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Yang S, Zhao H, Zhang H, Wang J, Jin H, Stirling K, Ge X, Ma L, Pu Z, Niu X, Yu D. Current status and continuing medical education need for general practitioners in Tibet, China: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:265. [PMID: 38459539 PMCID: PMC10924353 DOI: 10.1186/s12909-024-05143-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/07/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND The Tibetan area is one of China's minority regions with a shortage of general practice personnel, which requires further training and staffing. This research helps to understand the current condition and demand for general practitioner (GP) training in Tibetan areas and to provide a reference for promoting GP education and training. METHODS We conducted a cross-sectional survey using stratified sampling targeting 854 GPs in seven cities within the Tibetan Autonomous Region, utilizing an online questionnaire. Achieving a high response rate of 95.1%, 812 GPs provided invaluable insights. Our meticulously developed self-designed questionnaire, available in both Chinese and Tibetan versions, aimed to capture a wide array of data encompassing basic demographics, clinical skills, and specific training needs of GPs in the Tibetan areas. Prior to deployment, the questionnaire underwent rigorous development and refinement processes, including expert consultation and pilot testing, to ensure its content validity and reliability. In our analysis, we employed descriptive statistics to present the characteristics and current training needs of GPs in the Tibetan areas. Additionally, chi-square tests were utilized to examine discrepancies in training needs across various demographic groups, such as age, job positions, and educational backgrounds of the participating GPs. RESULTS The study was completed by 812 (812/854, 95.1%) GPs, of whom 62.4% (507/812) were female. The top three training needs were hypertension (81.4%, 661/812), pregnancy management (80.7%, 655/812), and treatment of related patient conditions and events (80.5%, 654/812). Further research shows that the training required by GPs of different ages in "puncturing, catheterization, and indwelling gastric tube use" (64.6% vs. 54.8%, p = 9.5 × 10- 6) varies statistically. GPs in various positions have different training needs in "community-based chronic disease prevention and management" (76.6% vs. 63.9%, p = 0.009). The training needs of GPs with different educational backgrounds in "debridement, suturing, and fracture fixation" (65.6% vs. 73.2%, p = 0.027) were also statistically significant. CONCLUSIONS This study suggests the need for targeted continuing medical education activities and for updating training topics and content. Course developers must consider the needs of GPs, as well as the age, job positions, and educational backgrounds of GPs practicing in the Tibetan Plateau region. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Sen Yang
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
- Department of General Practice, Lazi County Health Service Center, Xigatse, Tibet, 858100, PR China
| | - Huaxin Zhao
- Department of Oncology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Hanzhi Zhang
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Junpeng Wang
- Medical Administration Affiliationision, Yangpu Hospital, Tongji University School of Medicine, Shanghai, 200090, PR China
| | - Hua Jin
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
- Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090, PR China
| | - Kyle Stirling
- Crisis Technologies Innovation Lab, Luddy School of Informatics, Computing and Engineering, Indiana University, Bloomington, IN, 47408, USA
| | - Xuhua Ge
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Le Ma
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Zhen Pu
- Department of General Practice, Lazi County Health Service Center, Xigatse, Tibet, 858100, PR China
| | - Xiaomin Niu
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 Huaihai West Road, Shanghai, 200030, PR China.
| | - Dehua Yu
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China.
- Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090, PR China.
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Barrett AK, Cashy JP, Thorpe CT, Hale JA, Suh K, Lambert BL, Galanter W, Linder JA, Schiff GD, Gellad WF. Latent Class Analysis of Prescribing Behavior of Primary Care Physicians in the Veterans Health Administration. J Gen Intern Med 2022; 37:3346-3354. [PMID: 34993865 PMCID: PMC9550922 DOI: 10.1007/s11606-021-07248-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Benzodiazepines, opioids, proton-pump inhibitors (PPIs), and antibiotics are frequently prescribed inappropriately by primary care physicians (PCPs), without sufficient consideration of alternative options or adverse effects. We hypothesized that distinct groups of PCPs could be identified based on their propensity to prescribe these medications. OBJECTIVE To identify PCP groups based on their propensity to prescribe benzodiazepines, opioids, PPIs, and antibiotics, and patient and PCP characteristics associated with identified prescribing patterns. DESIGN Retrospective cohort study using VA data and latent class regression analyses to identify prescribing patterns among PCPs and examine the association of patient and PCP characteristics with class membership. PARTICIPANTS A total of 2524 full-time PCPs and their patient panels (n = 2,939,636 patients), from January 1, 2017, to December 31, 2018. MAIN MEASURES We categorized PCPs based on prescribing volume quartiles for the four drug classes, based on total days' supply dispensed of each medication by the PCP to their patients (expressed as days' supply per 1000 panel patient-days). We used latent class analysis to group PCPs based on prescribing and used multinomial logistic regression to examine patient and PCP characteristics associated with latent class membership. KEY RESULTS PCPs were categorized into four groups (latent classes): low intensity (23% of cohort), medium-intensity overall/high-intensity PPI (36%), medium-intensity overall/high-intensity opioid (20%), and high intensity (21%). PCPs in the high-intensity group were predominantly in the highest quartile of prescribers for all four drugs (68% in the highest quartile for benzodiazepine, 86% opioids, 64% PPIs, 62% antibiotics). High-intensity PCPs (vs. low intensity) were substantially less likely to be female (OR: 0.30, 95% CI: 0.21-0.42) or practice in the northeast versus other census regions (OR: 0.10, 95% CI: 0.06-0.17). CONCLUSIONS VA PCPs can be classified into four clearly differentiated groups based on their prescribing of benzodiazepines, opioids, PPIs, and antibiotics, suggesting an underlying typology of prescribing. High-intensity PCPs were more likely to be male.
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Affiliation(s)
- Alexis K Barrett
- VA Center for Medication Safety/Pharmacy Benefits Management Services, U.S. Department of Veteran Affairs, Hines, IL, USA.
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, USA.
| | - John P Cashy
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, USA
| | - Carolyn T Thorpe
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, USA
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer A Hale
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, USA
| | - Kangho Suh
- Department of Pharmacy and Therapeutics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bruce L Lambert
- Department of Communication Studies, Center for Communication and Health, Northwestern University, Evanston, IL, USA
| | - William Galanter
- Department of Medicine, Department of Pharmacy Systems, Outcomes & Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Jeffrey A Linder
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gordon D Schiff
- Center for Patient Safety Research and Practice, Brigham and Women's Hospital, Boston, MA, USA
- Center for Primary Care, Harvard Medical School, Boston, MA, USA
| | - Walid F Gellad
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, USA
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Lertxundi U, Domingo-Echaburu S, Orive G. Pharmaceutical Simplification: Killing Two Birds with One Stone. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:3. [PMID: 34932349 DOI: 10.1021/acs.est.1c07178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Unax Lertxundi
- Bioaraba Health Research Institute; Osakidetza Basque Health Service, Araba Mental Health Network, Araba Psychiatric Hospital, Pharmacy Service, Vitoria-Gasteiz, Spain. c/Alava 43, 01006 Vitoria-Gasteiz, Alava, Spain
| | - Saioa Domingo-Echaburu
- Pharmacy Service, Debagoiena Integrated Health Care Organization.Arrasate, Gipuzkoa 01006, Spain
| | - Gorka Orive
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, Vitoria-Gasteiz 01006, Spain
- Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN). Vitoria-Gasteiz 01006, Spain
- University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria 01006, Spain
- Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower 168751, Singapore
- Bioaraba, NanoBioCel Research Group, Vitoria-Gasteiz 01006, Spain
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