Knowledge Of Primary Health Care Providers Research Articles

Primary care provider attitudes, experiences and practices about cannabidiol (CBD) and barriers to patient-provider communication about CBD use: A qualitative study.

Federal hemp legalization and ongoing shifts in US marijuana laws have led to increased population-wide use of cannabidiol (CBD) supplements, often without the knowledge of primary healthcare providers (PCPs). Given the potential risks related to CBD use, especially in vulnerable subgroups, improved communication is warranted. This study aimed to examine PCP attitudes, experiences, and practice behaviors related to CBD and provider-reported barriers to communication with patients about CBD use. Fourteen PCPs were recruited and participated in semi-structured interviews. Transcripts were digitally analyzed using inductive thematic analysis. Analyses identified that most PCPs had neutral views about CBD use by their patients. The study found that discussions about CBD use were initiated by patients. Most PCPs cited lack of time, discomfort, low-quality evidence, and low prioritization as reasons for not discussing CBD with patients. PCPs rarely screen for or discuss CBD use with their patients and most of them had neutral views about CBD use by their patients. A number of barriers exist to open dialogue about CBD. Our study is the first in-depth report on PCP attitudes, experiences, and practice behaviors related to CBD. The findings of our study have the potential to significantly impact future PCP practice behaviors. These results can inform healthcare system policies around screening for CBD use and PCP communication training. In doing so, these efforts may mitigate risk and optimize benefits related to the expanding CBD market.

Challenges in the Diagnosis of Taenia solium Cysticercosis and Taeniosis in Medical and Veterinary Settings in Selected Regions of Tanzania: A Cross-Sectional Study.

Background Taenia solium (neuro) cysticercosis/taeniosis (TSCT) is a zoonotic disease complex. There is a perceived inefficient diagnosis of infections by either form, the adult pork tapeworm (taeniosis) and the larval stage of it (cysticercosis), in low-income settings, including Tanzania. This study aimed at identifying potential gaps around TSCT diagnosis and knowledge of primary healthcare providers (officers in charge (OICs) of primary healthcare facilities (PHFs)) and veterinarians (meat inspectors (MIs)) on various aspects of TSCT disease complex and addressing effective disease control in Tanzania. Methodology. A cross-sectional study was conducted between January and April 2020 in Manyara, Dodoma, Ruvuma, Iringa, and Arusha regions in Babati, Mbulu, Kongwa, Mbinga, and Nyasa districts. We interviewed 152 OICs of PHFs and 108 MIs using a structured questionnaire and 33 medical and veterinary officers from level I healthcare facilities and district livestock offices, respectively, from selected study districts to the respective ministerial level using key informant interviews. Results Quantitative data revealed inadequate microscopic diagnostic facilities (54.6%) and personnel (100%) for taeniosis diagnosis in PHFs (n = 152). Approximately 81.2% of MIs compared with only 42.1% of OICs of PHFs scored above average regarding T. solium cysticerci knowledge. Nevertheless, 61.2% of OICs of PHFs compared with only 42.6% of MIs scored above average regarding the adult T. solium tapeworm knowledge. Qualitative data revealed inadequate availability of advanced diagnostic facilities (neuroimaging) and trained personnel for specific diagnosis of TSCT with a focus on neurocysticercosis (NCC) in secondary and tertiary healthcare facilities. Inadequately number of qualified MIs, slaughter slabs, and resource facilitation challenged porcine cysticercosis diagnosis. Conclusion It is concluded that diagnostic capacity and knowledge of OICs of PHFs and MIs regarding TSCT are insufficient in both medical and veterinary sectors. A One Health approach should be adopted to improve TSCT diagnostic capacity and practitioners' knowledge in both medical and veterinary sectors.

Survey on physician attitudes and knowledge toward colorectal cancer screening in primary health care centers, Qassim, Saudi Arabia

Background: Colorectal cancer (CRC) is one of the leading causes of cancer incidence worldwide. In Saudi Arabia, it is ranked first most common cancer in males and second most common in females. CRC is an ideal for prevention because of the high incidence rate and the relative slow progression into an adenocarcinoma. Primary health care (PHC) setting is the ideal place where CRC screening should take place. This study was intended to evaluate awareness, knowledge and attitude towards CRC screening.Methods: A survey was performed among PHC physicians in Qassim province, Saudi Arabia. An electronic questionnaire adopted from the national cancer institute was formulated. Demographic data, specialty, qualifications, years of experience, knowledge and attitudes towards CRC screening, and perceived barriers regarding CRC screening were obtained.Results: A total of 94 physicians were recruited. 39.4% from the sample are females, and 60.6% are males. 99% of physicians agree that colorectal cancer screening is needed when age appropriate. However, 68% were very compliant in CRC screening in clinical practice. Only 52% of physicians were familiar with national CRC cancer screening guidelines. 53% of physicians scored correct on the age appropriate to initiate CRC screening for average risk patients.Conclusions: More efforts should be given to improve knowledge of primary healthcare providers regarding CRC prevention. More funding and planning are needed to provide primary health care providers with the required tools and systems in order to make CRC prevention more efficient.

A Step Toward Timely Referral and Early Diagnosis of Cancer: Implementation and Impact on Knowledge of a Primary Care-Based Training Program in Botswana.

Health system delays in diagnosis of cancer contribute to the glaring disparities in cancer mortality between high-income countries and low- and middle-income countries. In Botswana, approximately 70% of cancers are diagnosed at late stage and median time from first health facility visit for cancer-related symptoms to specialty cancer care was 160 days (IQR 59-653). We describe the implementation and early outcomes of training targeting primary care providers, which is a part of a multi-component implementation study in Kweneng-East district aiming to enhance timely diagnosis of cancers. Health-care providers from all public facilities within the district were invited to participate in an 8-h intensive short-course program developed by a multidisciplinary team and adapted to the Botswana health system context. Participants' performance was assessed using a 25-multiple choice question tool, with pre- and post-assessments paired by anonymous identifier. Statistical analysis with Wilcoxon signed-rank test to compare performance at the two time points across eight sub-domains (pathophysiology, epidemiology, social context, symptoms, evaluation, treatment, documentation, follow-up). Linear regression and negative binomial modeling were used to determine change in performance. Participants' satisfaction with the program was measured on a separate survey using a 5-point Likert scale. 176 participants attended the training over 5 days in April 2016. Pooled linear regression controlling for test version showed an overall performance increase of 16.8% after participation (95% CI 15.2-18.4). Statistically significant improvement was observed for seven out of eight subdomains on test A and all eight subdomains on test B. Overall, 71 (40.3%) trainees achieved a score greater than 70% on the pretest, and 161 (91.5%) did so on the posttest. Participants reported a high degree of satisfaction with the training program's content and its relevance to their daily work. We describe a successfully implemented primary health care provider-focused training component of an innovative intervention aiming to reduce health systems delays in cancer diagnosis in sub-Saharan Africa. The training achieved district-wide participation, and improvement in the knowledge of primary health-care providers in this setting. www.ClinicalTrials.gov, identifier NCT02752061.