Opinions, Attitudes, and Prescribing Practices of Oral Contraceptive Pills of General Practitioners and Gynecologists in India

Background Prescribing behavior of oral contraceptive pills (OCPs) by physicians, gynecologists, and alternative medicine practitioners (AMPs). Materials and Methods Close-ended questionnaire-based cross-section study was performed between 1st September 2012 and 28th February 2014 in three groups of responders, i.e., AMP, general medical practitioners (GMPs), and obstetricians and gynecologists (ObGy). A stratified random cluster sample was used. Data of 400 subjects in all three groups were obtained using both univariate and multi-variate sophisticated statistical analyses for analyzing attitude and practices and were recorded on an ordinal scale using appropriate non-parametric test. Results Of the 1,237 subjects surveyed, 400 completed questionnaires were received from each of the three groups viz; AMPs, GMPs, and ObGy. Remaining 37 incomplete questionnaires were not included in the final analysis. Conclusion There are equal misconceptions regarding OCPs among users and prescribing physicians. Preference for OCPs in married and unmarried women is also equally low. OCP usage and their prescription practices can be improved by removing potential barriers, developing public–private partnership, and training promoters.

Dental Attendances to General Medical Practitioners in Wales: A 44 Year-Analysis

One-third of the UK population is composed of problem-oriented dental attenders, seeking dental care only when they have acute dental pain or problems. Patients seek urgent dental care from a range of health care professionals, including general medical practitioners. This study aimed to identify trends in dental attendance at Welsh medical practices over a 44-y period, specifically in relation to dental policy change and factors associated with repeat attendance. A retrospective observational study was completed via the nationwide Secure Anonymised Information Linkage (SAIL) Databank of visits to general medical practice in Wales. Read codes associated with dental diagnoses were extracted for patients attending their general medical practitioner between 1974 and 2017. Data were analyzed with descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 439,361 dental Read codes, accounting for 288,147 patient attendances. The overall attendance rate was 2.60 attendances per 1,000 patient-years (95% CI, 2.59 to 2.61). The attendance rate was negligible through 1987 but increased sharply to 5.0 per 1,000 patient-years in 2006 (95% CI, 4.94 to 5.09) before almost halving to 2.6 per 1,000 in 2017 (95% CI, 2.53 to 2.63) to a pattern that coincided with changes to National Health Service policies. Overall 26,312 patients were repeat attenders and were associated with living in an area classified as urban and deprived (odds ratio [OR], 1.22; 95% CI, 1.19 to 1.25; P < 0.0001) or rural (OR, 0.84; 95% CI, 0.83 to 0.85; P < 0.0001). Repeat attendance was associated with greater odds of having received an antibiotic prescription (OR, 2.53; 95% CI, 2.50 to 2.56; P < 0.0001) but lower odds of having been referred to another service (OR, 0.75; 95% CI, 0.70 to 0.81; P < 0.0001). Welsh patients’ reliance on medical care for dental problems was influenced by social deprivation and health policy. This indicates that future interventions to discourage dental attendance at medical practitioners should be targeted at those in the most deprived urban areas or rural areas. In addition, health policy may influence attendance rates positively and negatively and should be considered in the future when decisions related to policy change are made.

Telephone Consultations by Medical Scheme Patients Consulting General Medical Practitioners, South Africa

