Artificial intelligence promotes shared decision-making through recommending tests to febrile pediatric outpatients

BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.

Construction of a New Model of Contactless Medical Services for Outpatients Based on the Project-Achieving Quality Control Circle

Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of information office members from a grade A tertiary hospital in Wenzhou, was established to conduct a research project with the theme “Constructing a new model of contactless medical service based on outpatients’ experience.” According to the ten steps and PDCA cycle, an analysis was carried out before and after the QCC activities, focusing on improving pre-consultation services, providing steward-like services, and facilitating post-consultation management. Results: After the QCC activities, the mobile appointment rate, missed appointment rate, the proportion of smart check-ins, and the average check-in time were 55.68%, 4.02%, 39.75%, and 8.24 ± 3.66 min, respectively;in contrast, before the activities, they were 32.00%, 7.88%, 0.00%, and 14.96 ± 4.98 min, respectively;the difference between the two groups was statistically significant (χ2 = 3480.112, 4994.496;Fisher’s exact probability = 963788.570;t = 5.323, P < 0.001). Many experts have also visited the hospital to learn about this system, thus rendering social and economic benefits. Conclusion: Project-achieving QCC activities are suitable for complex situations, such as constructing a new model of contactless medical service, and can significantly improve outpatient service quality, enhance patients’ experience, and improve the abilities of circle members.

Vitamin D deficiency among outpatients and hospitalized patients with diabetic foot ulcers:A systematic review and meta-analysis

BACKGROUND The definition of diabetic foot syndrome(DFS)varies depending on the location and resources.Few classifications are available according to the indication.DF ulcers and vitamin D deficiency are common diseases among patients with diabetes.Previous literature has shown an association between DF ulcer(DFU)and vitamin D deficiency.However,the available meta-0analysis was limited by substantial bias.AIM To investigate the association between DFUs and vitamin D levels.METHODS We searched PubMed,MEDLINE,and Cochrane Library,EBSCO,and Google Scholar for studies comparing vitamin D levels and DF.The keywords DFU,DFS,diabetic septic foot,vitamin D level,25-hydroxy vitamin D,vitamin D status,and vitamin D deficiency were used.The search engine was set for articles published during the period from inception to October 2022.A predetermined table was used to collect the study information.RESULTS Vitamin D level was lower among patients with DFU compared to their counterparts[odds ratio(OR):-5.77;95%confidence interval(CI):-7.87 to-3.66;χ2 was 84.62,mean difference,9;I2 for heterogeneity,89%;P<0.001 and P for overall effect<0.001].The results remained robust for hospitalized patients(OR:-6.3295%CI:-11.66 to-0.97;χ2 was 19.39;mean difference,2;I2 for heterogeneity,90%;P=0.02).CONCLUSION Vitamin D was lower among outpatients and hospitalized patients with DFUs.Further larger randomized controlled trials are needed.

Study on the Risk Factors of Central Venous-Related Bloodstream Infection in Outpatients

Objective:To analyze the risk factors of catheter-related bloodstream infection in outpatients and propose feasible prevention and control measures.Methods:The medical records of outpatients with peripherally inserted central catheter(PICC)from January 2020 to December 2021 were selected for retrospective analysis,and the factors that may be related to the occurrence of catheter-related bloodstream infection were analyzed by logistic multivariate analysis.Results:The incidence rate of catheter-related bloodstream infection among the enrolled patients was 4.78%.It was found that age,duration of catheterization,catheter site,number of punctures,and diabetes were all risk factors for catheter-associated bloodstream infection,and the differences were statistically significant.Conclusion:Age,duration of catheterization,catheterization site,and diabetes are all risk factors for catheter-related bloodstream infection,and medical personnel should fully understand and learn more about these risk factors and actively develop countermeasures to reduce the risk of catheter-related bloodstream infection.

