Healthcare Professional Communication Research Articles

CLINICIANS' PERCEPTIONS OF MANUAL HANDLING POLICIES IN STROKE REHABILITATION: A QUALITATIVE FOCUS GROUP STUDY.

The professional literature guides manual handling in numerous health care settings. The effects of these guidelines on stroke rehabilitation and the clinical communication of health care professionals are unknown. This paper aims to investigate the perspectives of nurses and physiotherapists on handling guidelines in their professions to identify conflicts in opinions to provide optimum care to people with stroke. A qualitative focus group study. Three focus groups were conducted. The participants were physiotherapists or nurses with 1 year of stroke care experience. The data were thematically analysed. Nineteen participants (12 physiotherapists and 7 nurses) were interviewed. The data analysis revealed 3 themes. First, "The application of handling in stroke rehabilitation" includes clinical reasoning and real-world handling practices. The second theme, "Physical Effects on Therapists," examines the long-term effects of manual handling on therapists, including work-related musculoskeletal disorders. The final theme, "Conflicts among health care professionals," investigates stroke rehabilitation equipment conflicts between nurses and physiotherapists. The study concludes that stroke transfer guidelines in the specialised literature may impact health care professionals' perspectives. Conflicts among health care professionals can impair teamwork. Thus, health care professionals should work together as stroke rehabilitation teams to develop unified transfer guidelines that aid rehabilitation and avoid work-related musculoskeletal disorders.

Stigma, risks, and benefits of medicinal cannabis use among Australians with cancer.

People with cancer who use medicinal cannabis do so despite risks associated with limited clinical evidence, legalities, and stigma. This study investigated how Australians with cancer rationalise their medicinal cannabis use despite its risks. Ten adults (5 males and 5 females; mean age of 53.3) who used cannabis medicinally for their cancer were interviewed in 2021-2022 about how they used and accessed the substance, attitudes and beliefs underpinning their use, and conversations with others about medicinal cannabis. Participants had cancer of the bowel, skin, oesophagus, stomach, thyroid, breast, and Hodgkin lymphoma for which they were receiving treatment (n = 5) or under surveillance (n = 5), with most (n = 6) encountering metastatic disease. Cannabis was used to treat a variety of cancer-related symptoms such as pain, poor sleep, and low mood. Cannabis was perceived as natural and thus less risky than pharmaceuticals. Participants legitimised their medicinal cannabis use by emphasising its natural qualities and distancing themselves from problematic users or riskier substances. Cost barriers and a lack of healthcare professional communication impeded prescription access. Similarly, participants navigated medicinal cannabis use independently due to a lack of guidance from healthcare professionals. Findings highlight the need for robust data regarding the harms and efficacy of medicinal cannabis and dissemination of such information among healthcare professionals and to patients who choose to use the substance. Ensuring healthcare professionals are equipped to provide non-judgmental and evidence-based guidance may mitigate potential safety and legal risks.

Evaluating the impact of interprofessional training wards on patient satisfaction and clinical outcomes: a mixed-methods analysis.

Interprofessional teamwork is pivotal in modern healthcare, prompting the establishment of interprofessional training wards since 1996. While these wards serve as hubs for optimizing healthcare professional collaboration and communication, research into patient outcomes remains notably sparse and geographically limited, predominantly examining patient satisfaction and sparingly exploring other metrics like mortality or self-discharge rates. This study seeks to bridge this gap, comparing patient outcomes in interprofessional training wards and conventional wards under the hypothesis that the former offers no disadvantage to patient outcomes. We explored patient outcomes within an interprofessional student ward called A-STAR at a University Hospital from October 2019 to December 2022. Engaging with patients discharged between May 2021 and April 2022, we utilized digital and paper-based anonymous questionnaires, catering to patient preference, to gather pertinent data. Analysis of outcomes for 1,482 A-STAR (interprofessional student ward) and 5,752 conventional ward patients revealed noteworthy findings. A-STAR patients tended to be younger (59 vs. 61 years, p < 0.01) and more frequently male (73.5% vs. 70.4%, p = 0.025). Vital clinical outcomes, such as discharges against medical advice, complication-driven readmissions, and ICU transfers, were statistically similar between groups, as were mortality rates (1.2% vs. 1.3%, p = 0.468). A-STAR demonstrated high patient satisfaction, underscored by positive reflections on team competence, ward atmosphere, and responsiveness to concerns, emphasizing the value placed on interprofessional collaboration. Patient narratives commended team kindness, lucid explanations, and proactive involvement. This data collectively underscores the safety and reliability of patient care within training wards, affirming that patients can trust the care provided in these settings. Patients on the interprofessional ward demonstrated high satisfaction levels: 96.7% appreciated the atmosphere and conduct of ward rounds. In comparison, 98.3% were satisfied with the discussion and information about their treatment during their hospital stay.

