Short-Term Effect of Different Teaching Methods on Nasopharyngeal Carcinoma for General Practitioners in Jakarta, Indonesia

In Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period

An integrated program with home blood-pressure monitoring and village health volunteers for treating poorly controlled hypertension at the primary care level in an urban community of Thailand

Sawitree Visanuyothin,1,2 Samlee Plianbangchang,1 Ratana Somrongthong1 1College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand; 2Social Medicine Department, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand Purpose: Hypertension (HT) is accountable for death in half of the patients suffering from heart disease and stroke. Many treatment strategies have been used, but little research exists on an integrated program with home blood pressure monitoring (HBPM) and village health volunteers (VHVs) in an urban area of Thailand. The present study aims to determine the effectiveness of the integrated program, HBPM, and VHVs in supporting the target population. Patients and methods: This quasi-experiment was conducted from July to November 2017. Patients with poorly controlled HT were randomly selected from each of the two primary care units in Nakhon Ratchasima, Thailand. The participants were separated into an experiment (n=63) and control group (n=65). The experiment group participated in the integrated program, which was based on the 20-item Health Literate Care Model. A valid and reliable questionnaire was used to collect data from participant interviews. Blood-pressure monitoring was used to measure systolic home blood pressure and diastolic home blood pressure. Descriptive statistics, chi-squared tests, Fisher’s exact test, the independent t-test, and the Wilcoxon–Mann–Whitney test were used to compare the baseline data. Multiple logistic regression was used to compare the differences between the mean changes in the outcomes. Results: At the end of the 3-month follow-up appointment, significant statistical changes were found. Systolic home blood pressure, diastolic home blood pressure, and body mass index changed −4.61 (95% CI −8.32, −0.90) mmHg (P-value=0.015), −3.5 (95% CI −5.31, −1.72) mmHg (P-value <0.001), and −0.86 (95% CI −1.29, −042) (P-value <0.001) respectively. Participant scores in lifestyle and management knowledge, and self-management behaviors significantly increased by 0.76 (95% CI 0.15–1.38) point (P-value=0.016) and 0.15 (95% CI 0.06, 0.24) point (P-value=0.001), respectively. Conclusion: The integrated program, HBPM, and VHVs were effective in decreasing blood pressure and body mass index, and increasing knowledge and self-management behaviors among urban patients with poorly controlled HT. Keywords: self-management behaviors, lifestyle and management knowledge, health literacy of chronic diseases, adherence of hypertension patient

Appearance and potential predictors of poorly controlled hypertension at the primary care level in an urban community

Sawitree Visanuyothin,1,2 Samlee Plianbangchang,2 Ratana Somrongthong2 1Social Medicine Department, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand; 2College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand Purpose: Hypertension (HT) is the major risk factor for cardiovascular diseases because of its poor control. To control HT at the primary care level in urban communities, there is a demand for deeper comprehension of the manifestations of poorly controlled HT. This study aimed to examine appearance of HT, including the association between the appearance and home blood pressure (HBP) control at the primary care level in urban communities.Patients and methods: A cross-sectional study was conducted in July–October 2017 in an urban community in Thailand. The total sample size from randomization was 125 poorly controlled HT patients who were diagnosed with an average clinic blood pressure ≥140/90 mmHg in their last three visits. Data were collected by face-to-face interviews, HBP monitoring (HBPM), and blood and urine testing. Data analysis was conducted via descriptive statistics and the chi-square tests, with a significance level of p<0.05.Results: HBPM revealed that 58.4% of patients with poorly controlled blood pressure from clinic measurement had a systolic blood pressure and diastolic blood pressure that were below the HBP target. Most patients were overweight/obese, but they were nonsmokers and nondrinkers. As comorbidities, they had hyperlipidemia (64.0%) and diabetes mellitus (53.0%). One-quarter of them had good levels of knowledge and literacy. Nearly half had good health self-care literacy. Only 13% exhibited adequate self-management behaviors, but more than half had biochemistry results within normal limits. There were significant associations of smoking history and having hyperlipidemia as a comorbidity with HBP control (p =0.010 and 0.046, respectively).Conclusion: The role of HBPM is important in practice when it comes to monitoring HT control at the primary care level in an urban context. Smoking cessation and control of the blood lipid levels should be highlighted not only at the practice, but also at the policy level. Keywords: characteristics, risk factors, association, home blood pressure, knowledge, health literacy, self-management behaviors, biochemistr