Vol 39 # 2 June 2007 - Kma.org.kw

June 2007KUWAIT MEDICAL JOURNALOriginal ArticlePerception and Practice of Primary Healthcare Practitionersabout Delivering Preventive Measures and ObstaclesInvolvedFareeda Esmael Moquaddam, Nahil Naser Salmin, Amal Homoud Al-JeheidliPrimary Health Care, Dasma Clinic, KuwaitABSTRACTKuwait Medical Journal 2007, 39 (2):133-137O b j e c t i v e : To assess how adequately practitionersperceive and practice certain preventive measures andwhat are the barriers to providing them in a Kuwaitprimary healthcare centreSetting: Primary Health Care, Dasma Clinic, KuwaitMethods: Cross-sectional survey of general practitionersin 29 primary healthcare centersR e s u l t s : The results of the survey revealed thatpractitioners were familiar with the importance ofclinical preventive medicine. However, lack of time wasc o n s i d e red an important obstacle, for checking BP(49.0%), blood sugar (39.3%), cholesterol level (44.1%),counseling on smoking cessation (81.4%), diet counseling(84.4%) and self breast examination (74.9%). On the otherhand, insufficient training was a barrier to somecounseling pro c e d u res such as smoking cessation(53.0%), diet counseling (52.6%) and self bre a s texamination (36.7%).Conclusion: The study found that insufficient training ofGPs is a major obstacle in delivering preventive care. Thiswas declared by a large number of family and generalpractitioners. This was noticeable when GPs conductedcounseling on smoking cessation, dieting and self-breastexamination. A d d i t i o n a l l y, the study revealed somevaluable recommendations by the GPs.KEYWORDS: Kuwait, obstacles, prevention, primary careINTRODUCTIONThe term “Preventive Medicine” is given to anymedication or procedure that can maintain andpromote health. Moreover, it should contribute tothe reduction of risk factors that result in injury anddisease. In order to achieve these valuableambitions, certain primary, secondary and tertiaryprevention activities must be considered. Primaryp revention activities deter the occurrence of adisease or adverse event for e . g ., smokingcessation [1] . Meanwhile, secondary prevention orscreening like mammography detection of breastcancer [2] will assist in early detection of a disease orcondition in an asymptomatic stage. These result inproviding the right treatment that could delay theo c c u r rence of symptoms. Tertiary pre v e n t i o nmethods like rehabilitation attempts to disallowadverse consequences of existing clinical disease.Preventive activities or services have decreasedmorbidity and mortality from acute or chronicc o n d i t i o n s .H o w e v e , they r were not fully implementedby physicians, patients or the health systems. Thetraditional disease/treatment model should bemodified to incorporate more preventive services [3] .In reality, education alone is not enough toi m p rove prevention. This study supports theappropriate evaluation approach. Such approach isexpected to highlight the most effective ways ofprevention. It also improves our ability to applyobtainable and effective ways of disease preventionand health modalities [4] .Several studies have demonstrated that manypatients did not receive recommended preventivecounseling. At the same time, efforts were made toimprove preventive care but coverage often fell farshort of target level. Simultaneously, primary carephysicians were missing opportunities for healthpromotion and disease prevention in a regularfashion [5-10] .Inspite of previous difficulties, the provision ofprimary and secondary prevention has faced someobstacles. These obstacles involve physicians, patientdeterminants, office system and structural issues [ 11 - 1 4 ] .The intent of this study was to inspect the gapbetween the level of preventive care thatpractitioners perceived as satisfactory and the levelof coverage that has been achieved in primaryh e a l t h c a re settings. Another aim was to knowAddress correspondence to:Dr. Fareeda Esmael MRCGP, Primary Health Care, Dasma Clinic, P. O. Box 43806, Hawalli, Postal Code: 53032, Kuwait. Tel : 2532266 /2532265, Fax: 2549511, E-mail: friend29488@hotmail.com