SummaryWhat is known and objective: Polypharmacy has a significant impact on patients' health with overall expenditure on over-the-counter (OTC) medicines representing a substantial burden in terms of cost of treatment. The aim of this study, which was conducted within the framework of a European Project funded by the European Union under the Seventh Framework Programme and was entitled OTC-SOCIOMED, was to report on possible determinants of patient behaviour regarding the consumption of medicines, and particularly OTCs, in the context of primary care.Methods: A multicentre, cross-sectional study was designed and implemented in welldefined primary healthcare settings in Cyprus, the Czech Republic, France, Greece, Malta and Turkey. Patients completed a questionnaire constructed on the basis of the theory of planned behaviour (TPB), which was administered via face-to-face interviews.

BackgroundIrrational prescribing of over-the-counter (OTC) medicines in general practice is common in Southern Europe. Recent findings from a research project funded by the European Commission (FP7), the “OTC SOCIOMED”, conducted in seven European countries, indicate that physicians in countries in the Mediterranean Europe region prescribe medicines to a higher degree in comparison to physicians in other participating European countries. In light of these findings, a feasibility study has been designed to explore the acceptance of a pilot educational intervention targeting physicians in general practice in various settings in the Mediterranean Europe region.MethodsThis feasibility study utilized an educational intervention was designed using the Theory of Planned Behaviour (TPB). It took place in geographically-defined primary care areas in Cyprus, France, Greece, Malta, and Turkey. General Practitioners (GPs) were recruited in each country and randomly assigned into two study groups in each of the participating countries. The intervention included a one-day intensive training programme, a poster presentation, and regular visits of trained professionals to the workplaces of participants. Reminder messages and email messages were, also, sent to participants over a 4-week period. A pre- and post-test evaluation study design with quantitative and qualitative data was employed. The primary outcome of this feasibility pilot intervention was to reduce GPs’ intention to provide medicines following the educational intervention, and its secondary outcomes included a reduction of prescribed medicines following the intervention, as well as an assessment of its practicality and acceptance by the participating GPs.ResultsMedian intention scores in the intervention groups were reduced, following the educational intervention, in comparison to the control group. Descriptive analysis of related questions indicated a high overall acceptance and perceived practicality of the intervention programme by GPs, with median scores above 5 on a 7-point Likert scale.ConclusionsEvidence from this intervention will estimate the parameters required to design a larger study aimed at assessing the effectiveness of such educational interventions. In addition, it could also help inform health policy makers and decision makers regarding the management of behavioural changes in the prescribing patterns of physicians in Mediterranean Europe, particularly in Southern European countries.

Purpose of review To present an overview of the impact of idiopathic pulmonary fibrosis (IPF) on patients’ emotional well being and quality of life (QoL). Recent findings IPF is an interstitial lung disease which causes irreversible, progressive lung scarring in a pathological pattern of usual interstitial pneumonia. The incidence of IPF is increasing at a global level, subjecting an increasing number of people to its high morbidity and risk of mortality. Diagnosis is based on a multidisciplinary team approach and the exclusion of other interstitial lung diseases. Two novel antifibrotic treatments, pirfenidone and nintedanib, were recently approved by regulatory agencies around the globe, thus providing many IPF patients with treatment options for the first time. Several other drugs have entered the investigational pipeline, including many in early-phase or late-phase clinical trials. Given the incurable and progressive nature of IPF, even with antifibrotic therapy, depression and anxiety are common among patients; these and burdensome symptoms of breathlessness, cough and fatigue are factors that impact patients’ emotional well being and QoL. In addition to even more effective drugs, there is a need for psychosocial interventions and mental health support strategies focused on improving patients’ QoL so they are better equipped to live with this devastating condition. Summary The current article highlights the effects of IPF on patients’ emotional well being and QoL and offers suggestions for strategies to help patients with IPF live as well as possible in their daily lives.

Background. In Greece, both Primary Health Care (PHC) system and National Health System (NHS) in general, were plagued by several inefficiencies even prior to the financial crisis; the imposed austerity measures dramatically worsened the level of health provision and access, especially for vulnerable social groups, resulting in an exacerbation of existing disparities and access gaps.  Aim and methods. The current branch study was conducted in two regions of Greece, namely Crete and Epirus, with the main aim of eliciting responses to gather baseline information regarding crucial PHC-related aspects, using questionnaires with dichotomous questions. Directors or managers (physicians who have been assigned administrative/governance duties), of the Primary Health Care Centres (PHCCs) in two Greek geographic and administrative regions of Crete and Epirus, were invited to participate and to contribute to the investigation of issues on the provision of prevention and health promotion services, e-health topics and primary care research. Thirty directors/managers were approached and twenty-eight agreed to participate. Data processing and analysis of the responses was performed for the completed questionnaires.   Results. Data analysis did not demonstrate a surprisingly substantial deviation in the average score of positive responses of directors/managers in the PHCCs of Crete in comparison to those of directors/managers in the PHCCs of Epirus. The findings show that several gaps exist in terms of prevention and health promotion resources and activities in both regions, while e-health, electronic health record (EHR) and telemedicine services are poorly developed.  Conclusion. The study confirms that the Greek PHC is characterized by several inefficiencies, which may affect the quality of the services provided. An overall deficit has been emerged for PHCCs in both regions, a fact that indicates crucial points lacking in terms of overall PHC provision, thus adversely impacting upon living conditions, health quality and prevention.  

Background: The economic crisis’ effects on suicide rates for countries undergoing or exiting austerity measures have been widely debated. This integrative review aimed to identify, appraise, and synthesize available evidence of employment status effect on suicide mortality rates in Greece during the recent economic recession period. Methods: A literature review of studies evaluating suicides in the general Greek population, as well as across age and gender groups, in relation to employment during the economic crisis period was performed. PubMed electronic database was searched for relevant articles published in English or Greek language from 2009 up to February 2020. Appraisal was carried out based on the Hierarchy of Evidence Rating System and the GRADE guidelines. Results: A total of 24 articles met all inclusion criteria with 20 of them at level IV, 2 at level VII, and 2 at level VIII. A total of 18 studies reported increase of suicide rates during the economic recession period. About 12 studies examined the co-relation between unemployment and suicide rate, with ten studies showing a positive correlation. Moreover, thirteen studies reported data on the effect of gender and age variables on suicide rates. Conclusion: Evidence shows that suicide mortality rates in Greece increased after the eruption of economic recession, particularly after the implementation of radical austerity measures (2011–2014). This increase was positively correlated with unemployment and was more prominent among males of working age. Further in depth epidemiological research of regional variations in terms of profile and contributing or enabling factors of suicidal behavior is needed.