Motivators and barriers of seasonal influenza vaccination among primary health care physicians in Qatar.

Annual influenza vaccination is an effective way to reduce the burden of disease throughout the year. A cross-sectional study was conducted in primary healthcare centres in Qatar to determine vaccination coverage among physicians, motivators, and barriers. The vaccination rate was higher among physicians aged 45 years and above (p-value < 0.005). Most primary care physicians (95 %) strongly agree that being vaccinated reduces the risk of disease spread. The most frequently mentioned barriers were the belief that one could still get influenza after being vaccinated and the fear of side effects (92.6 % and 29.5 %, respectively). Health authorities can implement strategies that take these factors into account to increase immunization coverage.

Assessment of knowledge, attitude, and practice of primary healthcare physicians in Qatar towards hypertension management: An online cross-sectional study.

Primary health care is integral to diagnosing and managing hypertension. This study aimed to assess the knowledge, attitude, practice, priority, and confidence of primary care physicians in Qatar toward hypertension diagnosis and management, and to measure the determinants of good knowledge, desirable attitudes, and desirable practices. We conducted a cross-sectional web-based survey using a modified version of the World Hypertension League Questionnaire during the period from August 30th to October 23rd, 2020. All primary care physicians working in any of Qatar's 27 publicly run primary healthcare centers were invited to participate in the survey. Out of the 450 primary care physicians working at that time, 197 completed the study questionnaire with a response rate of 43.8%. Most respondents stated that they followed local or international treatment guidelines for hypertension management (96.4%). Primary care physicians were highly confident and prioritized hypertension management. The overall desirable practice score was 73.8%, with the highest score (95.4%) for assessing adherence to antihypertensive medications, whereas the lowest desirable practice score was 33.5% for counseling on home blood pressure monitoring. Fifty-one-point eight percentage and 62.4% correctly identified 140 mm Hg and 90 mm Hg as the systolic and diastolic blood pressure threshold for diagnosing hypertension in most patients. The lowest knowledge scores were for hypertension epidemiology in Qatar and recommended dietary modification for hypertensive patients. Respondents had positive attitudes toward task sharing with nonphysician healthcare workers for most items (58.9%-78.2%), except for drug prescriptions (30.5%). Primary care physicians in Qatar had positive attitudes, with high overall confidence and conviction (priority) scores toward hypertension. However, their knowledge scores and certain practices were suboptimal. Healthcare policymakers in Qatar should raise primary care physicians awareness of the current burden of untreated hypertension in the country by organizing targeted educational programs and emphasizing the importance of following national clinical practice guidelines in the diagnosis and management of hypertension.

Satisfaction of primary care physicians towards initiation of phone consultations during the COVID-19 pandemic management in Qatar: a cross-sectional study.

OBJECTIVES: To assess primary care physicians' satisfaction towards initiation of phone consultation during COVID-19 pandemic management in Qatar and to identify the factors associated with dis/satisfaction. DESIGN: A cross-sectional web-based survey was conducted from 1 June to 30 July 2020. SETTING: All the available 27 public primary healthcare centers in Qatar at the time of the study. PARTICIPANTS: Two hundred ninety-four primary care physicians working in the publicly run primary healthcare corporation in Qatar. PRIMARY OUTCOME MEASURES: Overall satisfaction of primary care physicians with the initiation of phone consultation during the COVID-19 pandemic in Qatar and their satisfaction towards each aspect of this management. RESULTS: Two hundred thirty-nine primary care physicians participated in the survey with a response rate of 53.1%. Overall, about 45% and 21% of respondents agreed that COVID-19 disease management has highly impacted and very highly impacted their daily practice, respectively. More than half of the physicians (59.9%) indicated being satisfied/highly satisfied with the initiation of telephone consultation service. On the other hand, few physicians were satisfied (14.3%) or highly satisfied (3.4%) with conducting telephone consultations with patients who lack previous electronic medical records. Also, only 20.3% and 3.8% of physicians were satisfied and highly satisfied with the lack of physical examination in telephone consultations, respectively. On bivariate analysis, primary care physicians' age was significantly associated with the perceived level of impact of COVID-19 management on daily practice (P = 0.03). There was no significant association between participants' characteristics and the level of satisfaction toward telephone consultations. On the other hand, there was a statistically significant association between physicians' age (p = 0.048) and gender (p = 0.014) and their level of satisfaction toward communication and support.

Primary healthcare physicians' satisfaction towards work safety and personal protective equipment during the COVID-19 pandemic in Qatar: A cross-sectional study.

