OBJECTIVES: A lack of physician training is a major obstacle for effective tobacco dependence treatment. This study assessed the feasibility of an active learning training program and its effects on smoking cessation counselling skills of medical residents in Armenia, an Eastern European country with high smoking prevalence. STUDY DESIGN: The study used a pre-post assessment of smoking cessation counselling activities and a course evaluation survey to assess the feasibility of the intervention in a different environment. METHODS: We adapted an active learning training model developed in Switzerland. Residents were trained in Yerevan, Armenia, using video-taped counselling sessions, role plays, standardized patients (actors), group discussions and immediate feedback. The training evaluation was done using a semi-structured anonymous questionnaire. The study assessed the physicians' self-reported smoking cessation counselling activities before and 6 months after the training. A non-parametric Mann-Whitney test was used to assess pre-post differences in physicians' counselling skills measured on ordinal scale. RESULTS: Of the 37 residents trained, 75% were female, 89% aged 20-29 years and 83% were never-smokers. Twenty-eight trainees (76%) returned the course evaluation survey and 32 (86%) answered a questionnaire on skills self-assessment at 6 months follow-up. The majority agreed the course was successful in achieving its learning objectives (64%-96%) and increased their confidence in assisting their patients to quit (74%). After 6 months, the physicians were more likely than at baseline to adhere to evidence-based counselling strategies, including assessing the smoking status and dependence and matching the advice to the patient motivation. The training did not, however, improve the prescription of tobacco dependence medications. CONCLUSIONS: Six months after the training, several self-reported smoking cessation counselling activities had significantly improved compared to baseline. This training model is acceptable for medical residents in Yerevan, Armenia and offers a promising approach in addressing the lack of physician counselling skills in similar settings and populations.
- MeSH
- Adult MeSH
- Program Evaluation MeSH
- Education, Medical, Continuing methods organization & administration statistics & numerical data MeSH
- Smokers psychology MeSH
- Physicians statistics & numerical data MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Smoking Cessation methods MeSH
- Patient Simulation MeSH
- Counseling education statistics & numerical data MeSH
- Tobacco Use Disorder diagnosis therapy MeSH
- Problem-Based Learning methods organization & administration statistics & numerical data MeSH
- Surveys and Questionnaires statistics & numerical data MeSH
- Feasibility Studies MeSH
- Models, Educational MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Armenia MeSH
Cieľ štúdie: Použiť metódu mystery shopping pri vzdelávaní študentov farmácie s cieľom sledovať, ako sa odporúčania o správnej dispenzácii a poradenstve realizujú vo verejných lekárňach na Slovensku. Použité metódy: 54 študentov Farmaceutickej fakulty Univerzity Komenského v Bratislave bolo edukovaných počas vzdelávacieho projektu o dispenzácii a poradenstve o OTC lieku a súčasne na úlohu mystery shopperov. Pre zvolenú tému poradenstva (prechladnutie, nádcha) sa vypracovali dva scenáre (priama požiadavka lieku a požiadavka na liečbu podľa symptómov ochorenia). Sledovali sme 3 kategórie poradenskej činnosti (identifikácia pacienta, dispenzačné informácie a komunikácia). Položky týchto kategórií sme hodnotili skórovaním (áno/nie), v prípade komunikácie to bola 5-stupňová Likertova škála (1 – výborná; 5 – nedostatočná) a opísali ich deskriptívnymi ukazovateľmi. Celkové skóre poradenstva sme vyjadrili ako váženú priemernú percentuálnu úspešnosť uvedených troch oblastí a ich váh (0–100 %). Pri analýze prediktorov úspešnosti poradenstva sme použili participačný model (p < 0,005). Všetky údaje sme získali anonymným spôsobom. Výsledky: Mystery shopping vykonali študenti v 270 lekárňach v 42 slovenských mestách. Celkové skóre poradenstva všetkých lekární dosiahlo úspešnosť 39,0 ± 22,4 %; identifikácia pacienta 30,6 ± 28,7 %; dispenzačné informácie 39,8 ± 25,1 % a komunikácia 74,3 ± 11,5 %. Pri takmer polovici návštev expedienti identifikovali pacienta a symptómy ochorenia. Z dispenzačných informácií sa až v 70 % návštev podali informácie o dávkovaní a o cene lieku. Bezpečnosti liečby sa nevenovala dostatočná pozornosť. Pozitívne sa vyhodnotila zrozumiteľnosť rozhovoru a očný kontakt. Spôsob poradenstva (p = 0,008), trvanie poradenstva (p = 0,022), expedient a vek expedienta (obidve s p < 0,001) boli signifikantnými prediktormi úspešnosti poradenstva. Záver: Práca poukazuje na možnosť použitia metódy mystery shopping ako inovácie pri vzdelávaní študentov farmácie a ako objektívneho spôsobu sledovania dispenzačnej a poradenskej činnosti vo verejných lekárňach.