Prevalence of depressive and anxiety disorders in Chinese gastroenterological outpatients

AIM:To investigate the prevalence and physicians' detection rate of depressive and anxiety disorders in gastrointestinal(GI)outpatients across China. METHODS:A hospital-based cross-sectional survey was conducted in the GI outpatient departments of 13 general hospitals.A total of 1995 GI outpatients were recruited and screened with the Hospital Anxiety and Depression Scale(HADS).The physicians of the GI departments performed routine clinical diagnosis and management without knowing the HADS score results.Subjects with HADS scores≥8 were subsequently interviewed by psychiatrists using the Mini International Neuropsy-chiatric Interview(MINI)to make further diagnoses. RESULTS:There were 1059 patients with HADS score ≥8 and 674(63.64%)of them undertook the MINI interview by psychiatrists.Based on the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition),the adjusted current prevalence for depressive disorders,anxiety disorders,and comorbidity of both disorders in the GI outpatients was 14.39%, 9.42%and 4.66%,respectively.Prevalence of depressive disorders with suicidal problems[suicide attempt or suicide-related ideation prior or current;module C (suicide)of MINI score≥1]was 5.84%in women and 1.64%in men.The GI physicians'detection rate of depressive and anxiety disorders accounted for 4.14%. CONCLUSION:While the prevalence of depressive and anxiety disorders is high in Chinese GI outpatients, the detection rate of depressive and anxiety disorders by physicians is low.

Economic burden and influencing factor analysis of outpatients with epilepsy: A cross-sectional study in Shanghai,Shanxi and Sichuan

Objective: To better understand the economic burden of patients with epilepsy receiving outpatient services in China and to analyze potential factors influencing epileptic economic burden through a cross-sectional study. Methods: Using a self-designed questionnaire, we collected information retrospectively from 754 patients with epilepsy evaluated in neurology clinics in Shanghai Municipality, Shanxi Province and Sichuan Province. Descriptive analyses were used after cost variables were presented as logarithms, and multiple linear regressions were performed to explore influencing factors. Results: Fifty percent of the investigated patients experienced an epilepsy attack before the age of 15, and 51.3% had suffered from epilepsy for more than five years. In the past year, 87.9% of patients had visited different hospitals multiple times for evaluation(40.3%) and maintenance treatment(40.7%). The total economic burden of epilepsy was US$ 1143.2. The average direct economic burden and indirect economic burden were US$ 939.0 and US$ 110.2, respectively. Multiple linear regressions showed that patients had to bear greater economic burden if they were hospitalized,using multiple antiepileptic drugs, experiencing illness for less than 5 years, in severe seizure index or active epilepsy with drug resistance, which was statistically significant. Totally only14.3% of patients could get reimbursement in outpatient services. Conclusions: Patients with epilepsy must present to hospitals regularly for satisfactory prognosis, which results in economic burden. Patients bear greater economic burden, especially direct medical costs, if they are newly diagnosed, experience severe seizures, or undergo multiple drug treatments that require more frequent monitoring. However, current insurance policy for outpatient services do not help reduce economic burden of patients efficiently.

Preferences for participation in shared decision making of psychiatric outpatients with affective disorders

Objective: To assess preferences for participation in shared decision making in a representative sample of psychiatric outpatients with affective disorders and to understand how clinical and socio-demographic variables influence patients’ preferences for participation. Method: A cross-sectional survey of 172 consecutive psychiatric outpatients with affective disorders attending at Community Mental Health Care setting was carried out. Patients expressed preferences on each of 3 aspects of decision making (seeking information, discussing options, making the final decision). The “CGI Severity and Improvement Scales” and the “Beck Depression Inventory” scale were used for severity assessment. Additionally the “Drug Attitude Inventory”, the “Beliefs about Medicine Questionnaire” and the “Leeds Attitude toward Concordance Scale” were applied to all participants. Effects of variables considered on preferences were assessed using proportional odds regression models. Results: We registered a high response rate of 85%. Nearly all patients (91%) preferred to leave final decisions to their treating psychiatrists and 87% preferred to rely on psychiatrists for medical knowledge rather than seeking their own information. In contrast, 81% of patients preferred to be offered options and to be asked their opinion by their doctors. Gender, age, educational level, number of psychotropics used and belief about psychiatric medication overuse were significant predictors in decision making dimensions considered. Conclusion: Shared decision making approach of patients with affective disorder must take into consideration a more doctor-directed approach preferred by the patients in which the desire to be offered options is not automatically linked with the willingness of taking decisions or getting more knowledge.