Patients' preoperative awareness of anesthesia

Research methods: systematic literature analysis and qualitative research – semi-structured interview. The sample of the qualitative research is 16 respondents. The data was analyzed using the method of qualitative content analysis. &#x0D; Conclusions. 1. Patients know what anesthesia is and for what purpose it is performed, most patients follow the preoperative preparation recommendations. Before the operation, patients want to be informed and know about the course of the operation, anesthesia, pre-operative requirements, risks and threats of complications, the postoperative period, rehabilitation. Patients emphasize that communication with healthcare professionals (doctors and nurses) before surgery is very necessary for them. The information provided to some patients was insufficient, there was a lack of communication. Patients prefer an individual conversation and written or visual information about pre-operative preparation, anesthesia in a language they understand, without difficult medical terms. 2. Nursing roles emerged as important factors in patients' preoperative period. It has been established that the communication of health care professionals, including nurses, and the time devoted to patients in meeting their needs have a significant impact on patient awareness.

Orthopaedic trauma patients’ experiences with emergency department care and follow-up through Virtual Fracture Care review: a qualitative study

ObjectivesThis study aimed to identify factors influencing orthopaedic trauma patients’ experiences and satisfaction with emergency department (ED) care and follow-up through Virtual Fracture Care (VFC) review workflow.DesignThis study employed an...

Physician Awareness of the Safe Use of Cyproterone Acetate in Europe: A Survey on the Effectiveness of Additional Risk Minimization Measures.

Cyproterone acetate (CPA) is a synthetic progesterone derivative introduced in the 1970s and prescribed as antiandrogenic therapy for inoperable prostate cancer, sexual deviations in men, and signs of androgenization in women. In 2020, the CPA summary of product characteristics (SmPC)was revised to include an updated special warning and precaution about (1) the risk of meningioma with increasing cumulative dose and (2) contraindication in patients with meningioma or history of meningioma. A Direct Healthcare Professional Communication(DHPC) was distributed. The European Medicine Agency's Pharmacovigilance Risk Assessment Committee requested that marketing authorization holders in Europe conduct a survey to assess physicians' knowledge of the updated key safety information. The primary objective of this study was to measure physicians' awareness (i.e., did they receive and review the revised SmPC and DHPC) and level of knowledge and understanding of the key safety information pertaining to the restricted use of CPA monotherapy because of the risk of meningioma. This cross-sectional web-based survey was administered to dermatologists, endocrinologists, gynecologists, urologists, oncologists, psychiatrists, and general practitioners in France, Germany, Poland, Spain, and the Netherlands who had prescribed CPA monotherapy in the previous 12 months to assess awareness of the risk of meningioma associated with CPA monotherapy. Of the 613 physicians who participated, 85% correctly indicated that CPA monotherapy should be prescribed with the lowest effective dose, 75% correctly indicated that the risk of meningioma increases with increasing cumulative CPA monotherapy doses, and 73% correctly indicated that treatment with CPA-containing products must be stopped permanently if a patient is diagnosed with meningioma. Overall, 40% of physicians reported having received the DHPC, and 42% reported having received the revised SmPC. Despite low recall of receipt of the updated SmPC and DHPC, most physicians surveyed are aware of the meningioma risk and actions to mitigate the risk.

