Primary Health Care Physicians Research Articles

Guidelines on atopic dermatitis for Mexico (GUIDAMEX): using the ADAPTE methodology

With the advancement of knowledge in relation to the physiopathogenesis of atopic dermatitis (AD), several new therapeutic forms have been developed. There are also new guidelines for self-care. On the other hand, there is still an underdiagnosis of AD in Mexico. Thus, the need was seen to develop a national guide, with a broad base among the different medical groups that care for patients with AD. The Atopic Dermatitis Guidelines for Mexico (GUIDAMEX) was developed with the ADAPTE methodology, with the endorsement and participation of ten national medical societies, from physicians in Primary Healthcare to allergists and dermatologists. Throughout the manuscript, key clinical questions are answered that lead to recommendations and suggestions for the diagnosis of AD (including differential diagnosis with immunodeficiency syndromes), the recognition of comorbidities and complications, non-pharmacological treatment including therapeutic education, treatment of flares and maintenance therapy. The latter encompasses general measures to avoid triggering factors, first-line treatment focussed on repair of the skin barrier, second-line treatment (topical proactive therapy), and third-line phototherapy or systemic treatment, including dupilumab and JAK inhibitors.

Does increasing physician volume in primary healthcare facilities under the hierarchical medical system help reduce hospital service utilisation in China? A fixed-effects analysis using province-level panel data

ObjectiveTo examine whether increases in physician volume in primary healthcare facilities are associated with reduced utilisation of hospital outpatient and inpatient services after China facilitated the establishment of the hierarchical...

Editorial introductions.

Editorial introductions.

KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING FIBROMYALGIA AMONG PRIMARY CARE PHYSICIANS IN TABUK, SAUDI ARABIA

Background: Adequately informed family physicians have the greatest potential to correctly identify the diagnosis of fibromyalgia (FM) and develop an initial treatment plan. Therefore, it is substantial to determine the levels of weakness and inaccuracies of primary care physicians regarding FM diagnostic criteria and management strategies. Aim: This study aimed to assess the knowledge, attitude, and practices regarding FM among primary care physicians in Tabuk, Saudi Arabia. Methods:This cross-sectional study included family physicians who were board-certified or registered in the family medicine training program and working at the government family health care centers in Tabuk. A pre-designed, structured questionnaire was distributed either in a written form or as an online survey. Results: This study included 52 primary healthcare physicians. Twenty-two (42.3%) participants incorrectly recorded localized pain as a diagnostic symptom, and 45 (86.5%) incorrectly recorded nonsteroidal anti-inflammatory drugs, prednisolone, and/or opioids as drugs that are used for treating FM. Only 59.6% were confident recognizing symptoms of FM and 55.8% were confident differentiating FM from other similar diseases. Conclusions: The primary healthcare physicians working in the governments primary healthcare centers in Tabuk city, Saudi Arabia have low levels of knowledge about diagnostic criteria and treatment strategies of FM. These findings highlight the need for continuous professional development involving family physicians in the primary health care setting with suitable continuous medical education programs concerning FM.

Self-perceived level of competencies of family physicians in transitional Kosovo

Aim: Family physicians and general practitioners are currently facing increasing demands to meet patients’ expectations and rapid technological and scientific developments. The aim of this study was to determine the self-perceived level of competencies of primary health care physicians in Kosovo, a post-war country in the Western Balkans. Methods: A cross-sectional study was conducted in Kosovo in 2013 including arepresentative sample of 597 primary health care physicians (295 men and 302 women; mean age: 46.0±9.4 years; response rate: 90%). A structured self-administered questionnaire was used in order to determine physicians’ competencies regarding different domains of the quality of health care. The questionnaire included 37 items organized into six subscales/domains. Answers for each item of the tool ranged from 1 (“novice” physicians) to 5 (“expert” physicians). An overall summary score (range: 37-185) and a subscale summary score for each domain were calculated for each participant. General linear model was used to assess the association of physicians’ self-perceived level of competencies with covariates. Results: The internal consistency of the whole scale (37 items) was Cronbach’s alpha=0.98. Mean summary score of the 37-item instrument and subscale summary scores were all higher in men than in women. In multivariable-adjusted models, mean level of self-perceived competencies was higher among older physicians, in men, those with >10 years of working experience, physicians serving >2500 people, specialized physicians and those involved in training activities. Conclusion: Our study provides useful evidence on the self-assessed level of competencies of primary health care physicians in post-war Kosovo. Future studies in Kosovo and other transitional settings should identify the main determinants of possible gaps in self-perceived levels of physicians’ competencies vis-à-vis the level of physicians’ competencies from patients’ perspective.

