BMC primary care最新文献

{"title":"A digital and nurse-led support intervention, first year after prostate cancer treatment: a single-arm feasibility study in a Swedish primary care setting.","authors":"Nazmije Kelmendi, Ann Langius-Eklöf, Marina Taloyan, Kay Sundberg, Åsa Craftman, Marie Nilsson","doi":"10.1186/s12875-024-02669-x","DOIUrl":"10.1186/s12875-024-02669-x","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of patients with prostate cancer is increasing, and the first year after treatment is a vulnerable period for patients as they experience symptoms and unmet needs. Although electronic patient-reported outcomes that focus on patient self-management have demonstrated benefits, evidence is sparse regarding patients with prostate cancer in primary care settings and the role of nurses as a supportive resource. The significant role of primary care in future cancer care is on the agenda. This study aims to test the feasibility of a complex intervention that includes electronic patient-reported outcomes and self-management advice in an app, combined with nurse-led support, in primary care settings during the first year after curative intended prostate cancer treatment.</p><p><strong>Methods: </strong>The intervention lasted four weeks and was a single-arm study. Feasibility was assessed by examining the recruitment process, retention rate, adherence to the reporting of symptoms in the app, and acceptability of the intervention. Data was collected through (1) logged data from the app that included patient-reported outcomes and self-management advice, (2) field notes by the nurse, and (3) semi-structured interviews with patients. Descriptive statistics were applied to logged data. The interviews and the field notes were analysed using qualitative content analysis.</p><p><strong>Results: </strong>The recruitment rate was 55%, yielding 11 patients with high retention as all completed the intervention. Adherence to reporting was 100%, and all functions in the app were used. Individual variation in how patients used the app was found, which was attributed to patients' current needs. In total, 36 health dialogues with the nurse (virtual, face-to-face, telephone) were performed; all first dialogues lasted longer, while follow-ups were shorter. Patients described that the health dialogues covered relevant subjects and that the combination of using the app and health dialogues was tailored and provided supplementary support. No adverse events occurred; however, a few technical difficulties interfered with the intervention, and the patients gave valuable suggestions for improvement. Furthermore, patients suggested that the intervention should start immediately after treatment.</p><p><strong>Conclusion: </strong>As the patients adhered to and accepted the intervention, it was considered feasible. Findings suggest intervention should start directly after treatment ends.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"409"},"PeriodicalIF":2.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder study.","authors":"Rachel Canaway, Libby Dai, Christine Hallinan, Cassandra Caddy, Kelsey Hegarty, Douglas Boyle","doi":"10.1186/s12875-024-02662-4","DOIUrl":"10.1186/s12875-024-02662-4","url":null,"abstract":"<p><strong>Background: </strong>This study explored the feasibility of integrating a clinical decision support tool into general practice clinical management software in Australia to prompt for alcohol screening among patients who are pregnant or planning a pregnancy. The study aimed to increase understanding of what is an appropriate and acceptable clinical decision support tool, the circumstances when a prompt to use such a screening tool should occur, and the barriers and enablers of successful implementation.</p><p><strong>Methods: </strong>This feasibility study employed a mixed methods approach and purposive sampling to identify key stakeholders to interview. Participants included vendors of clinical software used in Australian general practice, clinicians in general practice, and relevant others. Data from a literature review and 23 interviews were analysed leading to recommendations which were 'sense-tested' by an additional 22 stakeholders.</p><p><strong>Results: </strong>Although there are at least 18 clinical software packages used in Australian general practice, it is feasible to integrate an alcohol screening tool for pregnancy into software for the majority of general practices in Australia. The AUDIT-C alcohol screening tool for pregnancy was widely accepted as suitable for such a purpose. Clinicians suggested the greatest barriers to screening were lack of time within antenatal consultations and insufficient remuneration for longer consultations. Many clinicians saw opportunity for introducing a multifunctional antenatal tool that could incorporate screening and clinical decision support for alcohol, tobacco and other substance use, mental health, domestic and family violence and potentially other areas informing healthy pregnancy. It could also be used opportunistically for preconception screening and counselling. Deployment of the tool could be supported by an education campaign from professional associations.