Knowledge Of Primary Care Physicians Research Articles

Factors Influencing Referral for Bariatric Surgery by Primary Care Physicians in Northern Israel.

Obesity is a chronic metabolic disease with global distribution among adults and children which affects daily functioning and ultimately quality of life. Primary care physicians (PCPs) provide an important role for the treatment of severe obesity. Better understanding of obesity and its treatment options may increase patients' referral rates to the various treatment modalities, including metabolic/bariatric surgery (MBS). A quantitative cross-sectional study used a self-reported questionnaire among PCPs of Clalit Health Services (CHS) in Northern Israel. The quantitative questionnaire examined the PCP's knowledge, opinions, attitude, and approaches to managing severe obesity. A total of 246 PCPs from Northern Israel filled the questionnaire (42.9%), the majority were Muslim Arabs (54.5%), who gained their medical degree outside of Israel (73.8%) and practicing for over 10years (58.8%). 64.3% of PCPs had a high workload (over 100 appointments per week), 77.1% did not know the definition of severe obesity, and 69.17% did not attend educational meetings regarding obesity during the previous year. The referral rate for MBS was 50.4% ± 23.3. Two prognostic factors that had a statistically significant effect on the referral rate for bariatric surgery were the total appointments per week, and the number of practice years. Both had a negative association. The knowledge and referral rates for bariatric surgery are higher among PCPs with lower workload and relatively fewer practice years. Workshops and annual training courses may fortify knowledge and awareness for the treatment of obesity, which in turn could increase the referral rate for MBS.

Knowledge and Preparedness of Physicians in Relation to Anaphylaxis at Primary Healthcare Centers in Al-Qassim, Saudi Arabia.

Background Anaphylaxis is a significant, often fatal, systemic allergic reaction with a rapid start that may affect the respiratory and/or circulatory systems; for patients to survive, emergency management must be done properly. When anaphylaxis is confirmed or highly suspected, epinephrine should be injected intramuscularly. This study aimed to assess the preparedness of primary healthcare physicians for anaphylaxis in terms of recognition and management of this condition in Al-Qassim, Saudi Arabia. Methods This cross-sectional study was carried out among primary healthcare physicians in the Qassim region of Saudi Arabia. A self-administered questionnaire was distributed among the targeted physicians. The questionnaire comprised sociodemographic characteristics, general awareness and management of anaphylaxis, and a 10-item questionnaire to assess physicians' knowledge of anaphylaxis. Results Out of 121 primary healthcare physicians, 61.2% were male, and 47.9% were aged between 25 and 35 years. Nearly all physicians (97.5%) believed that anaphylaxis is a life-threatening situation. The overall mean knowledge score was 4.74 out of 10 points. Nearly half (48.8%) were categorized as having poor knowledge levels, 43% as moderate, and only 8.3% as having good knowledge. Being specialists/consultants and being trained in managing anaphylaxis were the factors associated with increased knowledge. Conclusion The knowledge of primary care physicians regarding anaphylaxis was deficient. However, increased knowledge of anaphylaxis was seen more frequently among consultants or specialists who attended training for managing anaphylaxis cases. A multi-center study involving a bigger sample size is needed to establish physicians' knowledge of anaphylaxis.

Primary Care Physicians' Knowledge, Attitude, and Practice towards Diabetic Foot Ulcer at Primary Healthcare Corporation, Qatar: A Cross-Sectional Survey

Primary Care Physicians' Knowledge, Attitude, and Practice towards Diabetic Foot Ulcer at Primary Healthcare Corporation, Qatar: A Cross-Sectional Survey

Curriculum-based education in insomnia significantly improves primary care physician knowledge, competence and confidence

Curriculum-based education in insomnia significantly improves primary care physician knowledge, competence and confidence

