References of "Lygidakis, Charilaos 50022205"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailSocial Media as an Opportunity for Public Health Interventions: The #Metoo Movement as an Exemplar
Gomez Bravo, Raquel UL; Gomez Bravo, María; Lygidakis, Charilaos UL et al

in Journal of the International Society for Telemedicine and EHealth (2019), 7(e5), 1-7

Background: Social media have been used exponentially and globally, providing a means for billions of users to connect, interact, share opinions and criticise, becoming one of the main channels of ... [more ▼]

Background: Social media have been used exponentially and globally, providing a means for billions of users to connect, interact, share opinions and criticise, becoming one of the main channels of communication for users around the world. One of the most popular free social media networks is Twitter, with more than 100 million active users per day worldwide. Purpose: The aim of this study was to analyse a sample of the public conversations generated, using the hashtag #MeToo, around the topic of sexual abuse on Twitter. Methods: Using social media marketing software, the use of the #MeToo hashtag was analysed over a period of 60 days (14 September 2017 to 13 November of 2017). Results: The #MeToo conversation was mainly in English (79.3%), located in the United States (48.2% of cases), but with global repercussions. The volume of mentions of the #MeToo hashtag was far greater (97.7%), compared with other hashtags related to violence over this period of time, using mostly Twitter (96.2%). Conclusions: These results suggest that it is possible to describe different groups using the social media, and analyse their conversations to identify opportunities for successful public health interventions. If the topic is relevant for the general public, it will generate interest and conversations at the global level, supported by a universal and borderless channel such as Twitter. [less ▲]

Detailed reference viewed: 60 (0 UL)
Full Text
Peer Reviewed
See detailCombating non-communicable diseases: potentials and challenges for community health workers in a digital age, a narrative review of the literature
Mishra, Shiva Raj; Lygidakis, Charilaos UL; Neupane, Dinesh et al

in Health Policy and Planning (2019)

The use of community health workers (CHWs) has been explored as a viable option to provide home health education, counselling and basic health care, notwithstanding their challenges in training and ... [more ▼]

The use of community health workers (CHWs) has been explored as a viable option to provide home health education, counselling and basic health care, notwithstanding their challenges in training and retention. In this manuscript, we review the evidence and discuss how the digitalization affects the CHWs programmes for tackling non-communicable diseases (NCDs) in low- and middle-income countries (LMICs). We conducted a review of literature covering two databases: PubMED and Embase. A total of 97 articles were abstracted for full text review of which 26 are included in the analysis. Existing theories were used to construct a conceptual framework for understanding how digitalization affects the prospects of CHW programmes for NCDs. The results are divided into two themes: (1) the benefits of digitalization and (2) the challenges to the prospects of digitalization. We also conducted supplemental search in non-peer reviewed literature to identify and map the digital platforms currently in use in CHW programmes. We identified three benefits and three challenges of digitalization. Firstly, it will help improve the access and quality of services, notwithstanding its higher establishment and maintenance costs. Secondly, it will add efficiency in training and personnel management. Thirdly, it will leverage the use of data generated across grass-roots platforms to further research and evaluation. The challenges posed are related to funding, health literacy of CHWs and systemic challenges related to motivating CHWs. Several dozens of digital platforms were mapped, including mobile-based networking devices (used for behavioural change communication), Web-applications (used for contact tracking, reminder system, adherence tracing, data collection and decision support), videoconference (used for decision support) and mobile applications (used for reminder system, supervision, patients’ management, hearing screening and tele-consultation). The digitalization efforts of CHW programmes are afflicted by many challenges, yet the rapid technological penetration and acceptability coupled with the gradual fall in costs constitute encouraging signals for the LMICs. Both CHWs interventions and digital technologies are not inexpensive, but they may provide better value for the money when applied at the right place and time. [less ▲]

Detailed reference viewed: 49 (4 UL)
Full Text
Peer Reviewed
See detailFamily Violence Curricula in Europe (FAVICUE): a cross-sectional descriptive study protocol
Gomez Bravo, Raquel UL; Lygidakis, Charilaos UL; Feder, Gene et al

in BMJ Open (2019), 9

Introduction. Family violence (FV) is a widespread public health problem of epidemic proportions and serious consequences. Doctors may be the first or only point of contact for victims who may be hesitant ... [more ▼]

