WONCA NEWS August - September 2022

VOL 49 | NUMBER 7

NEWS

2022

S E P T E M B E R

WONCA PRESIDENT DR ANNA STAVDAL (NORWAY) EMAIL: PRESIDENT@WONCA.NET TWITTER: @ASTAVDAL WONCA IMMEDIATE PAST - PRESIDENT DR DONALD LI (HONG KONG) PRESIDENT-ELECT ASSOC PROF KAREN FLEGG (AUSTRALIA) EXECUTIVE MEMBER AT LARGE & HONORARY TREASURER PROF VAL WASS (UK) EXECUTIVE MEMBER AT LARGE DR MARÍA PILAR ASTIER PEÑA (SPAIN)

CONTENT FROM THE PRESIDENT

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FROM THE HEADQUARTERS

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WONCA REGIONS

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EXECUTIVE MEMBER AT LARGE PROF SHABIR MOOSA (SOUTH AFRICA)

WHO 72ND REGIONAL COMMITTEE FOR AFRICA

REGIONAL PRESIDENT, WONCA AFRICA DR DAN ABUBAKAR (NIGERIA)

BUILDING THE FOUNDATION FOR RESEARCH, POLICY, AND ADVOCACY TO STRENGTHEN FAMILY MEDICINE IN SOUTH ASIA

REGIONAL PRESIDENT, WONCA ASIA PACIFIC ASSOC PROF MOHAMMAD HUSNI JAMAL (MALAYSIA) REGIONAL PRESIDENT, WONCA EAST MEDITERRANEAN PROF TAGHREED MOHAMED FARAHAT (EGYPT) REGIONAL PRESIDENT, WONCA EUROPE PROF SHLOMO VINKER (ISRAEL) REGIONAL PRESIDENT, WONCA IBEROAMERICANACIMF ADJ/PROF JACQUELINE PONZO (URUGUAY) REGIONAL PRESIDENT, WONCA NORTH AMERICA DR JEFF MARKUNS (USA) REGIONAL PRESIDENT, WONCA SOUTH ASIA DR TARIQ AZIZ (PAKISTAN) YOUNG DOCTORS' REPRESENTATIVE DR SANKHA RANDENIKUMARA (SRI LANKA) WONCA CHIEF EXECUTIVE OFFICER DR HARRIS LYGIDAKIS WONCA WORLD SECRETARIAT WORLD ORGANIZATION OF FAMILY DOCTORS AVENUE DES ARTS 7-8 1210 BRUSSELS BELGIUM EMAIL: SECRETARIAT@WONCA.NET PHONE: +32 (0) 2 329 00 75 WONCA EDITOR MARIA DOLORES ZAVALA EMAIL: EDITOR@WONCA.NET TRANSLATIONS DR JIE GU DR HUA YANG DR JULIEN ARTIGNY

A CALL TO HONOUR SALVADOR TRANCHE

WP & SIGS NEWS

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POLICY ADVOCACY

FEATURED STORIES

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WPA WORLD CONGRESS OF PSYCHIATRY 2022 FAMILY MEDICINE RESIDENCY PROGRAM OF YUMA REGIONAL MEDICAL CENTER IN ARIZONA

WORLD PATIENT SAFETY DAY

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WONCA CONFERENCES

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ANNOUNCEMENTS AND UPDATES

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FROM THE PRESIDENT S E P T E M B E R

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PATIENT SAFETY DAY, 2022 : SAFE MEDICATION! Yes. Sixty years of studies have validated, repeatedly, that the doctor-patient relationship is a key to the placebo factor – how patients get well. It may represent as much as 30-40% of healing therapeutic responses, regardless of which medical personnel are involved, and including when medication is part of the treatment.

F R O M

But make no mistake about it: In our field, the prescription pad is one very powerful tool!

T H E

We Family Doctors must consider each aspect our Hippocratic Oath in every clinical decision we make: “Preferably cure, often alleviate, always comfort. But, first of all: Do no harm.” Among our more difficult choices to balance are medications: prescribing them for patients, following up on their effects and side-effects, and making decisions about ceasing to prescribe them.

P R E S I D E N T

That’s why we at WONCA are so supportive of the selection of “Safe Medication!” as the theme of this year’s annual WHO “Patient Safety Day”.

A bit of background: Launched in 2019 by WHO, the 17th of September each year is now the global “Public Health Day”. Their emphasis is on solidarity and strengthening concerted action worldwide, both among countries and international partners. As the quality of care and patient safety are core themes in the Family Doctors’ professional development, it’s natural

DR ANNA STAVDAL WONCA PRESIDENT

What is the drug you use with patients all the time?

The doctor is the drug.

Dr. Michael Balint

that WONCA’s Working Party on Quality and Patient Safety has forged such strong links to the WHO Department of Patient Safety in Geneva. We can thank them for leading the way in WONCA`s efforts to contribute to this global campaign.

I recommend that all WONCA members explore what contributions Family Doctors can make toward meeting the four objectives that the WHO has set for “Patient Safety Day, 2022 : Safe Medication! (Just so you know, WONCA’s Secretariat has created a toolkit for addressing these aims.): Objective 1: RAISE global awareness of the high burden of medication-related harm due to medication errors and unsafe practices, and ADVOCATE urgent action to improve medication safety.

We can look more closely at how we get our information about the medications we choose among, including how prescription guidelines have been devised, how specific they are about their treatment applicability, including within different fields and contexts. The pharmaceutical industry is central here.

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Obviously, they also play a major economic role.

Funding is crucial to developing new treatments, carrying out research, and distributing research results. But: revenue is a primary goal for Big Pharma. If we’re to be trusted, we physicians at the prescribing end of the process need to help each other catch on to marketing ploys – before we fall for them. We must also sharpen our skills at interpreting research results to protect our patients from harmful drug interactions as well as other potentially negative effects, such as becoming over-medicated. This requires us to trust our clinical experience, especially the individualized knowledge we gather about our patients thanks to the relationships that our commitment to continuity of care helps us build.

Results from randomized controlled trials are not necessarily applicable to the patient in front of us!

Objective 2: ENGAGE key stakeholders and partners in the efforts to prevent medication errors and reduce medication-related harm.

This aim invokes the person-centered nature of Family Medicine. Recommending that someone take a medication every day is actually quite a radical intervention. Patient compliance – whether or not a patient follows our advice – depends also on us. Has the information we’ve communicated been sufficient, and tailored to that specific person right now? Have we made clear what positive effects we expect, as well as potential side effects? Have we also informed the patient what risks – and/or benefits – that might result from not taking the medication? Our patients need to experience that we evaluate each prescription carefully, and trust that we will reassess regularly whether – or not – the medication continues to be useful for them.

Objective 4: SCALE UP implementation of the WHO Global Patient Safety Challenge: Medication Without Harm.

We have our work cut out for us to achieve an honest mix: pharmaceuticals in service of our doctor-patient relationships. Not the opposite!

