scholarly journals Prevalence and Management of Anemia in Adolescents in Primary Care Settings

2021 ◽  
pp. 229-235
Author(s):  
Faisal Suliman Algaows ◽  
Jazi Abdullah Aloseimi ◽  
Fatima Mohammed Almahmoudi ◽  
Abdulaziz Ali Mohammed Alzawani ◽  
A. Alzahrani Omar Abdulaziz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
General Practice ◽  
Family Medicine ◽  
Blood Cell ◽  
Primary Care Physicians ◽  
Negative Effects ◽  
Primary Care Settings ◽  
Rbc Count

Anemia is defined as a drop in haemoglobin (Hb), hematocrit (HCT), or red blood cell (RBC) count. Anemia is a widespread issue in primary care, and primary care physicians are generally the first to notice its symptoms. Anaemia is a prevalent clinical concern among the adolescents.  It is widely known that haemoglobin levels drop with age increase. Anemia has been linked to a variety of negative effects, including higher mortality, hospitalisation, and a worse quality of life. epidemiological reporting of anaemia is fragmented. Anemia is diagnosed in part by symptoms reported in general practice/family medicine (GP/FM). Management of anemia relies on the type of anemia and underlying cause, in this review we will be looking at Prevalence, etiology, classification and management of Anemia.

scholarly journals The Impact of a Primary Care, Pharmacist-Driven Intervention in Patients with Chronic Non-Cancer Pain—A Pilot Study

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 113
Author(s):  
Mo Chen ◽  
Tejal Patel ◽  
Feng Chang
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Cancer Pain ◽  
Family Health ◽  
Primary Care Settings ◽  
Pain Intervention ◽  
Family Health Team ◽  
The Impact

Background: Chronic pain is a prevalent condition, experienced by 15.3% to 55% of Canadians, that is difficult to manage. With their broad accessibility and expertise on drugs, primary care pharmacists can help patients optimize their pain management. Methods: The objective of this study is to examine the effectiveness of a primary care, pharmacist-driven chronic pain intervention on pain and quality of life in patients with chronic non-cancer pain. A three-month naturalistic prospective study was conducted in primary care settings (five community pharmacies and one Family Health Team) across Ontario, Canada with a total of six pharmacists and 19 study participants. The primary care, pharmacist-driven chronic pain intervention consisted of patient assessments, medication reviews, care plan recommendations, and patient education. In order to evaluate the effectiveness of the intervention, pain intensity, pain interference, and quality of life were evaluated at baseline and at follow up (week 2 and month 3). Results: Trends towards improvement in pain and quality of life were found, however, these improvements were not statistically significant at follow up (month 3). Conclusions: This study provides the foundational research required to better understand the impact of Ontario pharmacists’ extended role in pain management in non-cancer patients within multiple primary care settings (e.g., Family Health Team, etc.) and has illustrated the importance of modifying and customizing care plans in patients with chronic pain. A larger sample size with tailored outcome measures may be necessary to better highlight significant improvements in pain and quality of life in patients with chronic non-cancer pain using a primary care, pharmacist-driven intervention.

Differences between primary care physicians and specialised neurotologists in the diagnosis of dizziness and vertigo in Japan

2020 ◽  
Vol 134 (9) ◽  
pp. 764-768
Author(s):  
T Ito ◽  
S Matsuyama ◽  
T Shiozaki ◽  
D Nishikawa ◽  
H Akioka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Patient Satisfaction ◽  
Diagnostic Accuracy ◽  
Medical Records ◽  
Primary Care Physicians ◽  
Symptom Relief ◽  
Accurate Diagnosis ◽  
High Quality

AbstractObjectiveVertigo and dizziness are frequent symptoms in patients at out-patient services. An accurate diagnosis for vertigo or dizziness is essential for symptom relief; however, it is often challenging. This study aimed to identify differences in diagnoses between primary-care physicians and specialised neurotologists.MethodIn total, 217 patients were enrolled. To compare diagnoses, data was collected from the reference letters of primary-care physicians, medical questionnaires completed by patients and medical records.ResultsIn total, 62.2 per cent and 29.5 per cent of the patients were referred by otorhinolaryngologists and internists, respectively. The cause of vertigo or dizziness and diagnosis was missing in 47.0 per cent of the reference letters. In addition, 67.3 per cent of the diagnoses by previous physicians differed from those reported by specialised neurotologists.ConclusionTo ensure patient satisfaction and high quality of life, an accurate diagnosis for vertigo or dizziness is required; therefore, methods or materials to improve the diagnostic accuracy are needed.

