Point-of-Care Testing for Anemia, Diabetes, and Hypertension: A Pharmacy-Based Model in Lima, Peru

Saldarriaga, Enrique M.; Vodicka, Elisabeth; Rosa, Sayda La; Valderrama, Mariano J.; García, Patricia J.

doi:10.1016/j.aogh.2017.03.514

Cited by 14 publications

(27 citation statements)

References 34 publications

(35 reference statements)

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“…Diabetes point-of-care devices could be used to transfer real time data to physicians, allowing physicians to monitor patient’s conditions and adjust treatment16 while nurses at health centres could implement the physician’s recommendations delivered with mHealth technology. Point-of-care service model of management of chronic disease conditions has been tested and found to be feasible and acceptable in other LMICs 17…”

Section: Discussionmentioning

confidence: 99%

Patients’ and healthcare providers’ perspectives of diabetes management in Cambodia: a qualitative study

et al. 2019

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ObjectiveThis study aimed to explore the challenges encountered by patients and healthcare providers and opportunities for improvement in managing diabetes mellitus (DM) in a low- and middle-income country (LMIC) facing a rise in DM prevalence.DesignQualitative cross-sectional study.SettingUrban, semiurban, and rural areas in Cambodia.ParticipantsThirty health service providers and fifty-nine adult DM patients.ResultsMost of the 59 DM patients reported having developed DM complications when they first sought treatment. The biggest challenges for the patients were geographical barriers, diet control, and shortage of medication supply. The healthcare staff expressed concerns about their limited knowledge and lack of confidence to treat diabetes, limited availability of diabetes care services, inadequate laboratory services, shortage of staff, poor patients’ compliance, and insufficient medication supplies. Both healthcare staff and patients urged an expansion of diabetes services in Cambodia and prioritisation of diabetes care in a manner similar to communicable disease control programmes of the recent past.ConclusionsCurrently, the Cambodian healthcare system has very limited capacity to provide quality care for chronic diseases. As a consequence, many patients are either left untreated or have interrupted care due to several barriers including financial, geographical, and lack of knowledge and skills. A more comprehensive and multipronged approach is urgently needed to improve DM care, which would require a collaborative effort from government, external funding agencies, private sector, and communities.

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Section: Discussionmentioning

confidence: 99%

Patients’ and healthcare providers’ perspectives of diabetes management in Cambodia: a qualitative study

et al. 2019

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“…A recent systematic review on the role of community pharmacists for the screening and management of poorly controlled asthma and chronic obstructive pulmonary disease (COPD) delineated potential roles of pharmacists in primary care: timely screening, referral of at-risk individuals to primary healthcare providers, and ongoing support and management for chronic conditions [ 19 ]. When provided adequate training, pharmacists and pharmacy workers in different settings have been shown to be valuable partners in the detection of a number of conditions including poorly controlled asthma and COPD [ 19 ] anemia, diabetes and hypertension [ 35 – 36 ]. A previous study in Peru implemented a network of trained pharmacy workers and physicians that was acceptable at the community level and was effective for the prevention and management of STIs [ 37 – 38 ].…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitudes and practices related to tuberculosis in pharmacy workers in a cross-sectional survey in El Agustino, Peru

