Evaluation of Inappropriate Prescribing in Patients Older than 65 Years in Primary Health Care

To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care. Design: cross-sectional study. Setting: Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain. Participants: Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area. The data were collected by interview on a structured data collection form. Study variables. Dependent variable: Potentially inappropriate prescribing (PIP) (STOPP/START criteria). Predictor variables: Sociodemographic characteristics, clinical characteristics and medication use. A descriptive analysis of the variables was performed. Statistical inference was based on bivariate analysis (Student’s t or Mann-Whitney U test and chi-squared test) and multivariate analysis was used to control for confounding factors. 73.6% of participants met one or more STOPP/START criteria. According to information about prescribed treatments, 48.5% of participants met at least one STOPP criterion and 43.30% of them met at least one START criterion. The largest percentage of inappropriate prescriptions was associated with cardiovascular treatments. More than three-quarters of the participants had one or more inappropriate prescriptions for medicines in primary care, according to STOPP/START criteria. In addition, PIP was directly related to the number of prescribed medications, gender and specific pathologies (diabetes).

Download Full-text

Brazilian National Household Health Survey and PCAT: the case of Mato Grosso do Sul, Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.511 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L F Pinto ◽

D Soranz ◽

L J Santos ◽

M S Paranhos ◽

L S Malta ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Data Collection ◽

Health Survey ◽

Household Surveys ◽

Mato Grosso ◽

Primary Health ◽

The World ◽

Mato Grosso Do Sul

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.

Download Full-text

Opinions on mental illness from the perspective of primary care nurses in Portugal

Revista Gaúcha de Enfermagem ◽

10.1590/1983-1447.2019.20190034 ◽

2019 ◽

Vol 40 ◽

Author(s):

Carla Silvia Neves da Nova Fernandes ◽

Wallace Borges Costa dos Santos ◽

Wanderson Carneiro Moreira ◽

Divane de Vargas ◽

Maria do Perpétuo Socorro de Sousa Nóbrega

Keyword(s):

Primary Care ◽

Health Care ◽

Mental Illness ◽

Primary Health Care ◽

Cross Sectional ◽

Primary Health ◽

People With Mental Illness ◽

Primary Care Nurses ◽

Opinions About Mental Illness ◽

Unit Of Action

Abstract Objective: To identify the opinions of primary care nurses regarding mental illness and the care provided to this population. Methodology: Cross-sectional, quantitative study with the participation of 328 nurses of primary health care in Porto, Portugal. Data collected between April and August of 2018 through the scale "Opinions about Mental Illness" and socio demographic and labor questionnaire. Descriptive and correlational statistics were applied. Results: A total of 50% of the nurses presented positive opinions about the mental illness. Regarding the assistance provided in their unit of action, 53.4% considered inadequate and 50.3% recognized as adequate their knowledge about the role that primary health care has in assisting the person with mental illness. Conclusion: Positive opinions and recognition of the importance of primary care to people with mental illness are important indicators for qualified mental health care outside the field of specialty.

Download Full-text

Challenges and lessons from a primary care intervention in a Brazilian municipality

Revista de Saúde Pública ◽

10.11606/s1518-8787.2019053000457 ◽

2019 ◽

Vol 53 ◽

pp. 45

Author(s):

Mônica V Andrade ◽

Kenya Noronha ◽

Clareci S Cardoso ◽

Claudia D L Oliveira ◽

Júlia A Calazans ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Chronic Conditions ◽

Household Survey ◽

Cross Sectional ◽

Care Network ◽

The Public ◽

Primary Health ◽

Health Care Network

OBJECTIVE: To address the implementation of the Lab for Innovation in Chronic Conditions in Santo Antonio do Monte, indicating the main challenges and lessons of a new chronic condition model. METHODS: This is an observational study based on two sources of data: 1) two cross-sectional household surveys, 2013 (2012 as reference year) and 2015 (2014 as reference year), representative for the entire population and four target groups (pregnant women; children under two years old; individuals with hypertension and diabetes); medical records of individuals who self-reported having hypertension or diabetes in the household survey of 2013. A descriptive statistics analysis was performed. RESULTS: The main findings showed that the public health system is the main provider of health services, mainly primary care, in Santo Antonio do Monte. Besides, the implementation of Lab for Innovation in Chronic Conditions showed the importance of building a Primary Health Care network in small municipalities. CONCLUSIONS: Community health agents and health managers played a fundamental role in the Primary Health Care network. The case study of Santo Antonio do Monte poses some challenges and lessons that clarify future interventions on building a Primary Health Care network that is essential to provide an adequate and longitudinal care to chronic conditions.