A Refresher on Herpes Zoster, Current Status on Vaccination, and the Role of the Dermatologist

2011 ◽  
Vol 15 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Lyn C. Guenther ◽  
Charles W. Lynde
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Herpes Zoster ◽  
Preventive Medicine ◽  
Primary Care Physicians ◽  
Current Status ◽  
Age Group ◽  
Increased Risk

Background: Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a significant impact on quality of life. PHN is often chronic and difficult to treat. Dermatologists have always been involved in making the diagnosis of these conditions and, most recently, teaching the need for early antiviral therapy. Objective: With the introduction of a new vaccine, HZ and its difficult-to-treat complication PHN can be prevented or minimized. Preventive medicine is important and has been supported by dermatologists with sun safety programs. Patients receiving biologics are at increased risk of developing zoster. Conclusion: Dermatologists should embrace zoster vaccination and recommend routine vaccination of immunocompetent individuals > age 60 years, as well as patients of any age who are starting immunosuppressants, including biologics. Given that individuals over age 50 years are at risk for PHN and studies have shown that the vaccine's immunogenicity and safety are maintained in individuals age 50 to 59 years, vaccination in this age group may be considered. Some dermatologists may consider vaccinating their own patients, but most will likely recommend that vaccination be performed by their patients' primary care physicians.

Otitis externa

2018 ◽  
Vol 11 (6) ◽  
pp. 298-304
Author(s):  
Emma Dickson
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
General Practice ◽  
Otitis Externa ◽  
External Auditory Meatus ◽  
Diagnosis And Management

Otitis externa is inflammation of the external auditory meatus. It is a common, acute and chronic presentation to general practice, with around 10% of the population suffering at least one episode. Pain and itching are common symptoms and affect quality of life. Identifying the cause of otitis externa can be a challenge. This article considers different presentations of otitis externa, their diagnosis and management in primary care.

scholarly journals Restless legs syndrome: literature review

2010 ◽  
Vol 128 (3) ◽  
pp. 167-170 ◽  
Author(s):  
Emmanouil Symvoulakis ◽  
Dimitrios Anyfantakis ◽  
Christos Lionis
Keyword(s):  
Quality Of Life ◽  
Restless Legs Syndrome ◽  
Negative Effects ◽  
Restless Legs ◽  
Care Services ◽  
Primary Care Settings ◽  
Inappropriate Treatment ◽  
Occupational Life ◽  
Distressing Condition

Restless legs syndrome is a distressing condition, with negative effects on sleep and daytime activities that affect personal, family and occupational life. The overall impact of restless legs syndrome on quality of life is comparable to that of chronic and frustrating conditions such as depression and diabetes. Misdiagnosis and inappropriate treatment may increase patients' suffering in terms of uncertainty, overuse or misuse of care services and lack of trust. Presenting a synthesis of the main topics in the literature on restless legs syndrome facilitates for a better understanding and its management in primary care settings.

scholarly journals Impact of superimposed nephrological care to guidelines-directed management by primary care physicians of patients with chronic kidney disease: a randomized controlled trial

2019 ◽  
Author(s):  
Patrick Saudan ◽  
Belen Ponte ◽  
Nicola Marangon ◽  
Chantal Martinez ◽  
Lena Berchtold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Physicians ◽  
Clinical Care ◽  
Randomised Trial ◽  
Dialysis Initiation ◽  
The Impact

Abstract Background: Optimal clinical care of patients with chronic kidney disease (CKD) requires collaboration between primary care physicians (PCP) and nephrologists. We undertook a randomised trial to determine the impact of superimposed nephrologist care compared to guidelines-directed management by PCPs in CKD patients after hospital discharge. Methods: Stage 3b-4 CKD patients were enrolled during a hospitalization and randomised in two arms: Co-management by PCPs and nephrologists (interventional arm) versus management by PCPs with written instructions and consultations by nephrologists on demand (standard care). Our primary outcome was death or rehospitalisation within the 2 years post-randomisation. Secondary outcomes were: urgent renal replacement therapy (RRT), decline of renal function and decrease of quality of life at 2 years. Results: From November 2009 to the end of June 2013, we randomised 242 patients. Mean follow-up was 51 + 20 months. Survival without rehospitalisation, GFR decline and elective dialysis initiation did not differ between the two arms. Quality of life was also similar in both groups . Compared to randomised patients, those who either declined to participate in the study or were previously known by nephrologists had a worse survival. Conclusion: These results do not demonstrate a benefit of a regular renal care compared to guided PCPs care in terms of survival or dialysis initiation in CKD patients. Increased awareness of renal disease management among PCPs may be as effective as a co-management by PCPs and nephrologists in order to improve the prognosis of moderate-to-severe CKD.

scholarly journals Physical activity promotion for multimorbid patients in primary care settings: A protocol for a systematic review evaluating health benefits and harms.

