BACKGROUND

Telemedicine offers a solution to healthcare access issues, especially during the COVID-19 pandemic when physical distancing limited in-person visits. It can also be used by the Doctors-to-the-Barrios (DTTBs), who are often newly licensed physicians who have not undergone residency training yet, to remotely consult specialists and assist them in providing better healthcare recommendations to their patients. Understanding the acceptance of telemedicine particularly among DTTBs is crucial to optimizing its implementation, as local studies on this topic are lacking.

OBJECTIVE

The purpose of this study is to determine the factors affecting acceptance of telemedicine by the DTTBs.

METHODS

This study employed a descriptive and analytical cross-sectional research design from 2021 to 2022. Ethical approval was obtained prior to study implementation. Informed consent form was sent to all enrolled master’s students in the DTTB program. The study adapted the questionnaire utilized by Zailani et al. using a five-point Likert scale to identify the determinants of acceptance of telemedicine based on the following constructs: government policy, external supplier’s capacity, project team’s capacity, top management support, perceived usefulness, attitude, self-efficacy, acceptance of telemedicine, and organizational culture. Linear regression was performed to identify significant constructs that determine acceptance of telemedicine. All data were reported at 95% confidence interval.

RESULTS

Total of 116/180 DTTBs participated in the study. Attitude (β = 0.5849, p < 0.01) and self-efficiency (β = 0.5327, p < 0.01) together with organizational culture had a significant positive impact on the acceptance of telemedicine.

CONCLUSION

This study shows the current state of acceptance of telemedicine by our DTTBs. It highlights their positive attitude and self-efficiency towards telemedicine and the lack of support they receive from the government in funding and implementing telemedicine efforts despite its potential to address healthcare access issues.

Telemedicine ; Telerehabilitation ; Community Medicine

Human ; Community Medicine ; Family

BACKGROUND: Family doctors are increasingly managing the diabetes care of Korean-Americans. Little is known about the prevalence of diabetes among non-obese Korean-Americans, or the extent to which they receive timely and appropriate diabetes care. The purpose of this investigation is to: (1) identify the prevalence of diabetes and to determine the adjusted odds of diabetes among non-obese Korean-Americans compared to non-Hispanic White (NHW) Americans, (2) examine the factors associated with having diabetes in a large sample of non-obese Korean-Americans, and (3) determine the prevalence and adjusted odds of optimal frequency of eye care, foot care and A1C blood glucose level monitoring among non-obese Korean-Americans with diabetes in comparison to NHWs with diabetes. METHODS: Secondary analysis of population-based data from the combined 2007, 2009, and 2011 adult California Health Interview Survey. The sample included 74,361 respondents with body mass index (BMI) <30 kg/m2 (referred to as ‘non-obese BMI’), of whom 2,289 were Korean-Americans and 72,072 were NHWs, and 4,576 had diabetes. RESULTS: The prevalence and adjusted odds of diabetes among non-obese Korean-Americans are significantly higher than among their NHW peers. More than 90% of Korean-Americans with diabetes were non-obese. NHWs had substantially higher odds of having optimal frequency of eye care, foot care and A1C glucose level monitoring, even after adjusting for insulin dependence, sex, age, education, income, and BMI. CONCLUSION: Non-obese Korean-Americans are at higher risk for diabetes and are much less likely to receive optimal diabetes care in comparison to NHWs. Targeted outreach is necessary.
Adult ; Asian Americans ; Blood Glucose ; Body Mass Index ; California ; Chronic Disease ; Community Medicine ; Cross-Cultural Comparison ; Education ; Emigrants and Immigrants ; Foot ; Glucose ; Healthcare Disparities ; Humans ; Insulin ; Prevalence ; Surveys and Questionnaires

To clarify the clinical application of the group standard (T/CACM 1035-2017) of the Chinese Society of Traditional Chinese Medicine (TCM), the clinical practice guideline on traditional chinese medicine therapy alone or combined with community acquired pneumonia, and to understand the clinical applicability of the Guideline. The clinical workers trained in terms of the Guideline in hospitals at all levels in China were selected as the research objects. A total of 494 questionnaires on application evaluation and 511 questionnaires on applicability evaluation were collected to construct the database of the post-effect evaluation of the Guideline. Excel software was used for statistical analysis. The overall evaluation of the Guideline was 92.31%, 91.06%, 87.45% respectively in efficacy, safety and economy. The Guideline was well used in clinical application, and 99.41% of the patients were willing to follow the recommended scheme. The agreed ratio in rationality evaluation was 97.98%, 92.37%, 94.53% and 92.71% in treatment rules, syndrome differentiation and classification, prevention of complications, and rehabilitation method. The effective rate of the prescriptions recommended in the Guideline was all above 65%. More than 80% of the prescriptions were Tanreqing Injection, Yinqiao Powder, Qingjin Huatan Decoction, Maxing Shigan Decoction, Shengmai San and Shashen Maidong Decoction. Adverse reactions, unknown active components and economy of Chinese patent medicines were the important factors affecting drug use and efficacy, providing a clinical basis for updating and revising the standard.
Anti-Bacterial Agents ; China ; Community-Acquired Infections ; drug therapy ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Pneumonia

