medRxiv - Primary Care Research最新文献

{"title":"People's expectations about the likely duration of common acute infections: a national survey of the Australian public","authors":"Kwame Peprah Boaitey, Mina Bakhit, Mark Jones, Tammy Hoffmann","doi":"10.1101/2024.06.22.24309159","DOIUrl":"https://doi.org/10.1101/2024.06.22.24309159","url":null,"abstract":"Objectives To explore people's expectations about the likely duration of acute infections that are commonly managed in primary care, and if care is sought for these infections, reasons for doing so.\u0000Design A cross-sectional online survey. Participants A nationwide sample of 589 Australian residents, 18 years or older with representative quotas for age and gender, recruited via an online panel provider. Outcome measures For eight acute infections, participants' estimated duration of each, time until they would seek care, and reasons for seeking care. Results For four infections, participants mean estimates of duration were within an evidence-based range - common cold (7.2 days), sore throat (5.2 days), acute otitis media (6.2 days), and impetigo (8.3 days); and >70% of participants estimated a duration within the range. However, participants estimated mean duration was shorter than evidence-based estimates for acute cough (7.6 days), sinusitis (5.6 days), conjunctivitis (5.7 days), and uncomplicated urinary tract infections (5.4 days); and >60% of participants underestimated the duration. Of the 589 participants, 365 (62%) indicated they were unlikely to routinely seek care for self-limiting infections. Most common reasons for care-seeking were severe or worsening symptoms, a desire for quick recovery, and fear of progression to complications. After being shown typical durations, the proportion of participants who reported having no concerns waiting for spontaneous resolution while managing symptoms with over-the-counter medications ranged across the infections and was highest for common cold (68%) and lowest for UTI (31%). Conclusion Participants underestimated the duration of some infections compared to evidence-based estimates and were accurate in their estimates for other infections. Many stated that they would not be concerned about waiting for illnesses to self-resolve after learning the typical duration. Communicating the expected duration of common acute infections during routine consultations can help manage patients' expectations of recovery and need to seek care.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141528820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antipsychotic management in primary care: a longitudinal population-based study","authors":"Alan Woodall, Alex Gampel, Huw Collins, Lauren E Walker, Frances S Mair, Sally B Sheard, Pyers Symon, Iain Buchan","doi":"10.1101/2024.06.18.24309122","DOIUrl":"https://doi.org/10.1101/2024.06.18.24309122","url":null,"abstract":"Background: The use of antipsychotics in primary care is increasing, and more are being used for non-psychotic illnesses. Long-term use of antipsychotics confers increased risk of cardiometabolic disease, so ongoing need should be reviewed regularly by psychiatrists. This study explored changes over time in antipsychotic management and prescribing in primary care, and proportions of patients (≥18 years) prescribed antipsychotics receiving psychiatrist review. Methods and Findings: This was a retrospective, population-based observational study using data from the Secure Anonymised Information Linkage databank of approximately 3 million people in Wales (2011 to 2020). Outcomes were prevalence of patients who had received ≥6 antipsychotic prescriptions per year, proportion of patients prescribed antipsychotics who had received psychiatrist review in the preceding 12 months, and proportion of patients prescribed antipsychotics who were registered on the UK Primary Care Serious Mental Illness, Depression and/or Dementia registers, or were not on these registers. The prevalence of adults prescribed antipsychotics increased from 1.06% (95%CI 1.04 to 1.07%) in 2011 to 1.45% (95%CI 1.43 to 1.46%) in 2020; 1 in 69 adults were prescribed antipsychotics in 2020. The proportion of adults taking antipsychotics solely managed by primary care increased from 40% (95%CI 39 to 41%) in 2011 to 48% (95%CI 47 to 49%) by 2020. The proportion of antipsychotics prescribed to patients not on the Serious Mental Illness register increased from 50% (95%CI 49 to 51%) in 2011 to 56% (95%CI 56 to 57%) by 2020, meaning many patients may not be monitored for the cardiometabolic risk from antipsychotics. Conclusions: Antipsychotic prescribing is increasing. More people are solely managed by general practitioners without psychiatrist review and are not on relevant disease registers, so are less are likely to undergo vital cardiometabolic monitoring. These trends pose risks for patients and need to be addressed urgently.