5 research outputs found
INFLUENCE OF PHARMACOLOGICAL CORRECTION ON THE QUALITY OF LIFE OF CHILDREN WITH FUNCTIONAL DYSPEPSIA
Objective: To study the influence of pharmacological psychocorrection with drugs derived from GABA on the quality of life of primary school-aged children with functional dyspepsia.
Materials and methods. 80 children aged 6–12 years with FD have been examined. Children were divided into 4 groups: Group 1 – 20 patients who received γ-amino-β-phenylbutyric acid hydrochloride along with baseline therapy, Group 2 – 20 patients who received comprehensive treatment and calcium hopantenate, Group 3 – 20 children who received vitamin-mineral complex and protocol treatment, and Control Group – 20 children who received baseline treatment. Study Design: general clinical, instrumental, psychodiagnostic, statistical.
Results. Using the PedsQL questionnaire, physical functioning disorders were found in children with FD – 97.5±1.2 % (78/80) of children, emotional functioning disorders – 91.3±1.6 % (73/80) of cases, functioning at school disorders – 88.8±2.7 % (71/80) of patients. During one-month case monitoring, children who took GABA drugs reported an improvement in the quality of life compared with baseline treatment and a group of children, who took a mineral-vitamin complex: physical functioning – (р1=0,016), (р2=0,03), emotional functioning – (р1˂0,001), (р2˂0,001), functioning in school – (р1=0,005), (р2=0,004).
Conclusion. The use of γ-aminobutyric acid drugs is safe and effective and they significantly improve the quality of life of children with FD
Overuse of medical care in paediatrics: A survey from five countries in the European Academy of Pediatrics.
Studies and initiatives such as the "Choosing wisely" (CW) campaign emphasise evidence-based investigations and treatment to avoid overdiagnosis and overtreatment. The perception of the extent of medical overactivity among professionals and drivers behind are not well studied in the paediatric field.
Aim
We aimed to investigate the physicians' opinion and clarify the main drivers regarding medical overactivity in member countries of the European Academy of Paediatrics (EAP).
Methods
In this study, paediatricians, paediatric residents, primary care paediatricians, and family doctors treating children were surveyed in Norway, Lithuania, Ukraine, Italy, and Switzerland. Over-investigation was defined as "diagnostic work-up or referral that is unlikely to provide information which is relevant for a patient" and overtreatment was defined as "treatment that does not benefit or can harm more than benefit the patient." The original questionnaire was developed in 2018 by a working group from the Norwegian Paediatric Association.
Results
Overall, 1,416 medical doctors participated in the survey, ranging from 144 in Lithuania to 337 in Switzerland. 83% stated that they experienced over-investigation/overtreatment, and 81% perceived this as a problem. The majority (83%) perceived expectations from family and patients as the most important driver for overtreatment in their country. Other drivers for overuse were use of national guidelines/recommendations, worry for reactions, and reduction of uncertainty.
Conclusion
This is the first study investigating knowledge and attitude toward medical overactivity in European countries. Despite different cultural and economic environments, the patterns and drivers of increased investigations and medicalisation are similar
Over-investigation and overtreatment in pediatrics: a survey from the European Academy of Paediatrics and Japan Pediatric Society
IntroductionAvoiding over-investigation and overtreatment in health care is a challenge for clinicians across the world, prompting the international Choosing Wisely campaign. Lists of recommendations regarding medical overactivity are helpful tools to guide clinicians and quality improvement initiatives. We aimed to identify the most frequent and important clinical challenges related to pediatric medical overactivity in Europe and Japan. Based on the results, we aim to establish a (European) list of Choosing Wisely recommendations.MethodsIn an online survey, clinicians responsible for child health care in Europe and Japan were invited to rate 18 predefined examples of medical overactivity. This list was compiled by a specific strategic advisory group belonging to the European Academy of Paediatrics (EAP). Participants were asked to rate on a Likert scale (5 as the most frequent/important) according to how frequent these examples were in their working environment, and how important they were considered for change in practice.ResultsOf 2,716 physicians who completed the survey, 93% (n = 2,524) came from 17 countries, Japan (n = 549) being the largest contributor. Pediatricians or pediatric residents comprised 89%, and 51% had 10–30 years of clinical experience. Cough and cold medicines, and inhaled drugs in bronchiolitis were ranked as the most frequent (3.18 and 3.07 on the Likert scale, respectively), followed by intravenous antibiotics for a predefined duration (3.01), antibiotics in uncomplicated acute otitis media (2.96) and in well-appearing newborns. Regarding importance, the above-mentioned five topics in addition to two other examples of antibiotic overtreatment were among the top 10. Also, IgE tests for food allergies without relevant medical history and acid blockers for infant GER were ranked high.ConclusionOvertreatment with antibiotics together with cough/cold medicines and inhaled drugs in bronchiolitis were rated as the most frequent and important examples of overtreatment across countries in Europe and Japan
