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1.
Am J Health Promot ; 36(5): 765-767, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34978209

RESUMO

Vaccine hesitancy in the United States continues to hamper ongoing coronavirus vaccination efforts. One set of populations with higher-than-average initial rates of vaccine hesitancy are certain religious groups, such as white evangelicals, African-American Protestants, and Hispanic Catholics. This article discusses the reasons underlying vaccine hesitancy in these populations, focusing on new trends in religious, political, and ideological beliefs that may influence vaccine acceptance. By using recent data and empirical case studies, this article describes how these trends could hinder the effectiveness of certain vaccine promotion strategies while also improving the potential efficacy of other forms of vaccine promotion, such as faith-based outreach. (100).


Assuntos
COVID-19 , Vacinas , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Humanos , SARS-CoV-2 , Estados Unidos , Vacinação , Hesitação Vacinal
3.
BMJ Open ; 8(6): e019491, 2018 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-29880563

RESUMO

OBJECTIVE: To establish the level of opioid prescribing for patients with chronic musculoskeletal pain in a sample of patients from primary care and to estimate prescription costs. DESIGN: Secondary data analyses from a two-arm pragmatic randomised controlled trial (COPERS) testing the effectiveness of group self-management course and usual care against relaxation and usual care for patients with chronic musculoskeletal pain (ISRCTN 24426731). SETTING: 25 general practices and two community musculoskeletal services in the UK (London and Midlands). PARTICIPANTS: 703 chronic pain participants; 81% white, 67% female, enrolled in the COPERS trial. MAIN OUTCOME MEASURES: Anonymised prescribing data over 12 months extracted from GP electronic records. RESULTS: Of the 703 trial participants with chronic musculoskeletal pain, 413 (59%) patients were prescribed opioids. Among those prescribed an opioid, the number of opioid prescriptions varied from 1 to 52 per year. A total of 3319 opioid prescriptions were issued over the study period, of which 53% (1768/3319) were for strong opioids (tramadol, buprenorphine, morphine, oxycodone, fentanyl and tapentadol). The mean number of opioid prescriptions per patient prescribed any opioid was 8.0 (SD=7.9). A third of patients on opioids were prescribed more than one type of opioid; the most frequent combinations were: codeine plus tramadol and codeine plus morphine. The cost of opioid prescriptions per patient per year varied from £3 to £4844. The average annual prescription cost was £24 (SD=29) for patients prescribed weak opioids and £174 (SD=421) for patients prescribed strong opioids. Approximately 40% of patients received >3 prescriptions of strong opioids per year, with an annual cost of £236 per person. CONCLUSIONS: Long-term prescribing of opioids for chronic musculoskeletal pain is common in primary care. For over a quarter of patients receiving strong opioids, these drugs may have been overprescribed according to national guidelines. TRIAL REGISTRATION NUMBER: ISRCTN24426731; Post-results.


Assuntos
Analgésicos Opioides/uso terapêutico , Prescrições de Medicamentos/economia , Dor Musculoesquelética/tratamento farmacológico , Padrões de Prática Médica/estatística & dados numéricos , Dor Crônica/tratamento farmacológico , Estudos de Coortes , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Reino Unido
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