Prescribing pattern of antibiotics by family physicians in primary health care

PurposeIrrational prescription of antibiotics is an ongoing global public health concern, leading to antibiotic resistance. Understanding the prescribing pattern of antibiotics is important to tackling mal-prescription and antibiotic resistance. We aimed to investigate the pattern and factors affecting outpatients’ antibiotic prescribing by family physicians in Primary Health Care (PHC).MethodsA cross-sectional study was conducted in 19 PHC facilities in Alborz province. Prescribing pattern of antibiotics was evaluated among 1068 prescriptions by family physicians. Prescribing pattern of antibiotics included prescriptions containing antibiotics, the number of antibiotics per prescription, type, name of antibiotic, and mal-prescription. Multiple logistic regression analysis was used to estimate the adjusted odds ratios and 95% confidence intervals.ResultsOverall, 57% of the prescriptions had ≥ 1 antibiotic and the average number of antibiotics per prescription was 1.27. Amoxicillin was the commonly prescribed antibiotic. There was a significant relationship between age, sex, type of health insurance, work experience of the physician, and seasons with antibiotic prescribing (P < 0.05). In 59.31% of antibiotic prescriptions at least one of the scientific criteria was not fulfilled. In the final analysis, after adjusting for the potential confounders, field experts of physicians (OR = 1.59; 95% CI: 1.08–6.17), female sex (OR = 2.23; 95% CI: 1.18–4.21), and winter season (OR = 3.34; 95% CI: 1.26–8.15) were found associated factors with antibiotic prescribing.ConclusionThe average number of antibiotics per prescription and the percentage of irrational prescriptions were relatively high in this study. There is need to improve antibiotic prescribing patterns among family physicians working in primary health care.

Approaches to organization of Fracture Liaison Services at the regional level with the involvement of primary care physicians

To prevent fractures which the elderly and the very old might deal with is a strategic task for preserving the life quality of the elderly and their independence from outside help, as well as reduce the health care and social support economic costs. The most effective and cost-effective organizational structure for reducing fractures frequency is the Fracture Liaison Service (FLS). The foundation of FLS at the regional level includes various models of these services, which is associated with a multi-level system of trauma care, different numbers of attached population and different number of specialists. Firstly, these are identification, assessment of clinical risk factors for osteoporosis, investigation for secondary osteoporosis causes and treatment initiation in the FLS with follow-up in the primary health care in 12–18 months’ time. Secondly, these are identification, risks assessment, patients’ investigation in the FLS during 3 months with the follow-up treatment initiating by the primary health care physician. And thirdly, these are assessment, investigation and treatment initiation by a primary care doctor immediately after trauma care. In any case of the FLS organization, a patient who has had a fragility fracture in any period after the fracture will be under the supervision of a primary care physician, and therefore additional efforts should be made by healthcare organizers, heads of a medical organization and other specialists in order to increase the identification of the patients with osteoporosis, their examination and treatment with anti-osteoporotic drugs in the primary health care. The article presents the results of the studies confirming the effectiveness of FLS with a coordinator, educational activities for patients and doctors, the role of a traumatologist in motivating a patient for examination and treatment, and other options to help a primary care physician with identifying, diagnosing and treating patients after fragility fractures.

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.

'Some of my patients only come to renew their prescriptions. They are not interested in any additional advice or support'. Physicians' perceptions on their roles in cardiovascular diseases risk reduction and management in Fiji.