Introduction. Family violence (FV) is a widespread public health problem of epidemic proportions and serious consequences. Doctors may be the first or only point of contact for victims who may be hesitant or unable to seek other sources of assistance, and they tend not to disclose abuse to doctors if not specifically asked. A comprehensive healthcare response is key to a coordinated community-wide approach to FV, but most of the practising physicians have received either no or insufficient education or training in any aspect of FV. Training of medical students concerning FV is often delivered in an inconsistent or ad hoc manner. The main aim of this project, Family Violence Curricula in Europe (FAVICUE), is to (1) describe current FV education delivery in European medical universities (undergraduate period) and during the specialist training in general practice (GP)/family medicine (FM) (postgraduate residency programme), and (2) compare it with WHO recommendations for FV curriculum. Methods and analysis. This is the protocol of a cross-sectional descriptive study consisting of two self-report online surveys (for undergraduate and postgraduate training, respectively) with 40 questions each. For both surveys, general practitioners, residents, medical students and professionals involved in their education from countries of the European region will be identified through the European Regional Branch of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA Europe) and will be invited to provide information regarding the training on FV. Descriptive tests will be carried out and a thematic analysis will be conducted on the open-ended questions. Ethics and dissemination Ethics approval has been obtained by the University of Luxembourg (ERP 17–015 FAVICUE). The results will provide important information concerning current curricula on FV, and can be used for mapping the educational needs and planning the implementation of future training interventions. They will be published and disseminated through WONCA Europe and its networks. [less ▲]

Detailed reference viewed: 77 (2 UL)
Full Text
Peer Reviewed
See detailA17044 Community health workers for non-communicable disease interventions in the digital age
Mishra, Shiva Raj; Lygidakis, Charilaos UL; Neupane, Dinesh et al

in Journal of Hypertension (2018, October)

Objectives: In this study, we review the evidence and discuss how the digitalization affects the CHWs programs for tackling non-communicable diseases (NCDs) in low-and-middle income countries (LMICs ... [more ▼]

Objectives: In this study, we review the evidence and discuss how the digitalization affects the CHWs programs for tackling non-communicable diseases (NCDs) in low-and-middle income countries (LMICs). Methods: We conducted a review of literature covering two databases: PubMED and Embase. A total of 97 articles were abstracted for full text review of which 21 are included in the analysis. Existing theories were used to construct a conceptual framework for understanding how digitalization affects the prospects of CHW programs for NCDs. Results: We identified three benefits and three challenges of digitalization. Firstly, it will help improve the access and quality of services, notwithstanding its higher establishment and maintenance costs. Secondly, it will add efficiency in training and personnel management. Thirdly, it will leverage the use of data generated across grass-roots platforms to further research and evaluation. The challenges posed are related to funding, health literacy of CHWs, and systemic challenges related to motivating CHWs. More than 60 digital platforms were identified, including mobile based networking devices (used for behavioral change communication), Web-applications (used for contact tracking, reminder system, adherence tracing, data collection, and decision support), videoconference (used for decision support) and mobile applications (used for reminder system, supervision, patients’ management, hearing screening, and tele-consultation). Conclusion: The digitalization efforts of CHW programs are afflicted by many challenges, yet the rapid technological penetration and acceptability coupled with the gradual fall in costs constitute encouraging signals for the LMICs. Both CHWs interventions and digital technologies are not inexpensive, but they may provide better value for the money. [less ▲]

Detailed reference viewed: 51 (0 UL)
Full Text
Peer Reviewed
See detailConducting primary care research using social media
Lygidakis, Charilaos UL; Neves, Ana Luísa; Laranjo, Liliana et al

in Goodyear-Smith, Felicity; Mash, Robert (Eds.) How To Do Primary Care Research (2018)

Social media offers great potential in primary care research. Online platforms can be used to conduct experimental studies, facilitating the recruitment and retention of participants, as well as the ... [more ▼]

Social media offers great potential in primary care research. Online platforms can be used to conduct experimental studies, facilitating the recruitment and retention of participants, as well as the delivery of the intervention. As patients are increasingly able to use information technology to help make informed decisions about their health care, reports show that the use of social media for health-information seeking is not limited to the younger demographics anymore. Notably, patients seem to be willing to share their health data in communities of peers, such as PatientsLikeMe, and actively engage with researchers. Additionally, publicly available social media data can be used for secondary analysis purposes, potentially contributing to the monitoring of health topics and disease surveillance. Finally, social media tools can be used to streamline the management of research projects and facilitate team collaboration. [less ▲]