et al. 2018

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IntroductionAlthough the worldwide incidence of tuberculosis (TB) is slowly decreasing, annual infection rates in Peru remain among the highest in the Americas. Pharmacies could play an important role in facilitating early detection of TB. However, the awareness, expertise and cooperation of pharmacy workers is fundamental. This study explored the TB-related knowledge, attitudes and practices of pharmacy workers in a district with one of the highest incidences of TB in Peru.MethodsThis cross-sectional study applied a questionnaire that was administered face to face using smartphones with one pharmacy worker at each of 45 randomly selected pharmacies in the El Agustino district of Lima, Peru.ResultsParticipants were primarily female (78%) and had an average age of 31.3 years old (range 18–57 years old). Only 11% of participants were pharmacists with complete university training. The pharmacy workers’ knowledge was adequate; however, workers had important knowledge gaps and myths regarding prevention of TB transmission. Most pharmacy workers (77%) reported they would send a client with a history of cough for more than two weeks to a healthcare center, while 23% reported they would offer them antitussive medication or antibiotics. Almost all workers reported talking with clients about diseases and reported respiratory symptoms as one of the most common causes for consultation (60%). Most participants expressed interest in learning more about TB and expanding their involvement in the fight against TB in their community.ConclusionPharmacy workers have adequate knowledge about TB. However, we identified gaps in knowledge with respect to prevention of TB transmission. Pharmacy workers commonly see patients with respiratory symptoms and some offer recommendations, including for treatment. Pharmacy workers are willing to learn more and contribute to TB control and could be a valuable asset in the control and prevention of TB in Peru. To achieve this integration of pharmacy workers into TB control and prevention, more research is needed.

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“…While in need of POC education and curricula (37), which could be adapted from Tables 3 and 4, pharmacists appear amenable to using POC tests (38), including in low- and middle-income settings (39). Future research should assess the potential for nurses, physician assistants, and other professionals to become part of POC-enabled teams.…”

Section: Public Health Implicationsmentioning

confidence: 99%

Point-Of-Care Testing Curriculum and Accreditation for Public Health—Enabling Preparedness, Response, and Higher Standards of Care at Points of Need

Kost

Zadran

et al. 2019

Front. Public Health

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Objectives: To develop awareness of benefits of point-of-care testing (POCT) education in schools of public health, to identify learning objectives for teaching POCT, to enable public health professionals and emergency responders to perform evidence-based diagnosis and triage effectively and efficiently at points of need, and to better improve future standards of care for public health practice, including in limited-resource settings and crisis situations.Methods: We surveyed all U.S. schools of public health, colleges of public health, and public health schools accredited by the Council on Education in Public Health (CEPH). We included accredited public health programs, so that all states offering public health education were represented. We analyzed survey data, public health books, and board certification guidelines. We used PubMed to identify public health curriculum papers, and assessed 2019 CEPH accreditation requirements. We merged POCT knowledge bases to design a new curriculum for teaching public health students and practitioners the principles and practice of POCT.Results: Public health curricula, certification requirements, and textbooks generally do not include POCT instruction. Only one book, Global Point of Care: Strategies for Disasters, Emergencies, and Public Health Resilience, and one online course on public health preparedness address POCT and public health intervention issues. The topic, POC HIV/HCV ED testing, appeared in one course and POC diagnostics in local clinics, in another. Papers on public health curriculum have not incorporated POCT. No curriculum addresses POCT in isolation units during quarantine, despite evidence that recent Ebola virus disease cases in the U.S. and elsewhere proved unequivocally the need for POCT. The modular learning objectives identified in this paper were customized for public health students. Public health graduates can use boot camps, online credentialing, and self-study to acquire POCT skills.Conclusions: Enhancing accreditation requirements, academic training, board certification, and field experience will generate public health healthcare professionals who will rely upon evidence-based medical decision making at points of care, including during crises when time is of the essence. A POCT-enabled public health workforce can help prevent and stop outbreaks. Public health-based medical professionals urgently need the skills necessary to perform POCT and prepare America and other nations for threats portending significant adverse medical, economic, social, and cultural impact.

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Point-of-Care Testing for Anemia, Diabetes, and Hypertension: A Pharmacy-Based Model in Lima, Peru

Cited by 14 publications

References 34 publications

Patients’ and healthcare providers’ perspectives of diabetes management in Cambodia: a qualitative study

Patients’ and healthcare providers’ perspectives of diabetes management in Cambodia: a qualitative study

Knowledge, attitudes and practices related to tuberculosis in pharmacy workers in a cross-sectional survey in El Agustino, Peru

Point-Of-Care Testing Curriculum and Accreditation for Public Health—Enabling Preparedness, Response, and Higher Standards of Care at Points of Need

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