Primary health care (PHC) physicians' perceptions are vital to understand as they are the first-line health care providers in cardiovascular diseases (CVD) risk assessment and management. This study aims to explore PHC physicians' perceptions on their roles and their perceptions on management and risk reduction approaches on CVD risk reduction and management in Fiji. This is a qualitative study conducted in the Suva Medical area among 7 health centers from 1 August to 31 September, 2021. Purposive sampling was used to recruit physicians who worked in the Suva medical area as PHC physicians with at least 6 months' experience in the Special Outpatients Department clinics. In-depth interview were conducted using a semi-structured questionnaire over the telephone and recorded on a tablet device application. The interview content was then transcribed, and thematic analysis was done. This study included 25 PHC physicians. From the thematic analysis, 2 major themes emerged with 6 subthemes. Theme 1 was CVD management skills with 3 subthemes including education, experience and trainings, beliefs and attitudes of physicians, self-confidence and effectiveness in CVD risk reduction and management. Theme 2 was roles and expectations with 3 subthemes including perceptions of effective treatment, perceptions of physicians' roles and perceptions of patients' expectations. Physicians generally see their role as central and imperative. They perceive to be important and leading toward combating CVDs. Physicians' perceptions on their commitment to prevention and management of CVDs through their skills and knowledge, beliefs and motivation should be acknowledged. It is recommended that the physicians are updated on the current evidence-based medicine. Limitations include results that may not be the reflection of the entire physician and multidisciplinary community and the difficulties in face-to-face interviews due to the coronavirus diseases of 2019 pandemic.

Knowledge of Tonsillectomy Indications among Primary Healthcare Physicians in Riyadh, Saudi Arabia

Background and Aims: Tonsillectomy is a common procedure in children and adults. Despite its popularity, many physicians still need to be adequately educated regarding the indications for tonsillectomy. Recurrent tonsillitis is the most common indication in which primary care physicians seek consultation from otolaryngology. This study aimed to assess the knowledge of indications for tonsillectomy among primary healthcare physicians in Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted between March and August 2022, with a sample size of 100 male and female primary healthcare physicians in Riyadh, Saudi Arabia. A questionnaire on demo¬graphic data, clinical practice and exposure, and basic knowledge of current tonsillectomy indications was administered to the participants, and data were analyzed. Results: Of the 73 primary care providers included in the study, almost 70% had an average-to-poor knowledge of tonsillectomy indications. Women had better knowledge than men. Conclusions: The results of the present study indicate that primary healthcare physicians’ knowledge regarding adenotonsillectomy indications is still inadequate. Enrichment of the otolaryngology teaching at medical school and in residency programs is essential for optimization of the primary care delivered to patients.

Knowledge and Practice in Addressing Atopic Dermatitis Amongst Primary Care Physicians in The Kingdom of Bahrain- A Cross-Sectional Study

Background: Atopic dermatitis is a chronic relapsing-remitting dermatosis commonly presented in primary healthcare facilities. Although there is no cure for atopic dermatitis, early diagnosis, and appropriate treatment are essential in the management of atopic dermatitis and in preventing its complications. Primary healthcare physicians are the first to encounter most patients with atopic dermatitis; hence, correct practices and knowledge of atopic dermatitis are important among primary healthcare physicians. This study aims to assess the knowledge and practice of primary healthcare physicians concerning diagnosing and treating patients with atopic dermatitis. Methods: A cross-sectional study was conducted among primary health care physicians working at governmental primary health centers in Bahrain to determine the knowledge, attitudes, and practices towards atopic dermatitis. In addition, a self-administered online questionnaire was distributed among the participants using online surveys. Results: A total of two hundred and eighty (n=280) primary healthcare physicians were recruited (response rate 80%). The average knowledge score (correct answers) was 46.7 ± 14.0 out of 100. Being a general practitioner (P&lt;0.002), having more years of experience (P=0.044), and being of older age (P=0.003) were significantly associated with a lower knowledge score. The study also showed a wide range of varying practices among participants in managing patients with atopic dermatitis. Conclusion: There were significant variations in the knowledge and practice amongst primary care physicians towards atopic dermatitis that could delay the treatment of the condition and, therefore, possibly decrease treatment adherence. Conducting targeted educational interventions and developing strategies by dermatologists could minimize such gaps in practice and knowledge.

