The role of hospitals in strengthening primary health care in the Western Pacific

Freijser, Louise; Annear, Peter Leslie; Tenneti, Naveen; Gilbert, Katherine; Chukwujekwu, Ogochukwu; Hazarika, Indrajit; Mahal, Ajay

doi:10.1016/j.lanwpc.2023.100698

Cited by 5 publications

(11 citation statements)

References 18 publications

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“…4 Second, hospitals can help supply frontline primary care services. 2 For example, psychiatrists and other mental health professionals can institute training programs for primary care providers in rural localities in assessing and managing common mental disorders found in Philippine community settings, such as Schizophrenia. For instance, the WHO Mental Health Gap Action Programme (mHGAP) intervention guide, an evidence-based manual, can be implemented by hospital psychiatrists in training primary care physicians.…”

Section: Dear Editormentioning

confidence: 99%

“… 1 In this paper, I argue and underscore the possible roles of hospitals in strengthening mental health services in primary care that can be considered in LMICs to expand mental health services to rural areas. I utilize the framework of hospital roles in primary care by Freijser et al, 2 which includes direct primary care service delivery, improving the supply of frontline primary care services, integrating different levels of health care, and adopting a population-health focus. Finally, I situate my arguments based on another LMICs with similar conditions, the Philippines.…”

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confidence: 99%

“… 3 It only has about 0.52 psychiatrists, 0.07 psychologists, and 0.49 mental health nurses per 100,000 individuals, who are unequally distributed. 2 , 3 For instance, the majority of psychiatrists are located in Metro Manila. 3 Thus, there is a need to strengthen mental health services in primary care since there is a limited number of specialists and underdeveloped community-based services.…”

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confidence: 99%

“…First, hospitals can provide direct care to people suffering from mental disorders by conducting community-based programs expanding from mental health promotion to assessment and management. 2 For instance, hospitals with psychiatry residency programs can set up community-based psychiatry rotations at primary care centers in rural areas to assist primary physicians in assessing and managing psychiatric patients. They can also conduct mental health promotion and education activities.…”

mentioning

confidence: 99%

“…Lastly, hospitals can promote continuity of care across the different levels of healthcare and population health by integrating their follow-up consultations and management with primary care services. 2 For instance, long-acting injectable medications may be administered in primary care settings. Hospital and primary care electronic charts can also be integrated to provide seamless access to medical history and management.…”

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confidence: 99%

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The Roles of Hospitals in Strengthening Mental Health Services in Primary Care in Low- and Middle-Income Countries: Reflections From the Philippines

Alibudbud

2023

Health�Serv�Insights

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Section: Dear Editormentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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The Roles of Hospitals in Strengthening Mental Health Services in Primary Care in Low- and Middle-Income Countries: Reflections From the Philippines

Alibudbud

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The impact of pharmacist interventions, follow-up frequency and default on glycemic control in Diabetes Medication Therapy Adherence Clinic program: a multicenter study in Malaysia