KNOWLEDGE AND ATTITUDE OF PRIMARY HEALTH CARE PHYSICIANS REGARDINGOBSTRUCTIVE SLEEP APNEA IN TABUK CITY

Obstructive sleep apnea is the most common type of sleep disorder breathing and is characterized by repeated brief episodes of upper airway obstruction during sleep for more than 10 seconds. It is a growing public health challenge with most of the cases remaining unidentified. The study aims to evaluate the general knowledge and attitude of primary health care physicians toward OSA in Tabuk city, Saudi Arabia during 2023. It is a cross-sectional study. The estimated sample size is based on comprehensive data collection in which all primary healthcare physicians are invited to participate in our research. The validated Obstructive Sleep Apnea Knowledge and Attitudes Questionnaire (OSAKA)was used. The data analysis was done by using SPSS for Windows version 21and GrpahPadPrism version 8.4.2. The level of significance is 0.05.The present study found that 65.7% of the participants (N=94) had good knowledge regarding OSA. The majority of participants had a positive attitude towards OSA. Additionally, results showed gender, nationality, and years of graduation had an association with knowledge regarding OSA (p=0.043, 0.047, 0.03 respectively). There was a statistically significant positive correlation between knowledge and attitude (Spearmans rho = 0.29, p = 0.001). Logistic regression analysis showed that females have good knowledge as compared to males (p=0.047*).

Knowledge and approach towards Helicobacter pylori diagnosis and management among primary care physicians in Cameroon: a cross-sectional study.

Low- and middle-income countries have a high prevalence of Helicobacter pylori infection (HPI). In Cameroon, the majority of HPIs are diagnosed and treated by primary care physicians (PCPs). We sought to assess the knowledge and practices of PCPs in the diagnosis and management of HPI in Cameroon. A hospital-based cross-sectional study was carried out in four randomly selected regions of Cameroon from November 2021 to June 2022. In each of the selected regions, PCPs were recruited by non-probability convenience sampling and interviewed using a pre-structured questionnaire. Chi-squared, Fisher's exact and Student's t-tests were performed for descriptive analyses. Multivariable logistic regression was used to examine associations between knowledge and practice, with the model adjusted by age of the PCP, geographic region, number of patients and years in practice. Analysis was performed in SAS version 9.4 (SAS Institute, Cary, NC, USA). A total of 382 PCPs were included in the analysis. The majority (60.0%) were males between the ages of 20-29y (64.1%). Most PCPs (80.9%) reported that HPI is the cause of gastroesophageal reflux disease and 41.8% reported that HPI is the main cause of dyspeptic symptoms. The dominant diagnostic tests used for HPI were serology (52.8%) and stool antigen (30.9%). The most frequently used first-line therapies were amoxicillin (AMX), clarithromycin (CLA), metronidazole (MNZ) and proton pump inhibitor (PPI) concomitant therapy (32.2%), AMX-CLA-PPI triple therapy (18.6%) and AMX-MNZ-PPI triple therapy (13.1%). Half of the practitioners (48.6%) treat HPI empirically, without positive H. pylori testing. About half of the PCPs (48%) do not request laboratory confirmation of H. pylori eradication following treatment. There is inadequate knowledge and significant differences in the clinical approach towards HPI among PCPs in Cameroon. We recommend more teaching programs and continuous medical education on HPI.

Knowledge and Behavior of Primary Care Physicians Regarding Utilization of Standardized Tools in Screening and Assessment of Anxiety, Depression, and Mood Disorders at a Large Integrated Health System.

Standardized screening, objective evaluation, and management of behavioral health conditions are major challenges in primary care. The Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), and Mood Disorder Questionnaire (MDQ) provide standardized screening and symptom management tools for generalized anxiety disorder (GAD), major depressive disorder (MDD), and Mood Disorders (MD), respectively. This study explores family physicians' knowledge, attitudes, and practices regarding the utilization of GAD-7, PHQ-9, and MDQ in outpatient primary care offices. The study method was a cross-sectional electronic and paper survey utilizing a self-administered questionnaire that assessed primary care physicians' demographics, knowledge, attitudes, and practices in rural and urban outpatient clinical settings regarding GAD-7, PHQ-9, and MDQ. Statistical software SAS 9.4 was used for descriptive and Chi-Square statistics. Out of 320 total participants,145 responded (45.3%). Responding family physicians demonstrated a high level of familiarity with the GAD-7 (97.9%), PHQ-9 (97.9%), and MDQ (81.3%) assessment tools. However, the reported utilization rates were relatively lower than knowledge, with 62.7%, 73.1%, and 31.9% extremely likely or likely to utilize the GAD-7, PHQ-9, and MDQ as screening and monitoring tools, respectively. Less than a quarter of the total respondents use the objective score for the future management of GAD, with significantly more residents utilizing the score for GAD-7 compared to attendings (P < .05). There was no statistical significance difference between residents and attendings for the objective evaluation of Major Depressive Disorder (P = .26) and Mood Disorders (P = .05). Despite being knowledgeable of the utility of GAD-7, PHQ-9, and MDQ, the primary care physicians in a large integrated health system in Central Pennsylvania and Northern Maryland report inconsistent utilization in their practice. Further studies are needed to determine the underlying factors contributing to the suboptimal usage of these screening tools and ways to increase it.