Characterization of Salmonella Enterica Serotype Typhimurium from Outpatients of 28 Hospitals in Henan Province in 2006

Objective To characterize the diarrheal patients with Salmonella typhimurium （S. typhimurium） infections and to set up the first baseline for S. typhimuri_um pulsed-field gel electrophoresis （PFGE） patterns in Henan province, thus laying a foundation for comprehensive surveillance of Salmonella in human as well as foods. Methods S. typhimurium isolates recovered from outpatients with diarrhea in Henan province from May to October of 2006 were characterized. Antimicrobial susceptibility tests of 8 antimicrobial agents and PFGE were carried out to analyze the S. typhimurium isolates. Results Twenty-four （0.9%） S. typhimurium isolates were identified from 2661 stool specimens of diarrheal cases. Eighty-eight percent of isolates showed resistance to at least one antimicrobial agent. The resistance to chloramphenicol （79%） was most common. Fifty-eight percent of isolates were resistant to ciprofloxacin. All the 14 ciprofloxacin-resistant isolates were resistant to more than five antimicrobial agents. Thirty-three percent of S. typhimurium isolates were resistant to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline （R-type ACSSuT）. Eight antimicrobia-resistant phenotypes were found among the 24 isolates in 16 PFGE patterns. Conclusion The rate of multidrug-resistant S. typhimurium is relatively high in S. typhimurium PFGE patterns of Henan province. Multidrug-resistant S. typhimurium should be considered a public health threat.

Antibiotics prescribed to febrile under-five children outpatients in urban public health services in Burkina Faso

Appropriate use of antibiotics remains critical for success in achieving MDG4. The aim of this study was to investigate antibiotics prescribing practices to febrile under-five children outpatients in urban public health services in a low income country. Methods: From March to April 2013, a cross-sectional epidemiological study of care facilities visit by under-five age, for febrile illness, was carried out in urban health services in Bobo-Dioulasso, Burkina Faso. Patient demographics, diagnoses and medications were recorded. We calculated for each diagnoses several indicators for antibiotics use. Results: Our study showed an over-prescription of antibiotics at the university teaching hospital (78.08%) and at the first level facilities (57.71%) for under-five outpatients for febrile illness. There was evidence of high antibiotic prescription in children with diarrhea (more than 9 on 10 at university teaching hospital of diarrhea cases and 60% at the first level facilities), in children with Upper respiratory tract infections (respectively 60% and 85.2% of cases at university teaching hospital and at the first level facilities) and in children with malaria (respectively 47.5% and 17.6% of cases at university teaching hospital and at the first level facilities). Overuse, misuse and inappropriately prescribed antibiotic coexisted in our results: at university teaching hospital 90.9% of diarrhea cases, 60% of URTI cases,?47.5% of malaria cases received antibiotic prescription;at first level heath care facilities 85.2% of URTI, 17.6% of malaria cases received an prescribed antibiotic and 11.8% of LRTI did not received a prescribed antibiotic. Developing countries have poor access to newer antibiotics and irrational antibiotics use remains a global problem. Overuse and misuse of antibiotics combat, rigorous infectious diseases diagnosis, antimicrobial resistance consequences education of users and health professional’s prescribers, and improved surveillance of antimicrobial resistance, must be strengthened.

