Dataset Information

Staphylococcus aureus, Including Meticillin-Resistant Staphylococcus aureus, among General Practitioners and Their Patients: A Cross-Sectional Study.

ABSTRACT: The role of general practitioners (GPs) as reservoir and potential source for Staphylococcus aureus (SA) transmission is unknown. Our primary objective was to evaluate the prevalence of SA and community-acquired methicillin resistant SA (CA-MRSA) carrier status (including spa typing) among GPs and their patients in Belgium. The secondary objective was to determine the association between SA/CA-MRSA carriage in patients and their characteristics, SA carriage in GPs, GP and practice characteristics.The Belgian GPs, who swabbed their patients in the APRES study (which assessed the prevalence of SA nasal carriage in nine European countries; November 2010 -June 2011), were asked to swab themselves as well (May-June 2011). GPs and their patients had to complete a questionnaire on factors related to SA carriage and transmission. SA isolation including CA-MRSA and spa typing was performed on the swabs.In eighteen practices 34 GPs swabbed patients of which 25 GPs provided personal swabs. The analysis was performed on 3008 patient records. Among GPs SA carriage (28%) was more prevalent than among their patients (19.2%), but CA-MRSA carriage was not present. SA was more prevalent among younger patients and those living with cattle. Spa typing SA and MRSA strains did not suggest correlation within practices or between patients and GPs, but chronic skin conditions of GPs and always handshaking patients by SA positive GPs were associated with more SA among patients, and hand washing after every patient contact with less SA among patients in practices with high antibiotic prescribing rates.No MRSA was found among GPs, although their SA carriership was higher compared to their patients'. Spa types did not cluster within practices, possibly due to difference in timing of swabbing. To minimise SA transmission to their patients GPs should consider taking appropriate care of their chronic skin diseases, antibiotic prescribing behaviour, handshaking and hand washing habits.

SUBMITTER: Michiels B

PROVIDER: S-EPMC4601797 | biostudies-other | 2015

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:BackgroundOverweight and obese patients attempt weight loss when advised to do so by their physicians; however, only a small proportion of these patients report receiving such advice. One reason may be that physicians do not identify their overweight and obese patients.ObjectivesWe aimed to determine the extent that Australian general practitioners (GP) recognise overweight or obesity in their patients, and to explore patient and GP characteristics associated with non-detection of overweight and obesity.MethodsConsenting adult patients (n?=?1,111) reported weight, height, demographics and health conditions using a touchscreen computer. GPs (n?=?51) completed hard-copy questionnaires indicating whether their patients were overweight or obese. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for GP detection, using patient self-reported weight and height as the criterion measure for overweight and obesity. For a subsample of patients (n?=?107), we did a sensitivity analysis with patient-measured weight and height. We conducted an adjusted, multivariable logistic regression to explore characteristics associated with non-detection, using random effects to adjust for correlation within GPs.ResultsSensitivity for GP assessment was 63 % [95 % CI 57-69 %], specificity 89 % [95 % CI 85-92 %], PPV 87 % [95 % CI 83-90 %] and NPV 69 % [95 % CI 65-72 %]. Sensitivity increased by 3 % and specificity was unchanged in the sensitivity analysis. Men (OR: 1.7 [95 % CI 1.1-2.7]), patients without high blood pressure (OR: 1.8 [95 % CI 1.2-2.8]) and without type 2 diabetes (OR: 2.4 [95 % CI 1.2-8.0]) had higher odds of non-detection. Individuals with obesity (OR: 0.1 [95 % CI 0.07-0.2]) or diploma-level education (OR: 0.3 [95%CI 0.1-0.6]) had lower odds of not being identified. No GP characteristics were associated with non-detection of overweight or obesity.ConclusionsGPs missed identifying a substantial proportion of overweight and obese patients. Strategies to support GPs in identifying their overweight or obese patients need to be implemented.

