At the end of this module you should be able to: 1. Extract a medical history that is useful for preventive health care. 2. Perform additional recommended physical examination procedures. 3. Perform only the recommended screening procedures. 4. Provide the recommended medical counselling. 5. Give the recommended vaccines. 6. Formulate a health maintenance plan for the patient.
FAMILY PRACTICE ; STANDARDS ; PREVENTIVE HEALTH SERVICES ; ADULT ; GUIDELINE

Costs and Cost Analysis ; Dentists ; Family Practice ; Humans ; Physician-Patient Relations ; Private Practice ; economics ; standards ; Social Values

OBJECTIVETo evaluate the necessity, scientificity, and feasibility of the drafted Practice Guidelines on Prevention and Treatment of Hypertension for Primary Care Physicians.

METHODSDerivative Dolphe Method was used to collect the responses from 50 experts in hypertension or related fields within the nation. An evaluation score of 1 to 5 was given to each item for selection, 1 for highly disagreed and 5 for highly agreed. The mean, standard deviation (SD) and coefficient of variance (CV) of the scores were calculated.

RESULTS(1) 90% experts responded to the evaluation sheet. (2) The mean score were above 4 for the five out of the six items related to necessity, the SD varied from 0.51 to 1.05, and the CV from 0.11 to 0.30. (3) Among the 28 items related to scientificity and rationality, the mean score was above 4 for 25 items and was between 3.5 and 4 for other three items. The CV was generally lower than 0.35. (4) Among the seven items related to feasibility, the mean score for five of them was lower than 4, and the CV varied from 0.21 to 0.33.

CONCLUSIONThe results indicate that the necessity and scientificity of the most content of the guidelines are confirmed by the invited experts.

Clinical Competence ; standards ; Humans ; Hypertension ; therapy ; Peer Review ; methods ; standards ; Physicians, Family ; Practice Guidelines as Topic ; standards ; Practice Patterns, Physicians' ; standards ; Reproducibility of Results ; Surveys and Questionnaires

Costs and Cost Analysis ; Dentists ; Family Practice ; Patient Rights ; Physician-Patient Relations ; Private Practice ; economics ; standards ; Self Care ; Social Values

Postgraduate Family Medicine (FM) training is important to train future primary care doctors to provide accessible and cost effective healthcare. In Singapore, a structured postgraduate FM training programme has been available for 20 years. This programme is characterised by involvement of both FM and non-FM doctors, well written modules and a rigorous assessment process. However, challenges faced by both the current healthcare system and training structure underlie the need to review the training structure to ensure its relevancy for future Family Physicians (FPs) to manage the needs of their patients. A workgroup was formed to review the current FM postgraduate programme and to explore the possibility of using the Accreditation Council for Graduate Medical Education (ACGME) framework to enhance our current system. The workgroup felt that broad-based training and comprehensive coverage of topics are areas that are important to retain in any new FM residency programme. Weaknesses identified included a lack of early FM exposure and the need to strengthen formative assessments. New organisational structures such as Family Medicine Centres (FMC) need to be established and the involvement of the private sector in any FM residency progammes could be enhanced. The implementation of the FM Residency Programme in 2011 presented a unique opportunity to realign FM postgraduate education in line with the national objectives and to equip FPs with the necessary knowledge and skills for managing the future healthcare needs of Singaporeans.
Clinical Competence ; standards ; Curriculum ; standards ; Education, Medical, Graduate ; organization & administration ; standards ; Family Practice ; education ; Humans ; Internship and Residency ; organization & administration ; Program Development ; Singapore

Seeking to understand patient perspectives is an important step in the efforts to improve the quality of health care. Developed by the EQuiP Task Force on Patient Evaluations of General Practice Care, the EUROPEP instrument aims to collect information on patient evaluations of general practice care. In order to expose the current state of patient satisfaction and make international comparisons, a study was conducted with relevant data collected from Turkey. The Turkish version of the EUROPEP instrument was administered to 1160 patients in six different Turkish cities. Thirty-three medical practices were included in the study. In every practice, a minimum of 30 adult patients who visited the practice for a consultation were consecutively included. The results were compared with previous values from European countries. "Helping you understand the importance of following his or her advice", "Getting through to the practice on the telephone", and "Providing quick services for urgent health problems" were evaluated best (76.7%, 76.3%, and 76.2%, 'good or excellent' ratings, respectively) and "Helping to deal with emotional problems related to the health status" was rated the worst (60.2%, 'good or excellent'). Other areas which had low ratings were: "Waiting time in the waiting room" (63.0%), "Quick relief of symptoms" (61.3%), and "Involving patients in decisions about medical care" (61.3%). Patient evaluations can help to educate medical staff about their achievements as well as their failures, assisting them to be more responsive to their patients' needs. In order to get the best benefit from EUROPEP, national benchmarking should be started to enable national and international comparisons.
Adult ; Benchmarking ; Comparative Study ; *Culture ; Europe ; Evaluation Studies ; Family Practice/*standards ; Female ; Human ; Male ; Middle Aged ; *Patient Satisfaction ; *Quality of Health Care ; *Questionnaires ; Registries ; Turkey ; Urban Population

INTRODUCTIONMedical talks, newsletter circulars, scientific meetings and conferences, and interaction with members of the pharmaceutical industry, have become convenient means of carrying out continuing medical education (CME) for many busy doctors.