Investigation of Specifics of Self-Management towards Dealing with Cancer Pain among Adult Outpatients

Purpose: This study aimed to identify specifics of self-management towards dealing with cancer pains among adult outpatients. Methods: Semi-structured interviews were conducted with 16 adult outpatients (9 males and 7 females) who suffered from cancer pain and the data obtained were analyzed using the qualitative synthesis method of KJ Ho. Results: An analysis of the results revealed these key findings for the following symbolic wording of the semi-structured interviews: Cooperative relationship with medical professionals;Problems originating from cancer pain;Self-regulation of analgesic medications based on the interactions with medical professionals;Self-regulation of the analgesic medications based on the physical perceptions of the effects;Self-regulation to maintain a balanced and calm mind, Fulfilling life by the pain alleviation and liberation from the restrictions imposed by the cancer;and Efforts to maintain their lives by themselves. Conclusion: Based on the cooperative relationship established with medical professionals, the patient carried out the self-regulation of cancer pain using analgesics, and self-regulation to maintain a balanced and calm mind. Nurses must therefore sufficiently educate patients regarding how to communicate successfully with medical professionals in order to improve cancer patients’ pain management regarding both physical and mental aspects.

Trends of Pediatric Outpatients Prescribing in Umm Al Quwain, United Arab Emirates

Background: Data with regard to local drug prescribing in pediatric population is scarce. This study was carried out to investigate the patterns of drug prescribing for pediatric outpatient in a general hospital in the United Arab Emirates. Methods: A total of 707 prescriptions were collected from a governmental hospital in Umm Al Quwain, United Arab Emirates covering the months of June and July, 2014. Encounters issued for patients older than 12 years were rejected. A total of 520 prescriptions for age groups ranging from 1 week to 12 years were studied. Prescriptions were analyzed using WHO drug use indicators. Results: All prescriptions were electronic and head lettered by the name of the hospital. Average number of drugs per prescriptions was 2.6 and all drugs were generics. Name of patient, age and gender and prescriber’s name and E-signature were present in 100%. Patient’s address, allergy and diagnosis were present in 21.15%, 83.26% and 64.42% of prescriptions respectively. Complete dosage regimen was present in all encounters. Patients were prescribed one, two, three, four or more than four drugs per prescription in 23.84%, 27.88%, 26.53%, 12.69%, and 8.65% respectively. The most commonly prescribed therapeutic classes of drugs were antibiotics (44.60%), antihistamines (43.65%), and analgesics/antipyretics (32.30%). The most commonly prescribed drugs among each class were amoxicillin (40%), xylometazoline (61.23%), and paracetamol (87.5%). Conclusion: Present results indicate that prescribing trends for pediatric population seems to be rational. However, there is over use of antibiotics and there are some areas that warrant further attention by the prescribers for a more significantly rational prescribing.

Impact of Somatic Symptoms on Identification of Depression among General Outpatients by Family Physicians in North-Western Nigeria

In many places in the world, General Practitioners are only able to identify depression in a small fraction of depressed patients presenting to general outpatient department. The effect of somatic symptoms on its recognition was investigated. The study determines the identification rate of depression by general practitioners among outpatients with somatic symptoms and those without somatic symptoms. This descriptive cross sectional study was conducted in Family Medicine Department, Aminu Kano Teaching Hospital, Kano, Nigeria. The Hospital Anxiety and Depression Scale (HADS) was used to screen selected participants. Forms were used by GPs to itemize medical and psychiatric symptoms elicited as well as medical and psychiatric diagnoses made. Schedule for Clinical Assessment in Neuropsychiatry (SCAN) version 2.1, was used to confirm the diagnosis of depression. Hamilton Depression Rating Scale (HDRS) was used for severity using items 11-14 of Hamilton Depression Rating Scale. Those with somatic symptoms score of 1-3 were rated as having low and those with 4-10 were rated as having high. Of the 410 outpatients recruited, 402 participated in the study. Two hundred and thirteen were screened depressed (HADS). Two hundred were confirmed depressed using SCAN (49.8%). The GPs identified 31.3% of those participants diagnosed depressed without somatic symptoms compared to 15.2% of those who were diagnosed depressed with somatic symptoms. However, no significant association was found between GPs ability to identify depression in the presence or absence of somatic symptoms (p = 0.09). This study found no association between GPs ability to identify depression and presence or absence of somatic symptoms (χ2 = 2.75, p = 0.09). However, this study found that the higher the level of somatic symptoms the more unlikely it’s for GPs to identify depression. To reduce the burden of depression by early detection and treatment, continuing medical education of GPs should include skills in identification of depression.