</p><p><strong>Conclusion: </strong>The integration of a tool for screening for alcohol use among women who are pregnant or planning pregnancy into general practice clinical software is feasible; however, a multifunctional antenatal screening tool, incorporating other psychosocial elements, was considered more useful than a stand-alone alcohol screening tool. Codesign is needed with vendors and end-users to develop an acceptable tool that can be widely implemented. Issues with GP renumeration need also to be addressed to encourage alcohol screening pre-pregnancy and in the early months of pregnancy.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"408"},"PeriodicalIF":2.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older people's perspectives on frailty screening in primary care settings - a citizens' jury study.","authors":"Annette Braunack-Mayer, Jackie M Street, Caitlin Reader, Lesley M O'Brien, Elsa Dent, Belinda Fabrianesi, Agnieszka Chudecka, Renuka Visvanathan, Justin Beilby, Michael Lawless, Rachel C Ambagtsheer","doi":"10.1186/s12875-024-02626-8","DOIUrl":"https://doi.org/10.1186/s12875-024-02626-8","url":null,"abstract":"<p><strong>Background: </strong>As the world's population ages, there is a growing concern with frailty, marked by reduced strength and greater vulnerability to stress. Overcoming obstacles like reluctance towards screening methods in this process is crucial for identifying and addressing frailty at an early stage. Understanding older people's perspectives can help adapt screening procedures in primary healthcare settings.</p><p><strong>Methods: </strong>A citizens' jury, comprising 14 purposively selected members reflecting community diversity, was conducted in South Australia to explore older adults' opinions on how and when frailty screenings occur within primary care settings. Participants engaged in discussions and deliberations informed by expert testimonies and evidence-based resources. This deliberative inclusive research method supported jurors to understand the evidence and contribute informed insights into health policy.</p><p><strong>Results: </strong>The jury systematically addressed several key concerns, including the major issues surrounding frailty screening, its benefits and potential harms, and measures to prevent screening bias and misdiagnosis. The outcome was 17 recommendations within the themes of screening age and frequency, consent, access and setting, communication and public awareness, and resources and cost.</p><p><strong>Conclusions: </strong>The study highlights the value of including older adults in the decision-making about health interventions aimed at them. The method proved effective in capturing a spectrum of community values and preferences, offering actionable recommendations for refining health screening policies to better address the needs and expectations of older adults.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"407"},"PeriodicalIF":2.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How primary and tertiary care services collaborate in urgent care delivery: an evaluation of general practice advice lines.","authors":"Adeola Bamgboje-Ayodele, Meredith Makeham, Diane Kancijanic, Nicki Newton, Kavisha Shah, Miranda Shaw, Adam Johnston, Fiona Robinson, Owen Hutchings, Sarah Norris, Jagdev Singh, Melissa Baysari, Clara K Chow, Tim Shaw, Liliana Laranjo","doi":"10.1186/s12875-024-02649-1","DOIUrl":"https://doi.org/10.1186/s12875-024-02649-1","url":null,"abstract":"<p><strong>Background: </strong>To address the rising demand for urgent care and decrease hospital use, health systems are implementing different strategies to support urgent care patients (i.e. patients who would have typically been treated in hospital) in the community, such as general practitioner (GP) advice lines. The aims of this study were to: identify the support and resources GPs need to manage urgent care patients in the community; assess the need for GP advice lines by primary care services in Australia; and identify the facilitators and barriers to adoption, and strategies to support the sustainability of GP advice lines.</p><p><strong>Methods: </strong>Qualitative study involving semi-structured interviews with GPs, hospital-based healthcare providers, consumers, and healthcare management, recruited via existing investigator networks and snowballing approach. The interviews were conducted between February and August 2023. Major themes were identified by an iterative and inductive thematic analysis.</p><p><strong>Results: </strong>We interviewed 16 participants (median age 50, IQR 38-59). Based on the aims of the study, three themes emerged: support and resources for GPs; motivation for GP advice lines; and factors influencing the uptake and sustainability of GP advice lines. Participants reported that better communication from hospital services with GPs is critical to ensure continuity of care between tertiary and primary settings. They also noted that GP advice lines can help increase capacity to manage urgent care patients in the community by providing timely decision-support to GPs. However, a reported barrier to the uptake and ongoing use of GP advice lines was the limited hours of the service. To sustain GP advice lines, participants highlighted a need to broaden the scope of the service beyond the pandemic, conduct rigorous evaluation on health outcomes, and further digitise the service so that a tiered level of support could be provided based on risk stratification.