Project description:ObjectivesTo support patients in their disease management, providing information that is adjusted to patients' knowledge and ability to process health information (ie, health literacy) is crucial. To ensure effective health communication, general practitioners (GPs) should be able to identify people with limited health literacy. To this end, (dis)agreement between patients' health literacy and GPs' estimations thereof was examined. Also, characteristics impacting health literacy (dis)agreement were studied.DesignCross-sectional survey of general practice patients and GPs undertaken in 2016-17.SettingForty-one general practices in two Dutch-speaking provinces in Belgium.ParticipantsPatients (18 years of age and older) visiting general practices. Patients were excluded when having severe impairments (physical, mental, sensory).Main outcome measuresPatients' health literacy was assessed with 16-item European Health Literacy Survey Questionnaire. GPs indicated estimations on patients' health literacy using a simple scale (inadequate; problematic; adequate). (Dis)agreement between patients' health literacy and GPs' estimations thereof (GPs' estimations being equal to/higher/lower than patients' health literacy) was measured using Kappa statistics. The impact of patient and GP characteristics, including duration of GP-patient relationships, on this (dis)agreement was examined using generalised linear logit model.ResultsHealth literacy of patients (n=1375) was inadequate (n=201; 14.6%), problematic (n=299; 21.7%), adequate (n=875; 63.6%). GPs overestimated the proportion patients with adequate health literacy: adequate (n=1241; 90.3%), problematic (n=130; 9.5%) and inadequate (n=4; 0.3%). Overall, GPs' correct; over-/underestimations of health literacy occurred for, respectively, 60.9%; 34.2%; 4.9% patients, resulting in a slight agreement (?=0.033). The likelihood for GPs to over-/underestimate patients' health literacy increases with decreasing educational level of patients; and decreasing number of years patients have been consulting with their GP.ConclusionsIntuitively assessing health literacy is difficult. Patients' education, the duration of GP-patient relationships and GPs' gender impact GPs' perceptions of patients' health literacy.

Project description:BackgroundThe World Health Organization recommends vaccination rates of 75% against seasonal influenza for patients over 65 years old. In the 2013/2014 season, the German vaccination rates ranged between 14 and 65%. This study aimed to compare the attitudes, personal characteristics and vaccination behaviours of general practitioners (GPs) in regions with high and low vaccination rates in Germany.MethodsIn May 2016, a questionnaire was sent to 1594 GPs practising in 16 districts with the highest and the lowest vaccination rates in Western and Eastern Germany as described by the Central Research Institute of Ambulatory Health Care in Germany for the 2013/2014 season. Descriptive statistics and multiple regression analyses were computed to identify potential factors associated with high vaccination rates.ResultsA total response rate of 32% (515/1594 participants) was observed in the study. GPs reported their attitudes towards vaccination in general and vaccination against influenza as mostly 'very positive' (80%, n = 352 and 65%, n = 288, respectively). GPs practising in regions with low vaccination rates reported their attitudes towards vaccinations in general (p = 0.004) and towards influenza vaccination (p = 0.001) more negatively than their colleagues from regions with high vaccination rates. Multiple logistic regression identified an increasing influence of year-dependent changing efficiency on GPs' influenza rates as the strongest factor for predicting GPs from highly vaccinating regions (OR = 4.31 [1.12-16.60]), followed by the patient's vaccination refusal despite GP advice due to already receiving a vaccination from another physician (OR = 3.20 [1.89-5.43]) and vaccination information gathering through medical colleagues (OR = 2.26 [1.19-4.29]).ConclusionsThe results of this study suggest a correlation between GPs' attitudes and regional vaccination rates. Beneath GPs' individual attitudes, the regional attitude patterns of patients, colleagues and medical assistants surrounding those GPs seem decisive and should be integrated into future campaigns to increase vaccination rates at a regional level.