Knowledge and attitudes of primary care physicians regarding childhood hearing loss in Malaysia.

Childhood hearing loss is a significant health concern. Early identification and intervention are essential to maximize hearing potential and developmental outcomes, with primary care physicians (PCPs) playing a pivotal role in this process. This study aimed to assess PCPs' knowledge and attitudes toward childhood hearing loss, investigate the association between knowledge and attitudes, and examine the influence of demographic factors on PCPs' knowledge and attitudes towards childhood hearing loss. This cross-sectional study was conducted from 30 November 2017 to 30 July 2018 at three public health clinics in Malaysia, specifically in the Federal Territory of Kuala Lumpur, Selangor, and Terengganu. A self-administered questionnaire assessed PCPs' knowledge of general facts, diagnosis and intervention, and risk factors for childhood hearing loss. Additionally, the questionnaire evaluated PCPS' attitudes across cognitive, affective, and behavioural domains regarding childhood hearing loss. Most participants lacked sufficient knowledge about childhood hearing loss, with 61.4% not seeing it as a major health issue. Almost half (45.9%) didn't know that children with hearing loss can succeed in regular schools, and 78% were unaware that hearing aids don't fully restore normal hearing. Participants' awareness of risk factors varied widely, ranging from 24.6% to 90.3%. Despite these knowledge gaps, participants generally had positive attitudes towards childhood hearing loss, especially in cognitive and behavioural aspects. The study found a strong positive link between knowledge and attitudes, but demographic factors didn't significantly affect them. This study highlights the urgent need to address knowledge gaps among Malaysian PCPs regarding childhood hearing loss. While these knowledge gaps exist, PCPs' positive attitudes form a foundation for developing targeted educational interventions to improve PCPs' knowledge and skills in managing childhood hearing loss. Collaborative efforts are essential to translate these findings into meaningful improvements in paediatric audiological care.

Abstract A049: Community partnership to empower Black men to drive research to identify barriers to prostate cancer early detection and equitable care

Abstract Introduction: Black men have a two-fold higher rate of prostate cancer death in the US compared with other men, the largest racial inequity in US cancer-related deaths. Annual PSA testing among Black men starting at age 45 years would reduce mortality compared with current screening practices. However, the US Preventive Service Task Force (USPSTF) guidelines do not make screening recommendations specifically for Black men. Black men comprised only 0-3% of practice-informing PSA screening trial cohorts. Given the burden of prostate cancer among Black men, capacity must be built to empower Black men and their communities to develop and execute clinical trials that may provide guidance on early detection strategies. Methods: We conducted semi-structured interviews to examine prostate cancer screening access among Black men in the Pacific Northwest, and we surveyed primary care physicians (PCPs) and urologists in the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region to assess knowledge, attitudes, and practices about prostate cancer screening. Interviews were recorded and transcribed; consensus coding and thematic analysis were used to identify structural barriers associated with screening access. Anonymous online surveys were distributed to physicians via email using REDCap. Results: 29 men participated in semi-structured interviews. We identified three equity-related barriers related to prostate cancer screening access: (1) lack of information on the benefits and harms of prostate cancer screening, (2) lack of PCP knowledge about prostate cancer disparities confronted by Black men, and (3) lack of trusted relationships with PCPs to support shared decision-making about prostate cancer screening. 32 urologists and 31 PCPs completed the survey. Nearly all urologists and PCPs were aware of the 2018 USPSTF guidelines regarding PSA testing (93.8% and 96.7%, respectively). 75% of urologists and 6.5% of PCPs agreed that PSA testing can significantly reduce prostate cancer mortality. Conclusion: Findings from the survey support the perception reported by interviewees that there is variation in knowledge and support for prostate cancer screening for early detection of prostate cancer among Black men. Our combined findings further demonstrate that (1) Black men have unique needs around early detection of prostate cancer and (2) patient partnerships can identify these areas of need and best inform patient-centered design of practice-changing research studies. Future Directions: With funding from the Patient Centered Outcomes Research Institute we will apply these findings by (1) building engagement and research capacity among a cohort of Black men with a history of prostate cancer and their advocates, (2) identifying community derived research priorities around the early detection of prostate cancer in Black men, and (3) developing a research agenda to inform future large, patient-centered, comparative effectiveness clinical trials in early detection of prostate cancer in Black men. Citation Format: Jenney R. Lee, Dante' Morehead, Ben Young, Victor Tolbert, John Masambe, Garrett Britt, Lars Neuenschwander, Kyle Schuppe, Richard Pelman, Debi Johnson, Sung Min Kim, Erika M. Wolff, John L. Gore, Yaw A. Nyame. Community partnership to empower Black men to drive research to identify barriers to prostate cancer early detection and equitable care [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A049.