Communication and coordination of care for people living with HIV: a qualitative study of the patient perspective

BackgroundThere is growing consensus that primary health care (PHC) providers have an important role in providing holistic, preventative care for people living with human immunodeficiency virus (PLHIV). In regional Australia, HIV care is primarily delivered through specialist services, thus adequate coordination and communication between specialist and PHC professionals is crucial. This study aimed to explore patient experiences of the coordination of care and health care professional communication for PLHIV in regional Australia.MethodsSemi-structured interviews with PLHIV in a regional area of Australia were conducted in March to April 2022. Interviews were conducted via video conferencing, face-to-face, or via telephone call. Interviews were audio-recorded and manually transcribed. Transcripts were coded inductively and thematic analysis was conducted to explore perspectives on communication and coordination.ResultsThirteen participants were interviewed. Most participants were male, aged 50–70, were diagnosed with HIV more than ten years ago, and had been living in regional Australia long-term. Through qualitative analysis, themes emerged in the following areas: (1) Patient perception of care coordination; (2) Patient understanding of modality of communication; (3) Positive attitudes towards communication between healthcare professionals; and (4) Concerns for information sharing between healthcare professionals. Many participants highlighted lack of clarity around care coordination as a key issue in their healthcare, with some citing themselves as the primary care coordinator. Participants identified that coordination and communication between PHC professionals and specialist services are essential in the delivery of their health care, but some were hesitant for this to occur. Hesitancy was entrenched in some patients’ distrust of healthcare due to previous experiences of confidentiality breaches and stigma.ConclusionThis study identifies the need for clarity in coordination between health care professionals to deliver safe and effective HIV care, which may occur through care plans. Patient support for communication between healthcare providers may be strengthened by ensuring trust in the people and systems involved. Eliminating stigma in healthcare as well as building more trustworthy electronic-based communication technologies are essential components to trust-building between PLHIV and healthcare systems.

Healthcare professional communication behaviours, skills, barriers, and enablers: Exploring the perspectives of people living with Inflammatory Bowel Disease

Healthcare professional communication behaviours, skills, barriers, and enablers: Exploring the perspectives of people living with Inflammatory Bowel Disease

Opinion of Patients and Healthcare Professionals on the Value of Integrating Emojis into Healthcare Communication

Introduction: Ability to discuss emotions can significantly strengthen the patient–Health Care Professional (HCP) relationship and improve outcomes. Communication barriers impede this relationship and limit the ability of HCPs to provide patient-centered care. Emojis are a universal language that has the potential to overcome these issues and are particularly suited for describing emotions.&#x0D; Aim: This 3-phase feasibility study aimed to collate current opinions around the utility of emojis in patient–HCP communication.&#x0D; Methods: In phase 1, a survey was conducted between September and October 2021 among members of the War On Cancer digital platform community (patients, friends, family, and others interested in the study) to determine how they used emojis in their personal and healthcare communications. In phase 2 (February 2022), selected patients were individually interviewed via zoom (9 questions; 30–60 minutes) to evaluate their current use of emojis in text-based communications, situations where emojis might and might not help them express themselves to HCPs, and emotions represented by different emojis. In phase 3 (February 2022), invited HCPs were individually interviewed face-to-face or via Zoom (6 open-ended questions; 30–45 minutes) to evaluate their current use of digital communications and emojis with patients, insights on the findings from phases 1 and 2, and overall thoughts on using emojis in patient communications.&#x0D; Results: The phase 1 survey had 290 respondents aged 15–84 years from 22 countries. The majority used emojis to express emotions in personal conversations and were positive about using them in HCP communications. In phase 2, 8 patients aged 30–70 years from the UK, US, and Sweden were interviewed. All used emojis in personal communications and a minority had used emojis to communicate with their HCP. Most interpreted emojis similarly, yet participants had varying views on when and how they should be used with HCPs, mainly because of the potential ambiguous interpretation. Some noted a lack of healthcare–adapted emojis. Participants identified 4 situations where emojis could be useful in HCP communication: emotional preparation before a visit, follow-up after a visit, situations with a language barrier, and to replace numeric scales for strength of emotion. Emojis were considered less useful as a substitute for face-to-face meetings, in serious situations, and when expressing serious emotions. In phase 3, 5 HCP volunteers (2 clinicians, 3 nurses) aged 30–45 years from the US and Sweden were interviewed. All communicated digitally with patients through electronic medical records or other platforms, sometimes only one-way (HCP to patient). No HCPs had used emojis directly with patients, noting that some platforms prohibit it. HCPs agreed with the scenarios identified in phase 2, further suggesting emojis may be most helpful for patients with poor literacy or who have difficulty expressing emotions.&#x0D; Conclusions: The findings of this survey and interviews demonstrated that both patients and HCPs recognize potential advantages in using emojis within healthcare conversations. Further research is required to determine the optimal settings in which emojis can be used to improve communications between patients and HCPs, and the associated clinical value.