Background: The COVID-19 climate has seen a shift in the manner that patients seek care. Lockdown measures and COVID-19 regulations, and the fear of contracting the virus at a health care facility has also changed health seeing behaviour among patients. The COVID-19 climate has seen a significant increase in the utilisation of virtual platforms to consult with providers. Objectives: The objective of this chapter was to conduct the descriptive analysis of telephonic consultations by members of medical schemes who consulted general medical practitioners. Methods: The study entailed a descriptive analysis of medical scheme claims data for the 2020 review period. The inclusion criteria were all National Pharmaceutical Product Interface (NAPPI) codes associated with a telephonic consultation consulting general medical practitioners. The ICD-10 code primary diagnosis was used to describe the diagnosis. The study mainly focused on outpatient patients with service dates between March and December 2020. Results: The analysis covered claims data from a total of 12 medical schemes. The schemes analysed accounted for 1,6 million lives. The total number of telephonic consultations was 17 237. The mean (SD) claimed amount for telephone consultation for a general medical practice consult was R2821 (SD = 20). This was slightly lower than the scheme tariff of R2872 (SD = 19). The study found that most telephonic consults were for Acute bronchitis, unspecified; Acute upper respiratory; Emergency use of U07.1 (Confirmed diagnosis); Emergency use of U07.2 (Suspected Diagnosis); Follow-up examination; Special screening. Conclusion: The study found evidence of patients utilising telephonic consultations for general medical practitioner services. The effect of COVID-19 in this respect was seen in the three main primary diagnoses that were associated with the consult, Acute upper respiratory, Emergency use of U07.1 (confirmed diagnosis) and Emergency use of U07.2 (suspected diagnosis). Even though the average telephonic consult was claimed at just under R3003, few general medical practitioners claimed between R4004 and R5005 which were higher than the industry average. There is a need to develop telephone consult guidelines at industry level, these should also address reimbursement rate differentials.

Pattern of practice on mental health issues and attitude towards referral among general medical practitioners of North India

Background: Still, in a larger part of the world, people with mental illnesses first consult general practitioners (non-psychiatrist practitioners) to treat their mental illness. Many such patients seek psychiatric consultation with reluctance after being referred by general practitioners due to stigma. The study aimed to assess the attitude of general medical practitioners towards consultation-liaison psychiatric services.Methods: In this cross-sectional survey, a total of 61 general medical practitioners, specialists, and subspecialist physicians, surgeons from a city of North India were evaluated in a questionnaire which was designed based on previous studies and observations to assess their attitudes towards liaison psychiatric services.Findings: Nearly 98% of the general practitioners deal with the patient of psychiatric illness, out of which nearly 30% treat the patient of their own. Nearly 88% of practitioners referring a patient to psychiatrists. More than 90% of general practitioners reported psychiatric problems are associated with medical illness. More than 40%prescribe psychotropic medication, out of which benzodiazepine is the most commonly prescribed one. Depression is commonly encountered in general medical practice. More than 70% of practitioners are not comfortable prescribing psychotropic medications. About 16.39% of general practitioners faced difficulty in referring patients to a psychiatrist for various reasons. Conclusion: General practitioners treat many patients with psychiatric illness though they are not comfortable prescribing psychotropic medications.

Pediatric chronic kidney disease: Manifestations and evaluation

Chronic kidney disease (CKD) is unique in children due to varying etiology, manifestation, and impact. Whereas it is far a lesser burden compared with adult CKD, childhood CKD has a psychosocial impact on caregivers, impair growth, quality of life, and ultimately associated with increased mortality. We summarize the manifestation, diagnosis, and evaluation of a child with CKD, whose early detection, and appropriate management will improve their outcome. Thus, we hope this will be valuable to the general medical practitioners, and pediatricians in the care of children with CKD.

General medical practitioners in Czechia: development trends and regional differences

In Czechia general practical medicine represents the bulk of basic primary healthcare both in terms of the number of doctors and the range of services provided. For the healthcare system to function effectively as a whole requires sufficient capacity and the even distribution of providers across the country. As observed throughout Europe, a key risk is the age structure of the general practitioner population, with most of the capacity being provided by older practitioners, which could affect overall primary care access in the future. In Czechia, the general practitioner age structure is skewed, with the proportion of older age groups continually increasing. This article analyses changes in selected indicators of the number, capacity and age structure of general practitioners at the regional level in 2010–2019 and identifies regions where general healthcare access may be at risk. These areas are often rural and, as the specially created municipality typology shows, the pace of change differs along an urban vs rural line.