2020 ◽  
Author(s):  
Simone Schweda ◽  
Inga Krauß
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Systematic Review ◽  
Primary Care ◽  
Health Benefits ◽  
The Body ◽  
Cochrane Library ◽  
Primary Care Settings ◽  
Activity Promotion

Background: To date multimorbidity has not received much attention in health policies, even though multiple chronic diseases put high demands on the health care system in industrial nations. Enormous costs of care and a physically, mentally and socially reduced quality of life are common consequences of multimorbidity. Physical activity (PA) has a positive preventive and therapeutic effect on common non-communicable . The objective of this study will be to evaluate the halth benefits and harms of PA interventions for sedentary adults with multimorbidity in primary care settings. Methods: This is the study protocol for a systematic review. We will serach PubMed, MEDLINE (Ovid), Web of Science, CINHAL and the Cochrane Library (from inception onwards). In addition, clinical trial registers and reference lists of included studies will be searched. We will include randomised controlled trials, quasi-experimental and non-randomised trials examining the health benefits and harms of PA interventions with or without additional lifestyle interventions for sedentary adult patients with multimorbidity (e.g. two or more chronic non-communicable diseases) in primary care. Eligible control groups will be standard care, placebo or medications. Two reviewers will independently screen all citations, abstracts data and full text articles. The primary outcomes will be health related quality of life and mortality. Secondary outcomes will include cardiovascular fitness, muscular strength and disease specific outcomes (e.g. depression score), biomarkers as well as control of metabolic risk factors (e.g. blood pressure, HBA1c, body weight) and any adverse event. The study methodological quality will be appraised using appropriate tools. If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g. study design, geographical location, or type of intervention). Strength of the body of evidence will be assessed according to the Grading of Recommendations Assessment (GRADE). Discussion: This review will evaluate the evidence on health benefits and harms of PA interventions for sedentary adults with multimorbidity in primary care settings. We anticipate our findings to be of interest to patients, their families, caregivers and healthcare professionals in selecting and conducting optimal health promotion programs. Possible implications for further research will be discussed.

scholarly journals Impact of superimposed nephrological care to guidelines-directed management by primary care physicians of patients with stable chronic kidney disease: a randomized controlled trial

2019 ◽  
Author(s):  
Patrick Saudan ◽  
Belen Ponte ◽  
Nicola Marangon ◽  
Chantal Martinez ◽  
Lena Berchtold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Physicians ◽  
Clinical Care ◽  
Randomised Trial ◽  
Dialysis Initiation ◽  
The Impact

Abstract Background: Optimal clinical care of patients with chronic kidney disease (CKD) requires collaboration between primary care physicians (PCP) and nephrologists. We undertook a randomised trial to determine the impact of superimposed nephrologist care compared to guidelines-directed management by PCPs in CKD patients after hospital discharge. Methods: Stage 3b-4 CKD patients were enrolled during a hospitalization and randomised in two arms: Co-management by PCPs and nephrologists (interventional arm) versus management by PCPs with written instructions and consultations by nephrologists on demand (standard care). Our primary outcome was death or rehospitalisation within the 2 years post-randomisation. Secondary outcomes were: urgent renal replacement therapy (RRT), decline of renal function and decrease of quality of life at 2 years. Results: From November 2009 to the end of June 2013, we randomised 242 patients. Mean follow-up was 51 + 20 months. Survival without rehospitalisation, GFR decline and elective dialysis initiation did not differ between the two arms. Quality of life was also similar in both groups . Compared to randomised patients, those who either declined to participate in the study or were previously known by nephrologists had a worse survival. Conclusion: These results do not demonstrate a benefit of a regular renal care compared to guided PCPs care in terms of survival or dialysis initiation in CKD patients. Increased awareness of renal disease management among PCPs may be as effective as a co-management by PCPs and nephrologists in order to improve the prognosis of moderate-to-severe CKD.

scholarly journals Feasibility, experiences and outcomes of using DIALOG+ in primary care to improve quality of life and mental distress of patients with chronic conditions: an exploratory non-controlled trial in Bosnia and Herzegovina, Colombia and Uganda

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Francois van Loggerenberg ◽  
Michael McGrath ◽  
Dickens Akena ◽  
Harriet Birabwa-Oketcho ◽  
Camilo Andrés Cabarique Méndez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Bosnia And Herzegovina ◽  
Mental Distress ◽  
Controlled Trial ◽  
Physical Conditions ◽  
Link Type ◽  
Primary Care Settings ◽  
Chronic Physical Conditions