Objective of study: To use the mystery shopping method in the education of pharmacy students considering how recommendations for good dispensing and counselling have implemented in community pharmacies in Slovakia. Methods: Fifty-four students of the Faculty of Pharmacy at Comenius University in Bratislava were educated during the special training on dispensing and counselling about the OTC medicine and for the role of mystery shoppers. Two scenarios (product-based request and symptom-based) were developed for the selected topic of counselling (common cold). Three categories of counselling (patient identification, dispensation information, and communication) were described. The items of these categories were evaluated by scoring (yes/no), in the case of communication it was the Likert scale with 5 points (1 – excellent; 5 – poor) and they were described by descriptive variables. The total counselling score was expressed as the weighted mean percentage success rate of the three categories and their weight (0–100 %). We used the participatory model (p < 0.005) to analyse the predictors of the total counselling score. All data was obtained in an anonymous manner. Results: Students performed mystery shopping in 270 pharmacies in 42 Slovak cities. The total counselling score for all pharmacies reached 39.0 ± 22.4 %, patient identification 30.6 ± 28.7 %, dispensation information 39.8 ± 25.1 % and communication 74.3 ± 11.5 %. The counsellors identified the patient and the symptoms of the illness in almost half of the visits. From dispensation information, up to 70 % of visits they provided the information on the dosage and price of the medicine. The safety of treatment has not given sufficient attention. Clarity of counselling and eye contact were positively evaluated. The counselling type (p = 0.008), the counselling duration (p = 0.022), expedient and expedient age (both with p < 0.001) were significant predictors of the counselling success. Conclusion: The study highlights the possibility of using the mystery shopping method as an innovation in the education of pharmacy students and as an objective method of monitoring dispensing and counselling in community pharmacies.
- Keywords
- mystery shopping, marketingový výzkum, dispenzace,
- MeSH
- Data Analysis MeSH
- Nonprescription Drugs MeSH
- Humans MeSH
- Marketing * methods education MeSH
- Counseling classification methods statistics & numerical data education MeSH
- Education, Pharmacy, Graduate * methods trends MeSH
- Community Pharmacy Services statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Slovakia MeSH
BACKGROUND: General practitioners play a fundamental role in combatting the current epidemic of physical inactivity, and pedometer-based walking interventions are able to increase physical activity levels of their patients. Supplementing these interventions with email counseling driven by feedback from the pedometer has the potential to further improve their effectiveness but it has to be yet confirmed in clinical trials. Therefore, the aim of our pilot randomized controlled trial is to evaluate the feasibility and potential efficacy of future trials designed to assess the additional benefit of email counseling added to a pedometer-based intervention in a primary care setting. METHODS: Physically inactive patients were opportunistically recruited from four general practices and randomized to a 12-week pedometer-based intervention with or without email counseling. To explore the feasibility of future trials, we assessed the speed and efficiency of recruitment, adherence to wearing the pedometer, and engagement with email counseling. To evaluate the potential efficacy, daily step-count was the primary outcome and blood pressure, waist and hip circumference, and body mass were the secondary outcomes. Additionally, we conducted a qualitative analysis of structured interviews with the participating general practitioners. RESULTS: The opportunistic recruitment has been shown to be feasible and acceptable, but relatively slow and inefficient; moreover, general practitioners selectively recruited overweight and obese patients. Patients manifested high adherence, wearing the pedometer on 83% (± 20) of days. All patients from the counseling group actively participated in email communication and responded to 46% (± 22) of the emails they received. Both groups significantly increased their daily step-count (pedometer-plus-email, + 2119, p = 0.002; pedometer-alone, + 1336, p = 0.03), but the difference between groups was not significant (p = 0.18). When analyzing both groups combined, there was a significant decrease in body mass (- 0.68 kg, p = 0.04), waist circumference (- 1.73 cm, p = 0.03), and systolic blood pressure (- 3.48 mmHg, p = 0.045). CONCLUSIONS: This study demonstrates that adding email counseling to a pedometer-based intervention in a primary care setting is feasible and might have the potential to increase the efficacy of such an intervention in increasing physical activity levels. TRIAL REGISTRATION: The trial was retrospectively registered at ClinicalTrials.gov (ID: NCT03135561 , date: April 26, 2017).
