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Routine Medical Check-Up and Self-Treatment Practices among Community-Dwelling Living in a Mountainous Area of Northern Vietnam. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8734615. [PMID: 33977109 PMCID: PMC8087461 DOI: 10.1155/2021/8734615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/11/2021] [Accepted: 04/17/2021] [Indexed: 11/17/2022]
Abstract
This study was conducted to evaluate the routine medical check-up and self-treatment behaviors of people living in a remote and mountainous setting in Northern Vietnam and identify their associations. A cross-sectional study was conducted on 175 people in August 2018 in Cao Son commune, Da Bac district, Hoa Binh. Information regarding routine medical check-ups and self-treatment behaviors was collected by using a structured questionnaire. Multivariate logistic regression was used to examine the associations. Results show that 24% of the mountainous people had routine medical check-ups in the last 12 months. The rate of self-treatment in the past three months was 33.7%. The number of chronic diseases (OR = 1.5, 95% CI = 1.0-2.3), health information sources from radio/television (OR = 3.3, 95% CI = 1.2-9.5), or social media (OR = 24.8, 95% CI = 1.2-512.4) was related to routine medical check-up. People who did not have routine medical check-up were more likely to have self-treatment practice (OR = 6.3, 95% CI = 1.9-21.1) than those who had a regular health check. Promoting health education and communication through mass media to raise people's awareness about regular health check-ups is a promising way to improve people's self-treatment status.
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Grauman Å, Hansson M, James S, Hauber B, Veldwijk J. Communicating Test Results from a General Health Check: Preferences from a Discrete Choice Experiment Survey. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 14:649-660. [PMID: 33778921 PMCID: PMC8357669 DOI: 10.1007/s40271-021-00512-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Health checks can detect risk factors and initiate prevention of cardiovascular diseases but there is no consensus on how to communicate the results. The aim of this study was to investigate the preferences of the general population for communicating health check results. METHODS A randomly selected sample of the Swedish population aged 40-70 years completed a discrete choice experiment survey that included questions on sociodemographics, lifestyle and health and 15 choice questions consisting of six attributes (written results, notification method, consultation time, waiting time, lifestyle recommendation and cost). Data were analyzed with a latent class analysis (LCA). Relative importance of the attributes and predicted uptake for several scenarios were estimated. RESULTS In the analysis, 432 individuals were included (response rate 29.6%). A three-class LCA model best fit the data. Cost was the most important attribute in all classes. Preferences heterogeneity was found for the other attributes; in Class 1, receiving consultation time and the written results were important, respondents in Class 2 dominated on costs and respondents in Class 3 found consultation time, waiting time and lifestyle recommendations to be important. Health literate respondents were more likely to belong to Class 3. The predicted uptake rates ranged from 7 to 88% for different health checks with large differences across the classes. CONCLUSION Cost was most important when deciding whether to participate in a health check. Although cost was the most important factor, it is not sufficient to offer health checks free-of-charge if other requirements regarding how the test results are communicated are not in place; participants need to be able to understand their results.
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Affiliation(s)
- Åsa Grauman
- Centre for Research Ethics and Bioethics, Uppsala University, Box 564, 751 22, Uppsala, Sweden.
| | - Mats Hansson
- Centre for Research Ethics and Bioethics, Uppsala University, Box 564, 751 22, Uppsala, Sweden
| | - Stefan James
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | - Brett Hauber
- Pfizer, Inc., New York, NY, USA
- The Comparative Health Outcomes, Policy and Economics (CHOICE) Institute, University of Washington School or Pharmacy, Seattle, WA, USA
| | - Jorien Veldwijk
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
- Erasmus Choice Modelling Centre, Erasmus University, Rotterdam, The Netherlands
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Gauld NJ, Baumgärtel CA, Buetow SA. Why are self-medication opportunities limited in Austria? An interview study and comparison with other countries. PLoS One 2021; 16:e0245504. [PMID: 33493218 PMCID: PMC7833129 DOI: 10.1371/journal.pone.0245504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/31/2020] [Indexed: 11/18/2022] Open
Abstract
Background Austria has high health resource use compared to similar countries. Reclassifying (switching) medicines from prescription to non-prescription can reduce pressure on health resources and aid timely access to medicines. Since Austria is less progressive in this area than many other countries, this research aimed to elucidate enablers and barriers to it reclassifying medicines and make recommendations for change in the context of similar research conducted elsewhere. Methods Qualitative research using a heuristic approach was conducted in Austria in 2018. Informed by their own “insider” and “outsider” knowledge, the authors identified themes from personal interviews with 24 participants, including reclassification committee members, government officials and stakeholders, before comparing these themes with earlier research findings. Results Significant barriers to reclassification included committee conservatism, minimal political support, medical negativity and few company applications. Insufficient transparency about committee decisions, expectations of adverse committee decisions and a limited market discouraged company applications. Austria’s ‘social partnership’ arrangement and consensus decision making aided a conservative approach, but the regulator and an alternative non-committee switch process were enabling. Pharmacy showed mixed interest in reclassification. Suggested improvements include increasing transparency, committee composition changes, encouraging a more evidence-based approach by the committee, more pharmacy undergraduate clinical training, and companies using scientific advisory meetings and submitting high quality applications. Conclusion Removing barriers to reclassification would facilitate non-prescription availability of medicines and encourage self-care, and could reduce pressure on healthcare resources.