Detailed reference viewed: 51 (3 UL)
Full Text
Peer Reviewed
See detailUsing social media to disseminate primary care research
Lygidakis, Charilaos UL; Gomez Bravo, Raquel UL

in Goodyear-Smith, Felicity; Mash, Robert (Eds.) How To Do Primary Care Research (2018)

Social media are a powerful means of communication among health-care professionals, patients and the public. Their use has been increasing steadily globally, transforming the way that people exchange ... [more ▼]

Social media are a powerful means of communication among health-care professionals, patients and the public. Their use has been increasing steadily globally, transforming the way that people exchange information, interact and collaborate. Physicians are using more and more social networks to connect with broader audiences, communicate with their patients and their colleagues and build a network of trustworthy peers. Researchers are also leveraging social media, capitalising on the velocity with which the messages can spread and the ability to disseminate their messages to the general public in addition to research communities, thus attracting more attention and increasing the influence and impact of their work. [less ▲]

Detailed reference viewed: 25 (8 UL)
Full Text
See detailThe D²Rwanda Study: March 2018 Report
Kallestrup, Per; Vögele, Claus UL; Uwizihiwe, JeanPaul et al

Report (2018)

The Community- and MHealth-Based Integrated Management of Diabetes in Primary Healthcare in Rwanda: the D²Rwanda Study (which stands for Digital Diabetes Study in Rwanda) is a twin PhD project, developed ... [more ▼]

The Community- and MHealth-Based Integrated Management of Diabetes in Primary Healthcare in Rwanda: the D²Rwanda Study (which stands for Digital Diabetes Study in Rwanda) is a twin PhD project, developed in collaboration with Aarhus University (AU) and the University of Luxembourg (UL), and under the auspices of the University of Rwanda and Rwanda Biomedical Centre. The project involves two PhD students, Jean Paul Uwizihiwe (enrolled at AU) and Charilaos Lygidakis (enrolled at UL), and is kindly sponsored by the Karen Elise Jensens Foundation, alongside AU and UL. In this report we wished to narrate what we had been working on for the past two years: from the first steps to understanding better the context and mapping the territory; from obtaining the necessary authorisations to developing the app and translating the questionnaires. [less ▲]

Detailed reference viewed: 81 (2 UL)
Full Text
Peer Reviewed
See detailOne consensual depression diagnosis tool to serve many countries: a challenge! A RAND/UCLA methodology
Nabbe, P.; Le Reste, J. Y.; Guillou-Landreat, M. et al

in BMC Research Notes (2018), 11(1), 4

From a systematic literature review (SLR), it became clear that a consensually validated tool was needed by European General Practitioner (GP) researchers in order to allow multi-centred collaborative ... [more ▼]

From a systematic literature review (SLR), it became clear that a consensually validated tool was needed by European General Practitioner (GP) researchers in order to allow multi-centred collaborative research, in daily practice, throughout Europe. Which diagnostic tool for depression, validated against psychiatric examination according to the DSM, would GPs select as the best for use in clinical research, taking into account the combination of effectiveness, reliability and ergonomics? A RAND/UCLA, which combines the qualities of the Delphi process and of the nominal group, was used. GP researchers from different European countries were selected. The SLR extracted tools were validated against the DSM. The Youden index was used as an effectiveness criterion and Cronbach's alpha as a reliability criterion. Ergonomics data were extracted from the literature. Ergonomics were tested face-to-face. [less ▲]

Detailed reference viewed: 81 (1 UL)
Full Text
Peer Reviewed
See detailRandomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website
Wallace, Paul; Struzzo, Pierliugi; Della Vedova, Roberto et al

in BMJ Open (2017), 7(11),

Background: Brief interventions (BIs) delivered in primary care have been shown to be effective in reducing risky drinking, but implementation is limited. Facilitated access to a digital application ... [more ▼]