A Case Control Study of Subjective Quality of Life in Outpatients with Depression

Background: Depression is one of the leading causes of disability including impairment in the subjective Quality of Life (QOL) of the patient. Unfortunately, only a fraction receives the correct diagnosis and treatment in general practice. This study aims to determine the subjective Quality of Life of depressed patients. Method: A representative sample of adults, 18 years and above (100 each for cases and controls), were assessed for QOL using the World Health Organization Quality of Life instrument (WHOQOL-BREF). Respondents were also evaluated for socio-demographic factors. Major depressive disorder was assessed using the Mini International Neuropsychiatric Interview. Severity of depression was measured using Hamilton’s Rating Scale for Depression and global functioning was assessed with the Global Assessment of Functioning scale. Results: Majority of the participants were females (62.0%) and young with a mean age of 39.11 ± 12.40 years. Overall subjective QOL (P P P P P P Conclusion: The finding of the study showed that depression is a serious illness that affects the patient’s perception of the quality of his/her life. It is therefore very necessary to innovate better treatment modalities to reduce its burden.

Assessment of Common Dental Indices and Need for Periodontal Treatment in the Cardiology Outpatients Unit at the University Hospital Gabriel Touré(UH-GT) in Bamako

Introduction: Little is known through the literature about dental status of patients seen in cardiology department, motivating this study which aims to assess most dental indices of outpatients and the need for periodontal treatment. Methodology: It was a cross-sectional study from November 2016 to April 2017 in the cardiology outpatient unit of the University Hospital Gabriel Touré (UH-GT) in Bamako. Included were all patients with minimum 24 teeth and willing to be involved in the study. History, cardiovascular parameters and dental examination by a resident in Odontostomatology were performed for each patient. Data were analyzed using SPSS 18, quantitative as means and standard deviation (SD) and categorical as proportions. Khi-2 Test, analysis of variance were applied with a significance level set at 0.05. All patients give their verbal consent after being informed about the procedures in the study. Results: Our sample involved 100 patients (66% female, mean age of 54.12 ± 16.150 and patients ≥ 60 years most represented with 50% for male and 37.9 for female patients. Tooth brush use was practiced by 100% and 98.5% respectively for male and female patients and twice daily brushing by 97.1% of male and 97% of female patients. Brushing duration was less than 3 minutes for 35.3% and 31.8% of respectively male and female patients. Plaque index and calculus index were in the male group with respectively 0.79 and 1.06 for male and 0.63 and 0.79 for female (p = 0.047 and 0.020). Mean Decayed Missed and Filled Teeth (DFMT) index showed a significantly increase from 0.22 in the age group under 30 to 0.68 for that other 60 years. Only 2.9% and 9.1% of respectively male and female patients had community paradontal index for treatment needs (CPITN) classe 0. The need for treatment was TN1 meaning instruction to an oral cavity hygiene, similar for both sex (55.9 and 57.6 respectively for male and female patients) and highest in the age-group 30 - 44 increased to 70%. The need for professional intervention in oral cavity was higher for men and higher for patients aged 45 - 59 and ≥60 years. Conclusion: Drawing attention of practitioners on the additional risk of bad periodontal conditions and education on a broad basis already in the school must be part of a preventive program in order to have a code 0 as goal.

