Attitudes Of General Practitioners Research Articles

Perspective of obstetric care-providers on being involved in cervical cancer screening during antenatal care in the Netherlands.

The aim of this study was to determine attitude of Dutch midwifes, gynecologists and general practitioners (GPs) towards involvement in antenatal cervical cancer screening (CCS) in the Netherlands. In 2021, Dutch midwives, gynecologists, and GPs were offered a single digital questionnaire assessing perceived feasibility, benefits, and harms of antenatal CCS. A total of 6943 Questionnaires were send and response rate was 18% (N = 1260). Of all respondents, 78% considered antenatal CCS via obstetric care providers feasible. Most respondents (85%) agreed that offering CCS in person can increase motivation to attend. Most midwives (93%) considered that women would feel less encumbered if cervical sampling would be performed by obstetric care providers, rather than by GPs. Results indicate that introduction of antenatal CCS is considered feasible by a majority of Dutch midwifes, gynecologists, and GPs. Considered benefits include improved motivation to attend and reduced test related barriers.

Promotion of a social prescribing pathway to general practitioners in a rural area (a feasibility study protocol)

PurposePsychosocial problems, including social isolation and loneliness, are prevalent in rural communities and can impact the use of health services and health outcomes. Current approaches to managing patients with predominantly psychosocial issues may not be the most appropriate. Social prescribing (SP) is a relatively new way of linking patients with sources of non-medical support within the community. Emerging literature suggests that community-based, non-medical activities are an effective and preferred approach to managing psychosocial problems. However, there is little evidence describing the attitudes of general practitioners (GPs) towards formal SP pathways.Design/methodology/approachThis research will occur in a general practice in a rural area of Tasmania, Australia. The project will deliver an education module to rural GPs to highlight the benefits of SP and provide a streamlined pathway for referring patients to community support hubs. Existing community organisations will act as “link workers” to connect patients with suitable community activities. GPs will complete a baseline and follow-up survey to measure their perception of SP and the acceptability, feasibility and appropriateness of such an intervention.FindingsThe acceptability, feasibility and appropriateness of the pathway will be assessed using published measures. Free-text responses to open-ended questions will be used to complement the quantitative data. A hybrid effectiveness-implementation method will be used to gather information about the rate of uptake and quality of the SP referral process and identify barriers and facilitators of the process in a real-world setting.Research limitations/implicationsWhile qualitative data for SP programmes is predominantly positive, quantitative data is lacking. Although the planned project is relatively short, it will provide a basis for future SP programme implementation and guide the approach to data collection and implementation assessment.Social implicationsThe barriers to and facilitators of introducing a SP programme in a rural general practice setting may be used to guide the development and implementation of future large-scale SP interventions. This research is both timely and relevant as the problem of social isolation and loneliness, especially in rural areas of Australia, is becoming more well-recognised as a driver of poor health and unnecessary health service usage.Originality/valueUsing SP to address psychosocial risks may reduce healthcare burden and costs. Few SP programmes have been delivered and formally assessed in Australia, and the best way to implement SP locally remains unclear. By delivering a SP intervention in a rural setting and assessing GPs’ responses, future SP projects will be better able to design and integrate social and medical care services.

Southern Queensland general practitioners' knowledge and attitudes towards Q fever and behaviours in the management of the disease.

Q fever (QF) is a zoonotic disease caused by Coxiella burnetii, often associated with abattoir workers and farmers. Recent analysis suggests that QF might occur more frequently in urban areas. This study ascertains the knowledge of, and attitudes towards, QF and behaviours in the management of QF among general practitioners (GPs) across rural and urbanareas. This cross-sectional survey study targeted GPs working in regional Queensland. GPswere asked to complete a 59-item questionnaire. Logistic regression wasused to compare respondent demographics with attitude ratings andknowledge scores. Diagnosing a patient with QF was significantly related to practitioner age, years in practice and practising in a ruralarea. This study shows gaps in GP QF knowledge, particularly around QF management. With increased urbanisation of rural areas potentially leading to increases in acute QF cases, GPs need to improve their knowledge ofthis disease.

