Healthcare Provider Preferences Research Articles

Anti-obesity treatment preferences of healthcare providers and people living with obesity: A survey-based study.

A cross-sectional, online survey was conducted in the United Kingdom, France, Germany, and the United States (14 November-22 December 2022) to investigate preferences for anti-obesity medication (AOM) among people with obesity (PwO) and healthcare providers (HCPs). Eligibility: Adult PwO who self-defined their body type as overweight/obese, were trying to lose weight and had BMI ≥30.0 or 27.0-29.9 kg/m2 with ≥1 obesity-related complication; HCPs had to see ≥30 PwO in a typical month and be a decision-maker regarding their weight loss. The survey included 2500 PwO and 500 HCPs. Exercise (96%) and diet (90%) were the most common weight management methods; AOM use was low (8%). Key barriers to use of prescribed AOMs among PwO were not wanting to take AOM (34%), side effects concerns (33%), and not trusting AOM (26%). Most HCPs (79%) had prescribed/recommended AOMs. Efficacy was the most common reason for preferring one of the shown product profiles among PwO (60%) and HCPs (86%); improving cardiovascular risk was also important to 95% of HCPs when deciding which AOM to prescribe. AOM preference is largely driven by efficacy. Increasing knowledge could help to address barriers to AOM use and improve outcomes for PwO.

Health care providers' perceptions of family participation in essential care in the intensive care unit: A qualitative study.

Family participation in essential care may benefit patients and relatives. To examine the needs, perceptions and preferences of health care providers about family participation in essential care in the adult intensive care unit. A qualitative descriptive study using inductive thematic analysis. Three focus group interviews with a total of 30 intensive care unit health care providers, consisting of 20 critical care nurses, one nursing assistant, five physicians, three physical therapists and one speech therapist working in three Dutch intensive care units. One overarching theme, balancing interests, and four main themes emerged: looking after the patient's interests, taking the relatives' perspective into account, looking after interests of intensive care unit health care providers and conditions for family participation. The first theme, looking after the patient's interests, included three sub-themes: insecurity about patient's wishes and needs, patient safety concerns and potential benefits for the patient. The second theme, taking the relatives' perspective into account, was also characterized by three sub-themes: concerns about the relatives' possible burden, potential benefits for the relative and the relationship between patient and relative. The third theme, looking after interests of intensive care unit health care providers, included three sub-themes: attitude towards family participation in essential care, differing perceptions of essential care and concerns about intensive care unit health care provider's burden. The last theme, conditions for family participation, included two sub-themes: establishing a relationship and considering family participation in essential care as a process. Health care providers' perceptions and preferences regarding family participation in essential care in the intensive care unit are summarized in the overarching theme balancing interests. This overarching theme also reflects the needs and perceptions of patients and relatives. These findings may support critical care nurses and other health care providers when encouraging family participation in essential care.

Healthcare Provider's Preferences on Open Versus Restricted Visiting Hours in Surgical Intensive Care Unit.

The increasing consideration of open visiting hours in intensive care units (ICUs) has presented implementation challenges. Recognizing the invaluable insights of healthcare providers, this study aimed to assess their perspectives on the potential impact of altering ICU visiting policies on patient care. In a single-institution, cross-sectional study, a five-point Likert survey was administered to healthcare providers working in a surgical ICU to assess their perceptions of open and restricted visiting hours. Descriptive statistics were used to analyze the responses. Ninety-three healthcare providers participated, including nurses (53%), resident physicians (23%), and other healthcare professionals. The majority (81%) did not believe that open ICU visiting hours would enhance patient-centered care. Providers expressed concerns that open visitation could lead to increased provider stress (89%), physical barriers to patient access (80%), disruption in workflow (90%), and provider burnout (76%). Conversely, they perceived that restricted visitation would preserve patient privacy (87%), promote better healing for patients (64%), reduce provider stress (81%), and improve workflow (95%). Nurses were more likely than resident physicians to perceive that open ICU hours would alleviate familial stress (p=0.022). Additionally, both nurses and other healthcare providers recognized the potential for open ICU hours to improve communication between patient families and healthcare teams (p<0.05). Notably, there were no significant differences among providers in perceptions of the impact of open versus restricted visitation on provider stress, workflow, or other factors (p>0.05). This survey reveals a negative perception of open ICU visiting hours among healthcare providers in a surgical ICU, with concerns that such a change could increase stress for both patients and providers. These findings underscore the potential challenges and negative impacts of implementing open visiting hours in this setting, emphasizing the need for careful consideration and further research to inform policy decisions and visitation practices.