Download Full-text

Primary Health Care Pediatricians’ Self-Perception of Theoretical Knowledge and Practical Skills in Life-Threatening Emergencies: A Cross-Sectional Study

Prehospital and Disaster Medicine ◽

10.1017/s1049023x20000114 ◽

2020 ◽

Vol 35 (2) ◽

pp. 152-159

Author(s):

José Antonio Cernuda Martínez ◽

Rafael Castro Delgado ◽

Pedro Arcos González

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Theoretical Knowledge ◽

Practical Skills ◽

Self Perception ◽

Cross Sectional ◽

Emergency Procedures ◽

Primary Health ◽

Life Threatening

AbstractIntroduction:Within out-of-hospital emergencies, Primary Health Care (PHC) pediatricians will likely be the first to provide health care at the scene of a life-threatening emergency (LTE) in children. Pediatricians should be trained to initially intervene, safely and effectively the LTEs, including the activation of Emergency Medical Systems (EMS), an adequate stabilization of patients and transport to the hospital.Study Objectives:The aims of this study are to know the training received for out-of-hospital LTEs by PHC pediatricians of the Principality of Asturias (Spain) and the perception they have about their own theoretical knowledge and practical skills in a series of emergency procedures used in LTEs; also, to analyze the differences according to the geographical context of their work.Methods:This was a cross-sectional, descriptive, and observational study of a sample of 27 PHC pediatricians from PHC Service of Asturias, Spain, from among the total of 88 pediatricians who make up the staff of pediatricians, conducted from April through May 2019. The survey was designed ad hoc using the Curriculum in Primary Care Pediatrics (CPCP) proposed by the European Confederation of Primary Care Pediatricians (ECPCP; Europe), which indicates the theoretical and practical procedures that must be acquired by the PHC pediatricians. It is composed of 30 procedures or techniques employed in LTEs using a 11-point Likert scale rating to detect their self-perception about theoretical knowledge and practical skills from zero (“Minimum”) to 10 (“Maximum”).Results:There are significant differences in the mean of theoretical knowledge and practical skills in many procedures or techniques studied, depending on the different areas of work.Conclusion:Asturian pediatricians are generally well-prepared to solve LTEs with a few exceptions. The degree of self-perception and acquisition of general theoretical knowledge and general practical skills in LTEs is heterogeneous, with differences according to the scope of work.

Download Full-text

Validation of the comprehensiveness of an instrument on ethical problems in primary care

Revista Gaúcha de Enfermagem ◽

10.1590/1983-1447.2014.01.39811 ◽

2014 ◽

Vol 35 (1) ◽

pp. 148-156 ◽

Cited By ~ 3

Author(s):

José Roque JUNGES ◽

Elma Lourdes Campos Pavone Zóboli ◽

Rafaela SCHAEFER ◽

Carlise Rigon Dalla NORA ◽

Mikaela BASSO

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Data Collection ◽

Ethical Problem ◽

Ethical Problems ◽

Methodological Research ◽

Primary Health ◽

Initial Stage

The study aimed to validate the comprehensiveness of an instrument on the occurrence of ethical problems in primary health care and discuss their results. This is a methodological research. The technique used was Delphi, which seeks to obtain a consensus on a subject by experts, using structured questionnaires that are modified to obtain consensus on the comprehensibility of content. The sample was composed by nine professionals with expertise in primary health care in São Leopoldo. Data collection was in March and April 2011. In the first round, the professional was asked to respond whether the described situation has represented an ethical problem, whether the statement was clear and whether there was any suggestion to rewriting the problem. Were presented thirty-six statements, and to twenty was suggested new rewrite. After the review and systematization the proposed amendments, has begun the second round to seek consensus among all the statements that its writing had changed. In the second round, the consensus required by the method was obtained. Using the method supported significantly to build the instrument in its initial stage, what makes it appropriated and comprehensive for the subsequent steps of the validation.