Prevalence and Associated Factors of Depression among General Outpatients in a Tertiary Institution in Kano, North-Western Nigeria

Background: Depression is common psychiatric disorder among general outpatients. Prevalence of depression and associated factors among this population has been studied in some parts of Nigeria. However, few if any were conducted in the most populous geopolitical zone of Nigeria. Materials & Method: This study determines the prevalence of depression and associated factors among general outpatients. It was a descriptive cross-sectional study. 402 of the 410 participants recruited for the study completed the study. Diagnosis of depression was confirmed using SCAN (Schedule for Clinical Assessment in Neuropsychiatry) ver. 2.1. Severity of depression was rated using HDRS (Hamilton Depression Rating Scale). Result: Two hundred were subsequently diagnosed depressed using SCAN out of 213 who scored HADS cutoff point, given the prevalence of 49.8%. The prevalence of subtypes of depression was: Mild 26.9%, moderate 20.4% and severe 2.5%. A statistically significant association was found between depression and some socio-demographic factors which include age (p = 0.001, X2 = 11.46), gender (p = 0.001, X2 = 20.58)), marital status (p = 0.001, X2 = 11.16), educational status (p = 0.001, X2 = 10.8) and chronic medical conditions (p = 0.001, X2 = 11.77). Depressed outpatient is more likely to be over 40 yrs, female, married, having low level of education and suffering from chronic medical condition(s). However, there was no significant association between depression and employment status, family history of mental illness and substance use in this study. Conclusion: This study found high prevalence of depression among general outpatients. It is associated with age, marital status educational level and chronic medical conditions. General practitioners should lookout for depression especially among patients with the associated socio-demographic factors. Some easy-to-use screening tools like PHQ-2 should be included in the routine assessment of outpatients in Family Medicine departments. Task-sharing strategy as enshrined in mental health gap (mhGAP) document should be implemented to improve detection of depression at primary care level.

Associations between C-Reactive Protein and Apolipoproteins, Lipoprotein (a) and Conventional Serum Lipids in Outpatients: Correlations and Time Trends

Background: Correlations between CRP and serum lipids are weak, and there are conflicting and incomplete results in the literature. The aim of the present study was to clarify the strength and independence of relationships between CRP and serum lipids in outpatients. Methods: Inclusion criteria were outpatients where all the following analyses were requested in clinical routine: high sensitivity CRP, total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, ApoB, ApoA-1 and Lp(a). Data for patients meeting the above criteria during a period of six years (2004-2010) were copied from Aleris Medilab’s Laboratory Information System to the software Statistica. Basic statistics and correlations were calculated for 2771 patients. In patients with two (n = 959) or more sampling times changes over time were calculated. The study was a quality assurance project without access to patient files. Results: Median age was 59 years and median serum CRP concentration was 1.5 mg/L. The strongest correlations (Spearman R) were seen between CRP and triglycerides (0.25), ApoB/ApoA-1 ratio (0.21) and HDL-cholesterol (&minus;0.18). Stepwise regression analysis showed that ApoB, total cholesterol, log triglycerides and log Lp(a) together explained 8% of the variation in log CRP. Unfavourable time trends for CRP and triglycerides counteracted a significant decrease in LDL-cholesterol and total cholesterol. Conclusion: In a large cohort of outpatients CRP showed stronger correlation with triglycerides and ApoB/ApoA-1 ratio than with LDL-cholesterol and Lp(a). LDL-cholesterol concentrations changed favorably over time whereas CRP and triglycerides did not.

Research on psychological factors which influence Doctor-Patient communications among outpatients

An Outpatient Department is the first point of contact with the hospital, and good Doctor-Patient communication would improve the service quality of the hospital, so it is important to construct a harmonious Doctor-Patient relationship. This article, from the perspective of psychology, investigates into the common psychological factors which affect the Doctor-Patient communication, the appearance of the communication problem, and make suggestions on possible solutions accordingly.

