in Poland

2022 ◽  
Vol 12 ◽  
Author(s):  
Magdalena Zielińska ◽  
Tomasz Hermanowski
Keyword(s):  
Primary Care ◽  
Clinical Guidelines ◽  
Primary Care Physicians ◽  
Demographic Data ◽  
Sources Of Information ◽  
Medicinal Products ◽  
Using Data ◽  
Credible Information ◽  
Source Of Information ◽  
Credible Source

Introduction: Primary care physicians need to have access to up-to-date knowledge in various fields of medicine and high-quality information sources, but little is known about the use and credibility of sources of information on medicinal products among Polish doctors. The main goal of this study was to analyze the sources of information on medicinal products among primary care physicians in Poland.Methods: A survey was conducted among 316 primary care physicians in Poland. The following information was collected: demographic data of participants, type and frequency of using data sources on medicinal products, barriers to access credible information, assessment of the credibility of the sources used, impact of a given source and other factors on prescription decisions.Results: The most frequently mentioned sources of information were medical representatives (79%), medical journals (78%) and congresses, conventions, conferences, and training (76%). The greatest difficulty in finding the latest information about medicinal products was the lack of time. The surveyed doctors considered clinical guidelines to be the most credible source of information, and this source also had the greatest impact on the choice of prescribed medicinal products.Conclusion: The study showed that clinicians consider clinical guidelines as the most credible source of information with the greatest impact on prescribing medicinal products. However, it is not the source most often mentioned by doctors for obtaining knowledge about medicinal products. There is a need to develop strategies and tools to provide physicians with credible sources of information.

Infant Sleep Position: Pediatricians' Advice to Parents

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 55-58
Author(s):  
Bonnie B. Hudak ◽  
Jane O'Donnell ◽  
Nadine Mazyrka
Keyword(s):  
Primary Care ◽  
New York ◽  
Primary Care Physicians ◽  
Sleep Position ◽  
Infant Sleep ◽  
Sources Of Information ◽  
Professional Literature ◽  
Infant Sleep Position ◽  
Supine Sleep ◽  
Question Survey

Objective. The American Academy of Pediatrics' (AAP) recommendation for side or supine sleep position in healthy babies has generated much controversy. We surveyed primary care physicians to determine the effect of the AAP statement on physician attitude toward infant sleep position and advice to parents. Methods. We sent a 23-question survey to 194 physicians in Western New York. The survey addressed their attitude toward the AAP recommendations and its impact on their advice to parents. Results. Of the 149 physicians treating newborns, 121 (82%) completed the questionnaire; 98% were aware of the AAP statement. The most common sources of information were the AAP (86%) and professional literature (77%). Of the respondents, 79% agreed with the AAP statement. Reasons for reservation were lack of data (64%), potential adverse consequences of supine position (52%), and their own experience (47%). Gender, years in practice, and type of reimbursement did not influence attitude toward the AAP recommendation. The AAP statement increased the frequency with which physicians routinely discussed sleep position from 34 to 70% (P < .02). Physicians recommending the prone position decreased from 57 to 7% (P < .001), while those recommending supine sleep position increased from 10 to 42% (P < .001). Conclusions. Most physicians agreed with the AAP statement and more frequently discussed sleep position following the AAP recommendations. However, they did not routinely recommend supine sleep position. The majority (69%) recommended the side position even though it is unstable. Although the AAP statement has increased discussion of infant sleep position by primary care physicians in WNY, only a minority recommend that infants sleep supine.

scholarly journals Optimising Seniors’ Metabolism of Medications and Avoiding Adverse Drug Events Using Data on How Metabolism by Their P450 Enzymes Varies with Ancestry and Drug–Drug and Drug–Drug–Gene Interactions

2020 ◽  
Vol 10 (3) ◽  
pp. 84
Author(s):  
Roger E. Thomas
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Adverse Drug Events ◽  
Meta Analysis ◽  
Gene Interactions ◽  
Rural And Remote ◽  
Remote Areas ◽  
Rural And Remote Areas ◽  
Enormous Variation ◽  
Using Data