BACKGROUND: During COVID-19 pandemic, healthcare workers are experiencing unprecedented pressure from stressors including enormous workload, virus exposure, and inadequate PPE. This study aimed to assess primary healthcare physicians' satisfaction towards work safety and personal protective equipment and their predictors during early stages of COVID-19 pandemic in Qatar. METHODS: A cross-sectional web-based survey was conducted in 27 primary healthcare centers in Qatar from 1st June to 30 July 2020. Descriptive and analytical statistics were used when appropriate. A multivariable linear regression analysis was done to identify predictors of satisfaction among participants. RESULTS: A total of 262 participants completed the questionnaire with a response rate of 58.2%. 51.9% were males and 68.3% were family physicians. Only 14.9% and 17.2% of respondents were satisfied or highly satisfied about the overall safety of work and the clinical guidelines on the use of PPE in the context of COVID-19 respectively. Participants who were general practitioners were significantly more likely to be satisfied with maintaining work safety and local PPE guidelines compared to family physicians by 2.93 scores (95% CI 1.43, 4,43 p -value <0.001), and 2.82 scores (95% CI 1.19, 4,44 p -value 0.001) respectively. Also, physicians who had more than ten years of experience in practice were significantly more likely to be satisfied with the PPE use guidelines compared to those who had fewer years of experience by 1.93 scores (95% CI 0.45, 3.41 p -value 0.011). CONCLUSION: Overall satisfaction of participants with the safety of work and PPE clinical practice guidelines was low.

Spectrum of COVID-19 clinical characteristics among patients presenting to the primary healthcare in Qatar during the early stages of the pandemic: a retrospective multicentre cross-sectional study.

OBJECTIVES: To describe clinical characteristics and laboratory investigations of patients with COVID-19 diagnosed in primary care in Qatar and to assess predictors of hospitalisation. DESIGN: A retrospective cross-sectional study. SETTING AND PARTICIPANTS: 3515 confirmed patients with COVID-19 diagnosed in any of the 27 primary healthcare centres in Qatar between 9 April 2020 and 30 June 2020. MAIN OUTCOME MEASURES: Demographic characteristics, comorbidities, contact tracing, clinical and laboratory data, in addition to patient disposition at the time of diagnosis RESULTS: Mean age of patients was 35.5 years (±14.7). 2285 patients (65.0%) were males, 961 patients (27.3%) had a history of concomitant comorbidity and 640 patients (18.2%) were asymptomatic. Adult patients (19-64 years old) were more likely to report symptoms than children or elderly. Fever and cough were the most frequently documented symptoms affecting 1874 patients (46.7%) and 1318 patients (37.5%), respectively. Most patients had normal vital signs at presentation; however, patients who were subsequently hospitalised had higher median temperature than non-hospitalised patients (37.7°C, IQR: 37.0°C-38.4°C, and 37.2°C, IQR: 36.8°C-37.8°C, respectively). Hospitalised patients had significantly higher C reactive protein (CRP) (median CRP: 20 mg/L, IQR: 5.0-61.2 mg/L) than non-hospitalised patients (median CRP: 4.6 mg/L, IQR: 1.7-11.50 mg/L), and lower median absolute lymphocyte count (1.5×103/µL, IQR: 1.1×103/µL-2.1×103/µL, and 1.8×103/µL, IQR: 1.3×103/µL-2.4×103/µL, respectively). Predictors of hospitalisation were increasing age (adjusted OR (AOR): 2.614, 95% CI 1.281 to 5.332 for age between 50 years and 64 years, and AOR: 3.892, 95% CI 1.646 to 9.204 for age ≥65 years), presence of two or more comorbidities (AOR: 2.628; 95% CI 1.802 to 3.832) and presence of symptoms (AOR: 1.982: 95% CI 1.342 to 2.928). CONCLUSION: The majority of COVID-19 cases diagnosed in primary healthcare in Qatar were symptomatic. Most cases had normal vital signs and laboratory results at presentation. Predictors of hospitalisation were increasing age, the presence of symptoms and having two or more comorbidities.

Primary health care physicians' perspective on COVID-19 pandemic management in Qatar: a web-based survey.

OBJECTIVES: To assess primary care physicians' satisfaction towards COVID-19 pandemic management in Qatar and to identify the associated factors with their satisfaction. DESIGN: A cross-sectional web-based survey conducted from 1 June to 30 July 2020. SETTING: All the 27 public primary healthcare centres in Qatar. PARTICIPANTS: 294 primary care physicians working in the publicly run primary healthcare corporation in Qatar. PRIMARY OUTCOME MEASURES: Overall satisfaction towards COVID-19 management in Qatar and satisfaction towards each aspect of this management including COVID-19 clinical practice guidelines, psychological support, team dynamics, work safety as well as institutional and governmental regulations. RESULTS: 294 primary care physicians participated in the survey with a response rate of 65%. Overall satisfaction of physicians towards COVID-19 19 management at Primary Health Care Corporation was 77%. The highest satisfaction was towards institutional and governmental support while it was the lowest towards the corporation case definition and management of COVID-19 guidelines. Female physicians were less satisfied with psychological support in comparison to males (64.1% and 51% respectively, p=0.049). Overall satisfaction towards case definition and management of COVID-19 guidelines were strongly correlated with their clarity, updating these guidelines in due time and applicability of the guidelines (r=0.759 P<0.001; r=0.701 P<0.001; r=0.698 P<0.001) respectively, while satisfaction towards work safety was strongly correlated with availability and quality of Personal Protective Equipment provided (r=0.83 P<0.001 and r=0.811 P<0.001 respectively). CONCLUSION: Most primary care physicians in Qatar who responded to the survey were satisfied with the COVID-19 guidelines developed rapidly in response to this pandemic. Availability and quality of PPE were a particular concern. The clinicians who were less satisfied were younger and female.