DR ANNA STAVDAL WONCA PRESIDENT

Also available in: Français Español

P R E S I D E N T

Tread carefully, however. We’re all aware of the doctor-assisted opiate addiction epidemic, and the burgeoning crisis of antibiotic-resistance after decades of over-prescribing, and, of course, there’s the anti-vaxx distrust.

T H E

'Better Living Through Chemistry’ was an American advertising slogan the DuPont chemical company came up with in the 1930’s. I’m told it was embraced as a rallying cry for mindexpanding drugs during the cultural upheavals of the ‘60’s and ‘70’s. Yet, from penicillin, to the smallpox vaccine, to stopping the scourge of polio, to slowing deaths by COVID, etc., it has proved prophetic.

F R O M

Family Doctors work at the community level where they engage with other professionals in Primary Care teams. Important assistance is provided by nurses, community health workers, pharmacists, among others, in the administering of medication, not least to elderly people exposed to polypharmacy. Secondary Care hospital services also prescribe medication. When patients return to their usual environment, be it their home or a nursing facility, the medications initiated during Secondary Care hospital treatments will need to be reevaluated. It serves the Family Doctor well to have established good collaborative relationships with their hospital and community co-workers. An example is when taking a patient off a specific medication that is no longer appropriate. Deprescribing turns out to be much harder than prescribing, often requiring genuine clinical courage. It is far less daunting to make and carry through on such difficult decisions when they’ve been arrived at on the basis of mutual professional assessment.

Objective 3: EMPOWER patients and families to be actively involved in the safe use of medication.

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H E A D Q U A R T E R S FROM THE HEADQUARTERS

THE SCIENCE & ART OF COMMUNICATION THINK LIKE A SCIENTIST

CREATE LIKE AN ARTIST

This is the second article in a series that aims to discuss core principles for the future of the Organisation — the first article is available here.

You would think, in the 21st Century, opening a bank account would be straightforward. A visit to the bank, a few pages to sign, some identification to show, and then voilà, you have a new account. I have discovered, however, that setting up an account for an international non-profit NGO, with a complex structure and many stakeholders, is actually a balancing act. A combination of patience, perseverance and–above all– communication.

The ordeal of setting up a bank account in Belgium for WONCA has been a learning curve for me, one which has caused more than a few sleepless nights and a whole lot of very complex logistics, including paperwork being flown around the world. But the real moment of insight came when, after months of exchanges, and we were inches from the finish line, they needed some clarity. “Who,” they asked, “are the beneficiaries of improving the quality of family medicine?”.

To me, and probably to you dear readers, the answer is as clear as day. Everyone benefits! I was taken aback by the question, frustrated by it. And that was the ‘aha’ moment: just because it’s obvious to me, doesn’t mean it’s obvious to them.

We talk all the time about the need to ‘know your audience’ when communicating effectively, but in reality this means so much more than just using the right tone or style, or sharing it on the right platforms.

It means going right back to questioning even the most basic assumptions we are making: what do I know which this audience may not know? It means sharing those things in a clear, ‘userfriendly’ way to that audience. It means adapting, pivoting, responding to feedback when there is something we have missed, instead of digging our heels in and holding onto our pride.

This got me thinking. I am far from perfect at communication, but I have learnt some helpful insights over the years (sometimes the hard way!).

There is no single recipe for good communication, but there are some core principles I have found to be profound and enduring.

So I want to share them with you and open a discussion, so that we as an organisation can keep building on our communication, both internally and externally, so we can operate more effectively, and so our message is better shared with the wider community.

THE FOUNDATIONS OF GREAT COMMUNICATION When I consider examples of great communication that I have seen, experienced and undertaken, I find a great approach is to think like a scientist and create like an artist. This means, first and foremost, to set up the communications ‘experiment’ like a scientist; in a methodical way,

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setting out the objectives clearly according to a well-formulated plan, and applying the right foundational knowledge and principles to this plan. What follows are some of what I believe to be the core principles of this part of the process.

THE PLANNING PHASE – THE SCIENCE Great communication is consistent and strategic.

It should not be a scatter gun approach, it should be aligned with a wider plan, both in terms of a communication-specific strategy and in terms of the core business strategy of the organisation.

This is key. The objectives of communication should be set out in advance and always kept in mind throughout the entire process. This way, we can avoid sharing information for the sake of it or throwing ourselves into new and shiny communications channels even when they don’t meet our aims.

An illustration of this, and one which resulted in the most part in a lot of ineffective consumer engagement, was during the big rush of brands to Twitter around 2010. Their ‘tweeting’ was awkward, inconsistent in message, and often caused more harm to the brand than help. They focused more on having a presence than considering their wider strategy, and it was – for most brands – a real comms failure.

Additionally, at the strategy & planning stage it is crucial to decide on the feedback & evaluation process of the ‘experiment’. How will feedback be gathered? What assessment tools will be used?

What criteria will be set to evaluate the effectiveness of what has been tried? Having this in mind from the start makes all the difference.

These are some of the core components on which to base a structurally sound plan for communication, which serves as a great container for future experimentation. Yet some of the real beauty and true impact of communication lies in the adaptability, responsiveness, and innovation in the approach to telling stories and sharing information.

THE EXPLORATION & INNOVATION PHASE – WHERE SCIENCE MEETS ART Once the groundwork has been laid, the experimenting can really begin. Over the years, I have learnt that being creative, adaptable and— above all—humble have been crucial when hitting the right notes with communication. Here is where the more ‘artistic’ side of the work comes in; space to explore, try new things, and observe new perspectives. To tell stories and get into the minds of the viewers; to be human. To let ideas percolate and become realised. To have some playfulness, fun even.

Another crucial aspect of communication, especially that done on behalf of or within an organisation (WONCA included), is that it needs to adhere with organisational policy and wider legal frameworks. This includes policies around privacy and confidentiality requirements, community etiquette, branding guidelines and copyright laws. When communication fails to meet these laws and guidelines, not only can this undermine the integrity and brand perception of an organisation, but it can lead to actual legal sanctions, such as in cases of data-privacy violations. Just a reminder to always check in with the rulebook!

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Of course, it is important to combine the artistry and creativity with the more methodical, scientific approach.

Fisher, Ury and Patton, in their seminal work ‘Getting to Yes’, touch upon this: “Premature judgment hinders creativity […] To invent creative options, then, you will need to separate the act of inventing options from the act of judging them.”

In reality, this looks like following the strategic principles discussed above, and aligning your efforts with the plan you have made. It means ensuring that some ground rules or parameters are in place throughout to ensure consistency.

Knowing in advance when and how you will assess the effectiveness of your communication means that you can then freely explore new ideas, without losing track of what is working in conveying your message.

To that end, there are some other principles I have found to be helpful in this ‘experiment & adapt’ part of the process.

