COVID-19 vaccine short-term adverse events in the real-life family practice in Krakow, Poland.

BACKGROUND: In manufacturers' trials, vaccination against COVID-19 proved to be safe and effective. The officially reported frequency of vaccine adverse events (VAEs) in Poland is lower than that declared by the manufacturers. The anti-vaccination activists questioned the trustworthiness of official data. OBJECTIVES: The aim was to explore the real-life prevalence of VAEs in general practice settings and the factors that may influence it. METHODS: In this pragmatic, mixed prospective and retrospective study, patients vaccinated against COVID-19 between May and October 2021 in three GP practices in Krakow, Poland, were enrolled. Their demographic (age, sex, level of education) and clinical data (weight and height, smoking status, history of allergies, COVID-19 and chronic diseases) were collected. Then, they were interviewed about VAEs they experienced. RESULTS: Out of 1530 patients invited to participate, 1051 (69%) agreed and were eligible for analyses. Only 8.8% did not report any VAE. Pain at the injection site was the most frequently reported reaction (800, 76.2%). The most prevalent systemic ones were excessive fatigue/lethargy (527, 50.6%), sleep/circadian rhythm disturbances (433, 41.6%) and headache (399, 38.3%). Fifty required medical assistance - 39 experienced presyncope (3.7%) and 11 loss of consciousness (1.1%). Only two others were hospitalised. Females, younger adults, those with higher education and with a history of COVID-19 reported systemic VAEs more frequently, while those who were older and obese were less likely to report local reactions. CONCLUSION: Although more than 90% of patients vaccinated against COVID-19 in general practice settings may experience VAEs, in short-term observation, the vast majority are localised and mild.

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland.

BACKGROUND: Despite worldwide efforts in encouraging routine pap smears for early detection of cervical cancer, Poland's screening rate lags behind the rest of the European Union at 20.2%. Family physicians (FPs) in Poland rarely perform pap smears, and little is known about the experiences and attitudes of Polish patients regarding pap smear screening in a primary healthcare (PHC) setting. METHODS: A cross-sectional questionnaire-based survey was performed. Questionnaires were distributed among 43 FPs and 418 of their patients in one Polish region. The data from patients were associated with the doctors' characteristics. Descriptive statistics, the χ2 test and the Mann-Whitney U test were used for analysis. RESULTS: Nearly two-thirds of patients (66%) declared willingness to undergo free pap smear screening by their FPs, with the most common reason being time saved. Among those objecting to receive pap smears from their FPs, immediate specialist care provided by gynaecologists in case of adverse results was the main concern. The factors that positively influenced the patients' decision to undergo cervical cancer screening in PHC were: (1) living in a city with more than 100 000 inhabitants, (2) being single, (3) having a female FP or (4) a physician with specialty training in family medicine. CONCLUSION: There is high level of acceptance for pap smears performed in PHC offices among patients in Poland. They are more likely to comply with the screening due to easy access. Establishing a solid physician-patient relationship is also crucial in encouraging screening.

Treatment of hypertension in central and eastern European countries: self-reported practice of primary care physicians.

OBJECTIVES: To describe self-reported hypertension treatment among primary care physicians in central and eastern Europe and to investigate international differences. METHODS: A cross-sectional survey of primary care physicians with a questionnaire translated into various languages was carried out in nine central and eastern European countries. Three thousand physicians were randomly selected from the national registers. RESULTS: Eight hundred and sixty-seven invited primary care physicians responded. For the patients with hypertension and low cardiovascular risk, 49% of physicians reported a treatment goal of less than 140/90 mmHg (69% in Slovenia, 20% in Latvia, P < 0.001). In patients with hypertension and diabetes mellitus, blood pressure (BP) targets of less than 130/80 mmHg and less than 120/80 mmHg were reported by 47 and 48% of physicians, respectively, and significant differences between countries were revealed. Angiotensin-converting enzyme inhibitors were the most common declared drugs used on a daily basis (over 90% of physicians in all countries). Various international differences were observed among the use of diuretics, ß-blockers and drugs from other classes. An immediate initiation of pharmacotherapy was declared by 24% of physicians at a SBP level of at least 180 mmHg and 20% at DBP level of at least 110 mmHg. CONCLUSION: In hypertension treatment, some decisions made by primary care physicians from central and eastern European countries are still done without any supporting evidence from clinical trials. They have declared lower treatment goals and the initiation of pharmacotherapy at lower BP levels than recommended in international guidelines. An innovative approach to continuous medical education should be introduced and the efforts to implement guidelines in everyday practice ought to continue.

[The influence of guidelines of asthma management in adults in reference to family physicians knowledge in the field of treatment]. / Wplyw wytycznych postepowania w astmie oskrzelowej u doroslych na wiedze lekarzy rodzinnych w zakresie leczenia pacjentów z astma.

AIM: Assessment of the influence of the guidelines on asthma for family physicians in reference to their knowledge in the field of patient's treatment. MATERIAL AND METHODS: The assessed group consisted of 111 physicians before training in family medicine and guideline implemention of asthma for family physicians and four years later. RESULTS: The knowledge of the physicians accessment in the first part of the examination in the field of patient's treatment was low (compatibility with the guidelines was 42% in the part "General principles of treatment" and 65% in "Pharmacotherapy"). In the second part of the study, there was a statistically significant improvement (p<0.05) of the level of knowledge in both fields (compatibility with the guidelines was 55% in "General principles of treatment" and 73% in "Pharmacotherapy"). The average improvement for the whole Questionnaire was 12.3% (13.3% for "General principles of treatment" and 8.4% for "Pharmacotherapy"). CONCLUSION: Guideline Implementing for family physicians in the management of bronchial asthma had a significant influence on the improvement of knowledge about patients treatment. Provided that assessment of knowledge concerning treatment of patients with asthma in our study was declared better than real management, there is a need for modification of continuous medical education in order to change the behaviour of physicians.