Assessment of knowledge, attitude, and practice of primary healthcare physicians in Qatar towards hypertension management: An online cross-sectional study.

Primary health care is integral to diagnosing and managing hypertension. This study aimed to assess the knowledge, attitude, practice, priority, and confidence of primary care physicians in Qatar toward hypertension diagnosis and management, and to measure the determinants of good knowledge, desirable attitudes, and desirable practices. We conducted a cross-sectional web-based survey using a modified version of the World Hypertension League Questionnaire during the period from August 30th to October 23rd, 2020. All primary care physicians working in any of Qatar's 27 publicly run primary healthcare centers were invited to participate in the survey. Out of the 450 primary care physicians working at that time, 197 completed the study questionnaire with a response rate of 43.8%. Most respondents stated that they followed local or international treatment guidelines for hypertension management (96.4%). Primary care physicians were highly confident and prioritized hypertension management. The overall desirable practice score was 73.8%, with the highest score (95.4%) for assessing adherence to antihypertensive medications, whereas the lowest desirable practice score was 33.5% for counseling on home blood pressure monitoring. Fifty-one-point eight percentage and 62.4% correctly identified 140 mm Hg and 90 mm Hg as the systolic and diastolic blood pressure threshold for diagnosing hypertension in most patients. The lowest knowledge scores were for hypertension epidemiology in Qatar and recommended dietary modification for hypertensive patients. Respondents had positive attitudes toward task sharing with nonphysician healthcare workers for most items (58.9%-78.2%), except for drug prescriptions (30.5%). Primary care physicians in Qatar had positive attitudes, with high overall confidence and conviction (priority) scores toward hypertension. However, their knowledge scores and certain practices were suboptimal. Healthcare policymakers in Qatar should raise primary care physicians awareness of the current burden of untreated hypertension in the country by organizing targeted educational programs and emphasizing the importance of following national clinical practice guidelines in the diagnosis and management of hypertension.

Diabetes care and education training audit for primary care physicians across 47 counties of Kenya: A pre-post intervention study

IntroductionThe purpose of the study was to evaluate the effectiveness of an online continuous medical education programme for Primary Care Physicians (PCPs) in improving diabetes management in Kenya. MethodsA pretest-post-test design was used to assess the change in knowledge across multiple modules and the overall change in the confidence level of the PCPs in managing people living with diabetes. The study was non-randomised. Course participants were nominated by local scientific associations. ResultsOut of a total of 1750 nominated participants, 1286 completed the training. A statistically significant (p=<0.001) change in knowledge and overall confidence was observed for each of the 8 modules of the training programme. Cohen’s D effect size was calculated as 2.20 and 1.40 for change in knowledge and confidence levels, respectively. DiscussionWeb-based training is an effective way to improve the knowledge and self-reported confidence of PCPs involved in the management of diabetes. This web-based model can support the training needs of PCPs at a pace and time to suit their situation. Similar evidence-based programmes should be considered and field-tested for other healthcare professionals working in the management of diabetes.

Knowledge and Training Needs of Primary Healthcare Physicians Regarding Obesity Management in Saudi Arabia: A Systematic Review