Firstly, the best communication is coherent, focused and clear. It considers the audience receiving it, clarifying key points, unpacking and simplifying more complex concepts. It is professional, while also speaking to people in a language they can understand. An excellent example of this is the TED/TEDx talks. One of the core principles is to take a complicated topic, and explain it in a way that the general public can understand (two WONCA leaders have already done that: Anna Stavdal, WONCA President: “Hyper-specialized health services need supergeneralists”; Rich Roberts, WONCA Past President: “Healing by Numbers”). In our work, this means really reflecting on who we are speaking to – health specialists vs non-specialists – and changing our message to meet them.

Secondly, an excellent starting point for developing an effective communication strategy is to draw from the ‘lean’ approach so popular with new businesses. This is about minimalism;

starting small, trying, learning and pivoting. It is about – at least in the early days – keeping costs down in a “no frills” approach to really investigate what works before putting a lot of money into it.

The key here is to keep it as simple as possible from the start, which ensures that you don’t put too much time, energy or financial resources into a strategy or communications output which doesn’t resonate with your audience or have the intended effect. It also makes it easier and lighter to adjust and adapt to new ideas because less has been invested into the original ones.

This ‘lean’ methodology is so important in communication in large part because of the need to be highly responsive to how it is being received or whether it is reaching the right people in the right way. Just as with a scientific experiment, where a hypothesis is set out, tested, and then the results are collected and assessed, leading to a new hypothesis and a new test, we need to keep reflecting on and learning from our attempts.

As set out above, there should already be a plan for when and how this cycle will take place, and how feedback loops will work in reality. Then we require a good dose of humility; we need to be modest enough to accept when something hasn’t worked, and to explore the reasons why, and then bold enough to change and adapt the strategy to meet this. Ultimately, this is the core of great innovation in any area, and no less so in the communications world.

Finally, we should aim to always ensure we are open, transparent, full of integrity and ready to own any mistakes we make in the process of communication. Often our intentions do not translate into impact, and what we share is not received in the way we hoped it would be. We should be candid with ourselves and with others, being empathetic yet direct about what is and isn’t working. If we can’t tolerate criticism, or feel uncomfortable with making errors, we will be unable to innovate and ever create really exceptional content.

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It is true that a culture of allowing mistakes not only breeds creativity, it also allows true best practices to arise. A great example of an industry which holds this belief at its core is the aviation sector. Here, there is a culture of openly sharing mistakes with no threat of sanctions, so that lessons can be learnt and changes can be made.

As a result, the quality and safety of airlines has improved year on year.

CONCLUDING THOUGHTS: WHY IS THIS RELEVANT TO WONCA? Ultimately, good communication is more than just a pretty story; it affects the entire operational integrity of an organisation or cause. It must be strategic, consistent, and focused, while also allowing room for exploration, reflection, and course-correction. Flexibility and adaptation are crucial parts of a creative process and also ensure that communication is as effective as it can be. As long as we hold our core objectives in mind, we have the space to be innovative and adventurous with what we produce.

Within WONCA, we have two separate sets of objectives in terms of communication – one for our internal strategy, and one for our external strategy. This is perhaps a discussion for another article, and certainly one I would be excited to have with members, so please do reach out to me with ideas.

In terms of our external objectives, these are to strengthen our brand identity, to reach out to unaddressed audiences (including patients and other civil society organisations), to make content from all internal stakeholders more visible to the outside world, to support advocacy, to drive membership growth, and to encourage more active engagement of the global community of family doctors.

It is crucial to note these differing objectives, while at the same time remembering that both require the same underlying principles as discussed in this article. If this is done well, and if, additionally, we can provide space to reflect on the objectives themselves and where they could benefit from innovation, we are likely to see some great breakthroughs and successes for WONCA. We will be able to build our brand, increase engagement with the wider world, share best practices so they can have more of an impact globally, and create a more connected and integrated community within our own membership.

I, for one, am excited about what that means.

Let’s all keep learning W O N C Atogether.

CEO

DR HARRIS LYGIDAKIS, WONCA CEO

As it stands for now though, our core objectives for our internal communications are to strengthen the dissemination of useful information inside WONCA, support communication among internal stakeholders (e.g. working parties, special interest groups, statutory committees, academic members and so on), to foster a culture of common identity and organisational awareness, to assist stakeholders in identifying synergies and establishing mutual collaboration, and to optimise project management and operations.

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WHO 72ND REGIONAL COMMITTEE FOR AFRICA The president of the Togo Republic Faure Gnassingbe declared the meeting open. The president got an award for eradicating four neglected Chronic NCDs in the Togo Republic.

Togo, therefore, became the first country to achieve this feat. He said among other things that his country was able to achieve this feat through the recruitment of over 7,000 healthcare workers within 10 years and by expanding healthcare facilities. He summarized by saying that ‘he made the impossible possible through imagination and determination.

The meeting agenda was divided into 4 main pillars with many subtitles under each pillar.

PREAMBLE The meeting was held at the prestigious CENTRE INTERNATIONAL DES CONFERENCES DE LOME 2226 August 2022.

However, on Sunday 21 August 2022, WALK THE TALK event was held and all participants were encouraged to join and T-shirts were given to participants.

The WHO DG TEDROS ADHANOM GHEBREYESUS who incidentally started his second tenure in office a week earlier on the 16th of August 2022 was in attendance.

The WHO AFRO Regional Director Dr Matshidiso Moetti was present too and lead the process.

Most Ministers of Health in Africa, stakeholders and WHO partners from Europe, Asia, America etc were in attendance.

There were presentations considered very important and necessary which were not on the agenda but were taken during lunch time; those who were interested participated in such meetings. There were other pieces of training done at night which were sponsored by some ministers.

Pillar 1. One billion more people benefitting from universal health coverage:

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- A regional strategy to address severe, chronic noncommunicable diseases [NCDs] at the intermediate level of national health systems was adopted.

- Framework to strengthen the implementation of the GLOBAL Mental Health action plan [20132030] was adopted.

- Financial risk protection towards universal health coverage in the WHO Africa region was adopted.

- Launch of the Regional Campaign Against Sickle Cell Disease on Tues 23rd AUG 2022 and the panellists were the Ministers of Health of Cameroon, Ghana, Uganda, SickleInAfrica representative and US Department of Human and Health Services /OGA. The Regional Director Dr Matshidiso Moetti gave the opening and closing remarks and it was adopted to be supported strongly by the Region.

Pillar 2. One billion more people better protected from health emergencies:

- The session on Artificial Intelligence was hosted by the Minister of economic transformation of Togo on Thursday 25th August 2022 and it was well received by the Region.

- Regional strategy for health security and emergencies 2022-2030 was adopted.

We currently have only English-speaking Member Organizations in Africa region.

Pillar 3. One billion more people enjoying better health and wellbeing:

I made contacts with Drs from DRC, Benin Republic, Cote D'Ivoire, Burkina Faso, Mali, Gambia, Malawi, Mozambique, Zambia, Namibia, etc.

- Updated regional strategy for the management of environmental determinants of human health in the Africa region 2022-2032 was adopted.