Download Full-text

Determinants of access to primary health care for the elderly in the province of Essaouira

E3S Web of Conferences ◽

10.1051/e3sconf/202131902021 ◽

2021 ◽

Vol 319 ◽

pp. 02021

Author(s):

Hicham Mejdouli ◽

Abdellatif Baali ◽

Hakima Amor ◽

Nadia Ouzennou

Keyword(s):

Health Care ◽

Primary Health Care ◽

Older People ◽

The Elderly ◽

World Health Organisation ◽

Health Care Facilities ◽

World Health ◽

Bivariate Analysis ◽

Cross Sectional ◽

Primary Health

Morocco is experiencing demographic and epidemiological changes marked by an increase in the proportion of elderly people accompanied by a growing prevalence of chronic diseases and disabilities, thus leading to an increase in the demand for health care. the Moroccan health system therefore faces the challenge of meeting the specific needs of older populations in terms of access to and use of health care services. To achieve this, the World Health Organisation (WHO) recommends a community-based approach, based on primary health care facilities (PHCFs), to the provision of services for older people. This is a descriptive, cross-sectional study based on a quantitative approach. The survey was carried out via a questionnaire intended for a sample of 739 people aged 60 years and over attending the ESSPs in the province of Essaouira between January and February of the year 2020. Our study has allowed us to understand the determinants related to the use of PHC by the elderly in the province of Essaouira. These determinants concern the characteristics of the elderly as well as the organisational and institutional aspects of the care offer. The bivariate analysis of the results showed a statistically significant association between the use of PHC by the elderly and the area of residence, gender, level of education, distance travelled to health facilities, quality of reception, and availability of medicines. Policymakers are called upon to consider the determinants of the use of PHC in order to better address the health needs of older people, and also to respond to WHO guidance in this area.

Download Full-text

Correlation Between Gender and Knowledge, with Practice and Referral Rate of Continuum Rehabilitation Cases by General Practitioners

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/ijpmr.v8i01.180 ◽

2020 ◽

Vol 8 (01) ◽

pp. 9-17

Author(s):

Hari Hari Peni Julianti ◽

Angela BM Tulaar BM Tulaar ◽

Tirza Z Tamin ◽

Tanti Ajoe Kesoema, ◽

Endang Ambarwati, ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Employment Status ◽

Referral Rate ◽

Cross Sectional ◽

Significance Level ◽

Primary Health ◽

Knowledge Practice ◽

Level Of Knowledge

Introduction: Indonesian Health Ministry had a strategy to make the primary care, including rhabilitation program by continuum of care. The purpose of this study was to determine factors related to the levelof knowledge, practice, and referral for continuum care cases that required rehabilitation services in Primary Health Care Doctors.Methods: The study design was cross-sectional. Participants were 23 Primary Health Care Doctors in Wonosobo District. Data collection was conducted in December 2017. The independent variablesconsist of gender, length of work, employment status, while the dependent variables were the level of knowledge, practice and referral cases of maternal, infants and toddlers, adolescents, adults and elderly.The measuring instrument was a questionnaire. Data were tested with chi-square, significance level <0.05.Results: Gender has correlation with the level of knowledge in maternal cases (PR = 0.121, 95% CI = 0.017-0.087, p = 0.026). Gender has correlation to the level of practice in maternal case (PR = 0.121,95% CI = 0.017-0.867, p = 0.026). Employment status has correlation to the referral rate of elderly cases(PR = 10.500, 95% CI = 1.015-108.577, p = 0.029).Conclusion: Gender has correlation with the level of knowledge and practice of maternal cases. Employment status has correlation with the level of referral rate of elderly cases.Keywords: Primary care doctors, Knowledge, Referral, Continuum Rehabilitation

Download Full-text

ANALISIS PENGGUNAAN ALAT PELINDUNG DIRI (APD) COVID-19 PADA PETUGAS PUSKESMAS DI KOTA PADANG

PREPOTIF : Jurnal Kesehatan Masyarakat ◽

10.31004/prepotif.v5i1.1531 ◽

2021 ◽

Vol 5 (1) ◽

pp. 271-281

Author(s):