Rationales and uncertainties for aspirin use in COVID-19: a narrative review.

OBJECTIVES: To review the pathophysiology of COVID-19 disease, potential aspirin targets on this pathogenesis and the potential role of aspirin in patients with COVID-19. DESIGN: Narrative review. SETTING: The online databases PubMed, OVID Medline and Cochrane Library were searched using relevant headlines from 1 January 2016 to 1 January 2021. International guidelines from relevant societies, journals and forums were also assessed for relevance. PARTICIPANTS: Not applicable. RESULTS: A review of the selected literature revealed that clinical deterioration in COVID-19 is attributed to the interplay between endothelial dysfunction, coagulopathy and dysregulated inflammation. Aspirin has anti-inflammatory effects, antiplatelet aggregation, anticoagulant properties as well as pleiotropic effects on endothelial function. During the COVID-19 pandemic, low-dose aspirin is used effectively in secondary prevention of atherosclerotic cardiovascular disease, prevention of venous thromboembolism after total hip or knee replacement, prevention of pre-eclampsia and postdischarge treatment for multisystem inflammatory syndrome in children. Prehospital low-dose aspirin therapy may reduce the risk of intensive care unit admission and mechanical ventilation in hospitalised patients with COVID-19, whereas aspirin association with mortality is still debatable. CONCLUSION: The authors recommend a low-dose aspirin regimen for primary prevention of arterial thromboembolism in patients aged 40-70 years who are at high atherosclerotic cardiovascular disease risk, or an intermediate risk with a risk-enhancer and have a low risk of bleeding. Aspirin's protective roles in COVID-19 associated with acute lung injury, vascular thrombosis without previous cardiovascular disease and mortality need further randomised controlled trials to establish causal conclusions.

Knowledge and intake of folic acid among teachers of childbearing age in the State of Qatar: a cross-sectional study.

OBJECTIVES: To assess the knowledge and intake of folic acid among teachers of childbearing age and to identify barriers to folic acid intake. SETTING: Governmental schools, which included 14 primary models, 29 primary, 14 preparatory and 16 secondary schools. The proportion of teachers in each stratum was then determined, and a stratified random sampling design had been used with proportional allocation. STUDY DESIGN: Cross-sectional study PARTICIPANTS: A total of 406 non-pregnant teachers of childbearing age enrolled in the study. A validated questionnaire in the Arabic language was used. RESULTS: The overall response rate was 98%. About 34.6% reported the optimal period in which they should take folic acid, 28.3% reported the correct intake duration and only 29.5% could name food rich in folic acid. Friends and healthcare providers were the main sources of information for the participants; however, 44% said that they did not receive enough information from their healthcare providers. CONCLUSION: There is a lack of knowledge and poor intake of folic acid among the participants. In particular, they lacked information about the appropriate time to start folic acid supplementations, the duration of intake and the folic acid-rich food. The most common reason being the limited advice given by their healthcare providers.Awareness campaigns are recommended to emphasise the role of healthcare providers in counselling women about the proper use of folic acid before pregnancy.

Metabolic syndrome among obese Qataris attending primary health care centers in Doha, 2010.

OBJECTIVES: To determine the prevalence of metabolic syndrome among obese patients using the IDF definition and to identify factors that are associated with it. MATERIALS AND METHODS: A cross-sectional randomized study was conducted at four primary care centers inside Doha, Qatar. One hundred and thirty-six Adults, ≥ 18 Qatari obese patients, were chosen by systematic random sampling. They were interviewed and screened for the presence of metabolic syndrome, which was diagnosed according to the International Diabetes Federation criteria: An abdominal circumference ≥ 94 cm in males or ≥ 80 cm in females, plus any two of the following: HDL cholesterol < 1.03 mmol / mL (< 40 mg / dL) [males] or < 1.3 mmol / mL (< 50 mg / dL) [females], Triglycerides ≥ 1.7 mmol / mL (≥150 mg / dL), Blood pressure ≥ 130 / 85 mmHg or the patient receiving antihypertensive treatment and baseline glycemia > 5.6 mmol / mL (> 100 mg / dL), or previously-diagnosed type 2 diabetes mellitus. RESULTS: The overall prevalence of the metabolic syndrome among obese patients was 46.3%. The prevalence was higher in females (50%) than in males (42.4%). It was seen to increase with increasing body mass index class, from class 1 to class 2. The prevalence of metabolic comorbidities of abnormal waist circumference, raised blood pressure, raised fasting blood glucose, high triglycerides, and reduced high density lipoprotein was 88.2, 42.6, 32.4, 31.6, and 27.9%, respectively. Based on the logistic regression multivariable analysis, increasing age and being diabetic were the only significant associated factors that influenced the risk of having the metabolic syndrome. CONCLUSION: The prevalence of the metabolic syndrome was high, and the highest comorbidities were abnormal waist circumference and high blood pressure. Diabetes and increasing age were the only significant risk factors of having this syndrome.