PCR228 Healthcare Provider Preferences for Attributes of Influenza Vaccines in the United States: Results From a Discrete-Choice Experiment Study

PCR228 Healthcare Provider Preferences for Attributes of Influenza Vaccines in the United States: Results From a Discrete-Choice Experiment Study

A Review: A Comparative Study of Branded and Generic Anti- Diabetic Drugs

This comprehensive review investigates the market landscape of antihypertensive medications, undertaking a detailed comparative analysis of branded and generic options. In the face of rising global prevalence of hypertension, the study aims to provide a holistic perspective on the efficacy, safety, and market dynamics shaping the use of branded and generic drugs in the management of these chronic conditions. Utilizing data derived from market trends, sales analytics, and consumer preferences, the review scrutinizes the market behaviors and forces influencing the adoption of branded and generic antihypertensive drugs. Factors such as cost-effectiveness, patient adherence, and healthcare provider preferences are explored to shed light on the complexities associated with medication selection in the context of chronic disease management. Through an in-depth examination of industry strategies, regulatory frameworks, and the role of healthcare policies, the review aims to uncover the interplay between market dynamics and clinical considerations. It seeks to inform healthcare professionals, policymakers, and industry stakeholders about the evolving landscape of choices in antihypertensive therapies, fostering a nuanced understanding that can guide optimal decision-making in patient care and resource allocation.

A Review: A Comparative Study of Branded and Generic Anti-Hypertensive Drugs

This comprehensive review investigates the market landscape of antihypertensive medications, undertaking a detailed comparative analysis of branded and generic options. In the face of rising global prevalence of hypertension, the study aims to provide a holistic perspective on the efficacy, safety, and market dynamics shaping the use of branded and generic drugs in the management of these chronic conditions. Utilizing data derived from market trends, sales analytics, and consumer preferences, the review scrutinizes the market behaviors and forces influencing the adoption of branded and generic antihypertensive drugs. Factors such as cost-effectiveness, patient adherence, and healthcare provider preferences are explored to shed light on the complexities associated with medication selection in the context of chronic disease management. Through an in-depth examination of industry strategies, regulatory frameworks, and the role of healthcare policies, the review aims to uncover the interplay between market dynamics and clinical considerations. It seeks to inform healthcare professionals, policymakers, and industry stakeholders about the evolving landscape of choices in antihypertensive therapies, fostering a nuanced understanding that can guide optimal decision-making in patient care and resource allocation.

Understanding healthcare providers' preferred attributes of pediatric pneumococcal conjugate vaccines in the United States.

As higher-valent pneumococcal conjugate vaccines (PCVs) become available for pediatric populations in the US, it is important to understand healthcare provider (HCP) preferences for and acceptability of PCVs. US HCPs (pediatricians, family medicine physicians and advanced practitioners) completed an online, cross-sectional survey between March and April 2023. HCPs were eligible if they recommended or prescribed vaccines to children age <24 months, spent ≥25% of their time in direct patient care, and had ≥2 y of experience in their profession. The survey included a discrete choice experiment (DCE) in which HCPs selected preferred options from different hypothetical vaccine profiles with systematic variation in the levels of five attributes. Relative attribute importance was quantified. Among 548 HCP respondents, the median age was 43.2 y, and the majority were male (57.9%) and practiced in urban areas (69.7%). DCE results showed that attributes with the greatest impact on HCP decision-making were 1) immune response for the shared serotypes covered by PCV13 (31.4%), 2) percent of invasive pneumococcal disease (IPD) covered by vaccine serotypes (21.3%), 3) acute otitis media (AOM) label indication (20.3%), 4) effectiveness against serotype 3 (17.6%), and 5) number of serotypes in the vaccine (9.5%). Among US HCPs, the most important attribute of PCVs was comparability of immune response for PCV13 shared serotypes, while the number of serotypes was least important. Findings suggest new PCVs eliciting high immune responses for serotypes that contribute substantially to IPD burden and maintaining immunogenicity against serotypes in existing PCVs are preferred by HCPs.