Background: Brief interventions (BIs) delivered in primary care have been shown to be effective in reducing risky drinking, but implementation is limited. Facilitated access to a digital application offers a novel alternative to face-to-face intervention, but its relative effectiveness is unknown.Methods: Primary care-based, non-inferiority, randomised controlled trial comparing general practitioner (GP) facilitated access to an interactive alcohol reduction website (FA) with face-to-face BI for risky drinking. Patients screening positive on the short Alcohol Use Disorders Identification Test (AUDIT-C) were invited to participate in the trial. Assessment at baseline, 3 months and 12 months was carried out using AUDIT and EQ-5D-5L questionnaires. Findings: 58 participating GPs approached 9080 patients of whom 4529 (49.9%) logged on, 3841 (84.8%) undertook screening, 822 (21.4%) screened positive and 763 (19.9%) were recruited. 347 (45.5%) were allocated to FA and 416 (54.5%) to BI. At 3 months, subjects in FA group with an AUDIT score of ≥8 reduced from 95 (27.5%) to 85 (26.8%) while those in BI group increased from 123 (20.6%) to 141 (37%). Differences between groups were principally due to responses to AUDIT question 10. Analysis of primary outcome indicated non-inferiority of FA compared with BI, and prespecified subgroup analysis indicated benefits for older patients and those with higher levels of computer literacy and lower baseline severity. Additional analyses undertaken to take account of bias in response to AUDIT question 10 failed to support non-inferiority within the prespecified 10% boundary.Interpretation: Prespecified protocol-driven analyses of the trial indicate that FA is non-inferior to BI; however, identified bias in the outcome measure and further supportive analyses question the robustness of this finding. It is therefore not possible to draw firm conclusions from this trial, and further research is needed to determine whether the findings can be replicated using more robust outcome measures.Trial registration number NCT01638338; Results. [less ▲]

Detailed reference viewed: 35 (3 UL)
Full Text
Peer Reviewed
See detailUniversal health coverage: an urgent need for collaborative learning and technology in primary care
Patel, Kunal D.; Mcloughlin, Clodagh; Lygidakis, Charilaos UL et al

in Education for Primary Care (2017)

Universal health coverage is an achievable goal for all health professionals globally. However, for it to be implemented technology and collaboration are essential. This letter focuses on recently ... [more ▼]

Universal health coverage is an achievable goal for all health professionals globally. However, for it to be implemented technology and collaboration are essential. This letter focuses on recently published recommendations for technology in primary care education in respect to Universal Health Coverage. [less ▲]

Detailed reference viewed: 60 (2 UL)
Full Text
Peer Reviewed
See detailRandomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website: cost-effectiveness analysis
Hunter, Rachael; Wallace, Paul; Struzzo, Pierluigi et al

in BMJ Open (2017), 7(11),

Objectives To evaluate the 12-month costs and quality-adjusted life years (QALYs) gained to the Italian National Health Service of facilitated access to a website for hazardous drinkers compared with a ... [more ▼]

Objectives To evaluate the 12-month costs and quality-adjusted life years (QALYs) gained to the Italian National Health Service of facilitated access to a website for hazardous drinkers compared with a standard face-to-face brief intervention (BI). Design Randomised 1:1 non-inferiority trial. Setting Practices of 58 general practitioners (GPs) in Italy. Participants Of 9080 patients (>18 years old) approached to take part in the trial, 4529 (49·9%) logged on to the website and 3841 (84.8%) undertook online screening for hazardous drinking. 822 (21.4%) screened positive and 763 (19.9%) were recruited to the trial. Interventions Patients were randomised to receive either a face-to-face BI or access via a brochure from their GP to an alcohol reduction website (facilitated access). Primary and secondary outcome measures The primary outcome is the cost per QALY gained of facilitated access compared with face-to-face. A secondary analysis includes total costs and benefits per 100 patients, including number of hazardous drinkers prevented at 12 months. Results The average time required for the face-to-face BI was 8 min (95% CI 7.5 min to 8.6 min). Given the maximum time taken for facilitated access of 5 min, face-to-face is an additional 3 min: equivalent to having time for another GP appointment for every three patients referred to the website. Complete case analysis adjusting for baseline the difference in QALYs for facilitated access is 0.002 QALYs per patient (95% CI −0.007 to 0.011). Conclusions Facilitated access to a website to reduce hazardous drinking costs less than a face-to-face BI given by a GP with no worse outcomes. The lower cost of facilitated access, particularly in regards to investment of time, may facilitate the increase in provision of BIs for hazardous drinking. Trial registration number NCT01638338;Post-results. [less ▲]