</p><p><strong>Conclusions: </strong>The benefits of GP advice lines are yet to be fully realised. With increasing technology sophistication, there remain opportunities to further digitise and optimise GP advice lines, whilst ensuring better integration within and across primary and tertiary care services. This is however dependent on continued financial and policy support from the government.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"406"},"PeriodicalIF":2.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake and experience of professional interpreting services in primary care in a South Asian population: a national cross-sectional study.","authors":"G Hieke, E D Williams, P Gill, G B Black, L Islam, C Vindrola-Padros, J Yargawa, S Braun, K L Whitaker","doi":"10.1186/s12875-024-02646-4","DOIUrl":"10.1186/s12875-024-02646-4","url":null,"abstract":"<p><strong>Background: </strong>Interpreting services bridge language barriers that may prevent patients and clinicians from understanding each other, impacting quality of care and health outcomes. Despite this, there is limited up-to-date evidence regarding the barriers to and facilitators of uptake in primary care. The aim of this study was to ascertain current national uptake and experience of interpreting services in primary care (general practice) by South Asian communities in England.</p><p><strong>Methods: </strong>We conducted a national cross-sectional survey in 2023 with people with limited or no English language proficiency (n = 609). Multilingual researchers interviewed people from Bangladeshi (n = 213), Indian (n = 200), and Pakistani (n = 196) backgrounds from four regions in England (Greater London, Midlands, Yorkshire and the Humber, North West).</p><p><strong>Results: </strong>Sixty-three percent of participants reported using professional interpreting services in primary care. The most common modality was face-to-face interpreting (55%), followed by telephone (17%) and video (8%). Multivariable analysis identified several correlates of lower uptake: participants from Indian backgrounds, those living in the Midlands, and those whose family member/friend interpreted for them within the past year were less likely to have used a professional interpreter provided by their general/family practice. Participants who had visited primary care within the last 12 months, had requested an interpreter but were told they could not have one, were informed about professional interpreting services, and were given choice in their language support were more likely to have used a professional interpreter.</p><p><strong>Conclusions: </strong>Our approach provides novel data on professional interpreting service use and evidence about the factors that may play a role in patient uptake and experience.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"405"},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising the treatment of chronic ischemic heart disease by training general practitioners to deliver very brief advice on physical activity (OptiCor): protocol of the systematic development and evaluation of a complex intervention.","authors":"Sabrina Hoppe, Alicia Prinz, Rik Crutzen, Norbert Donner-Banzhoff, Andrea Icks, Daniel Kotz, Oliver Kuß, Ute Mons, Markus Vomhof, Stefan Wilm, Sabrina Kastaun","doi":"10.1186/s12875-024-02655-3","DOIUrl":"10.1186/s12875-024-02655-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic ischemic heart disease (IHD) is one of the leading causes of morbidity and mortality. Physical activity (PA) is an effective secondary preventive strategy in IHD management. The German treatment guideline recommends that general practitioners (GPs) deliver PA advice to patients. This recommendation seems inadequately implemented, often due to GP's insufficient specific training. International guidelines recommend training GPs in how to deliver such advice effectively and efficiently. Evidence is lacking on whether such training can enhance the frequency and quality of PA advice in routine care. The OptiCor project aims to develop and evaluate a GP training in the delivery of very brief PA advice to optimise the treatment of patients with IHD in general practice.</p><p><strong>Methods: </strong>OptiCor comprises three study phases according to the Medical Research Council recommendations for developing and evaluating complex interventions. Phase 1 (needs analysis): A nationwide representative household survey will be conducted to collect data on the receipt of GP-delivered PA advice in people with IHD. Qualitative interviews and group discussions with GPs and people with IHD will help to explore, e.g., attitudes, experiences with, and barriers and facilitators of PA advice implementation or reception, respectively. Findings will inform the training development. Phase 2 (pilot): A pragmatic cluster randomised controlled trial (cRCT) on the effectiveness of the developed training on proportions of GP-delivered PA advice during routine care of IHD patients will be piloted. Phase 3 (evaluation): A full pragmatic cRCT will be conducted with patient-reported proportions of GP-delivered PA advice as primary endpoint. Collection of health economic and process-related data will facilitate a potential future broad implementation and health economic evaluation of the training.