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Miyashita M, Obara T, Ishikuro M, Kikuya M, Kuriyama S. Association between Recurrence or Exacerbation at Time of Disaster and Allergic Symptoms Several Years Later in Schoolchildren with Asthma or Atopic Dermatitis: The ToMMo Child Health Study. TOHOKU J EXP MED 2022; 257:23-32. [PMID: 35387905 DOI: 10.1620/tjem.2022.j018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University.,Tohoku University Hospital
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University.,Teikyo University School of Medicine
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University.,Tohoku University International Research Institute of Disaster Science
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Alvarez-Gutiérrez FJ. Asthma control and adherence to clinical practice guidelines: Mission impossible? Rev Clin Esp 2021; 221:230-232. [PMID: 32197781 DOI: 10.1016/j.rce.2019.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 12/26/2019] [Accepted: 12/27/2019] [Indexed: 11/30/2022]
Affiliation(s)
- F J Alvarez-Gutiérrez
- Unidad de Asma, Unidad Médico-Quirúrgica de Enfermedades Respiratorias (UMQER), Hospital Universitario Virgen del Rocío, Sevilla, España.
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Roman-Rodriguez M, Molina-Paris J, Fernandez-Sanchez A. Compliance with the clinical guidelines for managing asthma by primary care physicians: An ambispective observational study. Rev Clin Esp 2021; 221:207-216. [PMID: 32151431 DOI: 10.1016/j.rce.2019.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/23/2019] [Accepted: 11/02/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. MATERIAL AND METHODS We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. RESULTS Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3-30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4-33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13-0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12-0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40-2.06). CONCLUSIONS Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines.
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Affiliation(s)
- M Roman-Rodriguez
- Centro de Salud Son Pisa, Instituto de Investigación Sanitaria de Baleares, Palma de Mallorca, Baleares, España.
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Alvarez-Gutiérrez FJ. Asthma control and adherence to clinical practice guidelines: mission impossible? Rev Clin Esp 2021; 221:230-232. [PMID: 33998504 DOI: 10.1016/j.rceng.2019.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/27/2019] [Indexed: 10/22/2022]
Affiliation(s)
- F J Alvarez-Gutiérrez
- Unidad de Asma, Unidad Médico-Quirúrgica de Enfermedades Respiratorias (UMQER), Hospital Universitario Virgen del Rocio, Sevilla, Spain.
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Roman-Rodriguez M, Molina-Paris J, Fernandez Sanchez A. Compliance with the clinical guidelines for managing asthma by primary care physicians: An ambispective observational study. Rev Clin Esp 2020; 221:207-216. [PMID: 33998499 DOI: 10.1016/j.rceng.2019.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/02/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. MATERIAL AND METHODS We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. RESULTS Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3-30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4-33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13-0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12-0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40-2.06). CONCLUSIONS Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with a better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines.
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Affiliation(s)
- M Roman-Rodriguez
- Centro de Salud Son Pisa, Instituto de Investigación Sanitaria de Baleares, Palma de Mallorca, Baleares, Spain.
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Alrasheed AA, Alzufairi DA, Al-Alanda AM, Kamel MI, El-Shazly MK. Knowledge, attitude and practice of physicians and nurses toward peak expiratory flow meter in primary health care centers in Kuwait. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2011.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
| | | | | | - Mohamed I. Kamel
- Community Medicine Department, Faculty of Medicine , Alexandria University , Egypt
- Department of Occupational Medicine, Ministry of Health , Kuwait
| | - Medaht K. El-Shazly
- Department of Medical Statistics, Medical Research Institute , Alexandria University , Egypt
- Department of Health Information and Medical Records, Ministry of Health , Kuwait
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Laforest L, Belhassen M, Devouassoux G, Didier A, Ginoux M, Van Ganse E. Long-Term Inhaled Corticosteroid Adherence in Asthma Patients with Short-Term Adherence. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 4:890-899.e2. [PMID: 27587320 DOI: 10.1016/j.jaip.2016.07.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/19/2016] [Accepted: 07/20/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although the use of inhaled corticosteroids (ICS) in asthma is known to be overall erratic, the long-term use of ICS by patients selected during an episode of regular use is poorly documented. OBJECTIVE In a cohort of patients with asthma regularly acquiring ICS therapy over several months, we verified whether these patients remained treated in the following 12 months. The correlates of regular ICS use over this period were investigated. METHODS A historical cohort of patients with asthma was identified from the Echantillon généraliste de bénéficiaires national French health care reimbursement data (2007-2012). Patients (6-40 years) were selected during a regular ICS use episode, with 3 or more ICS refills within 120 days. Continuous multiple-interval measures of medication availability (CMA) were computed for the 12 months after the third dispensation, and the factors associated with a CMA value of 80% or more (adherent patients) were identified. RESULTS Among 5096 patients (42.1% children/teenagers, 48.8% females), only 24.0% had a CMA value of 80% or more (mean CMA = 54.4%) over the 12 months following the ICS selection period. Achieving a CMA value of 80% or more was primarily associated with being a child/teenager (P = .002), having more severe or less controlled asthma (P = .007), more previous dispensing of short-acting beta agonists (P < .0001), and receiving devices with 200 unit doses (P < .0001). Adherent patients had more frequent general practitioner visits (P < .0001), more distinct prescribers of respiratory therapy (P = .0002), and more frequent switches of ICS (P < .0001). CONCLUSIONS Most patients with asthma selected during an episode of regular ICS use did not maintain therapy over the following months. Adherence should be repeatedly monitored, and the reasons for discontinuation should be investigated, at prescriber and patient levels.
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Affiliation(s)
- Laurent Laforest
- PELyon, Lyon, France; HESPER, EA 7425, Health Services and Performance Research, Université Claude Bernard, Lyon, France
| | - Manon Belhassen
- PELyon, Lyon, France; HESPER, EA 7425, Health Services and Performance Research, Université Claude Bernard, Lyon, France
| | | | - Alain Didier
- Respiratory Medicine, Larrey University Hospital, Toulouse, France
| | - Marine Ginoux
- HESPER, EA 7425, Health Services and Performance Research, Université Claude Bernard, Lyon, France
| | - Eric Van Ganse
- PELyon, Lyon, France; HESPER, EA 7425, Health Services and Performance Research, Université Claude Bernard, Lyon, France; Respiratory Medicine, Croix Rousse University Hospital, Lyon, France.
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Imamura Y, Kawayama T, Kinoshita T, Sakazaki Y, Yoshida M, Takahashi K, Fujii K, Ando M, Hoshino T, Iwanaga T, Kohrogi H, Nakanishi Y, Mukae H, Watanabe K, Hayashi S, Kadota J, Ii T, Inoue H, Tochigi T, Fujita J, Nakamura H. Poor pharmacological adherence to inhaled medicines compared with oral medicines in Japanese patients with asthma and chronic obstructive pulmonary disease. Allergol Int 2017; 66:482-484. [PMID: 27887878 DOI: 10.1016/j.alit.2016.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/05/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022] Open
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Whalley D, Petigara T, Rasouliyan L, Tobe K, Tunceli K. Early patient experiences with montelukast orally disintegrating tablets in Japan: a cross-sectional survey of treatment satisfaction in patients with asthma and/or allergic rhinitis. Curr Med Res Opin 2017; 33:215-223. [PMID: 27764975 DOI: 10.1080/03007995.2016.1251891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Orally disintegrating tablets (ODTs) offer a valuable treatment option, particularly when swallowing solid tablets with water is difficult or inconvenient. Montelukast is an effective treatment for asthma and allergic rhinitis (AR), and an ODT formulation became available in Japan in 2015. This study investigated levels of satisfaction with this new formulation among adults with asthma and/or AR in Japan. METHODS Patients aged 20 years or older who were refilling a prescription for montelukast ODT in pharmacies across Japan completed questions on satisfaction with key features of montelukast ODT and the 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9). Study variables were analyzed descriptively. Factors associated with TSQM-9 global satisfaction and convenience domain scores were examined using analysis of covariance. RESULTS Of the 201 patients who participated, 89.6% reported overall satisfaction with montelukast ODT. Overall satisfaction was highest in patients with AR only (94.7% satisfied) or with asthma and AR (90.2% satisfied), and in patients with treatment duration <4 weeks (98.5% satisfied). Mean TSQM-9 global satisfaction and convenience domain scores were 58.9 and 66.7, respectively; scores were higher for patients with both asthma and AR and for those with longer disease duration. Overall ease of taking and dissolving speed were most closely associated with TSQM-9 global satisfaction scores, and ability to take without water and taste were most closely associated with TSQM-9 convenience scores. LIMITATIONS The generalizability of the findings was limited by the convenience sample and the descriptive, single-arm study design. The study was limited to adults with asthma and/or AR. CONCLUSION Montelukast ODT may be an acceptable dosage formulation for adults with mild-to-moderate asthma and/or AR in Japan. Satisfaction was high, particularly with respect to tablet size, dissolving speed, taste, and ease of taking.
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Affiliation(s)
- Diane Whalley
- a RTI Health Solutions , Manchester , United Kingdom
| | - Tanaz Petigara
- b Merck & Co. Inc. , Kenilworth , NJ , United States of America
| | | | | | - Kaan Tunceli
- b Merck & Co. Inc. , Kenilworth , NJ , United States of America
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Des Cormiers A, Légaré F, Simard S, Boulet LP. Decisional conflict in asthma patients: a cross sectional study. J Asthma 2015; 52:1084-91. [PMID: 26291135 DOI: 10.3109/02770903.2015.1047955] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed at determining the level of decisional conflict in asthmatic individuals facing recommendation-based decisions provided to improve asthma control. METHODS This was a cross-sectional study performed on a convenience sample of 50 adults aged between 18 and 65 years with a diagnosis of asthma. They completed a decisional conflict scale (possible range of 0-100%), asthma knowledge and control questionnaires (both 0% and 100%), and a general questionnaire on socio-demographic characteristics. A decisional conflict was considered clinically significant with a score greater than 37.5%. Simple descriptive statistics were used to investigate associations with decisional conflict. RESULTS Participants were mainly women (76%) and diagnosed with mild asthma (72%). The median age (1st and 3rd quartile) was 25 years (22 and 42). The median score (1st and 3rd quartile) of decisional conflict was 33% (24 and 44). A clinically significant score (>37.5%) was obtained in 36% of subjects. A statistically significant negative correlation between the knowledge score and the decisional conflict score (r(p) = -0.38; p = 0.006) was observed. The level of knowledge was the only statistically independent variable associated with the decisional conflict score (p = 0.0043). CONCLUSIONS A considerable proportion of patients with asthma have a clinically significant level of decisional conflict when facing decisions aimed at improving asthma control. Patients with poor knowledge of asthma are more at risk of clinically significant level of decisional conflict. These findings support the relevance of providing asthmatic patients with relevant information in decision aids.
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Affiliation(s)
- Annick Des Cormiers
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ), Knowledge Transfer, Education and Prevention Chair on Respiratory and Cardiovascular Health , Québec (Québec) , Canada and
| | - France Légaré
- b Centre de recherche du Centre hospitalier universitaire de Québec (CRCHUQ), Knowledge Transfer and Health Technology Assessment Research Group, Hôpital St-François D'Assise , Québec (Québec) , Canada
| | - Serge Simard
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ), Knowledge Transfer, Education and Prevention Chair on Respiratory and Cardiovascular Health , Québec (Québec) , Canada and
| | - Louis-Philippe Boulet
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (CRIUCPQ), Knowledge Transfer, Education and Prevention Chair on Respiratory and Cardiovascular Health , Québec (Québec) , Canada and
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Dima AL, Hernandez G, Cunillera O, Ferrer M, de Bruin M. Asthma inhaler adherence determinants in adults: systematic review of observational data. Eur Respir J 2014; 45:994-1018. [PMID: 25504997 DOI: 10.1183/09031936.00172114] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Nonadherence to inhaled medication leads to poor asthma control and increased healthcare utilisation. Many studies exploring adherence determinants have been conducted, but summaries of the evidence are scarce. We performed a systematic review of observational research on determinants of asthma inhaler adherence among adults. We searched for articles in English reporting quantitative observational studies on inhaler adherence correlates among adults in developed countries, published in EMBASE, Medline, PsychInfo and PsychArticles in 1990-2014. Two coders independently assessed eligibility and extracted data, and assessed study quality. Results were summarised qualitatively into social and economic, and healthcare-, therapy-, condition- and patient-related factors. The 51 studies included mainly examined patient-related factors and found consistent links between adherence and stronger inhaler-necessity beliefs, and possibly older age. There was limited evidence on the relevance of other determinants, partly due to study heterogeneity regarding the types of determinants examined. Methodological quality varied considerably and studies performed generally poorly on their definitions of variables and measures, risk of bias, sample size and data analysis. A broader adoption of common methodological standards and health behaviour theories is needed before cumulative science on the determinants of adherence to asthma inhalers among adults can develop further.