Detailed reference viewed: 31 (2 UL)
See detailDigital health: navigating towards meaningful and sustainable solutions
Lygidakis, Charilaos UL

Scientific Conference (2017, October 18)

Detailed reference viewed: 26 (1 UL)
See detailEmbracing diversity in the digital transformation of primary healthcare
Lygidakis, Charilaos UL

Scientific Conference (2017, June 30)

The use of information and communication technologies for health constitutes a strategic ally to the sustainable development goals and attaining universal health coverage through enabling equitable access ... [more ▼]

The use of information and communication technologies for health constitutes a strategic ally to the sustainable development goals and attaining universal health coverage through enabling equitable access to high quality and affordable health care services. The omnipresence of mobile devices and sensors, the increasing availability of data and computational power, and the breakthroughs in imaging and genomics, are creating a perfect storm that is bound to transform health care profoundly. At the population level, the coordination of disease control and prevention programmes is facilitated, cost-effective interventions are implemented, and ultimately the quality of life of our communities is enhanced. EHealth also plays a significant role in the delivery of people-centred and integrated health services, empowers individuals to make informed decisions and self-manage their health needs. For the first time in history, the individual is placed at the centre, has timely and affordable access to data, knowledge and tools, and health care is tailored for his/her diverse background, context and needs. A second perspective to the digital revolution is how our own discipline is transformed. As technology is a catalyst for sustainable, large scale social change, health care has the opportunity to invest in inter-professional collaboration, and leverage a diverse range of expertise, stakeholders and resources to expand its horizons and tackle old and future challenges. [less ▲]

Detailed reference viewed: 69 (0 UL)
Peer Reviewed
See detailCommunity- and mHealth-based integrated management of diabetes in primary healthcare in Rwanda (D²Rwanda): The study protocol
Uwizihiwe, Jean Paul; Lygidakis, Charilaos UL; Vögele, Claus UL et al

Scientific Conference (2017, June 29)

Introduction: The diabetes mellitus (DM) prevalence in Rwanda is estimated at 3.5%. In 2013, there were only one medical doctor and one nurse per 15,000 and 1,200 people respectively in Rwanda. A new ... [more ▼]

Introduction: The diabetes mellitus (DM) prevalence in Rwanda is estimated at 3.5%. In 2013, there were only one medical doctor and one nurse per 15,000 and 1,200 people respectively in Rwanda. A new programme employing frontline workers (Home-Based Community Practitioners (HBCPs)) is currently piloted, aiming at following-up patients with non-communicable diseases in their communities. We hypothesise that the management of DM at community level will improve following the introduction of a HBCP programme with regular monthly assessments and disease management, coupled with integration of a mobile health (mHealth) application with patient diaries, notifications and educational material. Objective: The aim of the study is to determine the efficacy of such an integrated programme in Rwanda. Methods: The study is designed as a one-year, open-label cluster trial of two interventions (arm1: HBCP programme, arm2: HBCP programme + mHealth application) and usual care (control). The primary outcomes will be changes in glycated haemoglobin levels and health-related quality of life. Mortality, complications, health literacy, mental well-being and treatment adherence will be assessed as secondary outcomes. Measurements will be conducted at baseline, 6 and 12 months. An intention-to-treat approach will be used to evaluate outcomes. Before trial onset, ethical approval will be sought in Rwanda, Luxembourg and Denmark, and a cross-cultural adaptation of questionnaires and a pilot will be carried out. Relevance: The project will provide evidence on the efficacy of innovative approaches for integrated management of DM and may spur the development of similar solutions for other chronic diseases in low-resource settings. [less ▲]

Detailed reference viewed: 124 (8 UL)
Full Text
See detailAchieving Universal Health Coverage: Technology for innovative primary health care education
Lygidakis, Charilaos UL; McLoughlin, Clodagh; Patel, Kunal

Report (2016)

The challenges to achieving universal health coverage (UHC) are obvious yet vast in their scope: leading these is a lack of strong primary health care (PHC) systems and a global shortage of well-trained ... [more ▼]