Preferences of healthcare providers in Switzerland for attributes of pediatric hexavalent vaccines: a discrete-choice experiment

Objective To understand the preferences of healthcare providers (HCPs) in Switzerland for pediatric hexavalent vaccine attributes. Methods A discrete-choice experiment included a series of choices between 2 hypothetical pediatric hexavalent vaccines with varying attributes: device type (including preparation time and risk of dosage errors), proportion of infants seroprotected against Haemophilus influenzae type b (Hib) at 11–12 months (pre-booster), packaging size, years on the market, and the thermostability at room temperature. Odds ratios (ORs) and conditional relative attribute importance (CRAI) were calculated using random-parameters logit. Results HCPs (150 pediatricians and 40 nursing staff) in Switzerland were unlikely to choose a vaccine conferring 50% (OR 0.00; 95% CI 0.00–0.00) or 70% (OR 0.01; 95% CI 0.00–0.01) of infants with Hib seroprotection at 11-12 months (pre-booster) compared with a vaccine conferring 90% seroprotection. The odds of choosing a vaccine available on the market for more than 3 years were nearly 5 times the odds of choosing a vaccine available on the market for less than 1 year (OR 4.76; 95% CI 1.87–7.65). The odds of choosing a vaccine in a prefilled syringe were nearly 3 times the odds of choosing a reconstituted vaccine (OR 2.77; 95% CI 1.39–4.15), and the odds of choosing a vaccine with a smaller package size were nearly 2 times the odds of choosing a vaccine with larger package size (OR 1.89; 95% CI 1.23–2.55). HCPs were equally likely to choose vaccines that can stay at room temperature for 6 versus 3 days (OR 1.07; 95% CI 0.73–1.42). According to CRAI, the most important attribute was Hib seroprotection, followed by years on the market, device type, and packaging size. Conclusion Hib seroprotection at 11–12 months was the most important hexavalent vaccine attribute to HCPs in this study.

An Insight Into the Experiences of Malaysian Patients With Advanced Cancer and Their Preferences in End-of-Life Care: A Qualitative Study.

Preferences of patients with advanced cancer are well studied in Western countries but less so in Asian communities where end-of-life discussions can be seen as taboo. This may lead to patients receiving care that is incongruent with their wishes as their disease progress. It is important for healthcare providers to have a better understanding of patients' experiences and preferences especially in a multicultural country like Malaysia with its diverse beliefs and values to facilitate better planning for future medical care. To explore the experiences and preferences of Malaysian patients with advanced cancer. Qualitative study of semi-structured interviews with thematic analysis. Purposive sampling of 19 patients with Stage 4 cancer recruited from inpatient and outpatient settings in National Cancer Institute Malaysia. Three major themes emerged in the exploration of patients' experiences and care preferences in facing advanced cancer namely: 1) Dealing with poor prognosis 2) Spirituality as a source of strength and 3) Enablers of advance care planning. This study highlighted the preference for healthcare providers to be culturally sensitive during end-of-life care discussion and the need for improved spiritual care for Malaysian patients with advanced cancer. Further studies exploring the role of spiritual and cultural factors in advance care planning among Malaysians would be helpful in guiding these efforts.

A phase 4, open-label study to evaluate the safety and immunogenicity of DTaP5-HBV-IPV-Hib in children previously vaccinated with DTaP2-HBV-IPV-Hib or DTaP5-HBV-IPV-Hib (V419-016)