Many individuals ≥65 have multiple illnesses and polypharmacy. Primary care physicians prescribe >70% of their medications and renew specialists’ prescriptions. Seventy-five percent of all medications are metabolised by P450 cytochrome enzymes. This article provides unique detailed tables how to avoid adverse drug events and optimise prescribing based on two key databases. DrugBank is a detailed database of 13,000 medications and both the P450 and other complex pathways that metabolise them. The Flockhart Tables are detailed lists of the P450 enzymes and also include all the medications which inhibit or induce metabolism by P450 cytochrome enzymes, which can result in undertreatment, overtreatment, or potentially toxic levels. Humans have used medications for a few decades and these enzymes have not been subject to evolutionary pressure. Thus, there is enormous variation in enzymatic functioning and by ancestry. Differences for ancestry groups in genetic metabolism based on a worldwide meta-analysis are discussed and this article provides advice how to prescribe for individuals of different ancestry. Prescribing advice from two key organisations, the Dutch Pharmacogenetics Working Group and the Clinical Pharmacogenetics Implementation Consortium is summarised. Currently, detailed pharmacogenomic advice is only available in some specialist clinics in major hospitals. However, this article provides detailed pharmacogenomic advice for primary care and other physicians and also physicians working in rural and remote areas worldwide. Physicians could quickly search the tables for the medications they intend to prescribe.

scholarly journals Quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension, by primary care physicians in different Russian regions

2021 ◽  
Vol 26 (4) ◽  
pp. 4332
Author(s):  
O. M. Drapkina ◽  
R. N. Shepel ◽  
L. Yu. Drozdova ◽  
A. M. Kalinina ◽  
E. S. Bulgakova ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Resistant Hypertension ◽  
Clinical Guidelines ◽  
Primary Care Physicians ◽  
Adult Population ◽  
Russian Regions ◽  
Target Values

In view of the high prevalence of hypertension (HTN) among Russian population, it becomes extremely important to meet the criteria for the medical care quality within the periodic examinations for this group of patients.Aim.  To assess the quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension (RH), by primary care physicians in different Russian regions.Materials and methods. As part of working visits of the expert group from the National Medical Research Center for Therapy and Preventive Medicine in 38 Russian regions in the period from February 1, 2020 to December 15, 2020, an analysis of ambulatory records of patients with grade 1-3 hypertension was carried out. A total of 3614 ambulatory medical records (AMRs) were analyzed, of which the grade 1-3 hypertension, with the exception of RH, was revealed in 764 ones. The analysis of records was carried out using an original checklist. Statistical processing was carried out using the software package IBM SPSS Statistics 20 (USA) and Microsoft Office Excel 2016 (USA).Results. An analysis of 764 AMRs was performed. The mean age of patients was 63,9-11,2 (women, 64,7-11,3 years; men, 62,7-10,9 years). The majority (58,9%) of participants were women. Follow-up monitoring was established in a timely manner in 450 people (58,9%) of patients, of which there were 189 men (42%) and 261 women (58%). In 87,9% (n=672) of cases, the diagnosis formulation met the established clinical guidelines criteria. In 36 cases (4,7%), there was no evidence in favor of hypertension according to the current clinical guidelines. In 21,1% (n=161) of cases, the minimum recommended periodicity of visits was not observed. In last visits of 323 patients, the blood pressure did not reach the target values. AMRs did not contain information on low-density lipoprotein cholesterol (LDL-C) in 91б4% of cases (n=698). Among patients with a known level of LDL-C, the target values were achieved only in 15,2% of cases (n=10).Conclusion. Our analysis revealed the insufficient quality of outpatient medical care to hypertensive patients within the periodic examinations. Proposals are created for monitoring and measures to improve the quality of care for this category of patients.

scholarly journals Human- Versus Machine Learning–Based Triage Using Digitalized Patient Histories in Primary Care: Comparative Study (Preprint)

2020 ◽  
Author(s):  
Artin Entezarjou ◽  
Anna-Karin Edstedt Bonamy ◽  
Simon Benjaminsson ◽  
Pawel Herman ◽  
Patrik Midlöv
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Physical Examination ◽  
Medical History ◽  
Primary Care Physicians ◽  
Interrater Reliability ◽  
Reference Group ◽  
Majority Vote ◽  
Medical Histories ◽  
Using Data

BACKGROUND Smartphones have made it possible for patients to digitally report symptoms before physical primary care visits. Using machine learning (ML), these data offer an opportunity to support decisions about the appropriate level of care (triage). OBJECTIVE The purpose of this study was to explore the interrater reliability between human physicians and an automated ML-based triage method. METHODS After testing several models, a naïve Bayes triage model was created using data from digital medical histories, capable of classifying digital medical history reports as either in need of urgent physical examination or not in need of urgent physical examination. The model was tested on 300 digital medical history reports and classification was compared with the majority vote of an expert panel of 5 primary care physicians (PCPs). Reliability between raters was measured using both Cohen κ (adjusted for chance agreement) and percentage agreement (not adjusted for chance agreement). RESULTS Interrater reliability as measured by Cohen κ was 0.17 when comparing the majority vote of the reference group with the model. Agreement was 74% (138/186) for cases judged not in need of urgent physical examination and 42% (38/90) for cases judged to be in need of urgent physical examination. No specific features linked to the model’s triage decision could be identified. Between physicians within the panel, Cohen κ was 0.2. Intrarater reliability when 1 physician retriaged 50 reports resulted in Cohen κ of 0.55. CONCLUSIONS Low interrater and intrarater agreement in triage decisions among PCPs limits the possibility to use human decisions as a reference for ML to automate triage in primary care.