The challenges to achieving universal health coverage (UHC) are obvious yet vast in their scope: leading these is a lack of strong primary health care (PHC) systems and a global shortage of well-trained health care professionals. Addressing these challenges is paramount, as it is well-trained health care professionals who will build the strong PHC systems that are necessary for UHC. Due to the continuing spread and evolution of information and communications technology (ICT) in health care and education, ICT should be considered as an essential tool for innovative primary health care education.  Many nations face a distinct lack of UHC, grossly unequal health services and an acute shortage of suitably qualified family doctors, nurses and allied health care professionals that constitute the primary health care team. It is estimated that by 2035, the world will have a shortage of 12.9 million health care professionals, however an additional 1.9 billion people will require health care. Recruiting, educating and retaining these primary health care teams is therefore fundamental to meet ongoing demands.  Family doctors contribute to high quality, cost-effective and accessible primary health care. However, PHC faces considerable challenges, including a preference from policymakers, the public, and members of the health care community for specialisation. Specialist-focused care may be attractive, but it is often economically unsustainable and absorbs resources that are necessary for PHC. Yet, cooperation between primary and secondary care is essential for delivering the best care to patients and communities. It should not be a matter of choosing between primary and secondary care, but rather of recognising and adequately supporting the unique attributes and skillsets that each has to offer.  Family medicine lies at the heart of primary health care. The key to producing skilled family doctors is good family medicine training, particularly at a postgraduate level. There is great potential to improve the scale and quality of family medicine training, starting with exposure to the field as early as possible. For the delivery of primary care to be effective – and lead to the achievement of universal health coverage – the composition of the primary care team should reflect the demography and health needs of the local population. Thus, the composition of the primary care team will differ from location to location, depending on the age/sex/ health needs of the local population. Family doctors and all of the PHC professionals should have a set of universal core skills, in addition to skills specific to the population and geography they serve. To provide effective care, health professionals need to understand the importance of social factors in influencing population health; therefore, training curricula must be adapted to local contexts  Career development through postgraduate training strongly motivates health professionals to stay in their own localities, as well as being vital for patient safety and improved outcomes. Yet, despite a thirst for postgraduate training among family doctors and other primary health care professionals, it is often difficult to access. ICT may be used to address recruitment and retention issues by providing easily accessible and good quality education.  This report examines a key question: Can ICT facilitate the education of PHC professionals worldwide in order to address the challenges facing PHC and UHC? Through in-depth literature reviews, analysis, and targeted interviews with key experts, the report concludes that ICT can indeed support, enhance and accelerate the education of the primary health care team’s members, in six key ways:  1. It is an effective means of developing workforce capacity. By overcoming geographical barriers and supplementing traditional instruction with online delivery from international and regional tutors, ICT can substantially increase health care professionals’ access to postgraduate education without the need for travel, thus helping to avoid disruption to healthcare delivery.  2. It helps to recruit and retain professionals. E-learning overcomes issues of access and isolation, and can be done flexibly to suit the learner. By providing access to specialist support, postgraduate courses and mentoring opportunities, e-learning and telehealth encourage in-country and rural retention of health care workers.  3. It is cost-saving. Traditional models of health professional education are expensive, both for the provider and for health care professionals. Developing ICT solutions may entail high initial costs but these are reduced over time, and with more users, achieve economies of scale.  4. It facilitates social and collaborative learning which has been shown to have the greatest impact on patient outcomes. A blend of synchronous and asynchronous e-learning is likely to be the most effective way of achieving interprofessional learning. Communities of practice are encouraged using ICT and social media, reducing professional isolation and improving collaboration.  5. It can help to bring contextualised care to where it is needed. For example, simulation-based medical education enables problem-based, interactive and contextualised learning. End-user (including patient) participation is paramount when designing ICT-based educational programmes.  6. It improves the quality of care by facilitating access to evidence-based medicine and reflective learning. Email alerts can support education by reaching a large audience and providing trustworthy information tailored to individual needs; social media can aid in streamlining vast amounts of information into a small number of tailored-to-the-individual articles; blogs and electronic portfolios can encourage reflective life-long learning. Capturing these opportunities will require stakeholders to consider the following:  a) Securing political and financial support to establish and maintain strong PHC systems  b) Adopting a collaborative interprofessional approach between health professionals, from medical school through to the workplace  c) Providing education and training relevant to the context and to user needs  d) Improving recruitment and retention through training  e) Encouraging the standardisation and accreditation of health professional education  f) Investing in ICT training for learners, educators and patients  g) Planning and developing programmes that use technology meaningfully to improve care quality, cost-effectiveness, accessibility, equity and patient safety  h) Recognise and consolidate the interdependence of all the health professionals in the PHC setting.  [less ▲]

