What are the main motivating factors for young general practitioner trainees to work in rural areas in the Czech Republic?

PURPOSE: The global health workforce suffers long-term understaffing in remote and underserved areas. To attract young doctors for rural work, it is necessary to identify the main motivating factors. MATERIALS AND METHODS: The pilot survey with 201 general practitioner trainees in the Czech Republic was conducted using a structured questionnaire. The response rate was 67%. RESULTS: Not only financial support motivates general practitioner trainees for rural work. A combination of incentives from sources other than medical would greatly increase the chance for general practitioner trainees to work in rural regions. CONCLUSIONS: To what extent can the survey outcomes relate with other European regions needs to be investigated further.

Factors associated with uptake, adherence, and efficacy of hepatitis C treatment in people who inject drugs: a literature review.

INTRODUCTION AND METHODS: Hepatitis C virus (HCV) infections are highly prevalent amongst people who inject drugs (PWID). Despite well documented evidence of its effectiveness, suggested cost-effectiveness, and potential to reduce HCV prevalence rates, the uptake of antiviral HCV treatment by PWID is low. This nonsystematic literature review describes factors associated with the uptake, adherence, and efficacy of HCV treatment among PWID and discusses strategies to increase their uptake of treatment. RESULTS: Low HCV treatment uptake among PWID is associated with a number of patient-related and provider-related barriers. Beliefs and fears about low efficacy and adverse effects on the patient's part are common. A substantial number of factors are associated with the chaotic lifestyle and altered social functioning of PWID, which are often associated with decompensation or relapsing into drug addiction. This may lead to perceived low adherence with treatment and low efficacy on the provider's part too, where lack of support, inadequate management of addiction, and other drug-related problems and poor treatment of side effects have been described. Practical issues such as the accessibility of treatment and finances also play a role. Strategies to improve the HCV treatment rate among PWID involve pretreatment management and assessment, a multidisciplinary approach, management of side effects, and enhanced education and counseling. CONCLUSION: Specific factors are associated with poorer treatment outcomes in PWID on the side of both the patient and the treatment system. However, given that PWID can achieve treatment adherence and sustained virologic response rates comparable with those in nondrug users, drug use per se should not be considered a criterion for exclusion from treatment. Further development of measures leading to higher uptake of treatment and adherence in PWID and appropriate adaptation of HCV treatment guidelines represent important tools in this regard.