Diabetic Care Challenges during COVID-19 Pandemic: Primary Healthcare Physicians’ Perspective

Background: Diabetes mellitus (DM) is the leading chronic disease worldwide. During the COVID-19 pandemic, primary healthcare centers were the main entry point for patients with diabetes. Additionally, the COVID-19 pandemic strained the primary healthcare system, including diabetic care. Objective: This study aimed to carry out an assessment of diabetes care challenges from the perspective of primary care physicians during the COVID-19 pandemic in Bisha, Saudi Arabia. Method: This cross-sectional study was conducted between 1 May 2021 and 30 June 2021 in primary health centers using a self-report questionnaire from PHC physicians. Challenges in providing health services for type 2 diabetes were assessed. Statistical analysis was conducted with SPSS software using descriptive statistics, T-tests, chi-square tests, and the ANOVA test. Statistical significance was set at p &lt; 0.05. Results: Two hundred and twenty-two primary care physicians participated in the study. Half of them, 114 (51%), had adequate confidentiality in treating patients with COVID-19. The majority of participating physicians (216; 97.3%) faced challenges in managing diabetic patients during the COVID-19 pandemic (p-value 0.05). Male, non-Saudi physicians &gt; 40 years, working in rural areas, without training were more likely to have faced challenges managing DM patients during COVID-19 (p-value 0.05). Conclusions: Most PHC physicians face challenges in managing patients with diabetes mellitus who have COVID-19. Decision makers should increase preparedness for future emergencies to address the significant challenges identified. Keywords: primary healthcare; physicians; COVID-19; chronic diseases; diabetes

Developing a scale to evaluate the usability of telemedicine as a safe and useful communication channel and outpatient record

Aim: Telemedicine has been appreciated as a smart solution to bridge the gaps in healthcare delivery. Several questionnaires were developed worldwide and designed to evaluate the usability of telemedicine. However, they might be inappropriate or inadequate for all forms of telemedicine services. In this paper, we aim to report on the development and validation process of our telemedicine usability scale. Materials and Methods: The scale was part of a self-administered online questionnaire developed and content validated by a panel of physicians to evaluate the usability of telemedicine from the primary healthcare physicians’ perspective in Oman. The study employed convenient sampling of all eligible primary healthcare physicians, resulting in 143 completed questionnaires. We used the FACTOR software to run exploratory factor analysis on a polychoric matrix. The unweighted least squares extraction method was selected with promin rotation to fit the ordinal data. The psychometric properties, including the reliability measures, unidimensionality, and goodness-of-fit indices, were reported. Results: A three-factor solution satisfied the concept of simple structure and explained about 53% of the total variance. The first factor represented the usability of telemedicine as a safe and useful service; the second factor represented the usability of telemedicine as an outpatient record; the third factor represented the usability of telemedicine as a communication channel. For all factors, Cronbach’s alpha and McDonald’s omega were greater than 0.85. The goodness-of-fit indices and measures of unidimensionality were acceptable for the three-factor solution. The same three-factor solution was also evident following the run of exploratory factor analysis on the Pearson correlation matrix. Conclusion: The proposed scale is a multi-faceted scale that has been built on cumulative knowledge and developed according to the best-practice recommendations to ensure its reliability and validity for evaluating the usability of telemedicine from the physicians’ perspective.

Primary Healthcare Physicians’ Knowledge, Practice, and Attitude Towards Influenza Vaccination of Pregnant Women in Bahrain

Background: Pregnancy is associated with immunological and physiological changes in many organ systems. Influenza in pregnancy has been associated with higher rates of morbidity and mortality. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) advocate antenatal influenza vaccination. Objective: This study aims to assess Primary Healthcare Physicians’ (PHPs) knowledge, practice, and attitude regarding influenza vaccination of pregnant women in Bahrain. Also, to identify the perceived facilitators and barriers to influenza vaccination for pregnant women among PHPs. Methodology: A cross-sectional study was conducted in all Primary Health Centers (PHCs) in Bahrain belonging to the Ministry of Health (MOH), which included 25 PHCs and 3 health clinics spread across five health regions. One hundred and nighty -two physicians responded to a survey about their awareness, practice, and attitude about influenza immunization in pregnancy. Conclusion: In general, physicians agree that influenza vaccination is necessary and safe for all pregnant women, not only those having high-risk pregnancies. Furthermore, good counseling can help overcome many fears or barriers.