</p><p><strong>Discussion: </strong>If the developed training successfully improves proportions and quality of GP delivered PA advice to patients with IHD, it could serve as a low-threshold and sustainable strategy for implementing PA recommendations in the secondary prevention of IHD in routine GP practice.</p><p><strong>Trial registration: </strong>Work package (WP) 1, WP5, and WP6 have been prospectively registered at German Clinical Trials Register (WP1: DRKS00031304, 19/06/2023; WP5: DRKS00034641, 10/07/2024; WP6: DRKS00034642; 10/07/2024).</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"404"},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional study exploring general practitioners' views on dietary supplements.","authors":"Sophia Wagner, Sascha Eickmann, Hansjörg Baurecht, Anne Herrmann","doi":"10.1186/s12875-024-02654-4","DOIUrl":"10.1186/s12875-024-02654-4","url":null,"abstract":"<p><strong>Background: </strong>Dietary supplements (DS) are often used by patients to enhance their health and well-being. General practitioners (GPs) are commonly the first point of contact for patients who enquire about DS. The aim of this study was to explore GPs' views on DS.</p><p><strong>Methods: </strong>A cross-sectional purposeful recruitment online survey of 162 general practitioners (GPs) in Germany was conducted between May and August 2021. The questionnaire assessed GPs' views on dietary supplements (DS), including perceptions of safety, efficacy, and importance in medical practice. Data were analyzed using inferential statistics and logistic regression analyses to explore associations between GPs' views and demographic factors.</p><p><strong>Results: </strong>Response rate could not be determined because multipliers were included here by means of personal networks, consent rate was 100%. Many respondents considered DS to be an important topic in their daily practice (64,8%, n = 99). Almost two thirds were convinced of their efficacy and considered DS to be safe for use (61,2%, n = 93). However, the majority of respondents were in favor of more standardized guidelines (86.8%, n = 132) and improved medical education on the handling of DS in routine care (89,5%, n = 136). Physicians who self-administered DS were statistically significantly more likely to perceive them as safe to use, with an OR of 4.25 (95% CI: 1.74-10.40). Self-administration [OR 4.52 (1.67-12.22)] and participation in continuous medical education (CME) [OR 3.52 (1.133-9.38)] were positively associated with perceiving them as an important topic.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first study to assess German GPs' perceptions regarding DS. The majority of physicians recognized the importance of DS in routine care but wished for improved regulation and more standardized guidelines regarding their use. The findings could be used to develop targeted educational interventions and improve handling of DS in daily general practice.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"401"},"PeriodicalIF":2.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Trends in low-value GP care during the COVID-19 pandemic: a retrospective cohort study.","authors":"Joris L J M Müskens, Tim C Olde Hartman, Henk J Schers, Reinier P Akkermans, Gert P Westert, Rudolf B Kool, Simone A van Dulmen","doi":"10.1186/s12875-024-02652-6","DOIUrl":"10.1186/s12875-024-02652-6","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"403"},"PeriodicalIF":2.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pertussis vaccination in adults: a behavioral study of physicians from the US, France, and Germany.","authors":"Donald Middleton, Liana Clark, Anne Mosnier, Ulrich Heininger","doi":"10.1186/s12875-024-02647-3","DOIUrl":"10.1186/s12875-024-02647-3","url":null,"abstract":"<p><strong>Background: </strong>Pertussis is a highly contagious respiratory tract infection that affects all ages, though it is most severe in young infants. Adults, especially those with respiratory conditions or other chronic illnesses can also suffer serious consequences of pertussis. Pertussis vaccination is the best method of disease prevention in a lifetime. This behavioral study aimed to assess physicians' attitudes towards pertussis vaccination in adults and the importance of pertussis vaccination for disease prevention, especially in those with chronic illnesses, and to determine the impact of the COVID-19 pandemic on adult vaccination behaviors.</p><p><strong>Methods: </strong>Between November 2022 and January 2023, physicians from the US, France, and Germany registered in an independent online database were contacted to participate in this study. After eligibility screening, participating physicians completed an online questionnaire addressing topics related to physician recommendations and vaccination behavior around pertussis in adults.