- MeSH
- Actigraphy instrumentation MeSH
- Walking physiology MeSH
- Adult MeSH
- Electronic Mail statistics & numerical data MeSH
- Program Evaluation MeSH
- Middle Aged MeSH
- Humans MeSH
- Pilot Projects MeSH
- Health Promotion methods MeSH
- Counseling statistics & numerical data MeSH
- General Practice * MeSH
- Aged MeSH
- Feasibility Studies MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- MeSH
- Hotlines statistics & numerical data utilization MeSH
- Communication MeSH
- Pharmacies statistics & numerical data trends utilization MeSH
- Humans MeSH
- Counseling methods statistics & numerical data utilization MeSH
- Postal Service utilization MeSH
- Telephone statistics & numerical data utilization MeSH
- Check Tag
- Humans MeSH
This article presents a retrospective case-note review of patients diagnosed and hospitalized with acquired syphilis between January 1999 and December 2005 performed at the two Departments of Dermatovenereology in Prague. The syphilis epidemic in the Czech Republic between 1994 and 2001 now seems to be declining. The high rates of immigration from Eastern Europe, unprotected sex, and prostitution provide the basis for an epidemic of sexually transmitted infections. Early identification of infected individuals and high-risk population groups, adequate treatment, partner notification, and treatment of infected partners therefore is essential.
- MeSH
- Adult MeSH
- Disease Outbreaks statistics & numerical data MeSH
- Financing, Organized MeSH
- HIV Seropositivity epidemiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Counseling statistics & numerical data MeSH
- Prevalence MeSH
- Primary Prevention statistics & numerical data MeSH
- Sex Work statistics & numerical data MeSH
- Retrospective Studies MeSH
- Risk-Taking MeSH
- Unsafe Sex statistics & numerical data MeSH
- Sexually Transmitted Diseases MeSH
- Sexual Partners MeSH
- Syphilis epidemiology prevention & control MeSH
- Contact Tracing MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Geographicals
- Czech Republic MeSH
Znalost pacientů o perorálních monokomponentních OTC přípravcích s obsahem ibuprofenu, kterési kupují pro sebe, byla hodnocena ve vztahu k tomu, jakým způsobem probíhala komunikacefarmaceut (farm. laborant) – pacient při výdeji v lékárně. Odpovědi respondentů byly zpracoványzvlášť pro skupinu těch, kteří si kupují přípravek poprvé, a těch, kteří ho již dříve pro samoléčenípoužívali. Znalost kontraindikací a nežádoucích účinků (posuzováno odděleně) byla zjištěna v obouskupinách respondentů vyšší než 50 %. Pacienti, kteří užívají přípravek opakovaně, však udávajísoučasnou neznalost nežádoucích účinků a kontraindikací jen 32,2 %, oproti novým uživatelům(60,0 %). Pacienti, kteří neznají ani kontraindikace ani nežádoucí účinky kupovaného přípravku, sipřesto myslí, že mají dostatek informací k tomu, aby jejich samoléčení bylo bezpečné (88,9 %opakovaných a 80,0 % nových uživatelů). Přibližně čtvrtina respondentů v obou hodnocených skupináchuvádí, že při výdeji nedostali v lékárně žádnou informaci. Pacienti přistupují k nákupu OTCpřípravku pasivně a téměř ve 40 % nevyužívají možnosti sami se na potřebné informace zeptat.Informace získané v lékárně považuje téměř 85 % respondentů z obou skupin za dostatečné. Farmaceuti(farm. laboranti) při výdeji OTC přípravku ve 45 % případů nezjišťují, zda pacient jižpřípravek užíval a zda o něm má nějaké znalosti. Úroveň poradenství při samoléčení by se v ČRměla zefektivnit.