Evaluation of deprescription by general practitioners in elderly people with different levels of dependence: cross-sectional study

BackgroundPolypharmacy is easily achieved in elderly patients with multimorbidity and it is associated with a higher risk of potentially inappropriate medication use and worse health outcomes. Studies have shown that deprescription is safe, however, some barriers have been identified. The aim of this study was to analyse Portuguese General Practitioners (GP) deprescription’s attitudes using clinical vignettes.MethodsCross-sectional study using an online survey with 3 sections: demographic and professional characterization; two clinical vignettes with an elderly patient with multimorbidity and polypharmacy in which the dependency level varies; barriers and factors influencing deprescription. Frequencies, means, and standard deviations were calculated to describe the GPs. Analysis of the deprescription attitude, globally and for each drug, for each clinical vignette applying the McNeemar’s test.ResultsA sample of 396 GP was obtained with a mean age of 38 years, most of them female. A statistically significant difference (p < 0.01) was observed in deprescribing according to the patient dependency level, with more GPs (80.4% versus 75.3%) deprescribing in the most dependent patient. A statistically significant difference was found for all drugs except for antihypertensive drugs. All medications were deprescribed more often in dependent patients except for anti-dementia drugs. More than 70% of the participants considered life expectancy and quality of life as “very important” factors for deprescription and more than 90% classified the existence of guidelines and the risks and benefits of medication as “very important” or “important”. In the open question, the factors most reported by the GP were those related to the patient (52,9%).ConclusionsThis is the largest study on this topic carried out in Portugal using clinical vignettes, with a representative sample of Portuguese GP. The level of dependence significatively influenced the deprescription attitude of Portuguese GPs. The majority of the GPs classified the quality of life, life expectancies, potential negative effects and the existence of guidelines as “very important” or “important” while deprescribing. It is important to develop and test deprescribing in real life studies to analyze if these attitudes are the same in daily practice.

Practices of French General Practitioners Regarding Vaccination of Boys Against Human Papillomavirus (HPV), One Year After the Application of Its Official Recommendation

In 2019, French health authorities extended the recommendation for human papillomavirus (HPV) vaccination to include boys aged 11 to 19 years. We describe HPV vaccination practices among French general practitioners (GPs) since this recommendation wasapplied. We also identified factors associated with the propensity to propose HPV vaccination to boys. Cross-sectional study, between May and August 2022, among French GPs using a questionnaire asking about the GPs, their practices, and opinions regarding HPV vaccination, including whether they systematically proposed HPV vaccination to eligible boys or not. We investigated factors associated with systematic proposal of HPV vaccination, using univariate and multivariate logistic regression. In total, 360 GPs participated (76.6% females; mean age 34.7 ± 7.8 years; 22.9% had additional training in gynecology or pediatrics); 5.5% reported that they systematically offered HPV vaccination to boys prior to the recommendation, whereas 61.2% do so systematically since the recommendation. Factors associated with systematic proposal to boys (post recommendation) were female GP sex (78.6% versus 66.2%; OR = 2.0 [95% confidence interval (CI) 1.2–3.3]; p = 0.007) and systematic proposal prior to the recommendation (8.5% versus 0.7%; OR = 13.3 [1.7–101.7]; p = 0.01). Protection against HPV-induced cancer was cited as an argument to vaccinate girls (98.3% versus 89.2%; p < 0.0001); while reducing the risk of transmission was more commonly an argument to vaccinate boys (78.1% versus 51.8%; p < 0.0001). This study underlines the positive impact of the official recommendation for HPV vaccination of boys on the attitude of GPs, with an increase in the systematic proposal of HPV vaccination to boys.

Rural general practitioner confidence in diagnosing and managing dementia: A two-stage, mixed methods study of dementia-specific training.

Dementias a prevalent chronic healthcare condition affecting 46 million people worldwide and projected to grow in the coming years. Australians living in rural and regional areas often lack access to specialist dementia care, despite greater prevalence relative to metropolitan areas. This study aimed to explore general practitioners (GP) understanding, confidence and attitudes towards dementia management in the rural context, and design and pilot a dementia-specific training program. A two-stage, mixed methods design, using qualitative and quantitative methods. Sixteen regional GPs from across Victoria participated in scoping semi-structured interviews. Fourteen separate GPs in the St Anthony Family Medical Practice group in the regional Loddon-Mallee area of Victoria completed the pilot training intervention. Pre- and post-training surveys (n = 10), as well as post-training interviews (n = 10), assessed attitude and knowledge changes. Analysis of semi-structured scoping interviews indicated three themes regarding experience of dementia management, including: (1) attitudes to and experiences of dementia; (2) supporting people living with dementia; and (3) knowledge, education and training of dementia. The pilot dementia-specific training was found to improve attitudes (agreement across 24 best-practice indicators improved from 30% to 79%), knowledge (median increase of 2.5/10) and confidence in managing dementia and disclosing dementia diagnoses (median increase 3/10 and 2.75/10, respectively). General practitioners in this study lacked initial confidence in detecting and managing dementia in a rural primary care setting. A targeted training program showed improvements in these areas. Accessible, locally delivered, dementia education has the potential to improve confidence in early detection and management of people with dementia and thereby may address gaps in access to care for people living with dementia in rural settings.

Practice and attitude of general practitioners towards initiating isotretinoin for acne vulgaris in Fars province, Iran: cross-sectional study

BackgroundSince general practitioners manage acne-related referrals, there needs to be more information in Iran about how drugs such as Isotretinoin are prescribed and the treatment plan. Thus, this study aimed to evaluate general practitioners s’ practices and attitudes in prescribing Isotretinoin for acne vulgaris in primary care.MethodsThis web-based cross-sectional descriptive study was conducted using two questionnaires designed with the target population of GPs working in Fars province in 2021 regarding the prescription of Isotretinoin. Moreover, demographic information, questions about interest in dermatology, and participation in dermatology workshops were gathered.ResultsA total of 308 complete questionnaires were obtained. According to our results, 85 (27.6%) GPs prescribed Isotretinoin in primary care. Based on our results, higher age (OR: 1.042; CI95%: 1.013–1.072; P-value:0.004) and attending dermatological courses (OR: 3.280; CI95%: 1.592–6.755; P-value:0.001) were significantly correlated with more frequent Isotretinoin administration. Among GPs who do not prescribe Isotretinoin, the most common causes are concerns about liver dysfunction (54.7%), teratogenic concerns (37.2%), and lack of familiarity with the drug (31.4%) respectively.ConclusionThe results of this study depicted the reluctance of most physicians to prescribe Isotretinoin and factors such as taking part in supplementary courses under the supervision of dermatologists and following national guidelines that could encourage them to prescribe Isotretinoin.

Attitudes of general dental practitioners toward preventive approach in pediatric patients: A cross-sectional survey

Abstract Objective: This cross-sectional survey aimed to assess the attitudes and practices of general dental practitioners regarding a preventive approach in pediatric patients. Methods: This cross-sectional survey involved 279 general dental practitioners and employed a structured questionnaire comprising multiple items to assess their attitudes and practices related to a preventive approach in pediatric patients and data were analyzed using the descriptive statistics and Chi-square tests. Results: The survey revealed that 60.1% of pediatric patients visited the clinic frequently and 71.0% were treated directly by the dentists. A preventive approach was common (69.2%) among practitioners. Prescription practices showed that 57.1% of dentists prescribed a specified amount of fluoridated toothpaste and 62.5% preferred fluoride gel over varnish. Nonfluoride remineralizing agents were preferred by 60.0% of dentists. Glass ionomer cement (66.7%) was preferred for pit fissure sealant applications. Conclusion: The survey indicates that general dental practitioners have a positive attitude toward preventive care in pediatric patients. However, further education and knowledge dissemination are needed to enhance their understanding and confidence.

Experience and attitudes of general psychiatrists in Turkiye towards persons with intellectual disability/intellectual developmental disorders: a cross-sectional survey

Background The global burden of psychiatric care of intellectual disabilities/intellectual developmental disorders (IDD) remains unaddressed in general. The aim of this study was to explore the knowledge and attitudes of general adult psychiatry practitioners in Turkiye. Methods A self-administered cross-sectional survey was conducted to gather information regarding the medical and postgraduate training experiences, views, and attitudes towards IDD (n = 265). Results Among the respondents, 47.9% reported receiving some training on IDD in medical school, and 75.4% during residency training. Almost all respondents felt strongly that further specialty training would be beneficial. Majority of respondents indicated that they would be willing to see patients with IDD despite finding it difficult to diagnose/manage their co-occurring mental disorders. The most common mental health problem endorsed was ‘challenging behaviour’. The most prescribed psychotropic medication class was antipsychotics. Conclusions The results of the study highlight need for training, normalization, and enhancement of community inclusion in IDD.

High vaccine confidence and strong approval of the mandatory immunization schedule among Bulgarian general practitioners in 2022

ABSTRACT In a context of recently decreasing childhood immunization coverage and low uptake of COVID-19 vaccines in Bulgaria, this study measures vaccine hesitancy among general practitioners (GPs) in the country, as they are central to forming patients’ attitudes. In 2022, a face-to-face survey was conducted through a simple random sample from an exhaustive national database of Bulgarian GPs. This study measured attitudes on vaccine importance, safety, and effectiveness, and attitudes toward the Bulgarian immunization schedule. Information was collected on demographic and GP practice characteristics and possible predictors of vaccine confidence in order to test for associations with attitudes toward immunization. GP attitudes toward vaccines and the immunization schedule in Bulgaria were generally positive. Among 358 respondents, 351 (98%,95%CI96–99%) strongly agreed/agreed that vaccines are important, 352 (98%,95%CI96–99%) that vaccines are effective, and 341 (95%,95%CI93–97%) that vaccines are safe. 347 respondents (97%,95%CI95–98%) affirmed that “it’s good that vaccines from the children’s immunization schedule are mandatory”, and 331 (92%,95%CI89–95%) agreed with the statement “Bulgaria’s childhood immunization has my approval”. Trust in information from official institutions was among the strongest predictors of vaccine confidence. Respondents’ vaccine confidence levels are within the ranges reported by GPs in other European countries and above those reported within the general Bulgarian population. GPs’ vaccine confidence is highly associated with trust in official institutions. It is important to maintain trust in official institutions and to support GPs in communicating vaccine knowledge with patients so that vaccine hesitancy in the general population is countered.

Gatekeepers in the health financing scheme: Assessment of knowledge, attitude, practices, and participation of Malaysian private general practitioners in the PeKa B40 scheme.

This is cross-sectional research done to assess the readiness of the private Malaysian general practitioners (GPs) for the implementation of the national health financing scheme. The study focused on their levels of knowledge and attitudes towards the types of health financing scheme, gatekeeper roles in the health financing scheme, and their participation in the PeKa B40 scheme. Their acceptance and level of participation in the national health financing scheme (NHFS) were also assessed. A set of self-designed and pre-tested questionnaires focusing on the aforementioned objectives were mailed to the respondents. The selection of respondents was done by stratified random sampling of the GPs in all 14 Malaysian states at both urban and rural levels. Out of a calculated number of 362 GPs targeted, 296 responses were received which represented a response rate of 81.7%. The respondents had a mean age of 50.7 years 165 (55.75%) were males and 131 (44.3%) were females. The rural respondents totalled 158 (53.4%) as compared to those from urban 138 (46.6%) areas. The outcomes observed were that GPs with PeKa B40 provider status, positive attitude towards health financing schemes, gatekeeper roles, and PeKa B40, were strongly associated with their acceptance and level of participation in the NHFS. The GPs possessed a positive attitude and were generally ready to participate in the NHFS, but the lower scores in knowledge levels would require definite education and training plans to further enhance their readiness. More incentives should be given to GPs to enrol as PeKa B40 providers. The results of this study should be strongly considered by the government in the efforts to engage the Malaysian private GPs in the forthcoming NHFS. Most importantly, the role of GPs as gatekeepers needed to be implemented, and the PeKa B40 scheme be greatly improved.

