Journal of evaluation in clinical practice
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Clinical practice guidelines (CPGs) are moving toward greater consideration of population-level differences, like health inequities, when creating management recommendations. CPGs have the potential to reduce or perpetuate health inequities. The intrinsic design factors of electronic interfaces that contain CPGs are known barriers to guideline use. There is little existing guidance on supporting the uptake of equity-specific recommendations within CPGs by end users. ⋯ This research extends existing literature by showing that including equity information tailored to the articulated purpose of each CPG, as perceived by end users, may maximise uptake. Our outlined strategies could be used by CPG developers to make equity-focused management recommendations more accessible. This may increase the implementation of equity-focused recommendations by clinicians, supporting current primary care strategies in achieving more equitable outcomes.
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To assess and evaluate consumer awareness and common medication use practices towards OTC analgesics, with a focus on the impact of irrational drug use and its implications for public health and safety. This includes identifying gaps in knowledge, evaluating the potential consequences of misuse, and discussing how these findings can inform future educational initiatives and policy development to promote safer medication practices. ⋯ Our study highlights the menace of self-medication practices and irrational use of OTC analgesic by the study participants. Immediate remedial measure need to be taken to discourage self-medication and improve rational use of OTC drugs which can be achieved by focusing on improving the consumers' awareness of self-medication and the rational use of medications.
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Dysfunctional exercise (DEX) is common among individuals with an eating disorder (ED) and poses significant challenges to treatment and recovery. While safe and nutritionally supported physical activity can enhance treatment outcomes without hindering weight restoration, clinicians often hesitate to address DEX with their patients. This mixed-method study aimed to evaluate the impact of a Safe Exercise at Every Stage (SEES) informed training on clinician knowledge and self-efficacy in managing DEX during ED treatment. ⋯ DEX continues to be preceived as a core ED symptom. To improve its managment clinician training and shifts in overarching field ideologies are needed. Providing programme-wide training is fundamental to equipping clinicians with the skills needed to address DEX and ultimately improve patient outcomes.
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Limited health literacy (HL) leads to poor health outcomes, psychological stress, and misutilization of medical resources. Although interventions aimed at improving HL may be effective, identifying patients at risk of limited HL in the clinical workflow is challenging. With machine learning (ML) algorithms based on readily available data, healthcare professionals would be enabled to incorporate HL screening without the need for administering in-person HL screening tools. ⋯ Elastic-Net Penalized Logistic Regression had the best performance when compared with other ML algorithms with a c-statistic of 0.766, calibration slope/intercept of 1.044/-0.037, and a Brier score of 0.179. Over one-third of patients presenting to an outpatient spine center were found to have limited HL. While this algorithm is far from being used in clinical practice, ML algorithms offer a potential opportunity for identifying patients at risk for limited HL without administering in-person HL assessments. This could possibly enable screening and early intervention to mitigate the potential negative consequences of limited HL without taxing the existing clinical workflow.
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Peter Drucker pointed out an important distinction between 'doing things right' and 'doing the right thing', which recognised that all problems are embedded in a context and thus can only be understood within their unique contextual setting. Contemporary research practices in clinical medicine often regards contextual factors as potential confounders that will bias effect estimates and thus must be avoided. However rigorous, research devoid of context ultimately deprives users of understanding of the support factors that make research transferable to policy decisions or managing care of individual patients-it stands in the way of 'doing the right thing' in 'real life' settings. ⋯ We discuss the need for researchers to a-priori consider the context of their research question as well as the structural relationships of the variables under investigation, which in turn provides the basis for choosing the most appropriate research design. We have a moral imperative to first 'do the right thing'-ask questions that address the contextual needs of our patients, and then to 'do it right'-choose the best research method to answer this contextually framed need. Only then will our research efforts have meaningful and lasting impacts on patient care.