Project description:BackgroundPoint-of-care testing (POCT) has numerous potential benefits to improve health care service, especially in resource-limited settings. We aim to identify which POC-tests (POCTs) of laboratory parameters are known, employed, and rated as useful by general practitioners (GPs).MethodsA questionnaire with 27 POCTs was posted to a random selection of GPs (n = 451) in Saxony, Germany.ResultsA total of 208 GPs replied (response rate 46.1%). Out of 27 POCTs, each GP knew an average of 20.3 as laboratory parameters and 9.2 as POCTs. Urine test strips (99.0%), blood glucose test (98.1%), and Troponin I/T (86.4%) were the best-known, followed by INR/Quick (82.5%), Microalbumin (79.1%), and D-dimer (78.6%) POCTs. Yet, solely 0 to 13 POC tests were actually used (mean value 4.6). Urine test strips were employed most frequently (97.6%), followed by blood glucose test (94.7%), Troponin I/T (57.8%), Microalbumin (57.3%), and INR/Quick POCTs (41.7%). Heart fatty binding protein (H-FABP), Syphilis, Coeliac disease, and Malaria appeared as the least frequently used POCTs. The majority of the GPs declared 14 of the 27 POCTs to be useful.Discussion/conclusionThe most recurrently employed POCTs are those for diagnosing or monitoring diabetes mellitus, ensued by POCTs addressing acute cardiovascular diseases (Troponin I/T, D-dimer) or monitoring the therapy of infectious diseases or the anticoagulant therapy. POCTs most often rated as useful by GPs are also widely known and frequently used. Nonetheless, the majority of GPs rate only a very limited number of POCTs as useful. Frequent concerns might be low economic benefit, over-reliance, and test accuracy coming along with the complex implementation of the tests requiring technical skills, accurate storage, and the correct interpretation of test results.Trial registrationIn accordance with the (Model) Professional Code for Physicians in Germany, neither human body materials nor data that can be assigned to a specific human being are used in our study. A declaration of no objection from the Ethics Committee of the Martin-Luther University Halle-Wittenberg (Medical Faculty) confirms no professional or ethical concerns due to completely anonymized data collection and analysis. Our study was therefore not registered in a corresponding registry.

Project description:ObjectivesThe study was designed to examine the sufficiency of general practitioners' (GPs) follow-up of patients on sick leave, assessed by independent medical evaluators.DesignCross-sectional study SETTING: Primary health care in the Western part of Norway. The study reuses data from a randomised controlled trial-the Norwegian independent medical evaluation trial (NIME trial).ParticipantsThe intervention group in the NIME trial: Sick-listed workers having undergone an independent medical evaluation by an experienced GP at 6 months of unremitting sick leave (n=937; 57% women). In the current study, the participants were distributed into six exposure groups defined by gender and main sick leave diagnoses (women/musculoskeletal, men/musculoskeletal, women/mental, men/mental, women/all other diagnoses and men/all other diagnoses).Outcome measureThe independent medical evaluators assessment (yes/no) of the sufficiency of the regular GPs follow-up of their sick-listed patients.ResultsEstimates from generalised linear models demonstrate a robust association between men with mental sick leave diagnoses and insufficient follow-up by their regular GP first 6 months of sick leave (adjusted relative risk (RR)=1.8, 95% CI=1.15-1.68). Compared with the reference group, women with musculoskeletal sick leave diagnoses, this was the only significant finding. Men with musculoskeletal diagnoses (adjusted RR=1.4, 95% CI=0.92-2.09); men with other diagnoses (adjusted RR=1.0, 95% CI=0.58-1.73); women with mental diagnoses (adjusted RR=1.2, 95% CI=0.75-1.77) and women with other diagnoses (adjusted RR=1.3, 95% CI=0.58-1.73).ConclusionsAssessment by an independent medical evaluator showed that men with mental sick leave diagnoses may be at risk of insufficient follow-up by their GP. Efforts should be made to clarify unmet needs to initiate relevant actions in healthcare and work life. Avoiding marginalisation in work life is of the utmost importance.Trial registration numberNCT02524392; Post-results.

Dataset Information

Staphylococcus aureus, Including Meticillin-Resistant Staphylococcus aureus, among General Practitioners and Their Patients: A Cross-Sectional Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets