Association of Age, Gender, Deprivation, Urbanicity, Ethnicity, and Smoking with a Positive Test for COVID-19 in an English Primary Care Surveillance Network: Cross Sectional Study of the First 500 Cases

2020 ◽  
Author(s):  
Simon de Lusignan ◽  
Jienchi Dorward ◽  
Ana Correa ◽  
Nicholas Jones ◽  
Oluwafunmi Akinyemi ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Positive Test ◽  
Sectional Study ◽  
Surveillance Network ◽  
Cross Sectional

scholarly journals Cross sectional study of the clinical characteristics of French primary care patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paul Sebo ◽  
Benoit Tudrej ◽  
Julie Lourdaux ◽  
Clara Cuzin ◽  
Martin Floquet ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Identification ◽  
Clinical Characteristics ◽  
Diagnostic Performance ◽  
Cross Sectional Study ◽  
Positive Test ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Care Patients

AbstractThe early identification of patients suffering from SARS-CoV-2 infection in primary care is of outmost importance in the current pandemic. The objective of this study was to describe the clinical characteristics of primary care patients who tested positive for SARS-CoV-2. We conducted a cross-sectional study between March 24 and May 7, 2020, involving consecutive patients undergoing RT-PCR testing in two community-based laboratories in Lyon (France) for a suspicion of COVID-19. We examined the association between symptoms and a positive test using univariable and multivariable logistic regression, adjusted for clustering within laboratories, and calculated the diagnostic performance of these symptoms. Of the 1561 patients tested, 1543 patients (99%) agreed to participate. Among them, 253 were positive for SARS-CoV-2 (16%). The three most frequently reported ‘ear-nose-throat’ and non-‘ear-nose-throat’ symptoms in patients who tested positive were dry throat (42%), loss of smell (36%) and loss of taste (31%), respectively fever (58%), cough (52%) and headache (45%). In multivariable analyses, loss of taste (OR 3.8 [95% CI 3.3–4.4], p-value < 0.001), loss of smell (OR 3.0 [95% CI 1.9–4.8], p < 0.001), muscle pain (OR 1.6 [95% CI 1.2–2.0], p = 0.001) and dry nose (OR 1.3 [95% CI 1.1–1.6], p = 0.01) were significantly associated with a positive result. In contrast, sore throat (OR 0.6 [95% CI 0.4–0.8], p = 0.003), stuffy nose (OR 0.6 [95% CI 0.6–0.7], p < 0.001), diarrhea (OR 0.6 [95% CI 0.5–0.6], p < 0.001) and dyspnea (OR 0.5 [95% CI 0.3–0.7], p < 0.001) were inversely associated with a positive test. The combination of loss of taste or smell had the highest diagnostic performance (OR 6.7 [95% CI 5.9–7.5], sensitivity 44.7% [95% CI 38.4–51.0], specificity 90.8% [95% CI 89.1–92.3]). No other combination of symptoms had a higher performance. Our data could contribute to the triage and early identification of new clusters of cases.

scholarly journals Clinical characteristics of SARS-CoV-2 patients: a French cross-sectional study in primary care

2020 ◽  
Author(s):  
Paul Sebo ◽  
Benoit Tudrej ◽  
Julie Lourdaux ◽  
Clara Cuzin ◽  
Martin Floquet ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Identification ◽  
Participation Rate ◽  
Cross Sectional Study ◽  
Positive Test ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smell Disorders ◽  
Taste And Smell

Abstract Background: The early identification of patients suffering from SARS-CoV-2 infection in primary care is of outmost importance in the current pandemic.Aim: To gain a better understanding of the specific symptoms of SARS-CoV-2 infection in primary care.Design and setting: We conducted a cross-sectional study between March 24 and May 7, 2020, involving consecutive patients undergoing RT-PCR testing in two community-based laboratories in Lyon (France) for a suspicion of COVID-19.Methods: We examined the association between various symptoms and a positive test using univariate and multivariate logistic regression, adjusted for clustering within the laboratories.Results: Of the 1561 patients tested, 1543 agreed to participate (participation rate: 99%). Among them, 253 were positive for SARS-Cov-2 (16%). In multivariate analysis, loss of taste (OR 3.8 [95%CI 3.3-4.4], p-value<0.001), loss of smell (OR 3.0 [95%CI 1.9-4.8], p-value<0.001), muscle pain (OR 1.6 [95%CI 1.2-2.0], p-value 0.001) and dry nose (OR 1.3 [95%CI 1.1-1.6], p-value 0.01) were significantly associated with a positive result. The strength of association with taste and smell disorders was higher for symptom combinations (OR 6.5 [95%CI 3.9-10.8] for loss of taste and smell, OR 6.7 [95%CI 5.9-7.5] for loss of taste or smell). In contrast, sore throat (OR 0.6 [95%CI 0.4-0.8], p-value 0.003), stuffy nose (OR 0.7 [95%CI 0.6-0.7], p-value<0.001), diarrhea (OR 0.6 [95%CI 0.5-0.6], p-value<0.001) and dyspnea (OR 0.5 [95%CI 0.3-0.7], p-value<0.001) were inversely associated with a positive test.Conclusion: Our data could further facilitate targeted screening and contribute to the triage and early identification of new clusters of cases.