ADVERSE DRUG REACTIONS AMONG PATIENTS IN DEPARTMENT OF MEDICINE IN A TERTIARY CARE TEACHING HOSPITAL, KOLLAM

Objectives: Pharmacovigilance practices are still in the infancy in India, more so in South India. adverse drug reactions (ADRs) are often underreported and the risks are higher in adults and elderly due to the association of comorbidities, self-medication, combination of indigenous systems of medicines and modern medicine, and so on. The present study was done with the objective to analyze the ADRs among patients in the general medicine department, Government Medical College, Kollam. The primary objective is to determine the prevalence and nature of ADRs and secondary objective to assess the causality, severity, and preventability of the ADRs. Methods: In this cross-sectional study done in the Department of Medicine, Government Medical College, Kollam, 1000 patients of either sex were analyzed using CDSCO ADR reporting forms and the approved scales for causality, severity, and preventability. Results: Among 1000 patients studied, the prevalence of ADRs was 7.6%. The most common system involved were dermatological (41%) followed by cardiovascular (18%) and gastrointestinal and neurology (16% each). Majority of the ADRs came under probable (48.7%) with a Naranjo score of 5 (40.8%), of moderate severity (65.8%) and not preventable (71.1%). Conclusion: ADRs pose a major problem needing hospital stay or prolonging the duration of stay. Developing an ongoing ADR reporting system with continuous motivation and creating awareness among the healthcare professionals for reporting suspected ADRs will help to continue reporting and improving the patient safety. Improved communication of health-care professionals with the pharmacovigilance centers should be promoted for better patient healthcare.

Weight management communications in idiopathic intracranial hypertension: challenges and recommendations from the patients’ perspective

BackgroundIdiopathic intracranial hypertension (IIH) is a neurometabolic condition severely impacting the quality of life of people living with IIH (PwIIH). Most PwIIH are overweight or live with obesity, and weight...

Cytokine Release Syndrome: The Patient, Caregiver and Healthcare Professional Experience

Background: Cytokine release syndrome (CRS) is a supraphysiologic response to T-cell engaging immunotherapy that can negatively impact the treatment experience of patients with non-Hodgkin lymphoma (NHL) and other blood cancers. We explored patient, caregiver and healthcare professional (HCP) perspectives on key burdens and unmet needs associated with CRS. Methods: Existing insights from disease-level patient journeys (follicular lymphoma, diffuse large B-cell lymphoma, multiple myeloma [MM]) and reports from focus groups with a CRS patient working group from the USA, UK, Canada, and Belgium were assessed to identify key questions. Further interviews were conducted (November 2022-January 2023) in the USA, UK, Germany, and Austria to address these questions with patients, caregivers and HCPs. HCP insights were collected via 60-minute virtual interviews; patient and caregiver insights were collected via video homework tasks and 60-minute virtual interviews. Outputs were validated by the working group, consisting of patients with CRS experience and representatives of patient organizations. Results: A total of 34 HCPs (hemato-oncologists, n=24; nurses, n=10; Tables 1 &amp; 2) with varying degrees of experience of managing CRS were interviewed, along with 9 patients and 3 caregivers (associated diagnoses: NHL, n=6; MM, n=5; acute lymphocytic leukemia, n=1). All patients had experienced CRS (Grade 1-3) as a result of CAR T-cell (n=6) or bispecific antibody (n=3) therapy. Insights were based on five focus areas: 1) patient education and information; 2) CRS diagnosis and management; 3) CRS in different healthcare archetypes; 4) digital literacy and the role of technology in mitigating/monitoring/managing CRS; and 5) the caregiver perspective. CRS education was a primary unmet need, but overall awareness and knowledge of CRS was strong among the patient sample. Patients noted the life-threatening potential of CRS, but preferred to be on active treatment. HCP communication to patients focused on CRS being an expected occurrence rather than a marker of treatment failure, the need for in-patient admission in some cases and/or close monitoring, and the critical role of caregivers. Generally, HCPs were familiar with CRS and the procedures for its monitoring and management, but the variability in time to onset, severity of symptoms, and potential impact on quality of life (QOL) warranted caution. Logistics emerged as a common barrier, with CRS treatment often administered at major hospitals, as local, community-based clinics do not currently have the required capacity/capability to manage CRS; this could be achieved via the provision of training and support. Uncertainty remains regarding the broader roll out of bispecific antibodies, given the variability in CRS treatment between countries. Patients, HCPs and caregivers were aligned on their preferences for remote monitoring for CRS. All three groups expressed the need for simple, easy-to-use solutions that integrate seamlessly with existing systems and do not cause undue concern with false alarms, complex technical set-up and patient user experience. Patients emphasized the need for prompt and assured access to their medical team in case of an emergency. HCPs expressed a range of opinions on the feasibility of adopting such solutions. Some were open to using new tools and saw the potential for alleviating resource challenges. Others had reservations about interoperability and questions around over-informing patients with detailed data. Patients were open to adopting new technologies, if they added tangible benefit to their QOL, avoided additional logistical burden and improved their experience. Conclusions: There is strong awareness among patients, caregivers, and HCPs of the risks associated with CRS and the potential impact on QOL. HCPs with experience in administering cellular immunotherapies are confident in monitoring and managing CRS; however, its unpredictability and logistical burden need to be addressed. There is value in adopting digital solutions for CRS monitoring and management. Concerns remain around interoperability, data stewardship, and integration and validation within current hospital systems. Patients' concerns regarding the useability of such digital solutions and assured data privacy also need to be addressed as part of solution development in the CRS space.

