INTRODUCTION: Randomised controlled trials (RCTs) have informed guideline recommendations for the management of stable coronary artery disease (CAD). However, the real-world impact of contemporary guidelines and trials on practising physicians in the Asia-Pacific region remains uncertain. We aimed to evaluate the knowledge, attitudes and practices among cardiovascular physicians in the region regarding stable CAD management. METHOD: An anonymised cross-sectional electronic survey was administered to cardiovascular practitioners from the Asia Pacific, assessing 3 domains: 1) baseline knowledge on recent trials and society guideline, 2) attitudes towards stable CAD, and 3) case scenarios reflecting management preferences. Correlations among knowledge, attitudes and practice scores were assessed between physicians from developed and developing countries using Pearson correlation. RESULTS: Overall, 713 respondents from 21 countries completed the survey. The mean knowledge score was 2.90±1.18 (out of 4), with 37.3% of respondents answering all questions correctly, while 74.6% noted that guidelines have significant impact on their practice. Despite guidelines recommending optimal medical therapy, majority chose revascularisation (range 53.4- 90.6%) as the preferred strategy for the case scenarios. Practitioners from developed regions had higher knowledge scores and lower attitude scores compared to developing regions, while practice scores were similar in both groups. Weakly positive correlations were noted between knowledge, attitude and practice scores. CONCLUSION Variations exist in knowledge and attitudes towards guideline recommendations and correspondingly actual clinical practice in the Asia Pacific, with most practitioners choosing an upfront invasive strategy for the treatment of stable CAD. These differences reflect real-world disparities in guideline interpretation and clinical adoption.
Humans ; Coronary Artery Disease/therapy* ; Cross-Sectional Studies ; Practice Patterns, Physicians'/statistics & numerical data* ; Asia ; Health Knowledge, Attitudes, Practice ; Surveys and Questionnaires ; Male ; Practice Guidelines as Topic ; Female ; Attitude of Health Personnel ; Middle Aged ; Developing Countries

INTRODUCTION: Antimicrobial resistance (AMR) poses a critical global health threat, with millions of deaths attributed to it annually. Antibiotic stewardship to combat AMR is the responsibility of all healthcare professionals. Despite evidence suggesting that it is unnecessary, dentists routinely prescribe prophylactic antibiotics following third molar (3M) surgeries. METHOD: This mixed-methods study examined the behavioural barriers influencing antibiotic prescribing practices within the Division of Oral and Maxillofacial Surgery at the National University Centre for Oral Health Singapore. This study used the capability, opportunity and motivation for behavioural change or COM-B framework to implement interventions targeting the behavioural barriers. RESULTS: Pre- and post-intervention data over 6 months showed a significant reduction in antibiotic prescriptions from 84.45% to 20.89%, following the implementation of COM-B strategies (P<0.001). Qualitative feedback from focus group discussions highlighted a positive shift in clinicians' attitudes towards antibiotic reduction, acknowledging the minimal infection risk associated with non-prescribing practices. Notably, complication rates remained stable throughout the study period, indicating no adverse effects from reduced antibiotic usage. CONCLUSION These findings demonstrated that the COM-B model can be successfully applied to modify deeply ingrained prescription habits, and underscored the effectiveness of a structured behavioural change intervention in enhancing compliance with antibiotic stewardship guidelines. The study advocates continuation of initiatives to sustain this positive trend and mitigate AMR in clinical practice.
Humans ; Molar, Third/surgery* ; Anti-Bacterial Agents/therapeutic use* ; Singapore ; Antimicrobial Stewardship/methods* ; Practice Patterns, Dentists'/statistics & numerical data* ; Antibiotic Prophylaxis ; Female ; Attitude of Health Personnel ; Male ; Tooth Extraction ; Adult ; Focus Groups ; Practice Patterns, Physicians'

OBJECTIVE: Traditional Chinese medicine (TCM) incorporates traditional diagnostic methods and several major treatment modalities including Chinese herbal medicine, Chinese patent medicine, and non-pharmacological methods such as acupuncture and tuina. Even though TCM is used daily by more than 70,000 healthcare facilities and over 700,000 clinical practitioners in China, there is a poor understanding of the extent to which TCM diagnostic methods are used, how different treatment modalities are deployed in general, and what major factors may affect the integration of TCM and Western medicine. This study aimed to fill this void in the literature. METHODS: In the 2021 National Healthcare Improvement Evaluation Survey, we included three questions gauging the perception and practices of TCM amongst physicians working in TCM-related facilities, investigating the frequency of their deployment of TCM diagnostic methods, and predominant TCM treatment methods. Our empirical analysis included descriptive statistics, intergroup chi-square analysis, and binary logistic regression to examine the association between different types of facilities and individual characteristics and TCM utilization patterns. RESULTS: A total of 7618 clinical physicians comprised our study sample. Among them, 84.27% have integrated TCM and Western medicine in their clinical practice, and 80.77% of TCM practitioners used the 4 diagnostic methods as a tool in their clinical practice. Chinese herbal medicine was the most widely utilized modality by Chinese TCM physicians (used by 88.49% of respondents), compared with the Chinese patent medicine and non-pharmacological TCM methods, which were used by 73.14%, and 69.39%, respectively. Herbal tea as an out-of-pocket health-maintenance intervention is also a notable practice, recommended by 29.43% of physicians. Significant variations exist across certain institutions, departments, and individual practitioners. CONCLUSION Given that most of the surveyed physicians integrated TCM with Western medicine in their clinical practices, the practice of "pure TCM" appears to be obsolete in China's tertiary healthcare institutions. Notably, remarkable variation exists in the use of different TCM modalities across institutions and among individuals, which might be related to and thus limited by the practitioners' experience. Future research focusing on the efficacy and safety of TCM interventions for specific diseases, the development of standardized clinical guidelines, and the enhancement of TCM education and training are called for to optimize TCM-Western medicine integration. Please cite this article as: Guo R, Zeng D, Zhao Q, Zhang XY, Zhang XK, Liu YL. How are different traditional Chinese medicine modalities deployed by clinical practitioners in China? Findings from a national survey. J Integr Med. 2025; 23(1): 36-45.
Medicine, Chinese Traditional/statistics & numerical data* ; Humans ; China ; Surveys and Questionnaires ; Female ; Male ; Physicians/statistics & numerical data* ; Practice Patterns, Physicians'/statistics & numerical data* ; Adult ; Middle Aged

Depression is a mental health condition that affects more than 3.3 million Filipinos. Screening of adults and elderly patients is recommended with the use of validated tools like the Patient Health Questionnaire (PHQ-2 or PHQ-9) or the Geriatric Depression Scale-15 (GDS-15). The two-step approach can be followed for adults by using the PHQ-2 first, followed by the PHQ-9 if the PHQ-2 tests positive. Geriatric patients may be screened using the GDS-15 tool or PHQ-9. Diagnostic work-up should be done to rule out metabolic or organic conditions that can mimic or cause depression. Diagnosis of depression should be confirmed using the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. Referral to a specialist should be done in cases of severe depression, psychosis, high suicide risk, severe malnutrition, pregnant adults, or non-response to initial treatment.

Background: The coronavirus disease 2019 (COVID‑19) pandemic has affected education systems worldwide. The disruption in education systems has impacted over 90% of the student population of the world (UNESCO, 2020). Electronic learning (e‑learning), a form of teaching which involves electronic equipment and tools permits interaction between people involved in the education process. An example of which is the webinars. Webinars allow large groups of participants to engage in online discussions or training events and share audio, documents, or slides. Objective: We aim to assess the perception of resident physicians on the use of webinars to support learning during COVID‑19. Methodology: This is a cross-sectional study. An adequately powered paper survey was conducted among 123 resident physicians of St. Luke’s Medical Center Global City. A 5‑point Likert Scale was used for each of the questions in the questionnaire patterned after that of Nagar (2020). Descriptive statistics was used to analyze the data. Results: Majority of the respondents gave favorable answers to questions on pace of learning/ flexibility (91.5%), cost (95.1%), convenience and comfort (95.1%), motivation (76.1%), ease of access (96.1%), visual perception (87.5%), visual difficulty (79.9%), audio perception (83.7%), Internet connection (61.8%), and navigation (83.7%), while Internet connection (28.5%) was seen with the highest disagreement. Conclusion: Our data support the acceptability of webinars among resident physicians in a tertiary private hospital as an alternative learning tool in this COVID‑19 era where face‑to‑face interaction or traditional learning is less likely to be employed. Recommendations We recommend future studies that can focus on the efficacy of the webinars in the improvement of knowledge and practice of medicine by doing pre- and posttests. We also recommend doing a similar study in government hospitals where facilities may not be on par with private hospitals.
COVID‑19 ; Perception ; Physicians

BACKGROUND

The Universal Health Care (UHC) Act (RA 11223) which basically restructured the Philippine Health Insurance Corporation and enhanced health financing mechanisms, looks like a total reform of the Philippine health system. As a preparation for these reforms, the Philippine Academy of Family Physicians has undertaken a developmental project designed to prepare its members for these reforms. This research is an attempt to provide additional information for this PAFP project in terms of the primary care orientation of family practice clinics.

The overall objective of this research is to determine the primary care orientation of family practice clinics among the members of the PAFP Batangas Chapter.

This cross-sectional study aimed to assess the primary care orientation of family practice clinics, focusing on active members of the PAFP Batangas Chapter. Using purposive sampling, participants completed a pilot-tested questionnaire, evaluating aspects like first-contact, comprehensive, continuing, and coordinated care. Emphasis was placed on organized medical records and quality improvement activities. Despite facing initial reluctance, the survey garnered 74 responses from 117 members, acknowledging a shortfall in reaching the target and a decrease in confidence level from 95% to 85%. The study provides insights into diverse demographics and practice characteristics of voluntary participants among active PAFP members in Batangas.

The survey encompassed various aspects of healthcare provision among members of the Philippine Academy of Family Physicians (PAFP) Batangas chapter. In First Contact Care, respondents exhibited a consistent practice of providing after-hours contact, obtaining informed consent, and allocating varied consultation times. Notably, mental and behavioral assessments showed room for improvement. The Comprehensiveness of Services highlighted variations, with Fellows extending services, but family planning services exhibited lower engagement. In Record Keeping, there was an inclination towards paper-based records, with Fellows leading in standardized systems. Continuing Care reflected a positive trend in consistent doctor-patient relationships, while awareness levels varied. Coordination of Care demonstrated varying strengths in referral agreements, with Fellows consistently adhering more. In Quality Improvement, all Fellows engaged, while others showed diverse participation rates, emphasizing the reliance on clinical guidelines. The survey underscores a commitment to ongoing professional development, as reflected in Continuing Professional Development points. Overall, the findings reveal both strengths and areas for improvement, emphasizing the need for standardized practices and continuous enhancement in the provision of healthcare services.

This study identified the overall primary care orientation of family and community physicians who were active members of the PAFP Batangas Chapter. Armed with this information, effective strategies could be developed to prepare PAFP members for the reforms in the UHC.

OBJECTIVES: Reforming medical insurance payment methods is a key part of deepening the healthcare system reform. Understanding the influencing factors and underlying mechanisms of physicians' strategic behaviors under the diagnosis-related groups (DRG) payment system is crucial for reducing medical resource waste and improving the efficiency of health insurance fund utilization. METHODS: Based on the Theory of Planned Behavior, this study used grounded theory to construct a questionnaire encompassing belief, behavioral attitude, subjective norm, perceived behavioral control, behavioral intention, and behavior measurement items. Structural equation modeling was then used for empirical analysis. RESULTS: Physicians' behavioral intention had the most significant impact on their strategic behavior (β=0.606, P<0.001). Physician's attitude toward strategic behavior (β=-0.159, P<0.01), subjective norm (β=-0.093, P<0.05), and perceived behavioral control (β=-0.120, P<0.05) were major influencing factors of behavioral intention. Physicians' behavioral beliefs, normative beliefs, and control beliefs were significantly correlated with behavioral attitude (β=0.554, P<0.001), subjective norm (β=0.383, P<0.001), and perceived behavioral control (β=0.274, P<0.001), respectively. CONCLUSIONS Behavioral intention is the primary predictor driving physicians to engage in strategic behavior. Attitudes toward the behavior, subjective norms, and perceived behavioral control all significantly affect physicians' behavioral intentions.
Humans ; Physicians/psychology* ; Surveys and Questionnaires ; Attitude of Health Personnel ; Diagnosis-Related Groups/economics* ; Intention ; Female ; Male ; Adult

Background: Palliative care is an approach which improves the quality of life of patients and their families facing life-threatening illness, through the prevention, assessment and treatment of pain and other physical, psychosocial and spiritual problems. The Palliative and Hospice Care Act was enacted to improve quality of life of terminally- ill patient, however, the readiness of general practitioner to participate in palliative care is still a critical issues. Objectives: This study aimed to identify factors affecting provision of palliative care, as perceived by primary care physicians in Ilocos Norte. Methods: The study is a descriptive-comparative research utilizing the purposive sampling technique in selecting the participants. It used a structured survey questionnaire in google form and was sent through email. For participants having difficulty with online platform, printed questionnaire was distributed. Data gathered was entered and analyzed using Microsoft Excel. Specifically, mean, standard deviation was used for descriptive statistics and spearman correlation for inferential statistics was utilized. Results As to the knowledge of the primary care physicians, this study showed that they are knowledgeable as to the definition and objectives of palliative care. The study able to assess factors affecting the provision of palliative care in five (5) domains. Among the domains it was noted that national, regional and local healthcare networking and healthcare team are perceived challenges in provision of palliative care among the primary care physicians of Ilocos Norte.
Palliative Care ; Physicians, Primary Care

Background: The COVID-19 is a significant stressor for the resident physicians. This public health issue augmented the already rigid and demanding residency training. Objective: To determine the coping strategies employed by the resident physicians at the Southern Philippines Medical Center during the COVID-19 pandemic. Methods: The study was a cross-sectional design using the descriptive-survey research method. A total of 200 resident physicians participated in this study. The instruments used were a self-made sociodemographic profile questionnaire and the 37-item Filipino Coping Strategies Scale, adopted with permission from the developer. The study used frequency and percentage for categorical variables and mean and standard deviations for continuous variables. Results: The respondents were primarily female resident doctors (56%), unmarried (83%), with an average age of 30, and with the majority living with their immediate family (54%) with mostly three to four family members at home (64%). Most resident doctors were assigned to COVID-19 wards (52.5%) and managed COVID-19 patients directly (73%). Twenty percent of these respondents working in COVID-19 wards have reported and claimed having pre-existing health conditions. The most prevalent coping strategies employed were religiosity (3.15 ± 0.66) and problem-solving (3.11 ± 0.50). On the other hand, resident doctors rarely turned to overactivity or substance use. Conclusion This study has shown that residents most frequently utilized problem-focused (problem-solving) and emotion-focused (spirituality, relaxation/recreation, and tolerance) strategies. Coping is necessary for resident physicians to confront threats of COVID-19 infection. Psychological-emotional support for the well-being of resident doctors must be in place in every residency training program.
Physicians

Child ; Humans ; Speech ; Physicians, Primary Care ; Language Development Disorders/diagnosis* ; Speech Disorders