scholarly journals Management of spinal disorders by primary care providers in Saudi Arabia: Treatment options and referral patterns

2015 ◽  
Vol 4 (3) ◽  
pp. 143 ◽  
Author(s):  
KhalidAbdulrazzak Alsaleh ◽  
AbdullahSaleh Alluhaidan ◽  
YazeedKhalid Alsaran ◽  
HeshamSaad Alrefayi ◽  
NizarAbdullah Algarni ◽  
...  
Hand ◽  
2021 ◽  
pp. 155894472110085
Author(s):  
Landis R. Walsh ◽  
Laura C. Nuzzi ◽  
Amir H. Taghinia ◽  
Brian I. Labow

Background Although pediatric hand fractures are common and generally have good outcomes, they remain a considerable source of anxiety for non–hand surgeons, who are less familiar with these injuries. We hypothesized that this anxiety may manifest as inefficiency in referral patterns. Methods The records of pediatric patients with isolated, closed hand fractures without concurrent trauma seen at our institution by a hand surgeon between January 2017 and December 2018 were retrospectively reviewed. Results There were 454 patients included; 62.1% were men, and the mean age was 9.6 years at initial encounter. Most patients (89.6%) were treated nonoperatively and incurred few complications (0.5%). Roughly half of all cases (n = 262) initially presented to an outside provider. Of these, 24.0% (n = 64 of 262) were evaluated by 2+ providers before a hand surgeon. Most commonly, these patients were referred from an outside emergency department (ED) to our ED before hand surgeon evaluation (n = 45 of 64). Forty-seven patients required surgery; however, none were performed urgently. Although a greater proportion of 7- to 11-year-old patients saw 2+ providers prior to a hand surgeon ( P = .007), fewer required surgery ( P < .001). Conclusions Pediatric closed hand fractures are mainly treated nonoperatively and nonemergently with generally excellent outcomes. Our data suggest that many patients continue to be referred through the ED or multiple EDs/providers for treatment. These inefficient referral patterns demonstrate the need for better education for ED and primary care providers, as well as better communication between these providers and local pediatric hand surgeons. Advancements in these areas are likely to improve efficiency of care and decrease costs.


Vascular ◽  
2021 ◽  
pp. 170853812110443
Author(s):  
Sultan Alsheikh ◽  
Hesham AlGhofili ◽  
Omar A Alayed ◽  
Abdulkareem Aldrak ◽  
Kaisor Iqbal ◽  
...  

Introduction Patients with peripheral artery disease (PAD) are often underdiagnosed and undertreated. This study aimed to assess the knowledge of the recommended target levels of blood pressure, low-density lipoprotein cholesterol, glycosylated hemoglobin A1C, and knowledge and attitude about PAD risk reduction therapies among physicians working in primary care settings in Saudi Arabia. Methods This observational cross-sectional study included family medicine consultants, residents, and general practitioners working in a health cluster in the capital city of Saudi Arabia using a self-administered questionnaire. Results Of the 129 physicians who completed the survey, 55% had completed PAD-related continuing medical education hours within the past 2 years. Despite this, the knowledge score of the recommended target levels was high in only 13.2% of the participants. Antiplatelet therapy was prescribed by 68.2% of the participants. Conclusion Here we identified the knowledge and action gaps among primary care providers in Saudi Arabia. Physicians had an excellent attitude about screening for and counseling about risk factors. However, they showed less interference in reducing these risk factors. We recommend addressing these knowledge gaps early in medical school and residency programs.


2015 ◽  
Vol 34 (2) ◽  
pp. 63-72 ◽  
Author(s):  
Graham Gaylord ◽  
S. Kathleen Bailey ◽  
John M. Haggarty

This study describes a shared mental health care (SMHC) model introduced in Northern Ontario and examines how its introduction affected primary care provider (PCP) mental health referral patterns. A chart review examined referrals (N = 4,600) from 5 PCP sites to 5 outpatient community mental health services from January 2001 to December 2005. PCPs with access to SMHC made significantly more mental health referrals (p < 0.001). Two demographically similar PCPs were then compared, one co-located with SMHC. Referrals for depression to non-SMHC mental health services were 1.69 times more likely to be from the PCP not co-located with SMHC (p < 0.001). Findings suggest SMHC increases access to care and decreases demand on existing mental health services.


2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Diogo Beirão ◽  
Helena Monte ◽  
Marta Amaral ◽  
Alice Longras ◽  
Carla Matos ◽  
...  

Abstract Background Depression is a common mental health disease, especially in mid to late adolescence that, due to its particularities, is a challenge and requires an effective diagnosis. Primary care providers are often the first line of contact for adolescents, being crucial in identifying and managing this pathology. Besides, several entities also recommend screening for depression on this period. Thus, the main purpose of this article is to review the scientific data regarding screening, diagnosis and management of depression in adolescence, mainly on primary care settings. Main body Comprehension of the pathogenesis of depression in adolescents is a challenging task, with both environmental and genetic factors being associated to its development. Although there are some screening tests and diagnostic criteria, its clinical manifestations are wide, making its diagnosis a huge challenge. Besides, it can be mistakenly diagnosed with other psychiatric disorders, making necessary to roll-out several differential diagnoses. Treatment options can include psychotherapy (cognitive behavioural therapy and interpersonal therapy) and/or pharmacotherapy (mainly fluoxetine), depending on severity, associated risk factors and available resources. In any case, treatment must include psychoeducation, supportive approach and family involvement. Preventive programs play an important role not only in reducing the prevalence of this condition but also in improving the health of populations. Conclusion Depression in adolescence is a relevant condition to the medical community, due to its uncertain clinical course and underdiagnosis worldwide. General practitioners can provide early identification, treatment initiation and referral to mental health specialists when necessary.


Author(s):  
Sanjeev Sirpal ◽  
Natasha Chandok

Notwithstanding the groundbreaking achievement of hepatitis C curative treatment with direct acting antiviral therapies, Canada faces an uphill battle in reaching the 2030 goal of viral elimination set forth the by the World Health Organization, a goal made more difficult by the COVID-19 pandemic. There is limited understanding of the diagnostic and treatment barriers, and challenges in linkage to care in Canada, especially as it pertains to primary care providers in a community context. Therefore, in this article, the authors conducted a survey study to evaluate the following factors: primary care providers’ knowledge of specialist treatment options and the importance of screening and treatment; and patient factors, including transportation, linguistic barriers, and other socio-economic status indicators that impact the screening and management of hepatitis C. The results suggest that public health campaigns that protocolize and/or incentivize screening and referrals may provide solutions to addressing such barriers.


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