Radiological follow-up of adults hospitalised with pneumonia and SARS-CoV-2 infection, in Bristol UK, during the COVID19 pandemic

For patients with pneumonia and COVID19 repeating chest radiography is recommend in current British Thoracic Society (BTS) guidelines. Over two distinct time periods during the COVID19 pandemic (Aug-Dec 2020, Jun-Aug 2021) we undertook an audit of 829 patients hospitalised with infective radiological change (pneumonia=481, COVID19=348). 654/829 patients (79%) required radiological follow-up under BTS guideline criteria. 414/654 (63%) were planned, 322/654 (49%) occurred and, of patients receiving radiological follow-up, most occurred within BTS timelines (86%). Further audits should be conducted to ensure BTS guidelines adherence, to avoid delay in diagnosing underlying malignancy or chronic lung disease.

Early and Later Perceptions and Reactions to the COVID-19 Pandemic in Germany: On Predictors of Behavioral Responses and Guideline Adherence During the Restrictions

In March 2020, the German government enacted measures on movement restrictions and social distancing due to the COVID-19 pandemic. As this situation was previously unknown, it raised numerous questions about people’s perceptions of and behavioral responses to these new policies. In this context, we were specifically interested in people’s trust in official information, predictors for self-prepping behavior and health behavior to protect oneself and others, and determinants for adherence to social distancing guidelines. To explore these questions, we conducted three studies in which a total of 1,368 participants were surveyed (Study 1 N=377, March 2020; Study 2 N=461, April 2020; Study 3 N=530, April 2021) across Germany between March 2020 and April 2021. Results showed striking differences in the level of trust in official statistics (depending on the source). Furthermore, all three studies showed congruent findings regarding the influence of different factors on the respective behavioral responses. Trust in official statistics predicted behavioral responses in all three studies. However, it did not influence adherence to social distancing guidelines in 2020, but in 2021. Furthermore, adherence to social distancing guidelines was associated with higher acceptance rates of the measures and being older. Being female and less right-wing orientated were positively associated with guidelines adherence only in the studies from 2020. This year, political orientation moderated the association between acceptance of the measures and guideline adherence. This investigation is one of the first to examine perceptions and reactions during the COVID-19 pandemic in Germany across 1year and provides insights into important dimensions that need to be considered when communicating with the public.

ERS/EAACI statement on adherence to international adult asthma guidelines

Guidelines aim to standardise and optimise asthma diagnosis and management. Nevertheless, adherence to guidelines is suboptimal and may vary across different healthcare professional (HCP) groups.Further to these concerns, this European Respiratory Society (ERS)/European Academy of Allergy and Clinical Immunology (EAACI) statement aims to: 1) evaluate the understanding of and adherence to international asthma guidelines by HCPs of different specialties via an international online survey; and 2) assess strategies focused at improving implementation of guideline-recommended interventions, and compare process and clinical outcomes in patients managed by HCPs of different specialties via systematic reviews.The online survey identified discrepancies between HCPs of different specialties which may be due to poor dissemination or lack of knowledge of the guidelines but also a reflection of the adaptations made in different clinical settings, based on available resources. The systematic reviews demonstrated that multifaceted quality improvement initiatives addressing multiple challenges to guidelines adherence are most effective in improving guidelines adherence. Differences in outcomes between patients managed by generalists or specialists should be further evaluated.Guidelines need to consider the heterogeneity of real-life settings for asthma management and tailor their recommendations accordingly. Continuous, multifaceted quality improvement processes are required to optimise and maintain guidelines adherence. Validated referral pathways for uncontrolled asthma or uncertain diagnosis are needed.

Factors Conditioning the Adherence to Pharmacological Prescription in Patients with Hypertension Attending Primary Healthcare Units in Quito – Ecuador

Low adherence to pharmacological treatment in patients diagnosed with hypertension is related to poor blood pressure control and an increased incidence of cardiovascular complications and deaths. A cross-sectional study was performed to determine conditioning factors towards adherence. Questionnaires and clinical evaluations were applied to 187 patients attending three first-level health units; in 130 of them laboratory tests were carried out. Diagnostic criteria were based on the European Clinical Practice Guidelines; adherence was based on the Morinsky test. 57.1% of patients had blood pressure values above the controlled threshold, and 71.1% reported non-adherence to pharmacological prescription. Factors associated whit low adherence were coexisting moderate to severe depression (OR = 2,054; CI 1,064 - 3,964), low educational level (3.75 ± 3.05 years), poor understanding of medical prescriptions (OR = 2.3 CI 1.188 - 4.477), irregular supply and limited economic access to prescribed drugs ((OR = 1.97 CI 1.08 - 3.817), and low satisfaction with the care offered at health services (OR = 2.45; CI 1.202-5.00).

Adherence with the standard treatment regimen for the treatment of COVID-19 patients in Bangabandhu Sheikh Mujib Medical University

The present study was conducted to evaluate the adherence to standard treatment regimen in Bangabandhu Sheikh Mujib Medical University (BSMMU) for the treatment of corona virus disease 19 (COVID-19) patients. The study assessed the awareness of prescribers, adherence to treatment guidelines and reasons for non-adherence. A questionnaire survey was conducted followed by a retrospective and prospective medical review and in-depth interview. The study revealed that 79.9% of key prescribers are aware of treatment guidelines. Adherence was 28.4% in moderate cases and 53.3% in severe cases and difference was highly statistically significant (p<0.001). Adherence in moderate cases was highest in patients with hypertension (43.3%) and lowest in bronchial asthma (16.6%). Adherence in severe cases was highest with diabetes (80%) and lowest in bronchial asthma (20 %). In COVID-19 patients, the adherence was highest with International Guideline (96%), followed by institutional Guideline (74.6%) and National Guideline (23.5%). There is significant variation in extent of adherence in different age group of patients, co-morbidities and categories of guidelines. BSMMU J 2021; 14 (COVID -19 Supplement): 13-18