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pentavalent Vaccine: How Safe Is It Among Infants Accessing Immunization In Nigerian Health Facilities","authors":"Elemuwa Uchenna Geraldine, Enato Ehijie, Elemuwa Christopher Ononiwu, Elemuwa Tochukwu Daniel, Morufu Olalekan Raimi","doi":"10.1101/2024.05.28.24307998","DOIUrl":"https://doi.org/10.1101/2024.05.28.24307998","url":null,"abstract":"<strong>Rationale</strong> Pentavalent vaccines offer significant public health benefits by protecting against five major diseases with a single injection. However, concerns have been raised in various studies regarding potential associations between combined vaccines and conditions such as autism, febrile seizures, sudden unexpected death in infancy, demyelinating disorders, and neurodevelopmental disorders.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141196066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nowhere to Go: A parallel convergent mixed methods study examining the health of people who experience emergency shelter service restrictions","authors":"Suraj Bansal, Stephanie Di Pelino, Jammy Pierre, Kathryn Chan, Amanda Lee, Rachel Liu, Olivia Mancini, Avital Pitkas, Fiona Kouyoumdjian, Larkin Lamarche, Robin Lennox, Marcie McIlveen, Timothy O’Shea, Claire Bodkin","doi":"10.1101/2024.05.07.24306964","DOIUrl":"https://doi.org/10.1101/2024.05.07.24306964","url":null,"abstract":"<strong>Background</strong> Emergency shelters offer temporary sleeping accommodation to people deprived of housing and connect them to services. Service restriction is the practice of limiting or denying someone access to emergency shelters. This parallel convergent mixed methods study describes the characteristics, healthcare utilization, and morbidity of people experiencing service restrictions in Hamilton, Ontario, and explores the relationship between health and service restriction.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distress and factors for maintaining good mental health among general practitioners during the SARS-CoV-2 pandemic: Results from the cross-sectional PRICOV-19 study in Austria","authors":"Kathryn Hoffmann, Florian O. Stummer, Esther van Poel, Sara Willems, Silvia Wojczewski","doi":"10.1101/2024.04.30.24306629","DOIUrl":"https://doi.org/10.1101/2024.04.30.24306629","url":null,"abstract":"<strong>Background</strong> The COVID-19 pandemic has had a significant negative impact on the physical and mental health of healthcare workers worldwide. The aim of the paper is to measure the frequency of distress and wellbeing among general practitioners (GPs) in Austria during the pandemic and to identify key levers that could mitigate the risks of distress.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140881660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the Covid-19 pandemic on the continuity of sexual and reproductive health care in the maternity ward of a health and social promotion centre in Burkina Faso: a qualitative study","authors":"Patrice Ngangue, Mariam Ahmat Mahamat, Danièle Sandra Yopa, Gbètogo Maxime Kiki, Nestor Bationo, Douglas Mbang Massom, Josiane Seu, Birama Apho Ly","doi":"10.1101/2024.04.10.24305634","DOIUrl":"https://doi.org/10.1101/2024.04.10.24305634","url":null,"abstract":"<strong>Background</strong> The COVID-19 pandemic has significantly impacted the continuity of maternity care in Burkina Faso. This study aimed to compare the volumes of in-person visits and to explore the experiences of healthcare providers and users regarding the continuity of healthcare in the maternity ward of a Health and Social Promotion Center (HSPC) before, during and after the lockdown during the COVID-19 pandemic in Ouagadougou, Burkina Faso.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140609657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Judgements about carer assessments for carers of people with dementia: case vignette study","authors":"Paul Clarkson, Lucie Mills, Asif Butt, Baber Malik, Ruth Eley, Cecilia Toole, Caroline Sanders, Ian Sheriff","doi":"10.1101/2024.04.11.24305691","DOIUrl":"https://doi.org/10.1101/2024.04.11.24305691","url":null,"abstract":"<strong>Objectives</strong> UK carer assessments, in primary and social care, intend to discover what carers need in their caring roles and more widely. Evidence points to these not being configured sufficiently around carers of people with dementia, with potentially their breadth of needs not being recognised. We evaluated the extent of agreement, between carers of people with dementia, primary care, and social care professionals, on their recommendations from assessing carers’ needs in a range of circumstances. It is intended for findings to be taken forward as recommendations for policy and practice.