Pillar 4. More effective and efficient WHO providing better support to countries.

- Progress report on the African observatory was presented and adopted.

DR DAN ABUBAKAR

PRESIDENT, WONCA AFRICA REGION.

health

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A CALL TO HONOUR SALVADOR TRANCHE AND A TRIBUTE IN GUATEMALA The Iberoamerican Confederation WONCA CIMF, together with María Fernández, vice president of the Iberican Region of CIMF, to pay tribute to Salvador Tranche with a special call on research in Family and Community Medicine. This celebration will take place during the VIII FCM Summit scheduled for November in Guatemala.

María Fernández, acting president of the semFYC after the sudden passing of President Salvador Tranche, highlighted the role that Salvador Tranche played in the WONCA CIMF. “During the pandemic, he was always connected, even late at night, talking with colleagues from Latin America about how to deal with COVID-19 in our region.”

Salvador Tranche shared with family doctors worldwide the evidence and actions taken in Spain during the most challenging moments of the pandemic. In the same way, he highlighted the role of the semFYC battling the invisibility to which Primary Care and Family Medicine is often the victim. The same invisibility that our level of care suffers in the rest of the countries of the Ibero- American region. All this, even though Primary Care professionals and family doctors were essential in managing and preventing the adverse effects of the pandemic.

Jacqueline Ponzo, president of WONCA CIMF, and the rest of the board encouraged all family doctors to apply for this special call made in homage to our president Salvador Tranche. An honour also shared by semFYC. Jacqueline Ponzo, who presented the Salvador Tranche call during the National Congress in Seville, stated: "Salvador Tranche was a very dear person. The Spanish Ministry of Health also recognized his role with a special commission in tribute to his career."

The Guatemala Summit will be the first physical reunion of the Ibero-American community of family doctors after the pandemic, making it a long-awaited event. “This congress arises from a need and a request made by Guatemala. This is especially relevant because Guatemala does not yet have the specialty of Family and Community Medicine in place, so holding a WONCA CIMF summit there will undoubtedly be an interesting experience at a political, educational and scientific level.”

Discover all the information on how to apply for the Salvador Tranche call here [+] . (In Spanish) PAGE 11

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BUILDING THE FOUNDATION FOR RESEARCH, POLICY, AND ADVOCACY TO STRENGTHEN FAMILY MEDICINE IN SOUTH ASIA NOTES FROM THE FIELD INTRODUCTION South Asia, constituting India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, the Maldives, and Afghanistan represents the most populous region in the world. Unfortunately, despite obvious need, the field of primary care and family medicine in this region is underdeveloped and at a nascent stage. As a result, strengthening primary care systems and family medicine in South Asia needs to be a global imperative. Towards this goal, besides advocacy, educational programs, and support for clinical family medicine practice, fostering research in Primary Care by practicing family physicians is critical.

Any field, for it to stay relevant and to effectively achieve its stated mission, needs to produce its own knowledge through research. This knowledge gleaned through research translates into patient care, practice models, education, and advocacy for health strengthening and reform.

Efforts by WONCA South Asia Region Since Nov 2021, as a part of the current leadership committee of WONCA South Asia, we have taken several concrete steps to build the foundation for primary care research in South Asia.

We aimed to nurture a cadre of researchers in family medicine and primary care who contribute to the primary care/family medicine perspective to improve patient outcomes, efficiency, transparency and sustainability of health care delivery in the South Asian context. Additionally, we wanted to create a platform for family medicine/primary care clinicians, health services researchers, and other experts to address the

Authors: Dr. Tariq Aziz, President WONCA South Asia Region (SAR) Dr. Hina Jawaid, Chair WONCA SAR Primary Care Research Network Dr. Ramakrishna Prasad, Editor WONCA SAR Journal

common, but complex, issues surrounding contemporary health care in the South Asian context to harness synergies and increase impact.

Accomplishments thus far: a) Establishing between leaders.

regular

communication

- Apart from attending numerous meetings (in person or online) both regionally and globally President SAR Dr Tariq Aziz attended the WONCA council in person at the Royal College of General Practitioners in London UK on 27th June 2022. b) Seeding research teams that involve several young FP investigators from across South Asia - Challenges faced by practising Family physicians in South Asia in conducting research. (study underway) - Climate change and Health disclosure: A multinational cross-sectional study of South Asian Physicians’ knowledge and perception about health effects of climate change. (manuscript submitted to an international journal ‘Family Practice’) - Breast cancer knowledge among health professionals: A pre-post knowledge-based intervention study (manuscript submitted for publication in PubMed indexed journal) - Knowledge and use of different types of contraceptive methods to prevent pregnancy and STIs among women in the reproductive age group. (Study underway) PAGE 12

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c) Monthly Research, Leadership, and Policy seminar series So far, the following have been conducted: - Supporting Primary Care Research by Dr Ramakrishna Prasad & Dr Hina Jawaid on 28th Dec 2021 - Research overview & Study design: Basic tips for beginners by Dr Basharat Ali & Dr Tehzeeb Zulfiqar on 11th March 2022 - Rural Primary Care Practice, Research & Leadership by Dr Pavitra Mohan on 30th May 2022 - Developing Family Medicine/Primary Care Education, Faculty and Leadership in South Asia: Lessons from an African context by Dr Kenneth Yakubu on 20th Aug 2022 - Research Ethics and Plagiarism by Dr Mariam Hasan scheduled for 14th September 2022 d) Advocacy and writing in the lay press: Newspaper columns, written by eminent Family Medicine faculty who are actively involved in teaching, training and research work locally, nationally and regionally. Dr. Hina Jawaid and Dr. Abdul Jalil Khan from Pakistan have been writing a series of articles on primary care and other health related issues on a regular basis. Articles on obesity and breastfeeding were co-authored

by Dr. Tehzeeb Zufiqar and Dr. Marriam Sheraz.

List of their published columns include: 1) Breast Cancer: myths, reality, and solutions! https://dailytimes.com.pk/688891/breast-cancermyths-reality-and-solution/ (Article published in The Daily Times newspaper on14th Nov 2020) 2) The mystery of unsafe injections in Pakistan. https://dailytimes.com.pk/712318/the-mysteryof-unsafe-injections-in-pakistan/ (Article published in The Daily Times newspaper on 12th Jan 2021)