Detailed reference viewed: 222 (7 UL)
Full Text
Peer Reviewed
See detailHow do general practitioners recognize the definition of multimorbidity? A European qualitative study.
Le Reste, Jean Yves; Nabbe, Patrice; Lazic, Djurdjica et al

in European Journal of General Practice (2016)

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 ... [more ▼]

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. OBJECTIVES: To investigate whether European GPs recognize the EGPRN concept of multimorbidity and whether they would change it. METHODS: Focus group meetings and semi-structured interviews as data collection techniques with a purposive sample of practicing GPs from every country. Data collection continued until saturation was reached in every country. The analysis was undertaken using a grounded theory based method. In each national team, four independent researchers, working blind and pooling data, carried out the analysis. To ensure the internationalization of the data, an international team of 10 researchers pooled the axial and selective coding of all national teams to check the concept and highlight emerging themes. RESULTS: The maximal variation and saturation of the sample were reached in all countries with 211 selected GPs. The EGPRN definition was recognized in all countries. Two additional ideas emerged, the use of Wonca's core competencies of general practice, and the dynamics of the doctor-patient relationship for detecting and managing multimorbidity and patient's complexity. CONCLUSION: European GPs recognized and enhanced the EGPRN concept of multimorbidity. These results open new perspectives regarding the management of complexity using the concept of multimorbidity in general practice. [less ▲]

Detailed reference viewed: 63 (5 UL)
Full Text
Peer Reviewed
See detailWhich DSM validated tools for diagnosing depression are usable in primary care research? A systematic literature review
Nabbe, P.; Le Reste, J. Y.; Guillou-Landreat, M. et al

in European Psychiatry (2016), 39

IntroductionDepression occurs frequently in primary care. Its broad clinical variability makes it difficult to diagnose. This makes it essential that family practitioner (FP) researchers have validated ... [more ▼]

IntroductionDepression occurs frequently in primary care. Its broad clinical variability makes it difficult to diagnose. This makes it essential that family practitioner (FP) researchers have validated tools to minimize bias in studies of everyday practice. Which tools validated against psychiatric examination, according to the major depression criteria of DSM-IV or 5, can be used for research purposes? [less ▲]

Detailed reference viewed: 70 (0 UL)
Full Text
Peer Reviewed
See detailDownload Your Doctor: Implementation of a Digitally Mediated Personal Physician Presence to Enhance Patient Engagement With a Health-Promoting Internet Application.
Lygidakis, Charilaos UL; Wallace, Paul; Tersar, Costanza et al

in JMIR Research Protocols (2016), 5(1), 36

BACKGROUND: Brief interventions delivered in primary health care are effective in reducing excessive drinking; online behavior-changing technique interventions may be helpful. Physicians may actively ... [more ▼]