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth versus face-to-face delivery of speech language pathology services: a systematic review and meta-analysis","authors":"Anna Mae Scott, Justin Clark, Magnolia Cardona, Tiffany Atkins, Ruwani Peiris, Hannah Greenwood, Rachel Wenke, Elizabeth Cardell, Paul Glasziou","doi":"10.1101/2024.04.08.24305455","DOIUrl":"https://doi.org/10.1101/2024.04.08.24305455","url":null,"abstract":"<strong>Background</strong> There is an increasing demand for the provision of speech language pathology (SLP) services via telehealth. Therefore, we systematically reviewed randomized controlled trials comparing telehealth to face-to-face provision of SLP services.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reach and effectiveness of a HEARTS hypertension control pilot project in Guatemala","authors":"Irmgardt Alicia Wellmann, José Javier Rodríguez, Benilda Batzin, Guillermo Hegel, Luis Fernando Ayala, Kim Ozano, Meredith P. Fort, Walter Flores, Lesly Ramirez, Eduardo Palacios, Mayron Martínez, Manuel Ramirez-Zea, David Flood","doi":"10.1101/2024.04.03.24305304","DOIUrl":"https://doi.org/10.1101/2024.04.03.24305304","url":null,"abstract":"The World Health Organization’s HEARTS Technical Package aims to improve the primary care management of hypertension and other cardiovascular risk disease factors at the population level. This study describes the first HEARTS implementation project in the Ministry of Health primary care system in Guatemala. This pilot project was implemented from April to December 2022 in 6 primary health facilities in 3 rural, Indigenous municipalities. The project consisted of HEARTS-aligned strategies that were adapted to foster program sustainability in Guatemala. Outcomes were defined using the RE-AIM framework. The primary <em>reach</em> outcome was treatment rate, defined as the absolute number of patients each month receiving medication treatment for hypertension. The primary <em>effectiveness</em> outcomes were mean systolic blood pressure (BP), mean diastolic BP, and proportion with BP control. In the first month of the post-implementation period, there was a significant increase of 25 patients treated (P=0.002), followed by a significant increase thereafter of 2.4 additional patients treated each month (P=0.007). The mean change in systolic BP was -4.4 (95 CI -8.2 to -0.5, P=0.028) mmHg and mean change in diastolic BP was -0.9 (95 CI -2.8 to 1.1, P=0.376) mmHg. The proportion of the cohort with BP control increased from 33.4% at baseline to 47.1% at 6 months (adjusted change of 13.7% [95 CI 2.2% to 25.2%, P=0.027]). These findings support the feasibility of implementing the HEARTS model for blood pressure control in the Guatemalan MOH primary care system where the vast majority of hypertension patients seek care.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A grounded theory study of beliefs underlying use of ancestral spirits for healing among Baganda traditional spiritual healers in Central Uganda","authors":"Yahaya H. K. Sekagya, Charles Muchunguzi, Payyappallimana Unnikrishnan, Edgar M. Mulogo","doi":"10.1101/2024.04.03.24304941","DOIUrl":"https://doi.org/10.1101/2024.04.03.24304941","url":null,"abstract":"The increasing global sensitivity to spirituality in medicine and sociology has elevated the relevance of beliefs in ancestral spirits as an integral element in Africa’s multi-ethnic society and biocultural diversity for health management. However, ancestral spirituality in healthcare in the local context, remains sparse and elusive since most literature relates spirituality with religion and religious practices. The study sought to explore the beliefs in ancestral spirits utilized for health management among practicing Baganda traditional spiritual healers (<em>Balubaale</em>). Qualitative data were gathered through semi-structured in-depth interviews and partial integration observation methods from twelve (10M, 2F) purposively selected and recruited <em>Balubaale</em> from Central Uganda between 15^th July 2019 and 29^th April 2020, and we prospectively interacted with them for 24 months. Transcribed data was coded and thematically analyzed using ATLAS ti. 22 computer software based on grounded theory approach. Data revealed themes related to beliefs in spiritual powers of categories of ancestral spirits, sacred places, living plants and animals, non-living things such as fire, water, the Sun, and non-materials such as symbols and colors. Spiritual powers can be potentiated through rituals, sacrifice and communal activities all of which are utilized during health managements. In conclusion, <em>Balubaale</em> believe that illness and health management are influenced by ancestral spirits and spiritual powers contained in nature and creation therein. We recommend more exploratory studies among spiritualists of other tribes to contrast the findings.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}