</p><p><strong>Results: </strong>Eight hundred physicians participated in the study (US: 400; France: 200; Germany: 200). Physicians' attitudes towards pertussis vaccination in adults were broadly similar between the countries. Overall, 65% of physicians believed in the importance of vaccination against pertussis, a lower proportion than for COVID-19 (82%), influenza (81%), pneumococcal disease (76%), and tetanus (73%). Physicians considered immunocompromised adults or those with chronic obstructive pulmonary disease (COPD), asthma, or other respiratory conditions to be at greatest risk from pertussis. Physicians estimated that two-thirds of the adult patients to whom they recommended pertussis vaccination agreed to receive it. The top reason why they felt patients did not receive pertussis vaccination as recommended was low perception of personal risk for pertussis. Physicians' pertussis vaccination behavior was found to be similar before and after the COVID-19 pandemic.</p><p><strong>Conclusions: </strong>While physicians in the surveyed countries recognized the value of pertussis vaccination in adults, they ranked its importance lower than that of other adult vaccines. Physicians recognized the need to immunize vulnerable adults who are at risk of severe pertussis, such as those with asthma and/or COPD, but this awareness frequently did not result in vaccination of these priority groups, especially without official recommendations to support such vaccination in these groups.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"402"},"PeriodicalIF":2.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of diabetes care services, data quality, and availability of resources in Ethiopia: Difference-in-differences analysis of the NORAD-WHO NCDs' midterm project evaluation.","authors":"Yimer Seid Yimer, Meaza Gezu Shentema, Zenawi Hagos Gufue, Awgichew Kifle Zemelak, Zeytu Gashaw Asfaw, Sefonias Getachew, Mulugeta Tamire, Kalkidan Solomon, Asmamaw Bezabeh Workneh, Girma Taye Aweke","doi":"10.1186/s12875-024-02650-8","DOIUrl":"10.1186/s12875-024-02650-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The Ethiopian government, supported by NORAD, the WHO, and other partners, is decentralizing diabetes care to primary health units via a task-shifting approach. Despite substantial investment, there is still a lack of up-to-date information on diabetes screening, diagnosis, treatment, and medication availability in the country.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study assessed the effects of the NORAD-WHO intervention on diabetes care services, data quality, and the availability of infrastructure and medical supplies in Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A quasiexperimental study was conducted across 31 NORAD-WHO project facilities and 62 control facilities in six regions of Ethiopia and Addis Ababa. We used descriptive statistics to assess diabetes screening, diagnosis, treatment services, medication availability, and data quality over 54 months from January 2019 to June 2023. Additionally, we performed a difference-in-differences (DID) regression analysis comparing data from two periods: before the intervention (January to December 2019) and after the intervention (July 2022 to June 2023).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study revealed a notable increase in diabetes services, with over 82% of facilities offering screening, early diagnosis, and treatment. Written treatment guidelines are present in three quarters of the facilities. The proportion of trained staff increased from 58% in 2019 to 100% in 2023 across all the evaluated facilities. Intervention facilities had significantly more functional glucometers than did control facilities, averaging four (95% CI: 3.4, 4.6) per month in 2023 compared with 2.5 (95% CI: 2.1, 2.9) in 2019. However, hemoglobin A1C testing remains uncommon. Despite improvements in diabetes service data, issues with missing records, overreporting, and timeliness persist, with an average reporting rate of 99.2% and on-time reporting rate of 51.5%. The NORAD-WHO intervention notably increased the average number of fasting blood sugar tests by 17 per month (95% CI: 12.2-21.8, p = 0.014).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This midterm evaluation revealed a significant increase in the availability of fasting blood sugar tests in the intervention facilities. Additionally, the availability of medical equipment, laboratory services, and medications has improved over the years. Intervention facilities, with more trained healthcare professionals and better resources, outperform control facilities in screening, diagnosing, treating, and managing high blood sugar levels. Notably, intervention facilities screened more clients for diabetes and showed that patients receiving follow-up care achieved better glycemic control than did those at control facilities. While there has been progress in diabetes service data availability, addressing issues such as missing data, overreporting, and reporting timeliness is essential for further improving the quality of diabetes services.&lt;/p&gt;&lt;p&gt;&lt;stron","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"25 1","pages":"400"},"PeriodicalIF":2.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}