BACKGROUND: Brief interventions delivered in primary health care are effective in reducing excessive drinking; online behavior-changing technique interventions may be helpful. Physicians may actively encourage the use of such interventions by helping patients access selected websites (a process known as "facilitated access"). Although the therapeutic working alliance plays a significant role in the achievement of positive outcomes in face-to-face psychotherapy and its development has been shown to be feasible online, little research has been done on its impact on brief interventions. Strengthening patients' perception of their physician's endorsement of a website could facilitate the development of an effective alliance between the patient and the app. OBJECTIVE: We describe the implementation of a digitally mediated personal physician presence to enhance patient engagement with an alcohol-reduction website as part of the experimental online intervention in a noninferiority randomized controlled trial. We also report the feedback of the users on the module. METHODS: The Download Your Doctor module was created to simulate the personal physician presence for an alcohol-reduction website that was developed for the EFAR-FVG trial conducted in the Italian region of Friuli-Venezia-Giulia. The module was designed to enhance therapeutic alliance and thus improve outcomes in the intervention group (facilitated access to the website). Participating general and family practitioners could customize messages and visual elements and upload a personal photo, signature, and video recordings. To assess the perceptions and attitudes of the physicians, a semistructured interview was carried out 3 months after the start of the trial. Participating patients were invited to respond to a short online questionnaire 12 months following recruitment to investigate their evaluation of their online experiences. RESULTS: Nearly three-quarters (23/32, 72%) of the physicians interviewed chose to customize the contents of the interaction with their patients using the provided features and acknowledged the ease of use of the online tools. The majority of physicians (21/32, 57%) customized at least the introductory photo and video. Barriers to usage among those who did not customize the contents were time restrictions, privacy concerns, difficulties in using the tools, and considering the approach not useful. Over half (341/620, 55.0%) of participating patients completed the optional questionnaire. Many of them (240/341, 70.4%) recalled having noticed the personalized elements of their physicians, and the majority of those (208/240, 86.7%) reacted positively, considering the personalization to be of either high or the highest importance. CONCLUSIONS: The use of a digitally mediated personal physician presence online was both feasible and welcomed by both patients and physicians. Training of the physicians seems to be a key factor in addressing perceived barriers to usage. Further research is recommended to study the mechanisms behind this approach and its impact. TRIAL REGISTRATION: Clinicaltrials.gov NCT 01638338; https://clinicaltrials.gov/ct2/show/NCT01638338 (Archived by WebCite at http://www.webcitation.org/6f0JLZMtq). [less ▲]

Detailed reference viewed: 56 (4 UL)
Full Text
Peer Reviewed
See detailWhat research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice?
Le Reste, J. Y.; Nabbe, P.; Lingner, H. et al

in BMC family practice (2015), 16(1), 125

BACKGROUND: Multimorbidity is an intuitively appealing, yet challenging, concept for Family Medicine (FM). An EGPRN working group has published a comprehensive definition of the concept based on a ... [more ▼]

BACKGROUND: Multimorbidity is an intuitively appealing, yet challenging, concept for Family Medicine (FM). An EGPRN working group has published a comprehensive definition of the concept based on a systematic review of the literature which is closely linked to patient complexity and to the biopsychosocial model. This concept was identified by European Family Physicians (FPs) throughout Europe using 13 qualitative surveys. To further our understanding of the issues around multimorbidity, we needed to do innovative research to clarify this concept. The research question for this survey was: what research agenda could be generated for Family Medicine from the EGPRN concept of Multimorbidity? METHODS: Nominal group design with a purposive panel of experts in the field of multimorbidity. The nominal group worked through four phases: ideas generation phase, ideas recording phase, evaluation and analysis phase and a prioritization phase. RESULTS: Fifteen international experts participated. A research agenda was established, featuring 6 topics and 11 themes with their corresponding study designs. The highest priorities were given to the following topics: measuring multimorbidity and the impact of multimorbidity. In addition the experts stressed that the concept should be simplified. This would be best achieved by working in reverse: starting with the outcomes and working back to find the useful variables within the concept. CONCLUSION: The highest priority for future research on multimorbidity should be given to measuring multimorbidity and to simplifying the EGPRN model, using a pragmatic approach to determine the useful variables within the concept from its outcomes. [less ▲]

Detailed reference viewed: 41 (0 UL)
Full Text
Peer Reviewed
See detailCross-Cultural Validation of the Definition of Multimorbidity in the Bulgarian Language.
Assenova, Radost S.; Le Reste, Jean Yves; Foreva, Gergana H. et al

in Folia medica (2015), 57(2), 127--132

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 ... [more ▼]

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. The AIM of the present study was to validate the translated definition of multimorbidity from English into the Bulgarian language. MATERIALS AND METHODS: The present study is part of an international project involving 8 national groups. We performed a forward and backward translation of the original English definition of multimorbidity using a Delphi consensus procedure. RESULTS: The physicians involved accepted the definition with a high percentage of agreement in the first round. The backward translation was accepted by the scientific committee using the Nominal group technique. DISCUSSION: Some of the GPs provided comments on the linguistic expressions which arose in order to improve understanding in Bulgarian. The remarks were not relevant to the content. The conclusion of the discussion, using a meta-ethnographic approach, was that the differences were acceptable and no further changes were required. CONCLUSIONS: A native version of the published English multimorbidity definition has been finalized. This definition is a prerequisite for better management of multimorbidity by clinicians, researchers and policy makers. [less ▲]

Detailed reference viewed: 32 (0 UL)