Diagnosis and Management of Postpartum Depression

Postpartum Depression (PPD) is a severe mental health problem that affects up to 15% of mothers. It is highly prevalent, and its drawbacks are not limited to the affected mothers. It also extends to their offspring, causing disturbances in their development. Recent research has identified several psychosocial and biological risk factors for PPD, including past depression, stressful life events, poor marital relationships, and social support. The obstetrician, pediatrician and primary health care physicians have a crucial role in screening for and treating PPD. This review aims to provide a holistic approach for PPD diagnosis and management.

Burnout in primary healthcare physicians and nurses in Turkey during COVID-19 pandemic.

Due to additional responsibilities and uncertainties during the COVID-19 pandemic, primary healthcare (PHC) workers are at increased risk of burnout. To determine and compare the burnout levels and related factors in PHC nurses and family physicians (FPs) during the COVID-19 pandemic. An online survey was delivered to PHC workers. Non-random sampling method was used. To evaluate burnout, the Maslach Burnout Inventory was used, which investigates burnout in three categories: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Multivariate linear regression was used to analyze factors associated with burnout for FPs and nurses separately. Among the participants, 55.7% were nurses, the mean age was 42.34. FPs and nurses experienced similar levels of burnout in terms of EE. Family physicians had higher levels of low PA and DP. Based on the results of the multivariate analysis, while higher EE levels were significantly associated with unequal distribution of workload and communication problems within the Family Health Center for physicians, the unequal distribution of PPE, lack of appreciation by patients or colleagues and restrictions on work-related rights were relevant factors for nurses. Lack of appreciation and restrictions of the rights were associated with increased DP scores in both groups. Unequal distribution of workload was also associated with reduced PA among FPs. PHC physicians and nurses are affected by burnout in different ways under the conditions of the COVID-19 pandemic based on gender, socioeconomic status and working conditions. To protect the mental health of PHC workers in the next public health emergency, clarification in the organization of services, empowering PHC workers in emergency risk communication and provision of timely, adequate and free PPE is essential. It is also crucial to ensure the rights of health workers through macro policy changes especially during emergencies.

Study of health seeking behaviour in parents of children in a population-based childhood visual impairment study in North India - "CHVI 2".

The background of this study is to determine the awareness about health seeking behaviour (HSB) in parents of visually impaired children in a population-based study. The study was conducted in population <16 years in urban area of North India. A total of 20,955 (97.3%) children underwent visual acuity examination. Of these, 789 children were referred to the centrally based clinic with unaided visual acuity <6/12 in any eye for undergoing detailed ophthalmic examination. Along with ocular examination, the parents of these 789 referred children, were interviewed for the questions related to HSB, the most common ocular symptom known to them was redness of eyes followed by watering and diminution of vision, 249 (34.6%) denied for any ocular problem in their children previously, amongst the remaining 469 parents/care takers with any ocular problem, a total of 367 (51.1%) referred children wore glasses and the proportion of parents wearing glasses was similar amongst these children (11.7% fathers and 11% mothers). Amongst the 118 respondents of visually impaired children (presenting visual acuity less than 6/18 in better eye with available correction), 56 (47.5%) denied for any ocular problem in their children previously, of the remaining 62 (52.5%), parents, 58 (93.5%) had consulted various healthcare agencies, 45.8% of the respondents reported not said that their children wore glasses prescribed to them. Only 24 (20.3%) respondents were aware that Vitamin A is good for eye health. Diminution of vision, watering and redness of eyes were the most common ocular symptoms known to parents of referred children. HSB can be further improved via primary healthcare physicians by primary healthcare creating awareness about importance of wearing glasses and healthy diet in parents of visually impaired children.

Effort-reward imbalance, emotional exhaustion and depersonalisation among public primary health care physicians: a cross-sectional study in Indonesia