3) Primary care in Pakistan: current situation and way forward. https://dailytimes.com.pk/735132/primary-carein-pakistan-current-situation-and-way-forward/ (Article published in The Daily Times newspaper on 17th March 2021) 4) Diabetes: No time to lose. https://www.thenews.com.pk/tns/detail/832389diabetes-no-time-to-lose (Published in The News on Sunday 9th May 2021 in the News on Sunday) 5) The way to universal health coverage. https://www.thenews.com.pk/tns/detail/855459the-way-to-universal-health-coverage (Published in The News on Sunday 27th June 2021) 6) Primary Care transformation). https://www.thenews.com.pk/tns/detail/865545primary-care-transformation (Published in The News on Sunday 18th July 2021) 7) A call for medical education reforms). https://www.thenews.com.pk/tns/detail/878247a-call-for-medical-education-reforms (Published in The News on Sunday 15th Aug 2021) 8) Need for leadership in primary healthcare). https://www.thenews.com.pk/tns/detail/893419need-for-leadership-in-primary-healthcare (Published in The News on Sunday 19th Sept 2021) 9) Little awareness about breast cancer). https://www.thenews.com.pk/tns/detail/904509little-awareness-about-breast-cancer (Published in The News on Sunday 31st Oct 2021) 10) Medical licensing. https://www.thenews.com.pk/tns/detail/925442medical-licensing (Column published in The News on Sunday on 16th Jan 2022) 11) Nutritional needs in early years of life. https://www.thenews.com.pk/tns/detail/944802nutritional-needs-in-early-years-of-life (Column published in The News on Sunday on 27th March 2022) 12) Dealing with obesity. https://www.thenews.com.pk/tns/detail/946765dealing-with-obesity (Column published in The News on Sunday on 3rd April 2022)

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13) Training primary care doctors. https://www.thenews.com.pk/tns/detail/963416training-primary-care-doctors (Column published in The News on Sunday on 5th June 2022) 14) Training primary-care doctors — II https://www.thenews.com.pk/tns/detail/967255training-primary-care-doctors-ii (Column published in The News on Sunday on 19th June 2022) 15) The cost of coping. https://www.thenews.com.pk/tns/detail/974203the-cost-of-coping (Column published in The News on Sunday on 17th July 2022) 16) Guest Editorial: Burden of the disease https://www.thenews.com.pk/tns/detail/977970burden-of-the-disease (Column published in The News on Sunday on 31st July 2022) 17) All the reasons to breastfeed https://www.thenews.com.pk/tns/detail/980230all-the-reasons-to-breastfeed (Column published in The News on Sunday on 7th Aug 2022) Click here to read the publications (2021-2022)

Select peer reviewed

The Path Forward: Priority Areas for future action, research, policy, and advocacy to strengthen Family Medicine in the South Asia: 1. Using a range of research methods, including mapping tools and policy analyses, to a) Determine trends in the supply, training and distribution of the primary care workforce b) Evaluate and improve quality of care through accreditation, c) Evaluate payment models and their impact, d) To appraise workforce shortages and maldistribution, e) To conduct robust needs and systems assessment at multiple levels of the health system 2. Generation and contribution of data and policy analyses and advocate for solutions that bring family medicine and primary care perspectives to health policy deliberations at the local, state, and international levels.

3. Establish partnerships and collaborations with individuals and institutions in order to accomplish the above in an impactful manner.

4. Serve as an incubation space for primary care research, writing, and education by facilitating and supporting scholarship, writing, and publication in primary care especially among medical students, family medicine residents and faculty, and practicing family physicians and general practitioners Through promoting research our aim is to encourage a shift from experience-based to evidence-based clinical practices among GPs and engage in health advocacy. Additionally, we must strive to further promote and nurture the core principles of Family Medicine and the ‘hidden curriculum’ that influences primary care at both undergraduate and postgraduate level.

Notable contributors to research from WONCA South Asia Region (2021-2022) 1- Dr Tariq Aziz (President WONCA SAR) 2- Dr. Ramakrishna Prasad 3- Dr Hina Jawaid 4- Dr Basharat Ali 5- Dr. Raman Kumar 5- Dr Abdul Jalil Khan 6- Dr Tehzeeb Zulfiqar 7- Ms. Swaati Balasubramanian 8- Dr Waseem Ayesha Hana 9- Dr Hassam Khan 10- Dr Ferdous Rehman 11- Dr Sankha Randenikumara 12- Dr Kinley Bhuti 13- Dr Husna 15- Dr Sadia Mustafa 16- Dr Marriam Sheraz 17- Dr Asif Rehman

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WP & SIGS NEWS

POLICY ADVOCACY Dear colleagues, We are delighted to announce the creation by WONCA of a new Special Interest group to focus on helping us to be more effective advocates for family medicine - in our own settings and with external stakeholders.

Family doctors across the world are hard-working clinicians busy at the frontline. Policy, and the systems issues that surround them, are sometimes far from their minds. The Special Interest Group (SIG) on Policy Advocacy aims to build capacity for policy advocacy by family doctors at global, regional, national and local level.

Within WONCA, there is a wealth of experience.

The objectives of the SIG are to: 1. Share experiences and insights on policy advocacy 2. Develop skills in policy advocacy for family medicine and primary health care 3. Share key knowledge and good practice more widely 4. Create a repository of resources to support policy advocacy 5. Support expertise for effective networking with stakeholders 6. Set up specific ‘learning sets’ for mentoring and support to those beginning to take up active advocacy roles.

The mission of the Special Interest Group (SIG) on Policy Advocacy is to build capacity for policy advocacy by family doctors at national and local level.

CONVENORS | CHAIRS PROF. SHABIR MOOSA MEMBER AT LARGE, WONCA

PROF. AMANDA HOWE PAST PRESIDENT, WONCA

JOIN THE THIS SIG

MISSION AND VISION The vision of the Special Interest Group (SIG) is family physician leaders at global, regional, national, and local level being expert at navigating the policy terrain and advocating effectively for family medicine and primary health care.

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WPA WORLD CONGRESS OF PSYCHIATRY 2022 WONCA President, Dr Anna Stavdal, joined the WPA World Congress of Psychiatry 2022, which took place from August 3-6 in Bangkok, Thailand.

About her participation in the WPA World Congress of Psychiatry 2022, Dr Anna Stavdal wrote:

Over four days, the event brought together—in person and online—experts and health professionals from the broader World Psychiatric Association community, which represents 140 psychiatric societies in 120 countries.

This was the second time I attended the annual conference of the World Psych Association, and the first time in person. Was it worthwhile? Indeed it was. I always find it energizing and meaningful to be an ambassador for family medicine. The WPA conference was no exception.

During the second day of activities, Dr Anna Stavdal participated in the Panel Discussion: Task-sharing in mental healthcare; Does it work?

Gabriel Ivbijaro, CEO of the World Federation for Mental Health and former chair of the WONCA Working Party on Mental Health, moderated the session.

Dr Stavdal wrapped up her participation with an inter-organisational symposium along with Dr Nasser Loza, President of the World Federation for Mental Health and past WPA President, Dr Juan Mezzich.

Mental health is high on the health policy agenda globally. Family doctors deal with patients with the diagnosis over the full spectrum of psychiatry, from so called lighter conditions of anxiety and depression to chronic conditions of all kinds: attention deficit disorders, bipolar disease, schizophrenia, schizoaffective disorders and everything in between.

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The group in need of chronic mental care takes up a large portion of the family doctor`s time. And in primary care based health systems, these patients receive most of their medical care from the family doctor and the primary care team, just like diagnosing and treatment are initiated on the same level.