Background/Objectives: Obesity has surged globally, posing various health risks. Its prevalence and management, especially in primary health care settings in Saudi Arabia, have recently been under the spotlight. This research synthesized various studies, analyzing the knowledge and preparedness of primary health care physicians in addressing and management of obesity in Saudi Arabia. Methods: An exhaustive evaluation of studies spanning different regions of Saudi Arabia, focusing on physicians' capabilities, knowledge, and practices in obesity management. This analysis also took into account the comparative approaches of countries like Canada, the UK, USA, and Hungary. Various factors, such as specialized obesity treatments, patient-centric approaches in pediatric obesity, career stages of physicians, obesity's correlation with noncommunicable diseases, and nutritional competence, were studied. Results: Nine studies were included. From a collective pool of 2430 participants across the discussed studies, challenges in obesity management were consistent. Despite having an understanding of obesity, there was a significant knowledge gap in specialized treatments, with many physicians feeling unprepared to manage the condition. Factors such as geographical diversity, physicians' experiences, external influences on pediatric obesity management, and the correlation between obesity and other health conditions were highlighted. The need for effective nutrition care, despite perceived capability, was a notable finding. Conclusion: Saudi Arabia faces a significant challenge in obesity management in primary health care settings, marked by knowledge gaps and the need for continuous training. The analyzed studies emphasize the importance of tailored interventions, robust training modules, and public health campaigns within Saudi Arabia's unique context to combat the obesity epidemic effectively.

Evaluation of the Knowledge of Primary Care Physicians About Important Nail Diseases Before and After a Short Online Training.

Nail diseases are often diagnosed late with a potential prognostic and functional impact. This could be partly due to knowledge gaps among primary care physicians (PCPs). To evaluate the knowledge about diagnosis and management of ten common/important nail conditions in a population of French PCPs and its improvement after a 31-minute online training session. We submitted 10 pre-test and post-test clinical cases and an educative online course on the diagnosis and the management of nail diseases to 138 volunteer PCPs; 73 completed the whole training path. Compared to pre-test, more PCPs in the post-test required an urgent second opinion to dermatologist for pigmented melanoma (100% versus 80.3%; P <0.05) and use of inappropriate/dangerous systemic treatment for trauma-induced nail changes was reduced after the training program (0% versus 6.8%; P <0.05). A lack of knowledge remained after training for amelanotic melanoma with an increase of mycological/bacteriological tests (9.6% versus 0%; P <0.05). Management of nail diseases by our panel of PCPs was suboptimal and was improved after a short online training.

Knowledge, attitude, and practice of primary care physicians for pretravel counseling for type 2 diabetes patients in Jazan Region, Kingdom of Saudi Arabia

ABSTRACT Background and Objective: Pretravel advice given by the primary healthcare (PHC) physicians is of vital importance to diabetic patients to maintain their glycemic status during their travel as many of them are not aware of the risks of travel on their health status. Our objective was to assess the status of pretravel counseling for type 2 diabetic patients (knowledge, attitude, and practice) in Jazan Region, Kingdom of Saudi Arabia (KSA) among the PHC physicians. Materials and Methods: A cross-sectional study was carried out among a sample of PHC physicians working at the PHC centers in Jazan Region, KSA. The data were collected using a validated self-administered questionnaire. Results: The study included 250 PHC physicians. The age of 45.2% of them ranged between 30 and 39 years, and males represented 56.2% of them. Overall, the knowledge score ranged between 0 and 10 with a median (interquartile range [IQR]) of 6 (5–7). Physicians aged 40–49 years (P &lt; 0.001), non-Saudis (P = 0.005), and more experienced physicians (&gt;15 years) (P &lt; 0.001) were more knowledgeable than their counterparts. The attitude score ranged between 6 and 30 with a median (IQR) of 25 (22–27). Saudi physicians were more likely than non-Saudis to have more positive attitude toward pretravel counseling for diabetic patients (P = 0.007). The practice score ranged between 1 and 13 with a median (IQR) of 6 (5–8). Conclusion: The PHC physicians in Jazan Region, KSA, had a moderate level of knowledge and practice as well as encouraging attitude concerning pretravel counseling for type 2 diabetic patients. However, their knowledge and attitude from one side were not associated with their practice from the other side.

Ways to optimize preventive measures in areas remote from the regional center

Aim. To identify problems in the management of preventive examinations in remote areas, using the example of the Khvoininsky district of the Novgorod Oblast and ways to improve it. The article reveals the problems of managing preventive measures in the regions of the Russian Federation, remote from the regional center.Material and methods. Observations and experience of preventive measures carried out by the staff of St. Petersburg State Pediatric Medical University within the "University — Region" project, data from electronic medical records of 178 patients were used.Results. A high proportion of loss to follow-up was noted — 99 out of 278 (36%). The bulk was patients over 40 years old, who were assigned to health group IIIa. The difficulty of conducting medical examinations in a sparsely populated area is associated with insufficient awareness of the population, combined with low interest, a shortage of specialists, untimely necessary studies, a significant bureaucratic work, unstable Internet connection, and insufficient cancer awareness among medical workers.Conclusion. Expanding the promotion and information component of preventive measures, increasing patient focus, combining the first and second stages of clinical examination into one with subsequent convenient routing of patients, introducing telemedicine technologies and portable diagnostic complexes, improving the professional knowledge and competencies of primary care physicians — all these activities are aimed at improving coverage of population, increasing the adherence of patients with effective medical follow-up.

