Professionals of family health team professionals against gestacional syphilis in a municipality of northeast Brazil

This study had as objective to evaluate the care regarding syphilis provided by the professionals of the family health teams during prenatal consultations. For this purpose, a structured questionnaire was applied to physicians and nurses working in the health units located in the urban and rural areas of the municipality of Nossa Senhora do Socorro, in Sergipe, and the results presented using simple descriptive statistics. It was found that 76.2% of the interviewees use the Pregnant Women's Manual during prenatal consultations, adequately recognizing each stage of the disease and the drug therapy to be instituted, but treatment is not started immediately due to a lack of medication in the unity. The interviewees (81%) carried out an active search of pregnant women who were absent from prenatal consultations, but 52.4% presented a strategy to attract their partners. It is concluded that the health professionals against syphilis have the knowledge, but they can not act in an effective way, making it necessary to discuss the knowledge and performance of these professionals, guaranteeing access to training. The need for improvements by health management is also emphasized in order to make the municipality's approach to syphilis more specific and qualified, increasing the chances of eradicating the disease.

Integrating Services for People Who Use Opioids in a Rural Primary Care Setting: The ROOT Program

In response to an emerging substance use crisis in rural Ontario, a Family Health Team initiated the Rural Outpatient Opioid Treatment program. This program includes access to an interdisciplinary team, opioid agonist therapy, counselling, and peer support. Patients report they appreciate the “seamless” integration of medical, social, and peer support.

53 Implementation of a Developmental Outreach Clinic housed within a Family Health Team - preliminary findings in building a shared care model for children and youth with mental health and developmental disorders

Background At our inner city hospital, we developed a shared care model between family health teams (FHTs), pediatricians and developmental pediatricians to care for children with mental health and developmental disorders. In phase one of our study, 84 FHT members participated in focus groups to inform the development of our clinic. Family physicians described their role as “referral agent”, “long term supporter” and “healthcare coordinator”. They expressed the desire to “learn” and “do more”, but noted barriers to providing care, including limited training, lack of service knowledge, limited communication, and cumbersome access to mental health and dual diagnosis services. Phase One was completed and accepted for publication. Phase Two describes the implementation of our clinic using a mixed methods approach and report preliminary findings. Objectives To evaluate the first two years of implementation of the developmental clinic housed within a family health team (FHT) an obtain feedback from members of the shared care model. Design/Methods Mixed methods were used including chart review of all patients referred to the clinic and semi structured interviews with primary care physicians, pediatricians and developmental pediatricians regarding their roles in managing children with developmental and mental health disorders, as well as use and impact of the developmental clinic. Results A total of 115 charts were reviewed between Feb 2016 and Jan 2018. Of all patients seen, 34% were female 64% male and 2% transgender. Ages ranged from 1-17 years. Eighty-one percent had an existing diagnosis and were referred for re-assessment while 43% received a new diagnosis: ASD (72%), ADHD (11%), GDD (11%), learning disorder (3%), Anxiety (1%), Other (1%). There was an 8% no show rate. Providers endorsed improved communication through use of a shared EMR for documentation and messaging, and improved service knowledge through availability of a pediatric service navigator who also used EMR to document service and funding applications. Longer term follow up, namely the roles and responsibilities of pediatrics vs. developmental pediatrics vs. primary care remained unclear. Conclusion Implementation of the shared care model for this population with primary care is feasible, and does address some stated barriers to care, including improved communication, increased service knowledge, and provision of reassessments. Further areas to develop include clarifying the roles and responsibilities of the different healthcare providers of children with mental health and developmental disorders, and determining what is needed for long-term follow up and transitional care.

The Impact of a Primary Care, Pharmacist-Driven Intervention in Patients with Chronic Non-Cancer Pain—A Pilot Study

Background: Chronic pain is a prevalent condition, experienced by 15.3% to 55% of Canadians, that is difficult to manage. With their broad accessibility and expertise on drugs, primary care pharmacists can help patients optimize their pain management. Methods: The objective of this study is to examine the effectiveness of a primary care, pharmacist-driven chronic pain intervention on pain and quality of life in patients with chronic non-cancer pain. A three-month naturalistic prospective study was conducted in primary care settings (five community pharmacies and one Family Health Team) across Ontario, Canada with a total of six pharmacists and 19 study participants. The primary care, pharmacist-driven chronic pain intervention consisted of patient assessments, medication reviews, care plan recommendations, and patient education. In order to evaluate the effectiveness of the intervention, pain intensity, pain interference, and quality of life were evaluated at baseline and at follow up (week 2 and month 3). Results: Trends towards improvement in pain and quality of life were found, however, these improvements were not statistically significant at follow up (month 3). Conclusions: This study provides the foundational research required to better understand the impact of Ontario pharmacists’ extended role in pain management in non-cancer patients within multiple primary care settings (e.g., Family Health Team, etc.) and has illustrated the importance of modifying and customizing care plans in patients with chronic pain. A larger sample size with tailored outcome measures may be necessary to better highlight significant improvements in pain and quality of life in patients with chronic non-cancer pain using a primary care, pharmacist-driven intervention.

A qualitative study on the implementation of Family Health Team: the perspectives of providers and patients

Background: Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept. The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of non-communicable disease[I1] prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention.Methods: In-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. A total of 121 individuals in the two rounds, split into different groups, where some of the participants of the FGD were also interviewed individually[I2] . Data were analysed using a thematic analysis, with codes being organised into larger themes.Results: Themes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings. Conclusions: The FHT concept implemented at 20 public primary health clinics has benefits appreciated by health care providers and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability.Trial registration: The study is registered with the National Medical Research Register, Ministry of Health Malaysia (NMRR-17-295-34771).

Perception of the Family Health Team on the care of drug user

RESUMO Estudo com objetivo de compreender a percepção da equipe da Estratégia Saúde da Família sobre o cuidado a usuários de drogas. Trata-se de estudo fenomenológico na abordagem de Maurice Merleau-Ponty, realizado com nove profissionais de uma Unidade de Saúde da Família no interior da Bahia, Brasil, no período de janeiro a março de 2012, por meio da entrevista aberta relacionada com a leitura de Desenhos-Estória com Tema produzidos pelos próprios participantes. A compreensão das descrições ocorreu mediante a técnica Analítica da Ambiguidade, que originou dois eixos temáticos: a crença na existência de um espaço de inserção próprio do usuário de drogas; e a crença de que o usuário está fora da sociedade. Assim, olhar o usuário como quem olha de fora, sem se entrelaçar com ele, contribui para a segregação e a exclusão social, o que requer dos profissionais a suspensão de teses que sustentam no campo do uso de drogas e a ressignificação da forma como veem e cuidam do usuário de drogas e sua família.

A qualitative study on the implementation of Family Health Team: the perspectives of providers and patients

Background: Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept (FDC). The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of NCD prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention. Methods: In-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. We explored their views on the design and plans for the intervention, the process, acceptance, adoption, feasibility and sustainability of the intervention, as well as patients’ awareness and understanding of the FHT implementation. Results: Themes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings. Conclusions: The FHT concept implemented at 20 public primary health clinics has benefits appreciated by HCPs and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability. Trial registration: The study is registered with the National Medical Research Register, Ministry of Health Malaysia (NMRR-17-295-34771).