Objectives: Currently, there is an urgent need to implement an Antimicrobial Stewardship Program (ASP) in outpatient settings since nearly half of the antibiotic prescribing is inappropriate or unnecessary. The implementation of ASP should emphasize educational interventions that are more interactive. This study examines the adoption of outpatient ASP by physicians in Jordan.
Methods: A cross-sectional study was conducted between 2 March 2022 and 20 May 2022 at major hospitals in Jordan. The survey was distributed randomly among ( = 187) Jordanian physicians.
Results: It was found that more than half of the physicians were females (51.9%). The participants who reported not including antibiotic stewardship-related duties in position descriptions were (40.1%). While (46.5%) of participants reported writing and displaying public commitments supporting antibiotic stewardship in ambulatory care settings. Physicians' adoption of () core elements of ASPs in ambulatory care settings was positive. Almost (24.6%) reported a lack of self-evaluation of their antibiotic-prescribing practices. It was reported that (69.5%) of physicians used effective communication strategies to educate patients about when antibiotics are necessary.
Conclusion: It was fair adoption of the core elements in the ambulatory care settings among Jordanian physicians. Progress necessitates a comprehensive strategy tailored to the needs of the health system.
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http://dx.doi.org/10.1080/14737167.2023.2293197 | DOI Listing |
BMC Palliat Care
December 2024
The Palliative Care Center, Päijät-Häme Wellbeing Services County, Lahti, Finland.
Background: Studies show that hospital deaths bring significant health care costs, and the involvement of specialized palliative care can help to reduce these costs. The aim of this retrospective registry-based study was to evaluate end-of-life hospital costs in patients dying in a university hospital oncology ward, with or without specialized palliative outpatient clinic contact at any timepoint.
Methods: The study population consists of all patients who died in the Kuopio University Hospital oncology ward in the years 2012-2018 (n = 457).
BMC Cardiovasc Disord
December 2024
School of Psychology, University of Southampton, Southampton, UK.
Background: Blood pressure (BP) control following stroke is important but currently sub-optimal. This trial aimed to determine whether self-monitoring of hypertension with telemonitoring and a treatment escalation protocol, results in lower BP than usual care in people with previous stroke or transient ischaemic attack (TIA).
Methods: Unblinded randomised controlled trial, comparing a BP telemonitoring-based intervention with control (usual care) for hypertension management in 12 primary care practices in England.
JAMA Netw Open
December 2024
Department of Health Policy and Management, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland.
Importance: The number of older adults in long-term correctional facilities (prisons) has increased rapidly in recent years. The cognitive and functional status of this population is not well understood due to limitations in the availability of longitudinal data.
Objective: To comparatively examine the prevalence and disability status of the population of adults 55 years and older in prisons and adults living in community settings for a 14-year period (2008-2022).
JAMA Netw Open
December 2024
Department of Epidemiology and Health Care Atlas, Central Research Institute of Ambulatory Health Care, Berlin, Germany.
Importance: A growing body of literature suggests the presence of a prodromal period with nonspecific signs and symptoms before onset of multiple sclerosis (MS).
Objective: To systematically assess diseases and symptoms diagnosed in the 5 years before a first MS- or central nervous system (CNS) demyelinating disease-related diagnostic code in pediatric patients compared with controls without MS and controls with another immune-mediated disorder, juvenile idiopathic arthritis (JIA).
Design, Setting, And Participants: This population-based, matched case-control study included children and adolescents (aged <18 years) in Germany with statutory health insurance from January 2010 to December 2020.
Am J Kidney Dis
December 2024
Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington; VA Puget Sound Healthcare System, Seattle, Washington.
Historically, the paradigm for all maladies was associated with an imbalance of the 4 humors: blood, black bile, yellow bile, and phlegm. Although our understanding of disease has evolved significantly since the time of Hippocrates, a similar cornerstone of inpatient and ambulatory care involves understanding and correcting imbalances of volume. The kidneys are the principal organs controlling extracellular volume, capable of both sensing and altering salt retention through multiple redundant pathways, including the sympathetic nervous system and the renin-angiotensin-aldosterone system.
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