scholarly journals Antibiotic Prescribing by Informal Healthcare Providers for Common Illnesses: A Repeated Cross-Sectional Study in Rural India

Antibiotics ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. 139 ◽  
Author(s):  
Shweta Khare ◽  
Manju Purohit ◽  
Megha Sharma ◽  
Ashok J. Tamhankar ◽  
Cecilia Stalsby Lundborg ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Rural India ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Illnesses ◽  
Tract Infections

Informal healthcare providers (IHCPs) are predominant healthcare providers in rural India, who prescribe without formal training. Antibiotic prescription by IHCPs could provide crucial information for controlling antibiotic resistance. The aim of this study is to determine the practices and seasonal changes in antibiotic prescribing for common illnesses by IHCPs. A repeated cross-sectional study was conducted over 18 months, covering different seasons in the rural demographic surveillance site, at Ujjain, India. Prescriptions given to outpatients by 12 IHCPs were collected. In total, 15,322 prescriptions for 323 different complaint combinations were analyzed, of which 11,336 (74%) included antibiotics. The results showed that 14,620 (95%) of antibiotics prescribed were broad spectrum and the most commonly prescribed were fluoroquinolones (4771,31%), followed by penicillin with an extended spectrum (4119,27%) and third-generation cephalosporin (3069,20%). Antibiotics were prescribed more frequently in oral and dental problems (1126,88%), fever (3569,87%), and upper respiratory tract infections (3273, 81%); more during the monsoon season (2350,76%); and more frequently to children (3340,81%) than to adults (7996,71%). The study concludes that antibiotics were the more commonly prescribed drugs compared to other medications for common illnesses, most of which are broad-spectrum antibiotics, a situation that warrants further investigations followed by immediate and coordinated efforts to reduce unnecessary antibiotic prescriptions by IHCPs.

scholarly journals Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shan Wang ◽  
Lihua Liu ◽  
Jianchao Liu ◽  
Likun Miao ◽  
Qian Zhuang ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Pediatric Patients ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Sectional Study ◽  
Cross Sectional ◽  
Short Supply ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Clinical Records

Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

scholarly journals GAMBARAN STATUS GIZI KURANG DAN KEJADIAN PENYAKIT ISPA PADA BALITA DI DESA BATUR, KECAMATAN GETASAN, KABUPATEN SEMARANG

2018 ◽  
pp. 233-242
Author(s):  
Kristiawan Prasetyo Agung Nugroho ◽  
Bagus P. S. Adi ◽  
Ria Angelina
Keyword(s):  
Nutritional Status ◽  
Random Sampling ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Sectional Study ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five ◽  
Nutritional Status Of Children ◽  
Tract Infections

ABSTRAK Kelompok usia yang sangat rentan terhadap masalah status gizi adalah kelompok anak usia 1–5 tahun. Status gizi pada balita berkaitan langsung dengan pola konsumsi dan penyakit infeksi. Penyakit infeksi terkait lingkungan dapat meliputi diare, Infeksi Saluran Pernapasan Atas (ISPA),dan pneumonia. Rendahnya status gizibalita dapat meningkatkan kejadian sakit pada balita. Tujuan penelitian ini adalah untuk mengetahui hubungan gizi terhadap kejadian penyakit pada balita usia 12-60 bulan Metode yang digunakan adalah pendekatan deskriptif dengan rancangan cross sectional study. Populasi penelitian yaitu seluruh balita di Desa Batur, Kecamatan Getasan, Kabupaten Semarang yang mengikuti penimbangan Posyandu Balita yang tersebar di 19 dusun. Teknik pengambilan sampel secara random sampling dengan responden penelitian adalah ibu yang memiliki balita berusia 12 – 60 bulan dengan status gizi kurang. Data didapat dari sumber sampel sebanyak 35 balita dengan status gizi kurang. Faktor-faktor yang mempengaruhi status gizi diantaranya umur ibu, pendidikan, pekerjaan, kebiasaan makan balita, dan lingkungan fisik rumah. Permasalahan Gizi kurang erat kaitannya dengan kejadian penyakit pada balita, namun kondisi badan panas (demam), batuk, dan pilek kerap dialami oleh balita yang menandai gejala ISPA. Kasus status gizi kurang pada balita di Desa Batur dikategorikan masih tinggi dilihat dari hasil penimbangan bulan september 2017 sebesar 10,29%.   Kata kunci: cross sectional study, random sampling, status gizi, ISPA, pneumonia     ABSTRACT The age groups that are particularly vulnerable to nutritional status are groups of children aged 1 - 5 years. The nutritional status of children under five is directly related to consumption pattern and infectious diseases. Illnesses related to environmental condition may include diarrhea, upper respiratory tract infections (ISPA), and pneumonia. The low nutritional status of children under five can increase the incidence of illness in toddlers. The purpose of this study was to determine the relationship of nutrition to disease incidence in children aged 12 - 60 months. The method used is descriptive approach with cross sectional study design. The research population is all children under five in Batur Village, Getasan Subdistrict, Semarang Regency which follow Balita Posyandu weighing spread in 19 hamlets.Sampling was done by random sampling with the respondents of the researchwere mothers who have children aged 12 - 60 months with less nutritional status. Data obtained from the sample source as many as 35 children under-five with less nutritional status. Factors that affect nutritional status include maternal age, education, occupation, toddler eating habits, and the physical environment of the house. Problems Nutrition is less closely related to the incidence of disease in toddlers, but the condition of fever, coughs, and colds are often experienced by toddlers that indicate symptoms of upper respiratory tract infections. Cases of underweight status of children under five in Batur village are still considered high in terms of weighing in September 2017 of 10.29%.   Keywords: cross sectional study, random sampling, nutritional status, ISPA,pneumonia

scholarly journals Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study

2020 ◽  
Author(s):  
Shan Wang ◽  
Lihua Liu ◽  
Jianchao Liu ◽  
Likun Miao ◽  
Qian Zhuang ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Pediatric Patients ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Sectional Study ◽  
Cross Sectional ◽  
Short Supply ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Clinical Records

Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infection (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from 138 hospitals across the country. All pediatric patients aged 0-14 years diagnosed with uncomplicated AURI visiting hospital ambulatory departments from 1 January 2015 to 31 December 2017 were included. We reported characteristics of pediatric patients diagnosed with AURI, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to test differences among subgroups. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over western drugs. The median cost per visit was 119.97 CNY. The median drug cost per visit was 92.70 CNY. The expenditures of antibiotics and CTPM per visit (40.54CNY and 39.35CNY) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities have been showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

scholarly journals Knowledge and Practice of Health Professionals in the Management of Dysphagia

2021 ◽  
Vol 18 (4) ◽  
pp. 2139
Author(s):  
Eduardo Sánchez-Sánchez ◽  
Ylenia Avellaneda-López ◽  
Esperanza García-Marín ◽  
Guillermo Ramírez-Vargas ◽  
Jara Díaz-Jimenez ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Clinical Settings ◽  
Sectional Study ◽  
Swallowing Disorder ◽  
Cross Sectional ◽  
Anonymous Questionnaire ◽  
Knowledge And Practice ◽  
Definition Of ◽  
Management Of Dysphagia

The aim of this study was to determine healthcare providers’ knowledge and practices about dysphagia. A descriptive cross-sectional study was carried out based on a self-administered and anonymous questionnaire addressed to healthcare providers in Spain. A total of 396 healthcare providers participated in the study. Of these, 62.3% knew the definition of dysphagia as a swallowing disorder. In addition, up to 39.2% of the participants reported that they did not know whether the EatingAssessmentTool (EAT-10) dysphagia screening test was usedin their own clinical settings. Similarly, up to 49.1% of them did not know the ClinicalExaminationVolume-Viscosity (MECV-V) method. Nearly all participants (98.8%) reported that thickeners must be used forall liquids administered to patients. A higher percentage of respondents based the choice of texture on patient’s tolerance (78.2%) rather than on the MECV-V result (17.3%). In addition,76.4% of the professionals had witnessed a bronchoaspiration; after it, 44.4% (n = 175) of them reported the appearance of pneumonia, and 14.5% (n = 57) the death of the patient (p = 0.005). The participants revealeda moderate/low knowledge ofthe definition, diagnosis, and clinical management of liquid dysphagia, which indicates some room for improvements.

scholarly journals Perspectives of Healthcare Professionals Regarding Factors Associated with Antimicrobial Resistance (AMR) and Their Consequences: A Cross Sectional Study in Eastern Province of Saudi Arabia

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 878
Author(s):  
Mohamed A. Baraka ◽  
Amany Alboghdadly ◽  
Samar Alshawwa ◽  
Asim Ahmed Elnour ◽  
Hassan Alsultan ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Inappropriate Prescribing ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Key Factors ◽  
Eastern Province ◽  
Cross Sectional ◽  
Factors Associated ◽  
Factors Influencing

Factors reported in the literature associated with inappropriate prescribing of antimicrobials include physicians with less experience, uncertain diagnosis, and patient caregiver influences on physicians’ decisions. Monitoring antimicrobial resistance is critical for identifying emerging resistance patterns, developing, and assessing the effectiveness of mitigation strategies. Improvement in prescribing antimicrobials would minimize the risk of resistance and, consequently, improve patients’ clinical and health outcomes. The purpose of the study is to delineate factors associated with antimicrobial resistance, describe the factors influencing prescriber’s choice during prescribing of antimicrobial, and examine factors related to consequences of inappropriate prescribing of antimicrobial. A cross-sectional study was conducted among healthcare providers (190) in six tertiary hospitals in the Eastern province of Saudi Arabia. The research panel has developed, validated, and piloted survey specific with closed-ended questions. A value of p < 0.05 was considered to be statistically significant. All data analysis was performed using the Statistical Package for Social Sciences (IBM SPSS version 23.0). 72.7% of the respondents have agreed that poor skills and knowledge are key factors that contribute to the inappropriate prescribing of antimicrobials. All of the respondents acknowledged effectiveness, previous experience with the antimicrobial, and reading scientific materials (such as books, articles, and the internet) as being key factors influencing physicians’ choice during antimicrobial prescribing. The current study has identified comprehensive education and training needs for healthcare providers about antimicrobial resistance. Using antimicrobials unnecessarily, insufficient duration of antimicrobial use, and using broad spectrum antimicrobials were reported to be common practices. Furthermore, poor skills and knowledge were a key factor that contributed to the inappropriate use and overuse of antimicrobials, and the use of antimicrobials without a physician’s prescription (i.e., self-medication) represent key factors which contribute to AMR from participants’ perspectives. Furthermore, internal policy and guidelines are needed to ensure that the antimicrobials are prescribed in accordance with standard protocols and clinical guidelines.

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