Evaluation of Knowledge, Attitude and Practice of General Practitioners regarding Oral Cancer in Tehran

Background: General practitioners (GPs) are the primary examiners of patients suspected of oral cavity cancer. The present study aims to determine the knowledge, attitude, and practice of general practitioners regarding oral cancer in Tehran.&#x0D; Methods: A 17-item questionnaire was applied to evaluate the knowledge, attitude, and practice of general practitioners in this cross-sectional, descriptive-analytical study, in 2019. The questionnaires were completed by 154 GPs participating in different medical congresses. Data were analyzed with a linear regression model using SPSS-25. P-value &lt; 0.05 was considered statistically significant.&#x0D; Results: Of 154 GPs, 44.8% were female with a mean age of 44.5 ± 13.3, mean clinical experience of 14.6 ± 11.6 years, and mean time of 16.9 ± 12.1 years elapsed from graduation. Age, sex, and marital status had no significant association with knowledge, attitude, and practice; however, the time elapsed from graduation had a significant indirect association with knowledge (p = 0.04), and mean clinical experience had a significant direct association with attitude towards oral cancer (p = 0.04).&#x0D; Conclusion: Educational interventions are required to improve the GPs’ knowledge and practice to improve the early diagnosis and prevention of oral cancer.

Lay and general practitioner attitudes towards endometrial cancer prevention: a cross-sectional study.

Effective and targeted endometrial cancer prevention strategies could reduce diagnoses by 60%. Whether this approach is acceptable to individuals and general practitioners (GPs) is currently unknown. This study sought to determine attitudes towards the provision of personalised endometrial cancer risk assessments and the acceptability of potential prevention strategies. Specific online questionnaires were developed for individuals aged 45-60 years with a uterus and UK-practising GPs, with social media, charity websites, and email used to advertise the study. Individuals completed the questionnaires between February and April 2022. Of 660 lay questionnaire respondents, 90.3% (n = 596) thought that undergoing an endometrial cancer risk assessment was a good or very good idea and 95.6% (n = 631) would be willing to undergo such an assessment. The commonest reasons for wanting to participate were "to try and reduce my risk" (n = 442, 67.0%), "to be informed" (n = 354, 53.6%), and "it could save my life' (n = 315, 47.7%). Over 80% of respondents would make lifestyle changes to reduce their endometrial cancer risk (n = 550), with half accepting a pill, Mirena, or hysterectomy for primary prevention. GPs were similarly engaged, with 93.0% (n = 106) willing to offer an endometrial cancer risk assessment if a tool were available, potentially during a Well Woman screen. Personalised endometrial cancer risk assessments are acceptable to potentially eligible individuals and GPs and could be accommodated within routine practice. Clinical trials to determine the effectiveness of lifestyle modification and Mirena for endometrial protection are urgently required and should be targeted at those at greatest disease risk.

General Practitioners' Knowledge, Attitudes, and Practices of Dietary Advice for Weight Control in Their Overweight Patients: A Scoping Review.

This scoping review assessed the knowledge, attitudes, and practices of general practitioners (GPs) regarding dietary advice for weight management. A systematic search of PubMed, EMBASE, CINAHL, and MEDLINE was conducted for any qualitative, quantitative, and mixed-methods studies published in the past five years that informed GPs' dietary advice for weight control. Thirteen studies were included in the analysis after screening 881 papers. These studies tended to focus mostly on GPs' practices rather than their knowledge and attitudes. The most frequently mentioned dietary advice was to reduce calorie intake; however, 32 different types of dietary advice were identified in the literature, including approaches such as intermittent fasting and a ketogenic diet that are not recommended in current guidelines. GPs showed varying levels of knowledge and attitudes regarding the best dietary advice for patients. Further research is needed to better understand GP perspectives, with efforts to assist GPs in providing tailored advice based on the latest evidence to improve patient outcomes required.

The Effects of Online Access to General Practice Medical Records Perceived by Patients: Longitudinal Survey Study.