ABSTRACT DTaP5-HBV-IPV-Hib (Vaxelis®) is a hexavalent combination vaccine (HV) indicated in infants and toddlers for the prevention of diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis, and invasive disease due to Haemophilus influenzae type b. Switching between HVs during the childhood vaccination series is sometimes necessary due to, for example, vaccine availability, health-care provider preference, and/or tender awards. The purpose of this study was to describe the safety, tolerability, and immunogenicity of a booster dose of Vaxelis® in participants who previously received a primary infant series of either DTaP2-HBV-IPV-Hib (Hexyon®) or Vaxelis®. Healthy participants approximately 11–13 months of age who previously received a two-dose primary series of Hexyon® (HHV group) or Vaxelis® (VVV group) all received a Vaxelis® booster dose. Immunogenicity was evaluated by measuring antibody levels to individual vaccine antigens approximately 30 days following booster vaccination. Safety was evaluated as the proportion of participants with adverse events (AEs). The proportions of participants with antibody-specific responses for antigens contained in both Vaxelis® and Hexyon® at 30 days post-toddler-booster vaccination with Vaxelis® were comparable between groups, and higher in the VVV group for Vaxelis® antigens PRN and FIM2/3. The overall proportions of participants with AEs were generally comparable between groups. Following a booster dose of Vaxelis®, immune responses were comparable between groups for all shared antigens, and higher in the VVV group for antigens found only in Vaxelis®. The booster was well tolerated in both groups. These data support the use of Vaxelis® as a booster in mixed HV regimens.

Sağlık Çalışanlarında Ağrı Değerlendirme Tercihleri: Türkiye'den Bir Çalışma

Objective: Pain assessment of individuals with acute or chronic pain while creating a physiotherapy program is of great importance in demonstrating the effectiveness of the treatment. The aim of this study is to determine the pain assessment preferences of healthcare providers. &#x0D; Material and Method: We tried to reach different healthcare providers who are dealing with patients suffering from pain, living and working in Turkey via a Google survey. Healthcare providers (aged 18-60) with at least one year of work experience in their field were included. In the questionnaire, age, gender, profession, working time in the profession, institution, acute/chronic patient follow-up, pain severity assessment scale preference, and pain localization assessment preference were questioned. &#x0D; Results: A total of 159 healthcare providers (114 females and 45 males) participated in this survey and replied to the questionnaire. 54.7% of them reported that they preferred the Visual Analogue Scale (VAS), and 11.9% of them preferred the Verbal Rating Scale (VRS) to evaluate pain intensity. The participants preferred verbal feedback and palpation to determine pain localization. &#x0D; Conclusion: In this survey was conducted in Turkey, health providers’ preferences were found to be similar to the related literature. The results obtained from this survey also indicate that health providers working in Turkey mostly prefer VAS in pain intensity assessment.

1741. A Phase 4, Open-label, Multicenter Study to Evaluate the Safety, Tolerability, and Immunogenicity of Vaxelis™ in Healthy Children Previously Vaccinated With a 2-Dose Primary Infant Series of Either Vaxelis™ or Hexyon™ (V419-016)