Chang

Ching

Hanafiah³

2023

J of Pharm Policy and Pract

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Background Pharmacist’s involvement in optimizing medication adherence among diabetic patients has been implemented for over a decade. Diabetes Medication Therapy Adherence Clinic (DMTAC) was set up to educate diabetic patients, monitor treatment outcomes, and manage drug-related problems. While evidence shows that pharmacist-led DMTAC was effective in reducing HbA1c, there was limited data regarding the impact of different intervention types and default to follow-up on glycemic control. Aim To assess the impact DMTAC on glycemic control and the difference in glycemic control between hospital and health clinic settings as well as defaulter and non-defaulter. In addition, the impact of pharmacist’s interventions, DMTAC follow-up frequencies, and duration of diabetes on glycemic control were also determined. Methods A retrospective study was conducted among diabetes patients under DMTAC care between January 2019 and June 2020 in five hospitals and 23 primary health clinics. Patients’ demographics data, treatment regimens, frequencies of DMTAC visits, defaulter (absent from DMTAC visits) and types of pharmacists’ intervention were retrieved from patients’ medical records and electronic database. HbA1c was collected at baseline, 4–6 months (post-1), and 8–12 months (post-2). Results We included 956 patients, of which 60% were females with a median age of 58.0 (IQR: 5.0) years. Overall, the HbA1c reduced significantly from baseline (median: 10.2, IQR: 3.0) to post-1 (median: 8.8, IQR: 2.7) and post-2 (median: 8.3, IQR: 2.6%) (p < 0.001). There were 4317 pharmacists’ interventions performed, with the majority being dosage adjustment (n = 2407, 55.8%), followed by lab investigations (849, 19.7%), drugs addition (653, 15.1%), drugs discontinuation (408, 9.5%). Patients treated in hospitals received significantly more interventions than those treated in primary health clinics (p < 0.001). We observed significantly less reduction in HbA1c in DMTAC follow-up defaulters than non-defaulters after 1 year (− 1.02% vs. − 2.14%, p = 0.001). Frequencies of DMTAC visits (b: 0.19, CI: 0.079–0.302, p = 0.001), number of dosage adjustments (b: 0.83, CI: 0.015–0.151, p = 0.018) and number of additional drugs recommended (b: 0.37, CI: 0.049–0.691, p = 0.024) had positive impact on glycemic control whereas duration of diabetes (b: − 0.0302, CI: − 0.0507, − 0.007, p = 0.011) had negative impact. Conclusion Glycemic control improved significantly and sustained up to one year among patients in pharmacists-led DMTAC. However, DMTAC defaulters experienced poorer glycemic control. Considering more frequent visits and targeted interventions by pharmacists at DMTAC resulted in improved HbA1c control, these strategies should be taken into account for future program planning.

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Analisis Kebutuhan Pasien Rawat Jalan Pada Pelayanan Kesehatan Primer: Studi Kasus Puskesmas Induk Kamaipura

Kareba,

Sudirman,

et al. 2023

Jurnal Manajemen Kesehatan Indonesia

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According to Law Number 36 of 2009 concerning Health, Article 5, paragraph 2 states that everyone has an equal right to access resources in the health sector and obtain safe, quality, and affordable health services. Health services in Primary Health Care involve two parties, so Assessing the quality of service should involve both the perspective of the Primary health care and the patients. This study aims to measure the aspects most needed by the community in outpatient health services at Pprimary Health Care using service quality indicators. The study uses a quantitative descriptive approach with a factor analysis design. The study was conducted at the Kamaipura Main Primary Health Care, Sigi Regency, Central Sulawesi Province, in 2022. The variables in this study include tangibility, responsiveness, reliability, assurance, and empathy. Data collection was carried out through observations, with the population and sample consisting of all patients who used outpatient services at the Kamaipura Primary Health Care totaling 228 people. Outpatients have two levels of needs divided into two components. Variables are grouped into components based on the highest correlation. The first component consists of variables such as reliability, assurance, tangible, and responsiveness. Variables in the first component can be prioritized as follows: 1) Responsiveness, 2) Tangible, 3) Assurance, 4) Reliability. In conclusion All aspects of healthcare services, such as Reliability, Assurance, Tangible, Empathy, and Responsiveness, are primary needs for outpatient patients. The analysis indicates that Responsiveness, Tangible, Assurance, and Reliability need improvement.

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The role of hospitals in strengthening primary health care in the Western Pacific

Cited by 5 publications

References 18 publications

The Roles of Hospitals in Strengthening Mental Health Services in Primary Care in Low- and Middle-Income Countries: Reflections From the Philippines

The Roles of Hospitals in Strengthening Mental Health Services in Primary Care in Low- and Middle-Income Countries: Reflections From the Philippines

The impact of pharmacist interventions, follow-up frequency and default on glycemic control in Diabetes Medication Therapy Adherence Clinic program: a multicenter study in Malaysia

Analisis Kebutuhan Pasien Rawat Jalan Pada Pelayanan Kesehatan Primer: Studi Kasus Puskesmas Induk Kamaipura

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