Knowledge, attitude, practice, and perceived barriers of colorectal cancer screening among primary care physicians in the Kingdom of Bahrain

Background: Colorectal cancer (CRC) is one of the lethal cancers all over the world. Early detection of colorectal cancer has been shown to reduce incidence and mortality. Primary care physicians have a crucial role in early detection of cancer. This study aims to explore the knowledge, attitude and practice of primary care physicians in Bahrain towards CRC screening and to determine the barriers related to CRC screening. Methods: A cross sectional study was carried out among primary care physicians working at primary health care centers in Bahrain. It included 174 physicians. A self-filled questionnaire that includes demographic information, knowledge scale, attitude scale, practice scale items and barriers of not performing CRC screening was used as the study tool. Results: The overall knowledge score revealed that 51.7% had poor knowledge score and 48.3% had adequate knowledge score. Majority of the participants (93.7%) agreed to have a structured screening program for colorectal cancer rather than an opportunistic one. Most of the physicians (60%) reported that less than 25% of those eligible patients truly receive a screening. Physician’s lack of time was the top barrier of not performing CRC screening. Conclusions: This study showed that most primary care physicians have poor knowledge regarding CRC screening and the majority do not screen their eligible patients for CRC.

Primary care physicians' knowledge and confidence in providing cancer survivorship care: a systematic review.

To systematically review existing literature on knowledge and confidence of primary care physicians (PCPs) in cancer survivorship care. PubMed, Ovid MEDLINE, CINAHL, Embase, and PsycINFO were searched from inception to July 2022 for quantitative and qualitative studies. Two reviewers independently assessed studies for eligibility and quality. Outcomes were characterized by domains of quality cancer survivorship care. Thirty-three papers were included, representing 28 unique studies; 22 cross-sectional surveys, 8 qualitative, and 3 mixed-methods studies. Most studies were conducted in North America (n = 23) and Europe (n = 8). For surveys, sample sizes ranged between 29 and1124 PCPs. Knowledge and confidence in management of physical (n = 19) and psychosocial effects (n = 12), and surveillance for recurrences (n = 14) were described most often. Generally, a greater proportion of PCPs reported confidence in managing psychosocial effects (24-47% of PCPs, n= 5 studies) than physical effects (10-37%, n = 8). PCPs generally thought they had the necessary knowledge to detect recurrences (62-78%, n = 5), but reported limited confidence to do so (6-40%, n = 5). There was a commonly perceived need for education on long-term and late physical effects (n = 6), and cancer surveillance guidelines (n = 9). PCPs' knowledge and confidence in cancer survivorship care varies across care domains. Suboptimal outcomes were identified in managing physical effects and recurrences after cancer. These results provide insights into the potential role of PCPs in cancer survivorship care, medical education, and development of targeted interventions.

Knowledge, Attitudes and Behaviors regarding Tick-Borne Encephalitis Vaccination and Prevention of Tick-Borne Diseases among Primary Care Physicians in Bavaria and Baden-Wuerttemberg, Germany, May-September 2022.

