Evaluating the role of primary care physicians in the treatment of latent tuberculosis: a population study
Notice bibliographique
Résumé
Background: Tuberculosis (TB) remains within the world's most important infectious causes of morbidity and mortality among adults. There are close to 10 million new cases of TB annually and latent TB (LTBI) is the main source of new active cases. Treatment of LTBI is long and often results in poor treatment completion rates. Primary care physicians have been identified as playing an important role in LTBI treatment; however, how large a role they currently play and the impact of this have not been assessed. Objective: To estimate the treatment completion rate in individuals receiving therapy for LTBI when the treatment is initiated by a primary care physician after controlling for initial health status and other patients characteristics. Study design and population: The province of Quebec (Canada) provides TB treatment free of charge to all residents. The study population consists of all Quebec residents who have been prescribed, for 30 days or more, LTBI therapy between January 1, 1998 and December 31, 2005.Data gathering: Using data from the regional health insurance board (Régie de l'Assurance Maladie du Québec), de-identified data was extracted from the beneficiaries database, the medical services database, the prescription claims database and the hospital services database (Med-Echo), all linked with a unique patient identifier. Basic descriptive statistics were done to describe the study population and determine the proportion of treatment initiated by primary care physicians. Regression modeling was used to determine what factors were significantly associated with completion rates including the type of prescribing physician. Results: Twenty-six percent of all LTBI prescriptions during the study period were initiated by primary care physicians. This proportion decreased from 1998 (28.7%) until 2005 (21.1%). A total of 6 059 (41.1%) individuals completed the treatment. Individuals prescribed by primary care physicians were less likely to complete the LTBI treatment (OR: 0.80, 95% CI: 0.67-0.95). Conclusions: More than half of patients treated for LTBI are still not completing the recommended regimen. Between a third and a quarter are initiated by primary care physicians. The reasons why completion is less likely for those initiated by primary care physicians need to be investigated.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».