Knowledge of patients about oral single-component OTC preparations containing ibuprofen, boughtfor their own use,was evaluated in relation to the manner of the process of communication betweenthe pharmacist (laboratory assistant) – patient during the supply at the pharmacy. The answers ofrespondents were processed separately for the group of those who bought the preparation for thefirst time and those who had already used it for self-medication. The knowledge of contraindicationsand undesirable effects (judged separately) was found to be higher than 50 % in both groups ofrespondents. Nevertheless, the patients who use the preparation repeatedly state simultaneousignorance of undesirable effects and contraindications only in 32.2 %, in contrast to the new users(60.0 %). The patients who know neither contraindications nor undesirable effects of the preparationwhich they buy nevertheless think that they have enough information so that their self-medicationcan be safe (88.9 % of patients using the preparation repeatedly and 80.0 % of new users).Approximately a quarter of respondents in both groups under evaluation state that during thesupply in the pharmacy they were not given any piece of information. Patients are passive whenbuying an OTC preparation and nearly 40 % of them do not use the opportunity to ask for pertinentinformation themselves. Nearly 85 % of respondents from both groups consider information gainedfrom the pharmacy to be sufficient. When supplying an OTC preparation, in 45 % of casespharmacists (laboratory assistants) do not inquire whether the patient have already used thepreparation, or whether he or she knows anything about it. The standard of counselling onself-medication in the Czech Republic should thus become more effective.
- Keywords
- APO-IBUPROFEN, BRUFEN, NUROFEN,
- MeSH
- Ibuprofen therapeutic use MeSH
- Drug Information Services statistics & numerical data trends MeSH
- Pharmaceutical Preparations standards MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Counseling statistics & numerical data trends MeSH
- Self Medication adverse effects statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
- Keywords
- peer program,
- MeSH
- Acquired Immunodeficiency Syndrome * prevention & control MeSH
- Hotlines statistics & numerical data MeSH
- Humans MeSH
- Health Promotion methods statistics & numerical data MeSH
- Counseling statistics & numerical data MeSH
- Needle-Exchange Programs organization & administration statistics & numerical data MeSH
- Unsafe Sex prevention & control statistics & numerical data MeSH
- Sex Education organization & administration statistics & numerical data MeSH
- Schools organization & administration statistics & numerical data MeSH
- Preventive Health Services methods organization & administration statistics & numerical data MeSH
- Social Work methods organization & administration statistics & numerical data MeSH
- HIV Testing statistics & numerical data MeSH
- Age Factors MeSH
- Health Risk Behaviors MeSH
- Health Services statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Publication type
- Tables MeSH
- MeSH
- Acquired Immunodeficiency Syndrome * economics epidemiology transmission prevention & control MeSH
- Hotlines statistics & numerical data MeSH
- Humans MeSH
- Health Promotion methods statistics & numerical data MeSH
- Counseling statistics & numerical data MeSH
- HIV Testing statistics & numerical data MeSH
- Health Education methods statistics & numerical data MeSH
- Health Services statistics & numerical data MeSH
- Check Tag
- Humans MeSH