In 2020, a record number of tick-borne encephalitis (TBE) cases was reported in major endemic areas in Germany, i.e., the southern federal states of Baden-Wuerttemberg and Bavaria. Most cases were unvaccinated. Other tick-borne diseases (TBDs), including Lyme borreliosis and tularemia, are rising, too. Thus, strategies are needed to increase TBE vaccination uptake in risk areas and promote education on TBD prevention. Primary care physicians are key providers of both vaccinations and TBD education. The TBD-Prevention (TBD-Prev) study aimed to investigate the knowledge, attitudes and behaviors of primary care physicians in Baden-Wuerttemberg and Bavaria with regard to TBE vaccination and prevention of TBDs and to derive strategies for increasing vaccination rates and improving knowledge about TBE and other TBDs in the population and among primary care physicians. We invited all primary care physicians (N = 14,046) in both states to participate by mail. Using standardized, self-administered questionnaires, available both on paper and online, we asked physicians anonymously about their knowledge, attitudes and behaviors with respect to TBE vaccination and TBD prevention and their need for further information/educational materials. A total of 2321 physicians participated between May and September 2022 (response rate 17%), of whom 1222 (53%) worked in Baden-Wuerttemberg and 1067 (46%) in Bavaria. Among the participating physicians, 56% were male, 71% were >50 years and 51% worked in an individual practice. Furthermore, 91% were aware of the German national vaccination guidelines, and 98% perceived their knowledge of the risks and benefits of vaccination as adequate. A total of 97% offer TBE vaccinations, 67% provide vaccination counselling during initial consultations with new patients and 64% actively remind patients about due vaccinations. In addition, 24% expressed a need for further information materials, mainly traditional, analogue media such as flyers (82%) and posters (50%), and named timeliness, quality assurance, easy comprehensibility and independence from the pharmaceutical industry as the most important characteristics of such materials. Almost all participating physicians reported offering TBE vaccinations and feeling well-informed about TBE vaccination and TBDs. However, active offering of vaccinations and education could be further improved, and additional, low-threshold information materials are needed. Based on these results, we will develop and provide various materials on TBE vaccination and TBDs, in particular flyers and posters, for use by physicians during consultations.

Palestinian physicians' self-reported practice regarding antibiotic use for upper respiratory tract infections in primary healthcare.

The main objective of this study was to evaluate the antimicrobial therapy knowledge, attitudes, and practices of primary care physicians in the West Bank and Gaza. Between January and April 2021, this cross-sectional survey was conducted. A link to the online survey was sent via confidential email lists to 336 primary care physicians who treated patients in Ministry of Health clinics. The survey questions scoring system was devised in order to evaluate the physicians' practice, knowledge, and attitudes. Our scoring system identified favorable (good) and unfavorable (average and poor) antibiotic practices. In addition to independent t-test, the Chi-square test was used to compare the two groups of physicians' knowledge, attitudes, and practices with their background characteristics. A multivariate analysis was performed to identify potential confounding variables having significant relationships. Of the 336 distributed questionnaires, 316 were completed, with a response rate of 94%. More than half (54.7%) were males, half (51.6%) were between 30 and 45 years of age, and most were general practitioners (74.1%). The overall good knowledge and attitude scores were 125 (39.6%) and 194 (61.4%), respectively. More than half (58.2%) had good antibiotic prescription practices. Females reported significantly more favorable practices than males, as did family medicine specialists compared with general practitioners. Finally, knowledge about antibiotic prescriptions had a substantial impact on changing their practices. However, physicians' attitudes toward antibiotic prescriptions did not have a significant role in shaping their practices. Overuse of antibiotics is a significant health issue in Palestine and worldwide. Most physicians know that improper antibiotic usage can cause antimicrobial resistance. More than two-thirds avoided needless antimicrobial prescriptions. In practicing antimicrobial stewardship, most prescribed fewer antibiotics and did not prescribe because of patient pressure. Family medicine specialists, female doctors, and those with high knowledge scores regardless of caseload were more likely to have good practices.

Knowledge, Attitude, And Practice Towards Colorectal Cancer Screening Among Primary Health Care Physicians In Buraydah, Qassim, Saudi Arabia.

Colorectal cancer is one of the common cancers globally. The knowledge of primary health care physicians (PHPs)regarding screening of colorectal cancer is important in the early identification of cancer and prompt treatment. Therefore, this study aimed to assess the attitude, practices, and knowledge of PHPs working at primary health care centers in Buraydah, Qassim, Saudi Arabia. This was a cross-sectional study conducted among PHPs in Buraydah, Saudi Arabia. Data was collected using a self-administrated validated questionnaire adapted from the National Cancer Institute in the United States of America (USA). Data was analyzed using SPSS version 21.0. Descriptive analysis was carried out to assess knowledge, attitude and practices. A total of 110 primary care physicians participated in the study. Two-thirds (67%) of the participants were Saudi nationals, and a similar proportion (66%) were male. The mean knowledge score was 6.93 ± 3.39. The mean score in the attitude domain was 10.58 ± 4.02. Around three fourth 75% of the physicians would start screening at the age of 45 years. We found a lower level of knowledge but a reasonable degree of attitude. This is an important finding that despite having a better attitude towards CRC screening, the physicians working in primary health care centers of Buraydah were deficient in knowledge which may have adverse impact on their practices. Further large-scale studies are recommended to generate robust evidence on the topic.