Erratum: Malnutrition in children under the age of 5 years in a primary health care setting

No abstract available.

Validity of self-reported substance use: research setting versus primary health care setting

Background Self-reported substance use is more likely to be influenced by underreporting bias compared to the biological markers. Underreporting bias or validity of self-reported substance use depends on the study population and cannot be generalized to the entire population. This study aimed to compare the validity of self-reported substance use between research setting and primary health care setting from the same source population. Methods and materials The population in this study included from Rafsanjan Youth Cohort Study (RYCS) and from primary care health centers. The sample from RYCS is made up 607 participants, 113 (18.62%) women and 494 (81.38%) men and sample from PHC centers is made up 522 individuals including 252 (48.28%) women and 270 (51.72%) men. We compared two groups in respect of prevalence estimates based on self-reported substance use and urine test. Then for evaluating validity of self-reported substance use in both group, the results of reference standard, urine tests, were compared with the results of self-reported drug use using measures of concordance. Results The prevalence of substance use based on urine test was significantly higher in both settings compared to self-reported substance use over the past 72 h. The sensitivity of self-report substance use over the past 72 h in research setting was 39.4, 20, 10% and zero for opium, methadone, cannabis and amphetamine, respectively and in primary health care setting was 50, 20.7, 12.5% and zero for opium, methadone, cannabis and amphetamine, respectively. The level of agreement between self-reported substance use over the past 72 h and urine test indicated fair and moderate agreement for opium in both research and primary health care settings, respectively and also slight agreement for methadone and cannabis in both settings were reported. There was no significant difference between the two groups in terms of self-reported substance use. For all substances, the level of agreement increased with longer recall periods. The specificity of self-report for all substances in both groups was more than 99%. Conclusion Individuals in primary health care setting were more likely to self-reported substance use than in research setting, but setting did not have a statistically significant effect in terms of self-reported substance use. Programs that rely on self-reported substance use may not estimate the exact prevalence of substance use in both research and primary health care settings, especially for substances that have a higher social stigma. Therefore, it is recommended that self-report and biological indicators be used for more accurate evaluation in substance use studies. It is also suggested that future epidemiological studies be performed to reduce bias of social desirability and find a method providing the highest level of privacy.

Malnutrition in children under the age of 5 years in a primary health care setting

In this study, we outlined the types of malnutrition amongst children, the causes of malnutrition intervention at the primary health care level and some recommendations to alleviate childhood malnutrition in South Africa.

Performance of Pharmacy students in a comprehensive medication management service in a Primary Health Care Setting

This study aims to assess the performance of pharmacy students in the provision of a comprehensive medication management (CMM) service in a primary health care setting. Methods: A retrospective, descriptive, observational study spanning one academic semester of the provision of the CMM service by pharmacy students was conducted. The data on the profile of patients attended, drug therapy-related problems (DRPs) identified, and the interventions proposed to resolve the DRPs were collected from electronic medical records held by the service. Key findings: A total of 20 patients were attended, predominantly women (65%), with a mean age of 69.2 years. The mean number of health problems per patient was 4.8 and mean medications per patient was 6.8. Of the total 35 DRPs identified, the most common were those related to indication (40%) and effectiveness (22.9%) of the drug therapy. The two most frequent interventions to resolve the DRPs involved starting new therapy and changing dosage, respectively. Conclusions: The results allowed inferences to be made about the effectiveness of pharmacy practice experience for developing clinical competencies of pharmacy students, given that the performance of students proved comparable to that of pharmacists in established CMM services reported in the literature.

Introduction of an Appointment System in Primary Health Care Setting in Baghdad: Views of Patients and Health Care Providers

Background: The appointment system is a common practice in primary health care clinics in developed countries. The patients and health care providers in the primary health care setting perceived the appointment system as an indicator of good quality service. Objective: The aim of this study was to survey patients’ and health care providers’ attitudes towards the introduction of an appointment system and their satisfaction with the existing ‘walk-in’ system in the primary health care setting. Subjects and Methods: A questionnaire survey was conducted included a convenient sample of 234 patients as well as 76 health care providers from two primary health care centers in Al-Karkh district, Baghdad governorate. The study used two separate questionnaires, for patients and staff. Results: Approximately half of the patients (51.7%) and the majority of the health care providers (85.5%) agreed on the introduction of the appointment system. The employee’s patients, highly educated patients, and patients with chronic illness showed a significant agreement to this idea. Most participants, patients, and providers agreed that reduction of workload, provision of quality care to the patient, and improvement of patient-provider relationship are the most important advantages of the application of an appointment system. While the lack of flexibility of this system was the main perceived disadvantage. Conclusion: Respondents showed great acceptance to the idea of introduction of the appointment system to be run concurrently with the existing walk-in system (mixed system) in the primary care setting in Iraq, and they preferred this system to be flexible and responsive to the needs and preferences of the patients as well as health care providers.

Effects of the Off-Label Drug Prescription in the Paediatric Population in Spain from the Adoption of the Latest European Regulation: A Pre-Post Study

The year 2021 marks the 15th anniversary of the Paediatric Regulation (1901/2006/EC) in Europe. The main aim of the study was to conduct a pre-post comparison on the annual off-label prescription rates in the under-18 population in Spain and assess the potential influence of the Paediatric Regulation adoption. An observational study in the paediatric population was performed. Four cross-sectional annual periods, one before and the three latest periods after the adoption of the Regulation, were compared. Prescriptions in the primary health care setting were sorted by age group and drug and off-label status were determined. The number of off-label prescriptions issued by paediatricians was over two million per year. Prior to the adoption of the Paediatric Regulation, the off-label prescription rate was estimated at 7% of total prescriptions. Although the increase in the off-label rate over the study periods was mild, it was statistically significant (OR: 1.045; 95% CI: 1.043–1.046; p < 0.05). One of the most vulnerable population groups was neonates and infants up to 1 year, in which the off-label prescription rates showed the highest increase during the post follow-up period, which was statistically significant (OR: 4.270; 95% CI: 4.253–4.287; p < 0.05). The findings can help raise awareness and advocate for the development and authorization of medicines for children in the primary health care setting.