Abstract 19115: In-situ Resuscitation Training in Cardiology Procedural Suites

Background: Critical Care Advanced Resuscitation Training (CC-ART) prepares critical care teams for emergency situations through training that occurs in a simulated clinical space. Simulated environments do not always accurately mirror the actual clinical environments. Simulations conducted in the actual clinical environment, also known as in-situ simulation, may overcome some of these challenges. Goal: To explored the impact of in situ, ART simulation in a Cardiac Catheterization Lab (CCL) and an Electrophysiology Lab (EPL) on the staff’s experience, confidence, and communication skills. Method: Key leadership and educator team members collaborated on the in-situ simulation set up. Coordination with Simulation Center and Central Supply Department was completed to arrange for delivery of high-fidelity manikins and training crash cart to the site. A team of physicians and nurse educators created CCL and EPL scenarios for the simulations and wrote a simulation evaluation survey for CCL and EPL nurses and technologists who attended. Results: . Simulations were run by both critical care anesthesiologist and clinical nurse educator. Pre-simulation and post-simulation surveys were collected immediately prior to and after the in-situ simulation. 38 staff completed pre and post surveys. Pre-simulation, 50.00% of staff strongly agreed that they were confident in their ability to care for a decompensated patient based on the prior CC-ART training versus, post-simulation, 84.21% strongly agreed. Pre-simulation, 26.32% strongly agreed that the simulation center training was similar to their actual work experience versus post-simulation, 78.95% agreed the in-situ simulation matched their actual work experience. Pre-simulation, 52.63% strongly agreed that they were confident in their ability to communicate their needs during emergencies or code blue situations versus post-simulation 86.84% agreed. Conclusion: This quality improvement project highlights the effectiveness of in situ resuscitation simulation in improving healthcare professionals' confidence, training realism, and communication skills . Analysis of patient outcomes is needed to determine the effectiveness and duration of impact of in situ training for clinical practice.

A digital medical tool for health care professionals communication with minority speaking heart surgery patients during hospitalization: A qualitative study