Patient online access to medical records is assumed to facilitate patient empowerment and advance patient-centered health care. However, to date, the actual effects of online access to medical records perceived by patients and other outcomes are insufficiently empirically tested. This study aimed to investigate the effects of online access to medical records on patient empowerment, informed decision-making, and the patient-provider relationship perceived by patients. A nationwide, 2-wave, longitudinal survey study was conducted among Dutch adults (N=2402). Linear regression analyses were performed. In model 1, the perceived effects of online access to medical records (measured at T1 [first measurement; July 2021]) on 16 outcomes (measured at T2 [second measurement; January 2022]), which were associated with the use of online access to general practice medical records in previous research, were investigated. Model 2 included sociodemographic factors and patient characteristics as confounders. Users indicated more strongly than nonusers that online access to medical records would increase their participation in health care, improve the relationship with their general practitioner, and support informed decision-making. These results were robust when adjusted for the influence of confounders. Effect sizes were very small, with unstandardized regression coefficients (B) ranging between -0.39 and 0.28. Higher digital and health literacy were associated with higher ratings of almost all effects. Online access to medical records has the potential to empower patients and foster informed decision-making among patients. The effects in this study were small but might grow over time. Other factors, such as the attitude of general practitioners toward online access to medical records, might moderate these effects. The results indicate that the potential benefits of online access to medical records might be unevenly distributed. We suggest future exploration of the conditions under which online access to medical records can improve health care system functioning and efficiency without increasing health inequality.

Using Academic Detailing to enhance the knowledge, skills and attitudes of clinicians caring for patients with behavioral and psychological symptoms of dementia: 18‐month follow‐up

AbstractBackgroundApproximately 90% of persons with dementia experience behavioral and psychological symptoms of dementia (BPSD) over the course of their illness. Primary care clinicians often provide care because specialty geriatric psychiatry consultation may be difficult to obtain. Academic detailing (AD) is an evidence‐based approach for engaging and persuading healthcare professionals to make changes in their practice. We sought to enhance the knowledge, skills and attitudes of primary care providers’ care of patients with BPSD using the AD model.MethodsWe implemented AD in an urban clinic serving a largely Black community and a rural clinic serving a largely White community. Each AD visit included didactic content, case discussion, and consultation regarding patients. Eleven visits over 18 months were planned for each site. Outcome measures included a 10‐item multiple‐choice knowledge assessment and an adaptation of the General Practitioners Attitude and Confidence Scale for Dementia at baseline, 6 and 18 months, and Likert‐scale measurement of acceptability at 6 and 18 months, all self‐report. Differences in knowledge and attitude scores were determined for those providing complete responses at baseline and follow‐up. Thematic analysis of qualitative feedback collected 18 months will be completed.ResultsFive urban and 14 rural providers completed baseline assessments. Providers were mostly White (95%) and Non‐Hispanic (100%); 47% were female (Table 1). Seventeen (89%) participated in one or more AD visits and 13 (68%) participated in the 6‐month survey. Knowledge, attitudes and confidence regarding BPSD and dementia care increased (Table 2). Assessments at 18‐months and qualitative analysis of case discussions are forthcoming and will be presented.ConclusionsAcademic detailing (AD) is a feasible way of increasing self‐reported knowledge and skills and improving self‐reported attitudes of primary care providers responsible for the care of patients with BPSD. Knowledge and confidence in BPSD and dementia care increased after 6 months’ participation in AD. During the pandemic we successfully adapted the AD model to a virtual platform, which has implications for portability of this model to other settings. The pilot data collected in this study will inform the design of a larger study to measure the impact of AD on patient outcomes.

Evaluation of the knowledge, awareness, and attitudes toward epilepsy among general practitioners in Eastern China

ObjectiveWe aimed to assess the knowledge, awareness, and attitudes toward epilepsy among general practitioners (GPs) from community health service centers (CHCs) in Hangzhou, Eastern China. MethodsOne hundred twenty three GPs working at CHCs participated in this cross-sectional study in 2022. A custom-built electronic questionnaire, which comprised four domains, including 12 items for general condition data, 10 items for awareness (including first aid), a 16-item scale for attitudes, and 6 items for demographic data, was administered to the GPs. Descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis H test, and Spearman’s rank correlation analysis were used to analyze the non-normal distribution of the data set. ResultsThe GPs’ average score on the awareness of epilepsy section was 18.14 ± 3.34 (aggregate score: 34), the first aid knowledge of epilepsy section scored 4.89 ± 1.54 (aggregate score: 7), and the epilepsy attitude section scored 62.28 ± 10.15 (aggregate score: 80). Age (rs = 0.218, P = 0.015), professional title (rs = 0.215, P = 0.017), and length of service (rs = 0.240, P = 0.008) correlated significantly with mean awareness of epilepsy scores. Age (rs = −0.234, P = 0.009) and educational background (rs = 0.199, P = 0.028) correlated significantly with attitudes toward epilepsy. Furthermore, when GPs faced newly diagnosed people with epilepsy (PWE), a referral was usually recommended (89.43%) and some would give Chinese traditional treatment (13.01%). In addition, the difficulties the GPs encountered in managing included PWE rarely appearing in the community (82.93%), the community lacking corresponding medical equipment (82.11%), and GPs lacking epilepsy-related experience (73.17%). ConclusionThe awareness and attitudes of GPs toward epilepsy in the CHCs were suboptimal. General practitioners age, professional title, length of service, and educational background influenced awareness and attitudes toward PWE. Effective public intervention programs, epilepsy training based on National Guidelines, and referral routes need to improve in China to enhance the care of PWE.