Abstract Background Vaxelis™ is a hexavalent combination vaccine (HCV) indicated in infants and toddlers for the prevention of diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis, and invasive disease due to Haemophilus influenzae type b. In practice, switching between HCVs during the childhood vaccination series is sometimes necessary due to vaccine availability, health care provider preference, tender awards, or other reasons. The various HCVs differ in the types of antigens used, which may affect immunogenicity and reactogenicity. The use of Vaxelis™ as a booster dose after another HCV has not previously been studied in a clinical trial. The purpose of this study was to describe the safety, tolerability, and immunogenicity of a booster dose of Vaxelis™ in toddlers who previously received a primary infant series of either Vaxelis™ or Hexyon™. Methods Healthy participants approximately 11 to 13 months of age who previously received a two-dose primary series of Vaxelis™ (VVV group) or Hexyon™ (HHV group) at approximately 2 and 4 months of age all received a Vaxelis™ booster dose. Safety was evaluated as the proportion of participants with adverse events (AEs). Immunogenicity was evaluated by measuring antibody levels to individual vaccine antigens approximately 30 days following booster vaccination. Results Participant characteristics were comparable between groups (VVV group n=85; HHV group n=82). The overall proportions of participants with AEs­─including injection-site, systemic, vaccine-related, and serious AEs─were generally comparable between groups. The proportions of participants with antibody-specific responses for antigens contained in both Vaxelis™ and Hexyon™ at 30 days postvaccination with Vaxelis™ were comparable between groups and higher in the VVV group for antigens FIM2/3 and PRN found only in Vaxelis™ (Table 1).Table 1.Proportions of participants meeting specified Vaxelis™ antigen responses at 30 days postvaccination Conclusion A booster dose of Vaxelis™ was well tolerated following a primary series of Hexyon™ with a safety profile similar to a 3-dose series of Vaxelis™. Immune responses were comparable for all shared antigens and higher for those found only in Vaxelis™. These data support the use of Vaxelis™ as a booster in mixed HCV regimens. Disclosures Andrea Guerra, MD, Merck Sharp &amp; Dohme LLC - United Kingdom: employee|Merck Sharp &amp; Dohme LLC - United Kingdom: Stocks/Bonds Federico Martinon-Torres, MD, PhD, Assoc. Prof, Ablynx, Gilead, Regeneron, Roche, Abbott and MedImmune: Honoraria|Ablynx, Gilead, Regeneron, Roche, Abbott and MedImmune: principal investigator|Astra Zeneca, GSK, Pfizer Inc, Sanofi, MSD, Seqirus, Moderna, Novavax, Biofabri, and Janssen: Advisor/Consultant|Astra Zeneca, GSK, Pfizer Inc, Sanofi, MSD, Seqirus, Moderna, Novavax, Biofabri, and Janssen: Board Member|Astra Zeneca, GSK, Pfizer Inc, Sanofi, MSD, Seqirus, Moderna, Novavax, Biofabri, and Janssen: Honoraria|Astra Zeneca, GSK, Pfizer Inc, Sanofi, MSD, Seqirus, Moderna, Novavax, Biofabri, and Janssen: speaker and investigator Courtney Lambeth, BS, Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA: employee|Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA: Stocks/Bonds Ziqiang Chen, PhD, Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA: employee|Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA: Stocks/Bonds Jessie Lumley, MA, Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA: employee|Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA: Stocks/Bonds David Johnson, MD, MPH, Sanofi: employee Marissa B. Wilck, MD, Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA: employee|Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA: Stocks/Bonds

Real-world treatment preferences among health care providers in the United States in selecting disease modifying therapies for patients with multiple sclerosis: a discrete choice experiment

AimsHealth care providers (HCPs) treating multiple sclerosis (MS) in clinical practice have numerous disease-modifying therapies (DMTs) to consider when evaluating treatment options. This study assessed the treatment preferences of HCPs in the United States, both direct (explicit) and derived (explicit and implicit), when selecting MS DMTs based on clinical and logistical treatment attributes.Materials and methodsA 45-minute web-enabled questionnaire was administered to HCPs who manage patients with MS to assess the importance of treatment attributes. HCPs were recruited through an online panel. This study examined treatment attributes relevant to treatment decisions in MS, with a focus on the burden to HCPs and their staff, as well as HCP attitudes toward various aspects of MS care such as diagnosis, treatment prioritization, and ease of initiating or switching DMTs. The study also employed a discrete choice experiment (DCE) to assess direct and derived treatment preferences.ResultsThe study recruited 145 HCPs. Direct assessments (a score of greater than 7.0 was considered important) suggested that safety (mean importance rating = 7.8/9) and relative risk reduction in relapses (7.6/9) and disability progression (7.5/9) were most important when selecting DMTs. In contrast, derived importance from the DCE (higher points corresponding to greater importance) suggested that logistical attributes such as dose frequency (mean relative attribute importance = 17.5%), dose titration (10.3%), formulation (9.4%), and volume of calls (9.1%) were important considerations, along with efficacy (16.5%), safety (9.8%), and gastrointestinal tolerability (9.4%).LimitationsThis study may have been subject to selection bias due to the application of eligibility criteria, the convenient sampling recruitment methodology, and recruitment of HCPs with internet access.ConclusionIn the direct assessment, clinical attributes were chosen as the most important treatment attributes by HCPs. However, in the DCE, derived treatment decisions rated logistical attributes as also being as important in treatment choice.