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The Foundation Dam Background/Introduction Despite today’s high-technology society, communications with minority speaking heart patients in hospitals still depend on non-verbal language, notes from informal caregivers and "google translate" in situations where interpreters are not available. Digital solutions may be of help, but research into this area is limited. Innovative research exploring the use of a 24-7 digital medical translation tool is needed prior to hospital implementation. Purpose To explore the health care professionals’ experiences using a digital, medical translation tool in communication with minority speaking heart surgery patients during hospitalization. Methods A digital medical translation tool was customized for use in communication with hospitalized heart surgery patients by including standardized checklists for safe surgery and phrases for symptom assessment. Then qualitative interviews with health care professionals, ultimately using the digital translation tool presented on a tablet with text and audio were performed a) at the hotel/ward, b) preoperatively by both operating room nurses and anaesthesia nurses at the operating room, c) in a postoperative unit, d) in an intermediary unit, and e) at the cardiothoracic ward. A semi-structured interview guide was used during face-to-face interview at a university hospital in Norway and were carried out during November – December 2022. Data analyses were performed in NVivo software tool, following Braun and Clarke`s thematic analysis process. Results A total of 24 healthcare professionals, 22 nurses and two physiotherapists, mean age of 33 (range 23-57 years), and a mean of 9.5 years of professional experience, were interviewed shortly after they had cared for a minority speaking heart surgery patient at their health care unit. Four main themes were identified: i) useful and user-friendly tool, ii) establishing trust with the patient, iii) mapping patients’ symptoms and needs and iv) safe translation reassures health care professionals communication with heart surgery patients. The digital medical translation tool was experienced as easy to navigate in and useful to inform the patient, for example about medications, and to build trust by communicating with the patient in their own language. Being able to secure mapping of patients’ symptoms, especially pain, was underlined as a highly positive experience. Health care professionals reported experiencing the minority speaking patients as understanding the information when communicating through the digital medical translation tool. Conclusions Health care professionals responsible for caring for the minority speaking heart surgery patients during hospitalization experienced the digital medical translation tool to improve communication in a safe and trustworthy way. The digital translation tool appeared to provide useful support and strengthen patient safety, increasing the quality of health care even without the presence of an interpreter.

Healthcare Professional Communication on Sexual Health: A Report from the Italian Working Group on Adolescents and Young Adults with Cancer.

Sexual function is an important concern for adolescent and young adult (AYA) with cancer. The aim of this study was to explore the attitude of Italian health care professionals who deal with AYA patients with cancer toward sexual health communication. A 11-question survey was developed by the AIOM (Associazione Italiana di Oncologia Medica) and AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) AYA workgroup and sent to AIOM and AIEOP members. The sample comprised 360 respondents, 54.2% AIEOP and 45.8% AIOM members. Eighty percent were physicians, 14.5% nurses, 4.7% psychologists, and 0.8% other professionals. Medical oncologists are more used to investigate about AYA sexual health than pediatric oncologists (58.2% vs. 46.2%), even if pediatrics more frequently refer patients to specific and shared protocol (40% vs. 26.1%). Both AIOM and AIEOP participants mostly talk about sexual health only on request or occasionally (78.8% and 79%, respectively). Clinician-reported barriers to communication identified in this study are lack of preparation and embarrassment for both the categories, plus the presence/interference of parents for pediatrics and lack of time for medical oncologists. Overall, less than 5% of clinicians in our survey received specific training on potential sexual health issues in AYA patients with cancer and only 2% felt adequately prepared to speak about it. Sexual health is a key component of comprehensive care for AYA with cancer during treatments. This study highlighted the need of Italian providers for specific training and guidelines on sex-related health issues encountered by AYA patients.

O.21.5 - “My gut feeling is…”: Identifying healthcare professionals communication about pain in rheumatology: Presenter(s): Sarah Peters, University of Manchester, United Kingdom

O.21.5 - “My gut feeling is…”: Identifying healthcare professionals communication about pain in rheumatology: Presenter(s): Sarah Peters, University of Manchester, United Kingdom

What Factors Make EU Regulators Want to Communicate Drug Safety Issues Related to SGLT2 Inhibitors? An Online Survey Study.