COVID-19 Era Effect on Pandemic and Post-pandemic Pediatric Telemedicine Use: A Survey of the European Academy of Pediatrics Research in Ambulatory Settings Network
Background: During the COVID-19 pandemic, telemedicine use has increased
within community pediatrics. This trend runs counter to reluctance to
adaptation of the new mode of healthcare that existed prior to the
pandemic. Little is known about what we can expect after the pandemic:
if physicians will opt for telemedicine modalities and if
tele-pediatrics will continue to be a significant mode of community
pediatric care.</p>
Objective: The goal of this study was to survey primary pediatric care
providers as to their experiences and clinical decision making with
telemedicine modalities prior to and during the COVID-19 pandemic, as
well as their projected use after the pandemic ends.</p>
Material and methods: Using the EAPRASnet database we surveyed
pediatricians throughout Europe, using a web-based questionnaire. The
survey was performed during the COVID-19 pandemic (June-July 2020),
assessed telemedicine use for several modalities, prior to and during
the pandemic as well as predicted use after the pandemic will have
resolved. Participants were also surveyed regarding clinical decision
making in two hypothetical clinical scenarios managed by
telemedicine.</p>
Results: A total of 710 physicians participated, 76% were
pediatricians. The percentage of respondents who reported daily use for
at least 50% of all encounters via telemedicine modalities increased
during the pandemic: phone calls (4% prior to the pandemic to 52%
during the pandemic), emails (2-9%), text messages (1-6%), social
media (3-11%), cell-phone pictures/video (1-9%), and video
conferencing (1-7%) (p < 0.005). The predicted post-pandemic use of
these modalities partially declined to 19, 4, 3, 6, 9, and 4%,
respectively (p < 0.005), yet demonstrating a prospectively sustained
use of pictures/videos after the pandemic. Reported high likelihood of
remotely treating suspected pneumonia and acute otitis media with
antibiotics decreased from 8 to 16% during the pandemic to an assumed 2
and 4% after the pandemic, respectively (p < 0.005).</p>
Conclusions: This study demonstrates an increased utilization of
telemedicine by pediatric providers during the COVID-19 pandemic, as
well as a partially sustained effect that will promote telemedicine use
as part of a hybrid care provision after the pandemic will have
resolved.</p>
COVID-19 Era Effect on Pandemic and Post-pandemic Pediatric Telemedicine Use: A Survey of the European Academy of Pediatrics Research in Ambulatory Settings Network
Background: During the COVID-19 pandemic, telemedicine use has increased within community pediatrics. This trend runs counter to reluctance to adaptation of the new mode of healthcare that existed prior to the pandemic. Little is known about what we can expect after the pandemic: if physicians will opt for telemedicine modalities and if tele-pediatrics will continue to be a significant mode of community pediatric care. ----- Objective: The goal of this study was to survey primary pediatric care providers as to their experiences and clinical decision making with telemedicine modalities prior to and during the COVID-19 pandemic, as well as their projected use after the pandemic ends. ----- Material and methods: Using the EAPRASnet database we surveyed pediatricians throughout Europe, using a web-based questionnaire. The survey was performed during the COVID-19 pandemic (June-July 2020), assessed telemedicine use for several modalities, prior to and during the pandemic as well as predicted use after the pandemic will have resolved. Participants were also surveyed regarding clinical decision making in two hypothetical clinical scenarios managed by telemedicine. ----- Results: A total of 710 physicians participated, 76% were pediatricians. The percentage of respondents who reported daily use for at least 50% of all encounters via telemedicine modalities increased during the pandemic: phone calls (4% prior to the pandemic to 52% during the pandemic), emails (2-9%), text messages (1-6%), social media (3-11%), cell-phone pictures/video (1-9%), and video conferencing (1-7%) (p < 0.005). The predicted post-pandemic use of these modalities partially declined to 19, 4, 3, 6, 9, and 4%, respectively (p < 0.005), yet demonstrating a prospectively sustained use of pictures/videos after the pandemic. Reported high likelihood of remotely treating suspected pneumonia and acute otitis media with antibiotics decreased from 8 to 16% during the pandemic to an assumed 2 and 4% after the pandemic, respectively (p < 0.005). -----Conclusions: This study demonstrates an increased utilization of telemedicine by pediatric providers during the COVID-19 pandemic, as well as a partially sustained effect that will promote telemedicine use as part of a hybrid care provision after the pandemic will have resolved