Understanding US healthcare provider preferences for consumption of publication content: opportunities to leverage omnichannel approaches

Objective Understanding the healthcare provider (HCP) journey of discovering and consuming medical and scientific information is critical for optimizing publication reach. A survey was conducted in 2019-2020 to understand how HCPs in the United States discover, review, and share publications of interest. A follow-up survey was conducted in 2021-2022 to assess how HCP behavior in the United States has evolved over the past 2 years, including due to the COVID-19 pandemic. Methods Expanding on the survey completed in March 2020, a 24-question, online survey was conducted via SurveyMonkey. Survey invitations were sent via email list, social media, and personal outreach to practicing US-based HCPs with MD or DO degrees. Results Thirty-nine HCPs responded in 2020. Of the 33 HCPs who responded in 2021-2022, 67% were community practitioners; 45% had practiced for >20 years, while 30% had practiced for <5 years. Medical media channels (preferred by 73%) were the most common means of discovering publications of interest (vs targeted PubMed/Embase searches in early 2020). Sixty-seven percent of HCPs found supplemental digital information (also called publication enhancers) moderately/very useful for understanding article content vs 56% in the 2020 survey. When asked about pandemic-related behavior changes, HCPs reported increases in social media use (55%), medical media use (52%), direct reading of research articles (45%), accessing supplemental digital information (39%), and sharing/recommending articles to colleagues (33%). Conclusions These survey results suggest that how HCPs interact with publication content is evolving and that these changes appear accelerated by the COVID-19 pandemic. This evolution is important to understand, and be accounted for, in the framework of omnichannel publication planning.

Community and Health Care Provider Preferences for Bacterial Sexually Transmitted Infection Testing Interventions for Gay, Bisexual, and Other Men Who Have Sex With Men: e-Delphi Study.

Canadian clinical guidelines recommend at least annual and up to quarterly bacterial sexually transmitted infection (STI) testing among sexually active gay, bisexual, and other men who have sex with men (GBM). However, testing rates are suboptimal. Innovative solutions are needed to close the gap because there is currently limited knowledge on how best to approach this issue. Our aim was to build consensus regarding interventions with the greatest potential for improving local STI testing services for GBM communities in Toronto, Ontario, Canada, using a web-based e-Delphi process. The e-Delphi method involves using a panel format to conduct successive rounds of prioritization, with feedback between rounds, to determine priorities among groups. We recruited experts separately from the community (GBM who sought or underwent STI testing in the preceding 18 months; conducted between October 2019 and November 2019) and health care providers (those who offered STI testing to GBM in the past 12 months; conducted between February 2020 and May 2020). The experts prioritized 6 to 8 potential interventions on a 7-point Likert scale ranging from definitely not a priority to definitely a priority over 3 survey rounds and ranked their top 3 interventions. Consensus was defined as ≥60% within a ±1 response point. Summaries of responses were provided in successive rounds. We reported the percentage of a priority (encompassing somewhat a priority, a priority, and definitely a priority responses) at the end of the final round of the survey. Of the community experts (CEs), 84% (43/51) completed all rounds; 19% (8/43) were living with HIV; 37% (16/43) were HIV negative and on pre-exposure prophylaxis; and 42% (18/43) were HIV negative and not on pre-exposure prophylaxis. We reached consensus on 6 interventions: client reminders (41/43, 95%), express testing (38/43, 88%), routine testing (36/43, 84%), an online booking app (36/43, 84%), online-based testing (33/43, 77%), and nurse-led testing (31/43, 72%). The CEs favored convenient interventions that also maintain a relationship with their provider. Of the provider experts (PEs), 77% (37/48) completed all rounds; 59% (22/37) were physicians. Consensus was reached on the same 6 interventions (range 25/37, 68%, to 39/39, 100%) but not for provider alerts (7/37, 19%) and provider audit and feedback (6/37, 16%). Express testing, online-based testing, and nurse-led testing were prioritized by >95% (>37/39) of the PEs by the end of round 2 because of streamlined processes and decreased need to see a provider. Both panels were enthusiastic about innovations that make STI testing more efficient, with express testing rating highly in both the prioritizations and top 3 rankings. However, CEs preferred convenient interventions that involved their provider, whereas PEs favored interventions that prioritized patient independence and reduced patient-provider time. RR2-10.2196/13801.

