Publications by authors named "Radost Assenova"

Background: The adoption of healthy self-care practices has proven necessary for professional life, as they often serve as a shield against stressors in the workplace. The COVID-19 pandemic created a high strain on general practitioners (GPs), contributing to increased workload, burnout, and anxiety. The present study aimed to identify self-care practices adopted by GPs amid the COVID-19 pandemic; and to explore the relationships between self-care practices and risk of distress.

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Background: The COVID-19 vaccination campaign in several European countries involved collaboration between public health and Primary Health Care (PHC).

Objective: To highlight the role of PHC professionals in the COVID-19 vaccination rollout, specifically in terms of vaccine administration, communication and contributing to vaccination population coverage.

Methods: A descriptive retrospective study of the COVID-19 vaccination campaign across 28 European countries was conducted, covering data from December 2020 to November 2021.

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Background: The COVID-19 pandemic has necessitated changes in European healthcare systems, with a significant proportion of COVID-19 cases being managed on an outpatient basis in primary healthcare (PHC). To alleviate the burden on healthcare facilities, many European countries developed contact-tracing apps and symptom checkers to identify potential cases. As the pandemic evolved, the European Union introduced the Digital COVID-19 Certificate for travel, which relies on vaccination, recent recovery, or negative test results.

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Background: Recruitment for surveys has been a great challenge, especially in general practice.

Methods: Here, we reported recruitment strategies, data collection, participation rates (PR) and representativeness of the PRICOV-19 study, an international comparative, cross-sectional, online survey among general practices (GP practices) in 37 European countries and Israel.

Results: Nine (24%) countries reported a published invitation; 19 (50%) had direct contact with all GPs/GP practices; 19 (50%) contacted a sample of GPs /GP practices; and 7 (18%) used another invitation strategy.

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Background: During the COVID-19 pandemic, the majority of patients received ambulatory treatment, highlighting the importance of primary health care (PHC). However, there is limited knowledge regarding PHC workload in Europe during this period. The utilization of COVID-19 PHC indicators could facilitate the efficient monitoring and coordination of the pandemic response.

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Background And Aim: Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic.

Methods: Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire.

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Article Synopsis
  • - The study aimed to analyze how primary health care (PHC) managed COVID-19 treatment across 30 European countries, highlighting both the commonalities and differences in patients' clinical pathways during the pandemic.
  • - Data was collected through questionnaires completed by general practitioners (GPs) regarding PHC workflows as of September 2020, revealing that case detection and testing occurred in 27 out of 30 countries, while specialized COVID-19 clinics were only present in 8.
  • - The findings showed varied practices in mandatory isolation, sick leave certification by GPs, and the availability of patient isolation resources, indicating that differences among countries should be addressed for better management in future health crises.
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Introduction: To reduce inappropriate polypharmacy, deprescribing should be part of patients' regular care. Yet deprescribing is difficult to implement, as shown in several studies. Understanding patients' attitudes towards deprescribing at the individual and country level may reveal effective ways to involve older adults in decisions about medications and help to implement deprescribing in primary care settings.

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Introduction: Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors and primary care practitioners' (PCPs') clinical decision-making for a vignette of a patient that could have lung cancer in five Balkan region countries (Slovenia, Croatia, Bulgaria, Greece, Romania).

Methods: PCPs participated in an online questionnaire that asked for demographic data, practice characteristics, and information on health system factors.

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Article Synopsis
  • - The study aims to develop and validate a predictive model for forecasting death or hospitalization within 30 days after heart failure decompensation, specifically using easily obtainable data in primary care settings.
  • - It includes a multinational approach, recruiting 561 patients in Barcelona for the derivation cohort and 250 patients across 9 European countries for validation, revealing significant differences in demographics and heart failure characteristics between the two groups.
  • - Key predictors identified in the model included worsening dyspnoea, low oxygen saturation, and high heart rate, resulting in a strong performance of the predictive model with an area under the curve (AUC) of 0.807 for the derivation cohort and 0.73 for the validation cohort.
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The Hopkins Symptom Checklist-25 (HSCL-25) is an effective, reliable, and ergonomic tool that can be used for depression diagnosis and monitoring in daily practice. To allow its broad use by family practice physicians (FPs), it was translated from English into nine European languages (Greek, Polish, Bulgarian, Croatian, Catalan, Galician, Spanish, Italian, and French) and the translation homogeneity was confirmed. This study describes this process.

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Objective: To evaluate the precipitating factors for heart failure decompensation in primary care and associations with short-term prognosis. Prospective cohort study with a 30-d follow-up from an index consultation. Regression models to determine independent factors associated with hospitalisation or death.

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Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014).

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Background: Multimorbidity is a challenging concept for general practice. An EGPRN working group has published a comprehensive definition of the concept of multimorbidity. As multimorbidity could be a way to explore complexity in general practice, it was of importance to explore whether European general practitioners (GPs) recognize this concept and whether they would change it.

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Introduction: Multimorbidity is a health issue with growing importance. During the last few decades the populations of most countries in the world have been ageing rapidly. Bulgaria is affected by the issue because of the high prevalence of ageing population in the country with multiple chronic conditions.

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Background: Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review.

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Patients coming to their family physician (FP) usually have more than one condition or problem. Multimorbidity as well as dealing with it, is challenging for FPs even as a mere concept. The World Health Organization (WHO) has simply defined multimorbidity as two or more chronic conditions existing in one patient.

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Background: When identifying patients for palliative care, medical specialists find it necessary to disclose "hidden" patients: the patient's relatives. The issue has been discussed sporadically in Bulgaria; the present study was part of a larger investigation that examined the opinion of medical specialists, patients, and their relatives.

Method: The study protocol was explained to participants who gave written informed consent.

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