Despite that, there are silos in mental care in many systems. The only way to overcome them is to learn to know how we can collaborate over the speciality boundaries.

I met with president Afzal Javed, President-Elect Danuta Wassermann, and several other key people of WPA. And I gave presentations at two panel discussions.

Prof. Afzal Javed, President WPA and Dr Danuta Wasserman, President Elect of WPA

Besides experiencing an open-minded and welcoming professional environment, we reached an agreement to formalise the collaboration between our two organisations and the World Federation of Mental Health (WFMH). Our CEO will follow up with concrete actions.

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FEATURED STORIES

FAMILY MEDICINE RESIDENCY PROGRAM OF YUMA REGIONAL MEDICAL CENTER IN ARIZONA

Through its Working Party on Education, WONCA has developed the “Standards for Postgraduate Family Medical Education”, against which academic programs in family medicine can be assessed and gain approval from our global organization.

On this occasion, accreditation was granted to the Department of Family and Community Medicine at Yuma Regional Medical Center (YRMC) in Arizona, which developed and implemented a Family Medicine residency program, initiated in 2013 and with the first residents graduating in 2016. This is the first time WONCA grants accreditation to a program in the USA. Facing the COVID-19 pandemic, the workload of the healthcare professionals and travelling restrictions, WONCA had to adapt its evaluation process accordingly. This WONCA Accreditation was first conducted virtually in March 2021, culminating with an on-site visit in 2022 to confirm the information presented during the virtual assessment and explore the implementation of the recommendations provided.

On behalf of the WONCA accreditation committee, Dr Victor Ng attended the on-site visit, highlighting “the friendliness and collegiality of the faculty and with a drive for innovation and getting to better”. During his visit, Dr Ng, who is

also Chair of the WONCA Working Party on Education, met the core faculty, hospital faculty, hospital leadership staff and residents, who shared their perspectives on the residency program.

The experience was reassuring for Yuma to confirm what we have known for some time now, and that is that we have a unique and great program to train physicians in Family Medicine, it was also very useful because it help us get a new perspective on some of our processes and how we could improve such processes. It also opens doors to our residents and faculty when it comes to networking and enchance education opportunities.

After three days of evaluations, productive discussions and feedback, the assessment team confirmed that the Yuma Family Medicine Residency Program met the WONCA Standards for Postgraduate Family Medicine Education. WONCA congratulates the faculty and leadership at Yuma.

As WONCA’s Accreditation is a quality improvement program, we are looking forward to discussing the progress on the recommendations provided. We also encourage the faculty to continue developing their skills and competencies.

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ABOUT WONCA ACCREDITATION WONCA Accreditation provides a professional, collegial context within which individual practices and postgraduate programs can review their standards, improve them where necessary, and gain accreditation if the assessment is judged satisfactory.

A variety of applications are possible, including self-assessment and program quality improvement; new program development; peer review; or recognition and accreditation.

Find more information about Accreditation and Certification here.

WONCA

WONCA Accreditation schemes were developed with intense inputs from our Working Party (WP) on Quality and Safety and our WP on Education, originally intended to support practices and programs developed in countries which did not yet have their own formal standards or national templates for delivery of comprehensive primary care.

As a global organization representing general practitioners and family doctors, WONCA Accreditation can help to consolidate the specialty and to support those professionals who are delivering the range of services which make up family medicine.

Adapting the standards of the World Federation of Medical Education (WFME) to fit with the needs specific to family medicine training, the WWP on Education set out standards across nine areas and 38 sub-areas.

The areas are defined as broad components in the structure, process and outcome of postgraduate medical education and training. They include: • Mission and outcomes • Training process • Assessment of trainees • Trainees • Staffing • Training settings and educational resources • Evaluation of training process • Governance and Administration and • Continuous renewal

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Every person around the world will, at some point in their life, take medications to prevent or treat illness. However, medications sometimes cause serious harm if incorrectly stored, prescribed, dispensed, administered or if monitored insufficiently.

Unsafe medication practices and medication errors are a leading cause of avoidable harm in health care across the world. Medication errors occur when weak medication systems and human factors such as fatigue, poor environmental conditions or staff shortages affect the safety of the medication use process. This can result in severe patient harm, disability and even death.

The ongoing COVID-19 pandemic has significantly exacerbated the risk of medication errors and associated medication-related harm. It is in this context that ‘Medication Safety’ has been selected as the theme for World Patient Safety Day 2022, with the slogan ‘Medication Without Harm’.

World Patient Safety Day is one of WHO’s global public health days. It was established in 2019 by the Seventy-second World Health Assembly through the adoption of resolution WHA72.6 – “Global action on patient safety”. Its objectives are to increase public awareness and engagement, enhance global understanding, and work towards global solidarity and action by Member States to enhance patient safety and reduce patient harm.

WITH INFOTMATION OF THE WORLD HEALTH ORGANIZATION

VISIT THE WHO WEBSITE

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WHO CALLS FOR URGENT ACTION BY COUNTRIES FOR ACHIEVING MEDICATION WITHOUT HARM

World Patient Safety Day aims to increase understanding among and engagement of the public and encourage countries to promote safety in health care.

Globally, half of all preventable harm in medical care is medication related, a quarter of which is severe or life-threatening. In the lead up to World Patient Safety Day on 17 September 2022, WHO is emphasizing the global burden of medication harm. The elderly population is one of the most at-risk groups of medication harm, especially those taking multiple medications. High rates of medication-related harm are also seen in surgical care, intensive care and emergency medicine.

This year has a particular focus on medication safety with the slogan ‘Medication Without Harm’.

The campaign will also see the consolidation of the ongoing WHO Global Patient Safety Challenge: Medication Without Harm, with the aim of reducing avoidable medication-related harm globally.

“Medicines are powerful tools for protecting health. But medicines that are wrongly prescribed, taken incorrectly or are of poor quality, can cause serious harm,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“Nobody should be harmed while seeking care.”

WHO is calling on stakeholders to continue efforts to reduce medication-related harm, develop strategies and structures to improve medication safety at local, national, regional and global levels, and make a pledge to adopt the Medication Without Harm Challenge.

Read more HERE.

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Medication without harm goes back to family medicine basics and its patient-life-course approach. WONCA joins the World Patient Safety Day 2022 campaign through multiple content, articles, quotes and graphics created with the support of our Executive members, Working Parties and Special Interest Groups. Thank you all for being part of this effort to advocate for patient safety.