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Affiliation(s)
- Natalie J. Gauld
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Christoph A. Baumgärtel
- Austrian Federal Office for Safety in Health Care, BASG/Austrian Agency for Health and Food Safety, AGES, Vienna, Austria
| | - Stephen A. Buetow
- Department of General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand
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Sommer I, Titscher V, Szelag M, Gartlehner G. What are the Relevant Outcomes of the Periodic Health Examination? A Comparison of Citizens' and Experts' Ratings. Patient Prefer Adherence 2021; 15:57-68. [PMID: 33500615 PMCID: PMC7823095 DOI: 10.2147/ppa.s281466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/04/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Despite evidence from clinical guideline development that physicians and patients show discordance in what they consider important in outcome selection and prioritization, it is unclear to what extent outcome preferences are concordant between experts and citizens when it comes to the context of primary prevention. Therefore, the objective of this study was to assess whether expert judgments about the importance of beneficial and harmful outcomes differ from citizen preferences when considering intervention options for a periodic health examination (PHE) program. PARTICIPANTS AND METHODS We conducted an online survey using a modified Delphi approach. The target population for the survey consisted of citizens who had attended the PHE (n=18) and experts who made evidence-based recommendations (n=11). Citizens and experts assigned a score on a 9-point Likert scale for each outcome of 14 interventions. We analyzed the intragroup agreement based on Krippendorff's alpha and the intergroup agreement using the cube root product measure (CRPm). We further tested for significant differences between the groups using the Mann U-test. RESULTS Agreements within the groups of citizens and experts varied across the interventions and tended to be poor (α ≤0 to 0.20) or fair (α = 0.21 to 0.40), with three exceptions showing moderate agreement (α = 0.44 to 0.55). The agreements between the citizens and experts across the interventions was fair (CRPm = 0.28) during the first Delphi rating round. The mean differences between the citizens and experts on the Likert scale ranged from 0.0 to 3.8 during the first rating round and from 0.0 to 3.3 during the second. Across interventions, the citizens rated the outcomes as more important than the experts did (p<0.01). Individual participants' ratings varied substantially. CONCLUSION Because experts generally underestimated the outcomes' importance to citizens, the involvement of citizens in guideline panels for preventive services is important.
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Affiliation(s)
- Isolde Sommer
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems, Austria
- Correspondence: Isolde Sommer Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, Krems3500, AustriaTel +43 (0)2732 893-2927Fax +43 (0)2732 893-4910 Email
| | - Viktoria Titscher
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Monika Szelag
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Gerald Gartlehner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems, Austria
- RTI International, Research Triangle Park, Raleigh, NC, USA
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Sommer I, Titscher V, Teufer B, Klerings I, Nußbaumer-Streit B, Szelag M, Affengruber L, Wagner G, Glechner A, Kien C, Ebenberger A, Schiller-Frühwirth I, Dorner TE, Siebenhofer A, Haditsch B, Bachler H, Siebert U, Gartlehner G. [Evidence-based recommendations for the revision of the Austrian periodic health examination]. Wien Med Wochenschr 2019; 169:339-349. [PMID: 31187373 DOI: 10.1007/s10354-019-0699-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/15/2019] [Indexed: 12/27/2022]
Abstract
The Austrian periodic health examination (PHE) was introduced in 1974 as a health insurance benefit and was redesigned for the last time in 2005. Therefore, the aim of this work was to revise the scientific basis of the PHE using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We updated the scientific evidence of examinations and consultations that are currently part of the PHE and searched and integrated new examinations. We assessed the expectations of the population towards the PHE in three focus groups. A panel of experts developed evidence-based recommendations for the revised PHE. They formulated 26 recommendations on 20 target diseases or risk factors. In comparison to the previous PHE, the panel added screening for abdominal aortic aneurysm, osteoporotic fracture risk, and chronic kidney disease to the recommendations, while screening for asymptomatic bacteriuria, screening for iron deficiency/pernicious anaemia, and risk identification of glaucoma should no longer be included.
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Affiliation(s)
- Isolde Sommer
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich.
| | - Viktoria Titscher
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Birgit Teufer
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Irma Klerings
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Barbara Nußbaumer-Streit
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Monika Szelag
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Lisa Affengruber
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Gernot Wagner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Anna Glechner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Christina Kien
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Agnes Ebenberger
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | | | - Thomas E Dorner
- Zentrum für Public Health, Abteilung für Sozial- und Präventivmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Andrea Siebenhofer
- Institut für Allgemeinmedizin und evidenzbasierte Versorgungsforschung, Medizinische Universität Graz, Graz, Österreich.,Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt am Main, Deutschland
| | | | | | - Uwe Siebert
- Institut für Public Health, Medical Decision Making und Health Technology Assessment, UMIT - Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall i.T., Österreich.,Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gerald Gartlehner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich.,Research Triangle Institute International, Raleigh, NC, USA
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