Virtual care and COVID-19: A survey study of adoption, satisfaction and continuing education preferences of healthcare providers in Newfoundland and Labrador, Canada.

Virtual care has expanded during COVID-19 and enabled continued access to healthcare services. For many healthcare providers, the adoption of virtual care has been a new experience in the provision of healthcare services. The purpose of this survey study was to explore healthcare providers' experiences with virtual care during COVID-19. A web-based survey-questionnaire was developed by applying Rogers' theory of diffusion of innovation and distributed to healthcare providers (physicians, nurses and allied health professionals) in Newfoundland and Labrador, Canada to explore virtual care experiences, satisfaction and continuing professional development (CPD) needs. Analyses included descriptive statistics and thematic analysis of survey responses. Fifty-one percent of respondents (n = 432) indicated they were currently offering virtual care and a majority (68.9%) reported it has improved their work experience. Telephone appointments were preferred over videoconferencing by respondents, with key challenges including the inability to conduct a physical exam, patients' cell phone services being unreliable and patients knowing how to use videoconferencing. Majority of respondents (57.5%) reported quality of care by telephone was lower than in-person, whereas quality of care by videoconferencing was equivalent to in-person. Main benefits of virtual care included increased patient access, ability to work from home, and reduction in no-show appointments. Key supports for adopting virtual care included in-house organizational supports (e.g., technical support staff), local colleague support, and technology training. Important topics for virtual care CPD included complying with regulatory standards/rules, understanding privacy or ethical boundaries, and developing competency and digital professionalism while engaging in virtual care. Beyond the COVID-19 pandemic, virtual care will have a continuing role in enhancing continuity of care through access that is more convenient. Survey findings reveal a number of opportunities for supporting healthcare providers in use of virtual care, including CPD, guidelines and resources to support adaptation to virtual care provision (e.g., virtual examinations/assessments), as well as patient educational support.

Regional variation in urinary catheter use in the Netherlands from 2012 to 2021: a population-based cohort.

Our aim was to evaluate trends and regional differences in the use of indwelling and intermittent urinary catheters in the community setting in the Netherlands from 2012 to 2021. For this population-based cohort study, data on catheter use was collected from the Drug and Medical Devices Information System of the National Healthcare Institute of the Netherlands. This database contains information on the Dutch insured population, which was 100% of the total population in 2018. Users were divided into 12 provinces according to the Nomenclature of Territorial Units for Statistics codes. The number of catheter users was adjusted for the total population of the provinces by sex and age, and was expressed by users per 100,000 people. Negative binomial regression (NBR) was used to test for differences in clean intermittent catheter (CIC) and indwelling catheter (IDC) users across Dutch provinces. Between 2012 and 2021, IDC users increased by 44.6% from 41,619 to 60,172, and CIC users increased by 27.3% from 34,204 to 43,528. The greatest increases were mainly observed among IDC users over 85 years old and male CIC users over 65 years old. NBR showed significant differences for IDC and CIC users between the 12 provinces. CIC incidence was higher in Drenthe and Groningen (Northern Netherlands) compared to Zuid-Holland (Southern Netherlands). IDC incidence was higher in seven provinces dispersed throughout the Netherlands compared to Noord-Holland. CIC and IDC users have continued to increase in recent years; this was especially observed among older men. In addition, there were regional differences in the number of CIC and IDC users; CIC was more prominent in the northern region of the Netherlands, and IDC varied between multiple provinces. Practice variation in urinary catheterization may result from patient population differences or healthcare provider preferences and their alignment with guidelines.

Supporting Interprofessional Collaboration in Deprescribing: Needs Assessment for an Education Program.

: Deprescribing is a complex process involving patients and healthcare providers. The aim of the project was to examine the learning needs and preferences of healthcare providers and students to inform the development of an interprofessional deprescribing education program. : An online survey of pharmacists, nurses, nurse practitioners, family physicians, and associated students practicing or studying in Nova Scotia was conducted. Respondents were recruited by purposive and snowball sampling to have at least five respondents within each professional/student group. Questions captured participant's self-reported comfort level and professional role for 12 deprescribing tasks and their learning preferences. : Sixty-nine respondents (46 healthcare providers and 23 students) completed the questionnaire. Average comfort levels for all 12 deprescribing tasks ranged from 40.22 to 78.90 of 100. Respondents reported their preferred deprescribing learning activities as watching videos and working through case studies. Healthcare providers preferred to learn asynchronously online, while students preferred a mix of online and in-person delivery. : Learning needs related to deprescribing tasks and roles were identified, as well as preferences for format and delivery of education. Development of an education program that can provide a shared understanding of collaborative deprescribing tailored to learner preferences may improve deprescribing in practice.