DISCOVER OUR TRELLO BOARD

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MESSAGE FROM THE WONCA WP QUALITY & SAFETY Special thanks to Professor José M Valderas, Chair of the WONCA Working Party on Quality & Safety, Dr Andrée Rochfort, President of EQuiP, Dr José Miguel Bueno Ortiz, Dr Maria Pilar Astier Peña, Dr Candan Kendir, Dr Oana Bulilete, Dr, Ignacio Ricci Cabello, and Dr Sky Koh Wei Chee Dear WONCA Members, Medications are the most widely utilized interventions in health care: every person around the world can expect to take medications at some point in their life. However, medications can sometimes cause serious harm if incorrectly stored, prescribed, dispensed, or administered. It is therefore not surprising that unsafe medication practices and medication errors are a leading cause of avoidable harm and injury in health care systems globally. The World Health Organisation (WHO) has long cautioned that more than 50% of all medicines are prescribed, dispensed or sold inappropriately and recent findings from the OECD confirm that almost half of all patients receive prescriptions for medication that do not meet their clinical needs. Acknowledging this substantial burden and recognizing the complexity of medication-related harm prevention and reduction, the World Health Organisation (WHO) has identified Medication Without Harm as the theme for the third Global Patient Safety Challenge and made " Medication Safety" the theme for World Patient Safety Day 2022.

On this day we want to join WHO in RAISING global awareness of the high burden of medication-related harm; ADVOCATING urgent action to improve medication safety; ENGAGING all people to participate in the efforts to prevent medication errors and reduce medication-related harm; EMPOWERING patients and families to be actively involved in the safe use of medication and SCALING UP implementation of the WHO Global Patient Safety Challenge: Medication Without Harm.

There is potential for errors to occur at multiple stages of the medication use process. Medication errors may occur when weak systems and/or human factors such as fatigue, poor environmental conditions or staff shortages affect prescribing, transcribing, dispensing, administration and monitoring practices, which can then result in severe harm, disability and even death. Multiple interventions to address the frequency and impact of medication errors have already been developed, yet their implementation is varied.

We need to adopt a systems approach and promote safe medication practices to prevent medication errors and reduce medication-related harm. Special consideration is necessary for areas where most harm occurs. The three key action areas of (1) high-risk situations, (2) transitions of care, and (3) polypharmacy have been identified across the domains of patients and the public, health care professionals, systems and practices of medication, and medicines.

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Family Physicians are ideally placed to play a crucial role in all these situations thanks to our unique whole-person life course approach and our role as coordinator of multiple sources of prescribing. The WONCA Working Party on Quality & Safety has also prepared and delivered workshops to support family doctors in improving the quality and safety of their practices in relation to deprescribing.

We would like to encourage our fellow WONCA members to lead the way by endorsing this initiative and promoting it locally and through social media, keeping up-to-date with best practices in the area (including relevant WHO Technical Reports). This is part of critically appraising how we can improve our own practices for the benefit of our patients and the wider population.

On this day, please do join us for the World Patient Safety Day 2022 Virtual Event. Among the distinguished presenters, our chairman will make the case for the key role of Family Physicians.

Video created by Dr María Pilar Astier-Peña, Executive Member-atLarge 2021-2023 about Medication Without Harm | World Patient Safety Day 2022

Professor José M Valderas, Chair of the WONCA Working Party on Quality & Safety, at the WHO World PatientSafety Day 2022 Global Virtual Event “Medication Without Harm”.

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FOCUSING ON MEDICATION ADHERENCE AMONG PEOPLE WITH MENTAL HEALTH DISORDERS IN PRIMARY CARE Lionis Christos, Rogers Heather, Petrazzuoli Ferdinando and on WONCA Working Party on Mental Health Mental ill health is a growing public concern that has received considerable attention during the COVID-19 pandemic. Pharmaceutical treatment is a key route in the management of mental health disorders (MHD). Severe Mental Disorders (SMD), including schizophrenia, bipolar and other chronic mental disorders require taking medications continuously for long time in order to ensure effectiveness and prevent relapse. There is a growing discussion with respect to the role of family physicians in the effective management of the people with SMD and this short paper, that responds to the WHO campaign on World Patient Safety Day and a subsequent invitation of WONCA Executive Committee to celebrate this day, aims to highlights areas for further improvement.

Barners and Haddad (2020) in their chapter discussed ways to improve adherence to medication in people with MHD noted that “There is no one solution to non-adherence, and the approach adopted needs to be tailored to the individual patient and made in commitment with them”. Deng et al (2022) conducted a qualitative study of mental health professionals and identified three major themes with an important influence on adherence for patients with SMD in China: (a) attitudes towards mental health/treatment, (b) inadequate after care, and (c) resource shortages.

Regarding psychotropic medication nonadherence, a systematic review and meta-analysis (Semahegn et al, 2020) indicated that 49% of individuals with a major psychiatric disorder were non-adherent. Importantly, life expectancy in people with SMD is shorter than among the general population, and cardiovascular disease is one of the major contributors to early deaths.

Adherence to non-psychotropic medication prescribed for co-morbidities also must be addressed.

Primary care is an appropriate setting to assist in the management of adherence to prescription medications and adherence in individuals with SMD is especially challenging. In the WONCA Working Party on Mental Health web-section, relevant guidance to manage physical conditions co-existing with SMD has been published: (https://www.globalfamilydoctor.com/groups/wo rkingparties/mentalhealth3.aspx).

The COVID-19 pandemic had an impact on the medication adherence among patients with SMD, especially in low-income families, and a Chinese study of these individuals (Wang et al, 2022) reported the adherence to medication was 51.5%.

Adherence was associated with modifiable factors such as higher level of medical expenditure, having subsidies for care and supervision, and having disability certificate and personal care.

These results suggest a role for government investment in medical care and social assistance programs.

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Research indicates that primary care can be an appropriate setting to invest to address medication non-adherence in individuals with MHD. Caregiver training is a critical component to achieving positive outcomes in medication adherence among people with mental health disorders (Hock et al, 2015); in this respect, family physicians are in a privileged position, having usually good relationship with both, patients and their familiar caregivers. Physician-directed interventions that incorporate problem solving and motivational approaches have been found to be effective in improving anti-psychotic medication adherence (Barnes and Haddad, 2020). Yet, further research is needed in the area of adherence to medication in people with MHD in primary care. Evidence from the perspectives of family physicians, primary care patients, and their family members (often caregivers) can provide additional insight into this complex challenge.

SANO Y SALVO: DÍA MUNDIAL DE LA SEGURIDAD DEL PACIENTE: MEDICACIÓN SIN DAÑO Como cada año desde su proclamación por primera vez en 2019 durante la 72ª Asamblea Mundial de la Organización Mundial de la Salud (OMS), el 17 de septiembre se celebra el Día Mundial de la Seguridad del Paciente con el objetivo de impulsar medidas dirigidas a reducir los daños evitables derivados de la asistencia sanitaria.

The WONCA Working Party on Mental Health has made this topic one of its priorities and will be addressing it in one of the chapters of a book on mental health challenges in primary care to be published next year. + REFERENCES

PROF CHRISTOS LIONIS CHAIR, WP ON MENTAL HEALTH

JOIN THE THIS WP

Bajo el lema "Medicación sin daño", el Día Mundial de la Seguridad del Paciente 2022 reafirma y potencia los objetivos señalados en 2017 dentro del tercer Reto Mundial de la OMS por la Seguridad del Paciente. A pesar del trabajo y los esfuerzos realizados en los últimos años, los problemas relacionados con el uso inseguro de la medicación continúan siendo la principal causa de daños evitables, y suponen más del 50% del total de los eventos adversos en todos los sistemas sanitarios del mundo.