Introducing Advanced Paramedics into the Rural General Practice Team in Ireland – General Practitioners Attitudes

Introduction:As Ireland's population increases and chronic disease becomes more prevalent, demand for limited general practice services will increase. Nursing roles within a general practice are now considered to be standard, yet alternative non-medical professional roles are under-explored within an Irish context. Non-medical personnel such as Advanced Paramedics (APs) may have the capability to provide support to general practice.Method:A sequential explanatory mixed methodology was adopted. A questionnaire was designed and distributed to a purposeful sample of GPs attending a rural conference followed by semi-structured interviews. Data was recorded and transcribed verbatim and thematically analyzed.Results:In total n=27 GPs responded to the survey and n=13 GPs were interviewed. The majority of GPs were familiar with APs and were receptive to the concept of closely collaborating with APs within a variety of settings including out-of-hours services, home visits, nursing homes, and even roles within the general practice surgery.Conclusion:GP and AP clinical practice dovetail within many facets of primary care and emergency care. GPs believe that current models for providing rural general practice care are unsustainable, and they realize the potential of integrating APs into the general practice team to help support services into the future. These interviews provide a detailed insight into the opinions of rural general practitioners in Ireland on healthcare provision and the clear necessity for support and change.

The early use of Antibiotics for At-risk children with InfluEnza in Primary Care (the ARCHIE programme)

The early use of Antibiotics for At-risk children with InfluEnza in Primary Care (the ARCHIE programme)

Topical Steroids: Awareness and Misuse Among General Medical Practitioners

Introduction: Topical steroids (TS) contributed in the management of several inflammatory, tumoral or allergic dermatoses. However, their misuse may lead to serious or even irreversible adverse effects. This study aimed to evaluate the knowledge and attitudes of general medical practitioners in Morocco regarding topical steroids use and misuse. Materials and Methods: Cross-sectional national survey over a 4-month period from 01/09/2022 to 30/12/2022. The data was collected by a Google Forms questionnaire which was shared on different professional groups on the social networks. The target population was Moroccan general practitioners. Data analysis was performed by Excel software. Results: A total of 200 general medical practitioners answered the questionnaire, of which 133(66.5%) practiced in the public sector and 67(33.5%) in the private sector. 11% had rated their frequency of prescription as high, 56% as medium and 33% as minimal or rare; the indications were dominated by eczema, atopic dermatitis and psoriasis. The prescription of topical corticosteroids started from the age of 1 year in 32.5% of general practitioners while the majority prescribed them at any age. Sixty (30%) were aware of the pharmacological effects of topical corticosteroids. The most frequently prescribed galenic form was cream in 95% of cases followed by gels, lotions and finally preparations. One hundred and thirty-three (66%) had answered correctly to the indications of topical corticosteroids and 106(53%) prescribed them in short cures. Few doctors (1%) had been able to identify all side effects. One hundred and fifty (75%) of the general medical practitioners had already seen patients presenting adverse effects dominated by skin atrophy, delayed healing, depigmentation, fungal or bacterial infection; their response consisted of degression in 75% of cases or switching to a lower class, while 11.5% had wrongly suggested an abrupt discontinuation. Conclusion: The high frequency of topical steroids side effects is an increasing problem encountered by dermatologists. Lack of some general practitioners and patient awareness are also important underlying factors. To our knowledge, this is the first Moroccan study that aimed to evaluate the knowledge, attitudes, and behavior regarding topical corticosteroids by general medical practitioners.