Abstract Background DIALOG+ is a resource-oriented and evidence-based intervention to improve quality of life and reduce mental distress. While it has been extensively studied in mental health care, there is little evidence for how to use it in primary care settings for patients with chronic physical conditions. Considering that DIALOG+ is used in existing routine patient-clinician meetings and is very low cost, it may have the potential to help large numbers of patients with chronic physical conditions, mental distress and poor quality of life who are treated in primary care. This is particularly relevant in low- and middle-income countries (LMICs) where resources for specialised services for such patients are scarce or non-existent. Methods An exploratory non-controlled trial will be conducted to primarily assess the feasibility and acceptability and, secondarily, outcomes of delivering DIALOG+ to patients with chronic physical conditions and poor quality of life in primary care settings in Bosnia and Herzegovina, Colombia and Uganda. Thirty patients in each country will receive DIALOG+ up to three times in monthly meetings over a 3-month period. Feasibility will be assessed by determining the extent to which the intervention is implemented as planned. Experiences will be captured in interviews and focus groups with care providers and participants to understand acceptability. Quality of life, symptoms of anxiety and depression, objective social situation and health status will be assessed at baseline and again after the three-session intervention. Discussion This study will inform our understanding of the extent to which DIALOG+ may be used in the routine care of patients with chronic physical conditions in different primary care settings. The findings of this exploratory trial can inform the design of future full randomised controlled trials of DIALOG+ in primary care settings in LMICs. Trial registration All studies were registered prospectively (on 02/12/2020 for Uganda and Bosnia and Herzegovina, and 01/12/2020 for Colombia) within the ISRCTN Registry. ISRCTN17003451 (Bosnia and Herzegovina), ISRCTN14018729 (Colombia) and ISRCTN50335796 (Uganda). Protocol version and date: v2.0; 28/07/2020 (Bosnia and Herzegovina), v0.3 02/08/2020 (Colombia) and v1.0, 05/11/2020 (Uganda).

scholarly journals Managing Depression in Diabetes Mellitus: A Multicentric Randomized Controlled Trial Comparing Effectiveness of Fluoxetine and Mindfulness in Primary Care: Protocol for DIAbetes Mellitus ANd Depression (DIAMAND) Study

2020 ◽  
Vol 42 (6_suppl) ◽  
pp. S31-S38
Author(s):  
Mina Chandra ◽  
Dhanya Raveendranathan ◽  
Johnson Pradeep R. ◽  
Suravi Patra ◽  
Rushi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Primary Care ◽  
Randomized Controlled Trial ◽  
Glycemic Control ◽  
Collaborative Care ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Primary Care Settings

Background: Suboptimal management of depression in type 2 diabetes mellitus (T2DM) often translates into poor glycemic control, medical complications, and impaired quality of life. Feasibility and effectiveness of collaborative care models of depression in diabetes in low- and middle-income countries (LMICs) remain unexplored. DIAbetes Mellitus ANd Depression (DIAMAND) study, a multicentric single-blind randomized controlled trial (SBRCT) comparing effectiveness of fluoxetine and mindfulness in primary care settings, addresses this gap in scientific literature. Methods: This trial conducted in diverse geographic settings of New Delhi, Bengaluru, and Bhubaneswar will comprise module-based training of primary care providers (PCPs) for screening, diagnosing, and managing depression in diabetes in phase I. Phase II will involve four-arm parallel group RCT on 350 participants with T2DM with comorbid depressive episode randomly allocated to receive fluoxetine, mindfulness therapy, fluoxetine plus mindfulness therapy, or treatment as usual at primary care settings. Interventions would include fluoxetine (up to 60 mg/day) and/or sessions of mindfulness for 16 weeks. Primary outcomes on standardized rating scales include depression scores (Hamilton Depression Rating Scale), treatment adherence (Adherence to Refill and Medication Scale), self-care (Diabetes Self-Management Questionnaire), diabetes-related distress (Diabetes Distress Scale), and glycemic control. Secondary outcomes include quality of life (World Health Organization Quality of Life Brief version [WHO-QOL BREF]) and mindfulness (Five Facets Mindfulness Questionnaire). Discussion: This RCT will investigate the effectiveness of module-based training of PCPs and feasibility of collaborative care model for managing depression in T2DM in primary care settings in LMICs and effectiveness of fluoxetine and/or mindfulness in improving diverse outcomes of T2DM with major depression.

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