The use of complementary medicine (CM) is on the rise worldwide. In Malaysia, CM is available as over-the-counter products in community pharmacies and consumers expect pharmacists to be knowledgeable about CM. However, little is known about Malaysian community pharmacists’ attitude and knowledge of CM. This cross-sectional study aimed to investigate the extent of integration of CM into practice, taking into account community pharmacists’ attitudes towards CM, their role in recommending CM, their knowledge of the evidence-base for commonly used CM, further education and training needs, and knowledge of information sources which can be used by pharmacists for CM information. Ethics approval was obtained and a pilot study was conducted to validate the questionnaire. After amendments were made, community pharmacists were invited to complete a 41-item paper-based or web-based questionnaire. Invitations to complete the survey were sent by either social media, email or face-to-face invitation. A response rate of 27% (453/1662) was achieved providing data from 453 community pharmacists. Most respondents were female (63%), aged 24-72 years. Only 42% of pharmacists always asked their customers presenting with a prescription about concomitant CM use. Forty-two percent (42%) of pharmacists personally recommended CM and slightly more than half (58%) had notified manufacturers of CM products of any suspected adverse drug reactions. On average, pharmacists achieved a score of 54% for knowledge on CM-drug interactions and 71% for knowledge of clinically proven benefits. Most pharmacists (75%) obtained their CM product training through self-directed learning. In addition, most pharmacists (66%) supported CM education at the undergraduate level and almost all (94%) recognised the need for additional CM education for pharmacists. Malaysian registered pharmacists do not routinely ask customers about CM use, or recommend CM products, but have a positive attitude towards their use and were interested in learning more about CM.
complementary medicine ; integrative medicine ; community pharmacists ; pharmacy practice ; quality use of medicines

BACKGROUND: The prevalence of diabetes for all age groups is estimated to be 2.8% globally in the year 200 affecting more men than women. Based on 2014-2016 annual census  of the Department of Family and Community Medicine at EVRMC, diabetes has been one of the leading causes of consultation at the Out-Patient Department of which 69% were elderly. This disease not only causes both macro and microvascular lesions resulting to psychological and psychosocial impacts leading to depression.

OBJECTIVE: To determine the prevalence of depression among elderly patients with type 2 diabetes in a tertiary government hospital from January to June 2017.

MATERIALS AND METHODS: This is an analytical study on the association of the socio-demographic characteristics and adherence to medication among elderly diabetics with depression. Those diagnosed with T2DM who could read and write were screened for depression using the Geriatric Depression Scale.

RESULTS: A total of 110 elderly diabetic patients were seen. Of these, only 75 of them could read and write and selected as subjects. Thirty-one or 41.0% of them turned positive for depression. Socio-demographic characteristics of elderly diabetics with depression showed that 55% were females, mostly belonging to age group 60-69 years old (77%), married (58%), who lived with their spouses (58%), unemployed (42%), mostly with elementary education (45%) and belonging to the lower socio-economic class (97%). Their financial support mainly comes from their children (45%). twenty or 87% of the subjects with depression were adherent to their medication.

CONCLUSION: Age is significantly associated with depression in elderly diabetics because as they grow older, they are faced with physical, psychological and social role changes that challenge their sense of self and capacity to live happily. Adherence to medication is important among elderlies with diabetes.

Human ; Male ; Aged 80 And Over ; Diabetes Mellitus, Type 2 ; Spouses ; Depression ; Prevalence ; Outpatients ; Censuses ; Community Medicine ; Medication Adherence ; Marriage ; Depressive Disorder

BACKGROUND: The Northern Mindanao Medical Center has set standards for quality of care as it was awarded ISO accreditation last 2015. Patient's waiting time in the Emergency Room (ER) of a tertiary hospital is a measure of effective health care delivery.

OBJECTIVE: To determine the waiting time among non-urgent adult patients seen in the Emergency Room-Triage and Ambulatory Care of the Northern Mindanao Medical Center-Department of Family and Community Medicine (NMMC-DFCM) from May 2016 to October 2016.

METHODOLOGY: The descriptive research design using time and motion activities of each non-urgent case at the NMMC Emergency Room was used. The following variables were included: the socio-demographic data as to the patient's age, gender, address,and occupation; as well as physician-related and administrative-related factors. Tabulation was done using Microsoft Excel. The Central Tendency (Mean) and Dispersion (SD,Range) were computed. 

RESULTS: A total of 1,290 patients were examined and who experienced average waiting time of 247.1 minutes. Patients were mostly in 18-30 age group (45%), females (52%), came from within Cagayan de Oro City (71%) and unemployed (67%). The longest waiting time (257.3 minutes) were handled by junior residents and seen in the Morning shift (263.7 minutes). Higher caseloads were noted in the Afternoon Shift (587 patients). On the other hand, the weekdays were busiest and longest waiting time (762 patients and 263.4 minutes, respectively).

CONCLUSIONS: The demographic profile of the youngest and female population in the study and coming from Cagayan de Oro City used the ER for non-urgent conditions and majority of patients were unemployed. The mean waiting time was 247.1 minutes. Patients managed by junior residents and seen during the Morning shift revealed longest waiting time On the other hand, Weekdays were busiest overall and were noted in the Afternoon Shift; with pronounced during the Holidays.

Human ; Female ; Adult ; Triage ; Tertiary Care Centers ; Community Medicine ; Emergency Service, Hospital ; Ambulatory Care ; Physicians ; Accreditation ; Occupations

Since 2016, the pediatric emergency centers (PECs) have been selected by the Korean Ministry of Health and Welfare, but there are still many problems in their designation and operation. The authors, affiliated with the policy research team in the Korean Society of Pediatric Emergency Medicine, sought to identify the current status and plans for improvement of PECs in Korea. The problems in the designation and operation are the disproportionate regional distribution of the PECs, financial difficulties in meeting the designation criteria, and recruitment of dedicated pediatric emergency specialists. To improve this, it is necessary to designate additional PECs and analyze the appropriateness of insurance cost, to strengthen the role other than the community practice, and to reinforce back-up treatment by pediatric sub-specialists in PECs.
Community Health Services ; Emergencies* ; Emergency Medicine ; Financial Support ; Geography, Medical ; Insurance ; Korea* ; Local Government ; Personnel Selection ; Specialization

Since 2016, the pediatric emergency centers (PECs) have been selected by the Korean Ministry of Health and Welfare, but there are still many problems in their designation and operation. The authors, affiliated with the policy research team in the Korean Society of Pediatric Emergency Medicine, sought to identify the current status and plans for improvement of PECs in Korea. The problems in the designation and operation are the disproportionate regional distribution of the PECs, financial difficulties in meeting the designation criteria, and recruitment of dedicated pediatric emergency specialists. To improve this, it is necessary to designate additional PECs and analyze the appropriateness of insurance cost, to strengthen the role other than the community practice, and to reinforce back-up treatment by pediatric sub-specialists in PECs.
Community Health Services ; Emergencies* ; Emergency Medicine ; Financial Support ; Geography, Medical ; Insurance ; Korea* ; Local Government ; Personnel Selection ; Specialization

BACKGROUND: Compared to other specialties, a lower number of medical students contemplate later choosing Family and Community Medicine. At the UP College of Medicine, only a small fraction of graduates pursue residency training in the specialty. A multitude of factors have been shown to have influenced the medical students of specialty considerations.
OBJECTIVE: To determine whether the Family and Community Medicine curriculum and medical school factors influence third to fifth year students of UP College of Medicine to consider Family and Community Medicine as a future specialty.
METHODOLOGY: UP College of Medicine third to fifth year students during Academic Year 2015-2016 rotating in the Department of Family and Community Medicine from January to June 2016 were asked to participate. A descriptive study design was used. Consideration of Family and Community Medicine was compared from pre- to post- rotation and factors associated with inclination towards residency training in the specialty were examined post-rotation through a questionnaire.
RESULTS: Of the medical students who planned to pursue residency training, 8% had Family and Community Medicine in the top three choices for residency training at the start of the rotation, which increased to 15% at the end of the rotation. Family and Community Medicine as a future specialty was "considered a little" by the three year levels at the start and end of the rotation. Many factors were deemed by the medical students to have no effect on considering the specialty. Some factors were considered to have a strong positive influence on choosing Family and Community Medicine, especially for medical clerks. A few factors were perceived to have a negative influence in considering the specialty.
CONCLUSION: Curriculum and medical school factors have an influence on the consideration of Family and Community Medicine as a future specialty.

Human ; Male ; Female ; Adult ; Choice Behavior ; Community Medicine ; Curriculum ; Internship And Residency ; Medicine ; Schools, Medical ; Students, Medical ; Surveys And Questionnaires ; Family Practice