Ayulia Fardila Sari ZA ◽

Syafrawati Syafrawati ◽

Laa Tania Fizikriy

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Workers ◽

Transmission Risk ◽

Primary Data ◽

Bivariate Analysis ◽

P Value ◽

Cross Sectional ◽

Primary Health ◽

Usage Behavior

Introduction: Health workers are groups that are vulnerable to contracting COVID-19. There are 20 health workers in West Sumatra test positive for COVID-19 until April 30th 2020, while six of them are Padang primary health care officers. Using Personal Protective Equipment (PPE) is important to prevent and reduce COVID-19 transmission risk of health workers. This study aimed to measure factors of using PPE for Padang primary health care officers. Methods: Research used a quantitative method with cross sectional design in 12 Padang primary health care from March to July 2020. Independent variables were age, PPE availability, leadership support, knowledge, and attitudes. Dependent variable was PPE usage behavior. Research population was health care officers who directly contacted with people in Padang primary health care area with 100 samples. Primary data collection used questionnaire with accidental sampling technique and analyzed using bivariate analysis. Results:There was a significant relationship between age and PPE usage behavior for health care officers, p value=0.037 (p

Download Full-text

Patient safety culture in Primary Health Care

Rev Rene ◽

10.15253/2175-6783.20212270874 ◽

2021 ◽

Vol 22 ◽

pp. e70874

Author(s):

Jéssica Karine Lopes Bohrer ◽

Ana Catarina Laboissière Vasconcelos ◽

Ana Lúcia Queiroz Bezerra ◽

Cristiane Chagas Teixeira ◽

Juliane Andrade ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Patient Safety ◽

Primary Health Care ◽

Safety Culture ◽

Patient Safety Culture ◽

Cross Sectional Study ◽

Cross Sectional ◽

Primary Health ◽

Primary Care Health

Objective: to evaluate the patient safety culture in a primary care health unit. Methods: cross-sectional study conducted with 51 professionals linked to Primary Health Care. Data were collected using the self-administered instrument Medical Office Survey on Patient Safety Culture, translated, adapted and validated for use in Brazil. Descriptive statistical analysis was performed. Nurses, physicians, Community Health Agents, among other professionals participated. Results: the dimensions of the patient safety culture in Primary Health Care indicated opportunities for improvement or weaknesses in the service. The general assessment of patient safety and the global assessment of the quality of care provided in Primary Health Care were appointed as good or fair. Conclusion: the safety culture in Primary Care did not identify strong dimensions; there were problems with equipment, performance and availability of test results and exchange of information with imaging centers/laboratories in the care network.

Download Full-text

Body Mass Index Assessment of Health Care Professionals in a Primary Care Setting in Portugal: a Cross Sectional Study

Acta Médica Portuguesa ◽

10.20344/amp.5141 ◽

2014 ◽

Vol 27 (5) ◽

pp. 609 ◽

Cited By ~ 5

Author(s):

Inês Campos-Matos ◽

André Peralta-Santos ◽

Bernardo Gomes ◽

Gustavo Borges ◽

Pedro Aguiar

Keyword(s):

Primary Care ◽

Health Care ◽

Body Mass Index ◽

Primary Health Care ◽

Body Mass ◽

Health Care Professionals ◽

Care Setting ◽

Primary Care Setting ◽

Cross Sectional ◽

Primary Health

Introduction: Obesity is an important public health problem because it is a risk factor for numerous diseases and is associated with a higher death risk. Evidence concerning the prevalence of excess weight in health professionals is scarce and this group is often overlooked in weight interventions programs. This paper aims to estimate the prevalence of obesity and overweight among Portuguese primary health care professionals and to describe differences between occupational groups. Material and Methods: This was a cross sectional study based on a primary care setting in Portugal in 2011. We collected data on occupation, age, sex and height of professionals from four primary care centers. We did a descriptive analysis of the main variables and an analysis of covariance to compare mean Body Mass Index. Results: Our sample represented 52.8% of the total population of the four primary care centers, and 38.6% were overweight and 16.9% were obese. When adjusted for age and gender, health service personnel had the highest average Body Mass Index, followed by nurses, physicians, and superior technicians, in that order. Discussion: Although we can’t ensure the generalisation of the results and cannot exclude the possibility of sampling bias, these results suggest high prevalence obesity and overweight in workers of primary health care in Portugal. Conclusion: In this primary care setting more than half of the health care professionals were overweight or obese. Tailored interventions might be needed to tackle this issue. Keywords: Body Mass Index; Health Personnel; Obesity; Portugal; Primary Health Care; Prevalence.

Download Full-text