ABSTRACT
Background: European patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have had only limited occasions to unite to have their voices heard, hence missing the opportunity to contribute to the improvement of CRSwNP care. Aims: To identify unmet needs in CRSwNP from the perspective of CRSwNP patients from the Patient Advisory Board (PAB) of the European Forum for Research and Education in Allergy and Airways diseases (EUFOREA). Methodology: Semi-structured interviews were conducted individually with 15 European patients with CRSwNP and with a disease history of more than 2 years. Patients shared their burden of the disease and frustrations related to CRSwNP care, experiences with key pillars of current treatment options, shortcomings of the current care pathways and recommendations for improvement of care. A panel of 30 members of the Patient Advisory Board reviewed the interview report and provided further input during 2 virtual meetings. Results: CRSwNP patients indicated the need for greater awareness from society and physicians of the disease burden with impact on social function and well-being. Along with a loss of ability to smell and the continuous presence of secretions in the nose, most patients reported poor sleep quality and psychological impact as the most bothersome symptoms. Patients' frustrations relate primarily to the underestimation of the disease burden, the lack of coordination of care and the limited treatment options available to them. Treatment options with oral corticosteroids and/or sinus surgery both have positive and negative aspects, including the lack of long-lasting efficacy. Better coordination of care, more patient-centered care, greater public awareness, increases in research on the disease mechanisms and better therapeutic options would be warmly welcomed by CRSwNP patients. Conclusions: This statement of the EUFOREA Patient Advisory Board on CRSwNP provides novel insights on the underestimation of the burden of CRSwNP and shortcomings of current care. Multiple recommendations made by the patients can underpin action plans for implementation of better care for CRSwNP among all physicians treating patients with this disabling disease.
ABSTRACT
[This corrects the article DOI: 10.3389/falgy.2021.761388.].
ABSTRACT
The aim of the study was to measure the results of a 15-year health promotion strategy towards osteoporosis, in an urban community of subjects over 45 years old, in terms of osteoporosis awareness and handling. To this end an ancillary study to a large survey of the Belgian population's self-perceived health status was carried out. A rectangular sample of 4800 individuals over 45 years old was randomly selected in two Belgian cities, among the affiliates of the two main health insurance providers. One of the cities (Liège) had been, since the early 1980s, the target of a constant health promotion strategy, directed to both the medical community and the general population, aimed at increasing osteoporosis awareness in women after the menopause. During the same period, no particular steps were taken in the other city (Aalst) to increase osteoporosis awareness in the community. In our study, the participants were asked to spontaneously report any chronic, serious and/or severe disorders that they had been suffering from, for at least 6 months, during the previous 12 months. They also provided a list of drugs they were taking at the time of the survey. Osteoporosis was reported to be a disease affecting 1.5% of men in Aalst and 1.3% of men in Liege (p = 0.61). For women, osteoporosis was reported to be present in 4.8% in Aalst and 10.8% in Liege (p<0.001). Self-reporting of osteoporosis prevalence in Liege was statistically significantly higher in women aged 45-64 years, 65-74 years or over 75 years (p<0.001). Obesity, alcohol consumption or physical activity were equally distributed between women from Liège and Aalst. Prescription drugs used for osteoporosis had been delivered to a similar proportion of men in Aalst and Liège. In women, a statistically significant difference in these prescription drugs was observed between Liège and Aalst, both for the overall population (p<0.001) and in each of the age classes (p<0.001 for 45-64 years and 65-74 years; p<0.009 for over 75 years). A continuous long-term health promotion strategy, directed toward both physicians and the general population, thus appears to increase awareness about osteoporosis in women over 45 years and/or in the medical community. This is reflected by an increase in self-reported prevalence of osteoporosis and in the prescription of drugs aimed at prevention and treatment of this disorder. Whether these observations reflect an appropriate diagnosis and a proper handling of the disease remains to be evaluated by objective diagnostic tools such as bone densitometry and by an evaluation of the effectiveness of prescription practices in postmenopausal women.
Subject(s)
Health Promotion/methods , Osteoporosis, Postmenopausal/prevention & control , Aged , Awareness , Female , Health Status , Humans , Male , Middle Aged , Patient Education as TopicABSTRACT
OBJECTIVE: To determine the effect of a non-committal registration specifying the intention of patients to contact a particular general practitioner, on patient loyalty in Belgium. SETTING: Antwerp and Liège DESIGN: Case control study. METHOD: Medical consumption was registered during one year by two health insurance companies for a group of 4000 participating patients (experimental group) and 4000 non-participants (control group) within two selected areas (Antwerp and Liège). Patient loyalty was measured by means of the normalised usual provider continuity index. RESULTS: No relevant differences were found between the experimental group and the control group. Even when taking into account that a general practitioner is not available 20% of the time, the proportion of loyal patients hardly reached 70%. CONCLUSION: A non-committal registration had no influence on patient loyalty. There is a clear difference between intention and actual behaviour. More coercive measures are needed to reach a more loyal behaviour.
Subject(s)
Contract Services , Physicians, Family/statistics & numerical data , Adolescent , Adult , Aged , Attitude , Belgium , Case-Control Studies , Child , Child, Preschool , Female , Humans , Longitudinal Studies , Male , Middle Aged , Patients/psychology , Physician-Patient RelationsABSTRACT
Data on marital status, living conditions and social contacts of 2586 elderly persons living in 19 towns from 12 European countries, who were born between 1913 and 1918, and who participated in the Euronut SENECA study on Nutrition of the Elderly in Europe, reflect on the whole a high quality of life in the elderly population of these small traditional European towns. Housing offers adequate comfort in general and many elderly people have access to gardens. In most survey towns the majority of men and women of this age group have at least one child within the town or nearer. In some of the southern and eastern towns 40% or more live with their children. In most survey towns 30-50% of the women live alone (more than 50% in the Danish and Norwegian towns Roskilde and Elverum) but in general social nets are strong enough to prevent the danger of acute isolation. But in four towns (Roskilde/Denmark, Chateau Renault-Amboise/France, Elverum/Norway and Padua/Italy) 10-13% of all women lived alone and did not know a neighbour well enough to call on for help. In three towns (Monor/Hungary, Vila Franca de Xira/Portugal and Marki/Poland) social contacts were distinctly less frequent than in all other towns and participation in community activities virtually non-existent. These were the same towns in which substantial groups reported food budgeting problems. Danger of isolation, however, seemed to be rather low. A high intensity of social contacts and no danger of acute isolation in spite of relatively few available children was noted in the German-speaking town of Switzerland (Burgdorf). Further analyses will have to test whether food consumption or nutritional status is related to any of the studied life-style factors.