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA HARDIANTO N, SOEMARKO D, SUGIHARTO A, FITRIANI D. Effort-reward imbalance, emotional exhaustion and depersonalisation among public primary health care physicians: a cross-sectional study in Indonesia. Family Medicine & Primary Care Review. 2023;25(1):40-49. doi:10.5114/fmpcr.2023.125491. APA HARDIANTO, N., SOEMARKO, D., SUGIHARTO, A., & FITRIANI, D. (2023). Effort-reward imbalance, emotional exhaustion and depersonalisation among public primary health care physicians: a cross-sectional study in Indonesia. Family Medicine & Primary Care Review, 25(1), 40-49. https://doi.org/10.5114/fmpcr.2023.125491 Chicago HARDIANTO, NOVA, DEWI SUMARYANI SOEMARKO, AGUS SUGIHARTO, and DEWI YUNIA FITRIANI. 2023. "Effort-reward imbalance, emotional exhaustion and depersonalisation among public primary health care physicians: a cross-sectional study in Indonesia". Family Medicine & Primary Care Review 25 (1): 40-49. doi:10.5114/fmpcr.2023.125491. Harvard HARDIANTO, N., SOEMARKO, D., SUGIHARTO, A., and FITRIANI, D. (2023). Effort-reward imbalance, emotional exhaustion and depersonalisation among public primary health care physicians: a cross-sectional study in Indonesia. Family Medicine & Primary Care Review, 25(1), pp.40-49. https://doi.org/10.5114/fmpcr.2023.125491 MLA HARDIANTO, NOVA et al. "Effort-reward imbalance, emotional exhaustion and depersonalisation among public primary health care physicians: a cross-sectional study in Indonesia." Family Medicine & Primary Care Review, vol. 25, no. 1, 2023, pp. 40-49. doi:10.5114/fmpcr.2023.125491. Vancouver HARDIANTO N, SOEMARKO D, SUGIHARTO A, FITRIANI D. Effort-reward imbalance, emotional exhaustion and depersonalisation among public primary health care physicians: a cross-sectional study in Indonesia. Family Medicine & Primary Care Review. 2023;25(1):40-49. doi:10.5114/fmpcr.2023.125491.

Current Experience of Primary Health Care Physicians on Drug Provision Issues

Achieving universal health coverage is a key policy goal in many countries that are committed to strengthening primary health care (PHC). In this context, it is important to determine access to medications and related issues on the part of medical specialists. The purpose of our study is to study the experience of the medical staffs (general practitioners, nursing staff, pharmacist, therapist) with the state of drug supply at the PHC level. Methods. A questionnaire developed which included three main parts: general part; consultation of the patient regarding drug provision as well as generating applications for medicines and timely provision of the right drug to patients in PHC. The survey was conducted through a Google form and a paper version among medical staffs of PHC at the city level. A total 122 respondents participated in survey. Results. A larger number of nurses, 36.4%, and general practitioners, 28.9% attended in survey (p&lt;0.001). Most of them worked in a government organization (81.1%). 89.9% of respondents believe that the healthcare system guarantees the safety of pharmacotherapy (p =0.009), and 84.2% agree with the statement that the success of treatment depends on the provision of professional pharmaceutical consulting services. Also, medical specialist indicated on needs for training 89.8%. Conclusion. Our research demonstrates current prescribing practices in PHC facilities. There is a need for training of PHC specialists on the issues of identifying and forming an application for medicines, taking into account site indicators.

CLINICAL AND BEHAVIORAL PRACTICES OF PRIMARY HEALTHCARE PHYSICIANS IN ANTIBIOTICS PRESCRIBING IN GREECE.

Aim: To evaluate primary health physicians' clinical and behavioral practices towards antibiotics administration in a specific region in Greece. Materials and methods: A cross sectional study was conducted using a questionnaire in all structures of primary health care (PHC) of the Peloponnese Region. The study was conducted in May-October 2020. Results: In total, 306 out of 404 primary healthcare physicians completed the questionnaire (response rate of 75.8%). Our results showed that most of physicians used to prescribing antibiotics empirically in common diseases, except for the prevention of secondary respiratory tract infection. Overall, 66.3% answered that they do not feel diagnostic uncertainty that would lead them to prescribe antibiotics. Approximately 40% of the physicians stated an increase on antibiotics use and patients demand for antibiotic prescribing, however 71.4% "rarely/never" affected by this requirement. 51.9% of the sample used to prescribed brand name antibiotics. Statistically significant differences were found between demographic and professional characteristics, and physicians' clinical and behavioral practices (p≤ 0.05). Conclusions: Our findings could provide decision makers with information on how to manage antibiotic prescribing in primary health care in the country, focusing mainly on the use of specific diagnostic tests as well as relevant guidelines and protocols for changing prescription behavior.