Improving quality of non-communicable disease services at primary care facilities in middle-income countries: A scoping review

Rao, Krishna D.; Mehta, Akriti; Kautsar, Hunied; Kak, Mohini; Karem, Ghassan; Misra, Madhavi; Joshi, Harsha; Herbst, Christopher H.; Perry, Henry B.

doi:10.1016/j.socscimed.2023.115679

Cited by 4 publications

(2 citation statements)

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“…While some global studies did not find a significant difference in clinical competence confidence between public and private practitioners [ 58 , 59 ], our study revealed that pharmacists from CHCs exhibited greater confidence in conducting pharmacist clinics compared to those from private hospitals, partially due to their greater exposure to training. Studies have also shown that community pharmacists, through enhanced training, can acquire expanded expertise and knowledge [ 60 , 61 ], leading to improved service quality in primary care [ 62 , 63 ]. Future efforts should focus on establishing a more efficient learning and continued education system for community practitioners in China [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitudes, and practices of primary healthcare practitioners regarding pharmacist clinics: a cross-sectional study in Shanghai

Zhang,

Tang,

Zhang

et al. 2024

BMC Health Serv Res

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Background Pharmacist clinics offer professional pharmaceutical services that can improve public health outcomes. However, primary healthcare staff in China face various barriers and challenges in implementing such clinics. To identify existing problems and provide recommendations for the implementation of pharmacist clinics, this study aims to assess the knowledge, attitudes, and practices of pharmacist clinics among primary healthcare providers. Methods A cross-sectional survey based on the Knowledge-Attitude-Practice (KAP) model, was conducted in community health centers (CHCs) and private hospitals in Shanghai, China in May, 2023. Descriptive analytics and the Pareto principle were used to multiple-answer questions. Chi-square test, Fisher’s exact test, and binary logistic regression models were employed to identify factors associated with the knowledge, attitudes, and practices of pharmacist clinics. Results A total of 223 primary practitioners participated in the survey. Our study revealed that most of them had limited knowledge (60.1%, n = 134) but a positive attitude (82.9%, n = 185) towards pharmacist clinics, with only 17.0% (n = 38) having implemented them. The primary goal of pharmacist clinics was to provide comprehensive medication guidance (31.5%, n = 200), with medication education (26.3%, n = 202) being the primary service, and special populations (24.5%, n = 153) identified as key recipients. Logistic regression analysis revealed that education, age, occupation, position, work seniority, and institution significantly influenced their perceptions. Practitioners with bachelor’s degrees, for instance, were more likely than those with less education to recognize the importance of pharmacist clinics in medication guidance (aOR: 7.130, 95%CI: 1.809–28.099, p-value = 0.005) and prescription reviews (aOR: 4.675, 95% CI: 1.548–14.112, p-value = 0.006). Additionally, practitioners expressed positive attitudes but low confidence, with only 33.3% (n = 74) feeling confident in implementation. The confidence levels of male practitioners surpassed those of female practitioners (p-value = 0.037), and practitioners from community health centers (CHCs) exhibited higher confidence compared to their counterparts in private hospitals (p-value = 0.008). Joint physician-pharmacist clinics (36.8%, n = 82) through collaboration with medical institutions (52.0%, n = 116) emerged as the favored modality. Daily sessions were preferred (38.5%, n = 86), and both registration and pharmacy service fees were considered appropriate for payment (42.2%, n = 94). The primary challenge identified was high outpatient workload (30.9%, n = 69). Conclusions Although primary healthcare practitioners held positive attitudes towards pharmacist clinics, limited knowledge, low confidence, and high workload contributed to the scarcity of their implementation. Practitioners with diverse sociodemographic characteristics, such as education, age, and institution, showed varying perceptions and practices regarding pharmacist clinics.

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Section: Discussionmentioning

confidence: 99%

Knowledge, attitudes, and practices of primary healthcare practitioners regarding pharmacist clinics: a cross-sectional study in Shanghai

Zhang,

Tang,

Zhang

et al. 2024

BMC Health Serv Res

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“…Of all NCD-related deaths, 80% occur in low- and middle-income countries. Moreover, tobacco use, unhealthy diets, the consumption of food with a high saturated fat content, and a lack of exercise are also factors affecting the onset of NCDs or can be the main cause of NCD development [ 2 , 3 ]. Alcohol consumption is also a major factor affecting the development of NCDs almost everywhere, and it also worsens the conditions of people who already have them [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Potential of Pectin and Its Derivatives in Chronic Diseases

Dambuza,

Rungqu,

Oyedeji

et al. 2024

Molecules

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Non-communicable diseases (NCDs) are described as a collection of chronic diseases that do not typically develop from an acute infection, have long-term health effects, and frequently require ongoing care and therapy. These diseases include heart disease, stroke, cancer, chronic lung disease, neurological diseases, osteoporosis, mental health disorders, etc. Known synthetic drugs for the treatment or prevention of NCDs become increasingly dangerous over time and pose high risks due to side effects such as hallucination, heart attack, liver failure, etc. As a result, scientists have had to look for other alternatives that are natural products and that are known to be less detrimental and contain useful bioactive compounds. The increasing understanding of the biological and pharmacological significance of carbohydrates has helped to raise awareness of their importance in living systems and medicine, given they play numerous biological roles. For example, pectin has been identified as a class of secondary metabolites found in medicinal plants that may play a significant role in the treatment and management of a variety of NCDs. Pectin is mainly made of homogalacturonan, which is a linear polymer composed primarily of D-galacturonic acid units (at least 65%) linked in a chain by α-(1,4)-glycosidic linkages. There are also modified pectins or derivatives that improve pectin’s bioavailability. Pectin is found in the cell walls of higher plants (pteridophytes, angiosperms, and gymnosperms), particularly in the middle lamella of the plant material. Citrus pectin is used in various industries. This article compiles information that has been available for years about the therapeutic importance of pectin in chronic diseases, different modes of pectin extraction, the chemistry of pectin, and the potency of pectin and its derivatives.

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