MATERIALS AND METHODSTo study the perceived importance of these various CME activities, a self-completed posted questionnaire survey was conducted among registered practitioners of a densely populated urban state in Malaysia.

RESULTSOf the 172 respondents [male, 77%; hospital-based, 37%; general practitioner (GP), 55%; private practice, 70%; respondent rate of 19.5%], most preferred local conferences and endorsements by local experts to their foreign counterparts. Meetings or conferences sponsored by the pharmaceutical industry were ranked similarly with those without such links, while the reputation of the pharmaceutical firms was of foremost importance. Among GPs (n = 95) and non-GPs (n = 77), medical society newsletters were rated significantly higher by GPs while overseas conferences were rated higher by non-GPs.

CONCLUSIONOur findings provide an important first look at this under-explored area among Malaysian doctors and described a high degree of acceptance for the involvement of the pharmaceutical industry in CME activities.

Adult ; Attitude of Health Personnel ; Congresses as Topic ; utilization ; Education, Medical, Continuing ; methods ; Evidence-Based Medicine ; education ; Family Practice ; education ; standards ; Female ; Health Care Surveys ; Humans ; Malaysia ; Male ; Middle Aged ; Periodicals as Topic ; utilization ; Societies, Medical ; Surveys and Questionnaires

BACKGROUND: Soil-transmitted helminthes (STH) infections are among the most common infections worldwide and affect the most deprived communities. Adequate water, sanitation, and hygiene (WASH) prevents environmental contamination, thereby preventing transmission of STH. Cognizant of this, WASH education was implemented in rural Dembiya to reduce intestinal parasitic infections. This study was, therefore, conducted to assess the impacts of the intervention on households' WASH conditions and prevalence of intestinal parasitic infections. METHOD: An uncontrolled before-and-after intervention study was used. Cross-sectional studies were done before and after the intervention. Two hundred twenty-five and 302 under five children were recruited randomly at the baseline and endline, respectively. Data were collected using a structured questionnaire and observational checklists. Direct stool examination and Kato-Katz methods were used to identify parasites in the stool. We used percent point change and prevalence ratio (PR) to see the effects of the intervention on WASH conditions and prevalence of intestinal parasitic infections respectively. Pearson chi-squared and Fisher's exact tests were used to test for statistically significant percentage point changes of WASH conditions. The effect of the intervention on intestinal parasitic infections was statistically tested on the basis of PR with 95% confidence interval (CI). RESULTS: The baseline prevalence of intestinal parasitic infections was 25.8%, and the endline prevalence was 23.8%. The prevalence of intestinal parasitic infections was not significantly decreased at the endline compared with the baseline [PR = 0.92, 95% CI = (0.62, 1.38)]. Ascaris Lumbricoides was the most prevalent parasitic infection both at the baseline and endline. The proportion of children who had good hygienic condition increased from 1.3% at the baseline to 34.4% at the end line (p <  0.05). The percentage of mothers/care givers who washed hands at different pick times was significantly increased from 24.4% at the baseline to 68.2% at the endline (p <  0.001). The proportion of households who practiced home-based water treatment was significantly increased from 7.6% at the baseline to 47% at the endline (p <  0.001). The proportion of households who used sanitary latrine was increased from 32% at the baseline to 49% at the endline (p <  0.05). CONCLUSION This before-and-after intervention study found that households' WASH performance was significantly improved at the endline compared with the baseline. The endline prevalence of intestinal parasitic infections was slightly lower than the baseline prevalence; however, the reduction was not statistically significant. The local health office needs to strengthen the WASH education program, mobilize the community to construct WASH facilities, and support the community to sustain households' WASH performance.
Adult ; Child, Preschool ; Cross-Sectional Studies ; Drinking Water ; parasitology ; standards ; Ethiopia ; epidemiology ; Family Characteristics ; Feces ; parasitology ; Female ; Health Behavior ; physiology ; Health Education ; Health Knowledge, Attitudes, Practice ; Helminthiasis ; epidemiology ; prevention & control ; Humans ; Hygiene ; education ; Infant ; Intestinal Diseases, Parasitic ; epidemiology ; prevention & control ; Male ; Prevalence ; Rural Population ; Sanitation ; Soil ; parasitology ; Surveys and Questionnaires