Hypertension (HTN) Knowledge and with Its Associated Factors: About 456 Outpatients Seen in Cardiology Department in University Hospital (UH) Gabriel Touré—Bamako (Mali)

Background: High Blood Pressure (HBP) is high prevalent among adult population in Bamako, but little is known about factors associated with knowledge. Methods: It was a cross-sectional study involving patients aged 15 years and more with a first classification in normal blood pressure (HTN-) and high blood pressure (HTN+), and Second classification inpatients without knowledge (who answered No) (K-) and patients with knowledge (who answered Yes) (K+). A logistic regression was performed to look up predictors among different variables. Results: The sample involved 456 patients with a mean age of 51.39 years and 65.1% of female. The age group 45 - 59 years old made 32.5% and unschooled patients 60.3%. Patients with HBP accounted for 69.7% and those reporting to know about it 67.3%. HTN- and HTN+ differed significantly except for HR, height, sex and level of schooling. HBP prevalence increased with age up to 74 years. Regarding knowledge, sex, age group and number of FDRs did not differ significantly. High education level and duration of HBP was predictive of knowledge with an OR of 1.186 [CI 0.058 - 0.796] and 1.192 [CI 0.332 - 4.275] respectively. Conclusions: Our study provided data on HBP knowledge among outpatients with high educational level and HBP duration associated with better knowledge on HBP.

The Introduction of Pharmaceutical Care in Psychiatric Outpatients in Community Pharmacy of the Northeast Region of Argentina

The purpose of this paper is to implement a pharmaceutical care program in psychiatric outpatients in a community pharmacy. Outpatients （536） with psychiatric treatment requiring the dispensing of medication prescribed by a psychiatrist were followed up in a community pharmacy, where different medicines were prescribed as PS （pharmaceutical specialties）, PC （pharmaceutical compounding） or both PS and PC. Each prescription was registered with details on a patient level. Also, three reporting sheets were designed： patients profile, patients monitoring and patients counseling. The total study population in the community pharmacy consisted of 536 outpatients： 357 （66.6%） females and 179 （33.4%） males. Most of the outpatients （78.5%） have health insurance, 50% correspond to public and 28.5% to private institution. The other patients （21.5%） do not have medical insurance. We also observed that the education level of these patients was： primary school 19.1%; high school 45.9%; college 15.3% and university 20.7%. Many patients had more than one psychiatric diagnosis, to whom were prescribed different medicines. All the medication studies on the charts were screened for prescriptions with antidepressants and other psychotropic drugs, starting on the date of first diagnosis made by a psychiatrist. The counseling to the patients was also registered. The possibility of the follow-up of these outpatients in the community pharmacy promoted the development of the psychiatric pharmacy and all advances in care for patients with mental health needs, working in closer collaboration with psychiatrists.

Influencing factors for colonoscopic compliance to colorectal cancer screening in outpatients

Objective To explore the influencing factors for compliance to colonoscopy screening for colorectal cancer in outpatients.Methods Patients aged 40-74 years who visited the outpatient gastroenterology department of 7 tertiary hospitals in 7 regions of Xinjiang from January 2022 to June 2022 were enrolled.Recommendations for colonoscopy screening were made according to the patient's medical conditions,and the questionnaire was used to collect information.The Chi-square test was used to compare the differences of compliant and noncompliant patients.Multivariate logistic regression was used to analyze the influencing factors of compliance to colonoscopy screening.Results A total of 463 valid questionnaires were obtained from 7 centers,in which,427 outpatients(92.2%)followed the recommendation for colonoscopy screening,and 36(7.8%)did not.Chisquare test results showed that there were statistically significant differences between the two groups in gender,age,education,subjective cognition of intestinal polyps,personal history of colorectal polyps,family history of colorectal cancer,family history of colorectal polyps。