scholarly journals A questionnaire-based survey to evaluate and improve the current HHT medical and social condition in Japan

2020 ◽  
Vol 11 ◽  
pp. 323
Author(s):  
Nobuhiko Arai ◽  
Takenori Akiyama
Keyword(s):  
Primary Care ◽  
Standard Deviation ◽  
Primary Care Physicians ◽  
Demographic Data ◽  
Final Diagnosis ◽  
Social Condition ◽  
Definite Diagnosis ◽  
Fukuoka Prefecture ◽  
Multiple Organs ◽  
Initial Symptoms

Background: Hereditary hemorrhagic telangiectasia (HHT) is a genetic systemic vascular disease affecting multiple organs and shows recurrent intractable symptoms. This disease has not been widely recognized in Japan until recently. Both diagnosed HHT patients and potential ones have faced difficulties because of the unfamiliarity with the disease in Japan. To evaluate the effect and degree of such a Japanese situation, a questionnaire-based survey was executed in this study. Methods: This survey was carried out among the members of HHT Japan Association. The organization consisted of 102 members (as of 6/2019), mainly HHT patients and their family members. A questionnaire was used to gather demographic data, the effort to reach the diagnosis, and information regarding current patients’ and their families’ medical managements. Results: Of the 102 questionnaires distributed, we have got 56 responses. The participants were mostly female (30) with an average age of 55.4 ± 14.8 (mean ± standard deviation [SD]) years. The average age of males was 53.5 ± 16.4. Relatively many HHT patients were born in huge cities such as Tokyo, Osaka, and Fukuoka Prefecture (n = 4 to 8 patients). The duration between the initial symptoms and the definite diagnosis was 8.8 ± 10.9 years. The number of hospitals involved in the final diagnosis was 2.38 ± 1.83. More than 70% of patients now have to visit at least two departments and 24% of HHT patients did not want their family to screen for HHT. Conclusion: HHT medical practice in Japan should be further modified, for example, by establishing HHT centers and educating primary care physicians and HHT patients.

Awareness, management, and practice patterns of pediatric NAFLD by primary care physicians

2021 ◽  
Author(s):  
Victoria Lee-Kim ◽  
Rachael Morkem ◽  
David Barber ◽  
Jennifer A Flemming ◽  
Mohit Kehar
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Clinical Guidelines ◽  
Primary Care Physicians ◽  
Practice Patterns ◽  
Dissemination And Implementation ◽  
Lifestyle Modifications ◽  
Nonalcoholic Fatty Liver ◽  
The North ◽  
Specialist Referral

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children. Primary-care physicians (PCPs) play a key role in identifying patients requiring specialist referral. In this study, we aim to determine PCPs’ practice patterns for paediatric NAFLD, as knowledge gaps have been reported for adult NAFLD. Methods A survey was sent to 60 PCPs in the Eastern Ontario Network from July 2019 to January 2020. Results Thirty-seven (62%) PCPs responded to the survey. Twenty-one incorrectly considered the prevalence of paediatric NAFLD to be ≤10%. The majority (35/36) cared for less than five paediatric NAFLD patients. Thirty-four (92%) were only ‘slightly familiar’ or ‘not familiar at all’ with paediatric NAFLD. Only one PCP routinely screens for NAFLD. Only one PCP was aware of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) clinical guidelines for paediatric NAFLD. Twenty-five (68%) correctly selected lifestyle modifications as a treatment option. Lack of confidence in the knowledge of NAFLD was the most common barrier for managing paediatric cases. Conclusion The majority of PCPs are not screening for paediatric NAFLD and are not familiar with its clinical spectrum, citing a lack of knowledge regarding NAFLD as the greatest barrier. This may cause delays in diagnosis and a presentation with advanced fibrosis at the time of specialist referral. Dissemination and implementation of clinical guidelines have the potential to improve knowledge and screening rates for NAFLD in children at the primary-care level.

Compliance with the clinical guidelines for managing asthma by primary care physicians: An ambispective observational study

2020 ◽  
Author(s):  
M. Roman-Rodriguez ◽  
J. Molina-Paris ◽  
A. Fernandez-Sanchez ◽  
Mohsen Abedianzadeh Timar ◽  
Jesús Acha Domínguez ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Clinical Guidelines ◽  
Primary Care Physicians
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