Previous studies have found differences in the communication of safety issues among medicines regulatory agencies. To explore (1) to what extent regulators' opinions regarding the need to communicate safety issues related to sodium-glucose cotransporter-2 (SGLT2) inhibitors might be influenced by their concern about the safety issue, and (2) whether regulators' concerns might be influenced by certain characteristics of the safety issue or by the demographic and professional characteristics and attitudes of the regulators. An online cross-sectional survey study with a rating-based conjoint analysis among clinical and pharmacovigilance assessors from the EU regulatory network was performed between April and June 2021. Regulators were invited by email, and participants were asked about their level of concern and their opinion regarding the need to communicate about 12 scenarios defined by four characteristics: adverse drug reaction, source of information, causality, and frequency. The outcomes for the first objective were to update the summary of product characteristics (SmPC; yes/no) and to send direct healthcare professional communications (DHPC; yes/no). The determinant was regulators' level of concern (range 0-100%). The outcome of the second objective was regulators' level of concern, and the determinants were the characteristics of the safety issue, demographic and professional characteristics, and attitudesof the regulators (beliefs about medicines and risk perception). A total of 222 regulators completed the survey (64% women; mean age 46 ± 10 years). Depending on the scenario, 54-94% and 25-74% of the participants would update the SmPC or send a DHPC, respectively. The participants' level of concern influenced their opinions regarding the need to update the SmPC and send a DHPC (odds ratio (OR) 13.0; 95% confidence interval (CI) 7.8-21.7 and OR 13.6; 95% CI 9.5-19.2, respectively, for every 10% increase in the level of concern). All characteristics of the safety issue influenced the level of concern. Younger participants, women, and those working for Eastern European agencies had a higher level of concern than older participants, men, and those working in other regions. Beliefs about medicines and general risk perception also influenced their concern. The opinion regarding the need to communicate safety issues was influenced by the concern of regulators. Regulators' concern was influenced bythe characteristics of the safety issue, demographic characteristics, and attitudes. Diverse groups of experts regarding such factors would ensure that various views are incorporated in risk communication decisions.

The Awareness and Adherence of the Valproate Pregnancy Prevention Program: A Questionnaire Survey among Healthcare Professionals, Pharmacists, and Patients in Denmark.

The European Medicine Agency (EMA) provided additional recommendations regarding the use of valproate during pregnancy in 2018 by introducing a pregnancy prevention program (PPP). This study aimed to investigate the adherence and the impact of the PPP and the awareness of valproate teratogenicity among Danish healthcare professionals (HCPs) and patients. As part of the EMA initiated multi-country survey, web-based questionnaires were distributed among Danish general practitioners (GPs), medical specialists, pharmacists, and patients. A total of 90 prescribers, 98 pharmacists, and 103 patients were included in the study. Some 95.0% of the prescribers, 78.6% of the pharmacists, and 81.6% of the patients were aware of the teratogenic risks of valproate. The patient guide (27.8%), the HCP guide (23.3%), direct healthcare professional communication (23.3%), and the warning sign on the outer medication package (23.5%) were the most applied measures from the PPP. A total of 54.4% of the prescribers and 32.7% of the pharmacists informed patients about the importance of effective contraception during the use of valproate. The study showed that in Denmark HCPs and patients are highly aware of the teratogenic effects of valproate. However, adherence to and the impact of the measures included in the PPP were low.

Caring for People with Severe Brain Injuries: Improving Health Care Professional Communication and Practice Through Online Learning.

Severe brain injuries can leave people in prolonged disorder of consciousness resulting in multifaceted medical, nursing, and rehabilitative needs that can be challenging for even the most experienced multidisciplinary team. The complexities of care, communication with families, and best interest decision-making about medical interventions means there is a need for ongoing training in clinical, social, ethical, and legal aspects. Using a combination of group discussions, interviews, and questionnaires with learners, this article reports an evaluation of designing and delivering an interprofessional, online work-based course to health care professionals caring for prolonged disorder of consciousness patients. There were challenges for staff uptake because of COVID-19, but engaging with it increased knowledge in defining and diagnosing patients' conditions, understanding multidisciplinary team roles, communicating with families, and navigating legal and ethical issues. Course participation also enhanced critical and reflective thinking skills, provided a sense of connection to other professionals, and generated plans to improve service provision. Online learning that enables health care professionals to engage at their own pace and also come together as an interprofessional community can provide invaluable continuing professional development and help to enhance joined up, holistic patient care. However, achieving this requires significant investment in creating research-led, multimedia, learning materials, and courses that include synchronous and asynchronous delivery to combine flexible study with the opportunity for peer networks to form. It also depends on a commitment from organizations to support staff online continuing professional development.

The internet as a space of professional communications of healthcare and medicine specialists

This article discusses the aspects of using the Internet space for communication of medical and healthcare professionals, primarily through blogging. The factors influencing the increase in the number of blogs are given, the most popular topics for blogging about health are listed. The influence of blogs about medicine on the healthcare industry as a whole is analyzed. The objectives of creating medical blogs and their key features are considered. The advantages of maintaining such blogs for authors and readers are given.