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Affiliation(s)
- Alexandra L Dima
- Dept of Communication Science, ASCoR, University of Amsterdam, Amsterdam, The Netherlands.
| | - Gimena Hernandez
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), Barcelona, Spain. Dept of Paediatrics, Obstetrics and Gynaecology and Preventative Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Oriol Cunillera
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Montserrat Ferrer
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), Barcelona, Spain. Dept of Paediatrics, Obstetrics and Gynaecology and Preventative Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Marijn de Bruin
- Dept of Communication Science, ASCoR, University of Amsterdam, Amsterdam, The Netherlands. Aberdeen Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Van Steenis MNA, Driesenaar JA, Bensing JM, Van Hulten R, Souverein PC, Van Dijk L, De Smet PAGM, Van Dulmen AM. Relationship between medication beliefs, self-reported and refill adherence, and symptoms in patients with asthma using inhaled corticosteroids. Patient Prefer Adherence 2014; 8:83-91. [PMID: 24470757 PMCID: PMC3895030 DOI: 10.2147/ppa.s44185] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Beliefs play a crucial role in medication adherence. Interestingly, the relationship between beliefs and adherence varies when different adherence measures are used. How adherence, in turn, is related to asthma symptoms is still unclear. Our aim was to investigate the relationship between beliefs (ie, necessities and concerns) about inhaled corticosteroids (ICS) and subjectively as well as objectively measure adherence and the agreement between these measures. Further, the relationship between adherence and asthma symptoms was examined. METHODS A total of 280 patients aged 18-80 years who filled at least two ICS prescriptions in the preceding year were recruited to complete a questionnaire. The questionnaire included the Beliefs about Medicines Questionnaire to assess necessity beliefs and concerns about ICS, four questions about ICS use to measure self-reported adherence, and the Asthma Control Questionnaire to assess asthma symptoms. Proportion of days covered was used to determine pharmacy refill adherence. RESULTS Data from 93 patients with asthma were analyzed. Necessities were positively related to self-reported adherence (P = 0.01). No other associations were found between beliefs and subjective or objective adherence. There was no correlation between self-reported and refill adherence. Participants were significantly (P < 0.001) less adherent according to self-report data (24.4%) than according to pharmacy data (57.8%). No relationship was found between adherence and asthma symptoms. CONCLUSION Higher necessities are associated with higher self-reported adherence, suggesting that it could be more important to focus on necessities than on concerns in an attempt to improve adherence. Self-reported and refill adherence measurements cannot be used interchangeably. No relationship between adherence and asthma symptoms was found.
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Affiliation(s)
- MNA Van Steenis
- Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - JA Driesenaar
- NIVEL (Netherlands institute for health services research), Utrecht, The Netherlands
- Correspondence: JA Driesenaar, NIVEL (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, The Netherlands, Tel +31 3 0272 9707, Email
| | - JM Bensing
- NIVEL (Netherlands institute for health services research), Utrecht, The Netherlands
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | - R Van Hulten
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands
| | - PC Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands
| | - L Van Dijk
- NIVEL (Netherlands institute for health services research), Utrecht, The Netherlands
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands
| | - PAGM De Smet
- IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - AM Van Dulmen
- NIVEL (Netherlands institute for health services research), Utrecht, The Netherlands
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Health Sciences, Buskerud University College, Drammen, Norway
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Hajia AM, Mohammed FA, Al-Saqer MA, Kamel MI, El-Shazly MK. Knowledge, attitude and practice of nurses toward peak expiratory flow meter in primary health care centers in Kuwait. ALEXANDRIA JOURNAL OF MEDICINE 2011. [DOI: 10.1016/j.ajme.2011.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Ali M. Hajia
- Ali Sabah Al-Salem Health Center, Ministry of Health , Kuwait
| | | | | | - Mohamed I. Kamel
- Department of Occupational Medicine, Ministry of Health , Kuwait
- Community Medicine Department, Faculty of Medicine , Alexandria University , Egypt
| | - Medhat K. El-Shazly
- Department of Health Information and Medical Records, Ministry of Health , Kuwait
- Department of Medical Statistics, Medical Research Institute , Alexandria University , Egypt
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