Human-centered design exploration with Kenyan health workers on proposed digital mental health screening and intervention training development: Thematic analysis of user preferences and needs.

BackgroundHealth providers' perceived sense of knowledge, competency, and self-efficacy to support the needs of their patients contributes to optimal patient health outcomes. With regards to mental health service delivery in Kenya, this area needs further exploration. Guided by the e-health technology acceptance mode, the needs and preferences of health care providers around mental health training for clinical management and their ability to intervene in peripartum adolescent mental health care are explored. We probed how well-equipped service providers are, their engagement with technology to learn and offer services. The health care provider's technology use preferences were also explored.MethodGuided by a human-centered design-focused qualitative inquiry we interviewed 20 specialists around their needs, perspectives, and preferences for digitized mental health screening and intervention. Mean age was 44.2 years, (range of 32–58 years), 25% (5) males and 75% (15) females. After a written consenting process, the online interviews (30−45 min) were conducted in April 2021, once personal information was de-identified interviews were transcribed and coded. Thematic analysis was used and we combined rapid appraisal of Google Jamboard online storyboards to do individual human-centered design personas alongside.ResultsOur participants were well-exposed to digital technologies. Prohibitive costs of data bundles, lack of funds for consistent online engagement, high workload, and instability of access to appropriate gadgets were found to be barriers to e-health training. Emerging opportunities were well-identified adolescent mental health service and intervention needs, willingness to take online courses offered on learning platforms, and wish for these to be disseminated through diverse social media. Other recommendations were the need to have a user-friendly interface such as data-light engaging and practical materials including animations, short, group-based learning.ConclusionUnderstanding contextual factors that influence perceived usefulness and ease of use of the remote/digital components would be critical for e-training development and its uptake.

Understanding healthcare provider preferences for ordering respiratory cultures to diagnose ventilator associated pneumonia: A discrete choice experiment.

Ventilator-associated pneumonia (VAP) can be overdiagnosed on the basis of positive respiratory cultures in the absence of clinical findings of pneumonia. We determined the perceived diagnostic importance of 6 clinical attributes in ordering a respiratory culture to identify opportunities for diagnostic stewardship. A discrete choice experiment presented participants with a vignette consisting of the same "stem" plus variations in 6 clinical attributes associated with VAP: chest imaging, oxygenation, sputum, temperature, white blood cell count, and blood pressure. Each attribute had 3-4 levels, resulting in 32 total scenarios. Participants indicated whether they would order a respiratory culture, and if yes, whether they preferred the bronchoalveolar lavage or endotracheal aspirate sample-collection method. We calculated diagnostic utility of attribute levels and relative importance of each attribute. The survey was administered electronically to critical-care clinicians via a Qualtrics survey at a tertiary-care academic center in the United States. In total, 59 respondents completed the survey. New radiograph opacity (utility, 1.15; 95% confidence interval [CI], 0.99-1.3), hypotension (utility, 0.88; 95% CI, 0.74-1.03), fever (utility, 0.76; 95% CI, 0.62-0.91) and copious sputum (utility, 0.75; 95% CI, 0.60-0.90) had the greatest perceived diagnostic value that favored ordering a respiratory culture. Radiograph changes (23%) and temperature (20%) had the highest relative importance. New opacity (utility, 0.35; 95% CI, 0.17-0.52) and persistent opacity on radiograph (utility, 0.32; 95% CI, 0.05-0.59) had the greatest value favoring bronchoalveolar lavage over endotracheal aspirate. Perceived high diagnostic value of fever and hypotension suggest that sepsis vigilance may drive respiratory culturing and play a role in VAP overdiagnosis.