scholarly journals Representativeness of patients and providers in the Canadian Primary Care Sentinel Surveillance Network: a cross-sectional study

CMAJ Open ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. E28-E32 ◽  
Author(s):  
J. A. Queenan ◽  
T. Williamson ◽  
S. Khan ◽  
N. Drummond ◽  
S. Garies ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Sentinel Surveillance ◽  
Sectional Study ◽  
Surveillance Network ◽  
Cross Sectional

Portuguese Patient Dignity Question: A cross-sectional study of palliative patients cared for in primary care

2020 ◽  
Vol 18 (6) ◽  
pp. 658-661
Author(s):  
Mafalda Lemos Caldas ◽  
Miguel Julião ◽  
Ana João Santos ◽  
Harvey Max Chochinov
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Clinical Tool ◽  
Cross Sectional ◽  
Old Patients ◽  
Promising Tool ◽  
Palliative Patients

AbstractIntroductionThe Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness.ObjectiveTo study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC).MethodA cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed.ResultsTwenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary.Significance of resultsThe PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.

scholarly journals Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044372
Author(s):  
Mat Nawi Zanaridah ◽  
Mohd Noor Norhayati ◽  
Zakaria Rosnani
Keyword(s):  
Primary Care ◽  
Evidence Based Medicine ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Sectional Study ◽  
Primary Care Practitioner ◽  
Cross Sectional ◽  
Primary Care Practitioners ◽  
Based Medicine

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.

scholarly journals Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046638
Author(s):  
Sk Masum Billah ◽  
Abdullah Nurus Salam Khan ◽  
S M Rokonuzzaman ◽  
Nafisa Lira Huq ◽  
Marufa Aziz Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Workers ◽  
Gestational Hypertension ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Care Facilities

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.

scholarly journals Obstetric Violence in Spain (Part III): Healthcare Professionals, Times and Areas

2021 ◽  
Vol 18 (7) ◽  
pp. 3359
Author(s):  
Desirée Mena-Tudela ◽  
Susana Iglesias-Casás ◽  
Víctor Manuel González-Chordá ◽  
María Jesús Valero-Chillerón ◽  
Laura Andreu-Pejó ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Informed Consent ◽  
Healthcare Professionals ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lack Of Information ◽  
Obstetric Violence

Background: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. Methods: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. Results: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and “other” professionals repeatedly appeared. Conclusions: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System’s structure and management but also on healthcare professionals’ training.

scholarly journals Development and validation of a Japanese version of the Patient Centred Assessment Method and its user guide: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037282
Author(s):  
Rieko Mutai ◽  
Yoshifumi Sugiyama ◽  
Shuhei Yoshida ◽  
Ryoko Horiguchi ◽  
Takamasa Watanabe ◽  
...  
Keyword(s):  
Primary Care ◽  
Factor Analysis ◽  
Japanese Version ◽  
Well Being ◽  
Cross Sectional Study ◽  
Assessment Method ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vas Scores ◽  
Patient Complexity

ObjectivesThe primary objective of this study was to develop the Japanese version of the Patient Centred Assessment Method (PCAM) and its user guide. The secondary objective was to examine the validity and reliability in the primary care setting.DesignCross-sectional study.SettingThree family physician teaching clinics located in urban residential areas in Tokyo, Japan.ParticipantsPatients who were aged 20 years or older, and who had an appointment with physicians at the three participating clinics.Main outcome measuresPatient complexity measured by PCAM and complexity/burden level measured by a Visual Analogue Scale (VAS).ResultsAlthough confirmatory factor analysis using a model described in a previous study revealed that the indices did not meet the criteria for good fit, exploratory factor analysis revealed a new three-factor structure of ‘Personal well-being,’ ‘Social interaction’ and ‘Needs for care/service.’ Cronbach’s alpha of PCAM was 0.86. Spearman’s rank correlation coefficients between PCAM scores and VAS scores were 0.51 for complexity (p<0.001) and 0.41 for burden (p<0.001). There were 42 patients (14.3% of total patients) with PCAM scores greater than its mean of 16.5 but with complexity VAS scores less than its mean of 20.8.ConclusionsThe Japanese version of PCAM and its user guide were developed through Japanese translation and cultural adaptation by cognitive debriefing. PCAM is a valid and reliable tool to assess patient complexity in the primary care settings in Japan. Additionally, although the correlation between total PCAM scores and complexity/burden as assessed by VAS was moderate, PCAM can more precisely identify patient complexity than skilled physician’s intuition.

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