Translation and standardisation into Greek of the standardised general Nordic questionnaire for the musculoskeletal symptoms.
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Greece↗
Biomedical subjects
Christos Lionis
Publications and source records attributed to Christos Lionis.
Seeking quality improvement in primary care in Crete, Greece: the first actions.
AIM: To implement quality improvement programs and assess the clinical effectiveness within the primary care setting. METHODS: The introduction of clinical governance teams, the establishment of a patient-based record system, and the dissemination of practice guidelines were included among the efforts made to improve the quality of care. The clinical effectiveness was measured using EUROPEP (European Task Force on Patient Evaluations of General Practice tool) for evaluating patient's opinion and contracts between health authorities and primary care physicians and nurses. RESULTS: Clinical governance teams of 5-6 practitioners were formed in all health centers. Health cards were created for 6,150 individuals, and a high satisfaction rate with the interest in the patient's personal situation (97.6% of participants assessed it as excellent), physical examination (97.6%), and giving information about symptoms and illness (97.6%) was recorded on the EUROPEP sample. Lack of infrastructure and diagnostic equipment were considered as important barriers in implementing contracts in primary care. CONCLUSION: Primary health care in a rural setting in Crete is engaged in setting up systems for implementing clinical governance and quality programs. The Regional Authorities of Health and Welfare should provide further support.
Greece↗
[Geographical inequalities in the distribution of general practitioners in Sweden].
AIM: To estimate trends in the inequalities in the distribution of general practitioners in Sweden during the past fifteen years. METHODS: Relative inequality indicators. We plotted the Lorenz curves and calculated the Gini coefficients for the entire country during 1986, 1991, 1996 and 2001. RESULTS: During the past 15 years in all a declining trend was noted in the inequalities in the geographical distribution of general practitioners in Sweden, with the lowest level in 1996. CONCLUSIONS: The degree of inequality in the geographical distribution of general practitioners appeared rather stable during the period, although with some increase in the final year studied. Since equality is part of quality, policy makers in all levels--national, regional and local--should pay attention as to how human resources are distributed.
Family Practice↗
Developing an appropriate EPR system for the Greek primary care setting.
The creation of an electronic patient record (EPR) system with a user-friendly interface based on the concept of the episode of care was considered an urgent priority in the present Greek context, where a Health Care Reform program is in progress. This paper reports the procedures of developing an EPR system, and outlines some of its essentials and key issues. We performed a systematic review and analyzed the perceptions and patterns of use of existing EPR systems among Greek general practitioners. On the basis of this analysis, Transhis was selected using defined criteria for appropriateness, efficiency, and feasibility for general practice as a prototype, for creating a Windows-based EPR system using the International Classification of Primary Care (ICPC-2) and International Classification of Diseases (ICD-10) as classifications. The new EPR system seems appropriate for use within the current Greek primary care setting. Further studies are required for its evaluation.
Ambulatory Care Information Systems↗
The significance of opthalmologic evaluation in the early diagnosis of inborn errors of metabolism: the Cretan experience.
BACKGROUND: The Inborn Errors of Metabolism (IEM) are far from the rare systemic diseases that mainly affect the neural tissue. There are very few written reports on ocular findings in subjects with IEM, thus it was interesting to study the frequency of ocular findings in the studied population and explore their contribution to the early diagnosis of IEM. METHODS: Our study involved the evaluation of IEM suspected cases, which had been identified in a rural population in Crete, Greece. Over a period of 3 years, 125 patients, who fulfilled the inclusion criteria of this study, were examined. Analytical physical examination, detailed laboratory investigation as well as a thorough ocular examination were made. RESULTS: A diagnosis of IEM was established in 23 of the 125 patients (18.4%). Ten (43.5%) of the diagnosed IEM had ocular findings, while 8 of them (34.8%) had findings which were specific for the diagnosed diseases. One patient diagnosed with glycogenosis type 1b presented a rare finding. Of the 102 non-diagnosed patients, 53 (51.96 %) presented various ophthalmic findings, some of which could be related to a metabolic disease and therefore may be very helpful in the future. CONCLUSIONS: The ocular investigation can be extremely useful for raising the suspicion and the establishment of an early diagnosis of IEM. It could also add new findings related to these diseases. The early management of the ocular symptoms can improve the quality of life to these patients.
Adolescent↗
Hematological abnormalities in inborn errors of metabolism--how frequent are they? The Cretan experience.
This study aimed to ascertain the frequency and type of hematological findings in a defined group of patients with inborn errors on Crete. The key role of these hematological findings in the diagnosis of the inborn errors in daily practice was explored. A variety of hematological findings were obtained from 31 of the 132 subjects who had been referred to the University Hospital of Heraklion. A diagnosis of inborn errors of metabolism (IEM) was confirmed in 21 subjects, but in 12 of them the diagnosis was combined with hematological findings. The hematological findings consist of a neglected area in the diagnosis of the IEM, and cooperation of primary care physicians and neurologists could help hematologists in the management of people with unexplained hematological symptoms and signs.
Adolescent↗
Medical education in Albania: current situation and perspective, with reference to primary care.
A radical primary health care-oriented reform of the medical services in Albania is now under way, calling for adequate revision in medical education. The reform has started in 1994. In January 1997, the Department of Family Medicine at the Faculty of Medicine, University of Tirana, was established for the development of general practice and family medicine, and with it a new era in medical education in Albania has begun. Mutual agreements for international collaborations are being realized, modern medical textbooks are being published, and the importance of continuous medical education is gaining a deserved appreciation. Here we describe medical education in Albania, including undergraduate education, vocational training, and continuing professional development. The emphasis is given on primary care, with some suggestions for concrete actions that would improve the current situation. A brief descriptive account is given of the ongoing Albanian medical education reform, primarily in the field of primary health care, which assumes its most interesting global aspects and at the same time reflects the unique demands of the country.
Albania↗
Greek-Turkish collaboration in general practice/family medicine: an example of country-to-country collaboration.
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Family Practice↗
The need for quality management in primary health care in Cyprus: results from a medical audit for patients with type 2 diabetes mellitus.
OBJECTIVES: To assess the quality of clinical management regarding metabolic and blood pressure control in a cohort of patients with type 2 diabetes in the primary health care setting of Cyprus. SUBJECTS AND METHODS: Medical care, received by 296 patients with type 2 diabetes from 4 primary care health centers in Cyprus, was assessed for 1 year. Data were collected retrospectively using chart review and a telephone survey. Most recent values of HbA1c, fasting blood glucose, blood pressure, and lipid values were used to assess attainment to internationally accepted treatment targets. RESULTS: Mean age was 70 years, 75% of patients being older than 65. Average diabetes duration was 13 years. Almost 90% of patients had visited a general practitioner during 1 year, on average 8.3 times. Hypertension and hyperlipidemia were present in 67% and 32% of patients, respectively. Overall, diabetes care provided by the 4 primary care health centers appeared to be suboptimal with regard to frequency of metabolic and blood pressure measurements as well as targets reached. Only 10.5% of all patients had at least 1 HbA1c value recorded, and 77.4% of them had HbA1c levels of 8% or more. Of the patients who had a low-density lipoprotein cholesterol measurement during the examined year (29.4%), only 20.7% had a value less than 100 mg/dL. Only 34.5% of patients used lipid-lowering agents, and only 15.9% were receiving aspirin. CONCLUSION: Our findings suggest that the management of type 2 diabetes is suboptimal in the primary health care setting of Cyprus. A multifaceted intervention, already in progress in 2 health centers, is expected to improve the quality of diabetes care.
Adult↗