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La campaña de este año destaca el impacto de la pandemia de COVID-19, que ha agravado significativamente el riesgo de errores de medicación debido tanto a las consecuencias de la interrupción en la prestación de servicios sanitarios, como al endurecimiento de las condiciones de trabajo cotidianas de los profesionales, a menudo complejas y adversas. La fatiga, las malas condiciones ambientales y la escasez de personal afectan a la seguridad del proceso de administración de medicamentos, pudiendo causar graves daños al paciente.

Los objetivos de esta campaña son los siguientes: 1. Aumentar la concienciación mundial sobre la elevada carga de daños relacionados con los medicamentos debido a errores de medicación y prácticas inseguras, y abogar por la adopción de medidas urgentes encaminadas a mejorar la seguridad de la medicación.

institucionales, gestores de los sistemas de salud, profesionales sanitarios, y pacientes, familiares y ciudadanía en general— a priorizar y llevar a cabo acciones dirigidas a su prevención. Acciones que conciernen a todos los profesionales del ámbito de la salud, particularmente a los de atención primaria dada su función coordinadora e integradora de las diferentes necesidades de asistencia de los pacientes.

El rol de los profesionales de atención primaria es clave en las tres áreas de acción priorizadas: la polimedicación, las transiciones asistenciales y las situaciones de alto riesgo, incluyendo los riesgos derivados del uso de medicamentos que se parecen en su aspecto físico o cuyo nombre suena similar.

2. Implicar a las principales partes interesadas y agentes involucrados en los esfuerzos para prevenir los errores de medicación y reducir los daños.

3. Empoderar a pacientes y familiares para que participen activamente en el uso seguro de los medicamentos.

4. Ampliar la aplicación del tercer Reto Mundial por la Seguridad del Paciente: "Medicación sin daño".

Teniendo en cuenta la complejidad que supone reducir los daños relacionados con la medicación, la OMS hace un llamamiento a todos los agentes involucrados —líderes y responsables de políticas

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La revisión clínica y conciliación de la medicación en las transiciones asistenciales; la consideración de las particularidades de cada paciente en relación con el momento evolutivo de su enfermedad y con su contexto social y laboral, y las actividades dirigidas a informar, formar y capacitar a los pacientes para que puedan participar en su seguridad, son acciones que realizan habitualmente los profesionales de atención primaria y que contribuyen a reducir los riesgos derivados del uso inseguro de la medicación.

Como se refleja en los materiales que la OMS ha elaborado para la divulgación de la campaña, todos tenemos un papel que desempeñar en el uso seguro de la medicación. A través de tres sencillas recomendaciones —infórmate, comprueba, pregunta— se insta a los pacientes y a los profesionales a disponer de la mejor información posible sobre la medicación (tanto de las características de cada medicamento como del conjunto de la medicación que está tomando el paciente), a realizar las comprobaciones necesarias para un uso seguro, así como a indagar y tratar de esclarecer las dudas que pueden surgir en relación con la medicación.

Además, la OMS remarca la necesidad de continuar trabajando para garantizar la calidad y la seguridad de los medicamentos en sí mismos.

Medidas como una adecuada denominación, etiquetado y envasado, que eviten confusiones por similitud en el nombre o en la apariencia externa —lo que se conoce como isoapariencia— y reduzcan errores en su utilización. También considera necesario trabajar en el proceso de la logística de distribución y almacenamiento de tal

forma que garantice la disponibilidad de los fármacos necesarios y en buenas condiciones de uso, para conseguir el producto correcto en el punto de atención correcta.

Al igual que en años anteriores la OMS organiza un evento virtual para conmemorar este día, que se celebrará el 15 de septiembre de 14:00 a 17:30 (hora central europea de verano). La inscripción al seminario web es gratuita y se dispondrá de traducción simultánea al español, entre otros idiomas. También, para potenciar la divulgación de la campaña a nivel mundial, propone a los 194 Estados Miembros que iluminen en color naranja los centros de trabajo, monumentos icónicos o lugares más conocidos, a que organicen actividades específicas en torno al día 17 de septiembre, y a que compartan las iniciativas desarrolladas.

En España, los responsables de la Estrategia de Seguridad del Paciente del Ministerio de Sanidad y de las Comunidades Autónomas, en colaboración con la Sociedad Española de Calidad Asistencial (SECA), han organizado una jornada científica bajo el lema "Uso seguro del medicamento", que tendrá lugar de forma presencial el viernes 16 de septiembre en el Ministerio de Sanidad. En ella se presentarán las 8 mejores prácticas puestas en marcha en los centros sanitarios de diferentes Comunidades Autónomas para fomentar el uso seguro de los medicamentos, tanto en atención primaria como en el ámbito hospitalario.

Continúe leyendo AQUÍ Lea la publicación en el Blog SANO Y SALVO

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AGEING & HEALTH: APP HELPS OLDER ADULTS TO SAFELY EXECUTE LONGTERM THERAPIES According to The World Health Organization at least 50% of patients do not adhere to treatment recommendations, which may lead to treatment ineffectiveness, medication side effects, lower quality of life and increased hospitalizations.

In order to change that situation, improve safety of use of medications and tackle medication nonadherence, research team from Department of Family Medicine, Medical University of Lodz, Poland has designed an innovative mobile application which helps patients to take their drugs regularly.

The app, called ‘My health every day’ (Polish: ‘Moje zdrowie na co dzien’) helps self-monitoring of the regularity of the treatment and presents patient’s level of adherence to medication.

However, the most important function of the app activates when the patient reports problems with following drug plan. In such a case, the application suggests realistic options for solving the underlying problems. Such an individualized coaching is supposed to be of great help for patients struggling with execution of their chronic therapies. Therefore, such an application is of particular use of older adults, of which a lot is accompanied with multimorbidity.

This innovative solution has been prepared under the framework of the GATEKEEPER project. This project, funded from the Horizon 2020 Program, is one of the flagship European projects aimed at the large-scale implementation of digital solutions, especially artificial intelligence, Internet of Things (IoT) and Big Data analytics in the area of health. As many as 43 institutions from 13 European countries, active in the field of health, medical research and modern digital technologies, take part in it. The immediate goal of the Gatekeeper project is to create an open, free platform that is to become an arena for the exchange of experiences and combining various ideas, technologies, needs and processes. They all have one common goal: to improve the health performance of aging European societies. At the same time, Gatekeeper intends to introduce the next generation of healthcare innovation, including personalized solutions for health risk assessment, and enabling the earliest possible implementation of interventions that improve the effectiveness of the treatment of chronic conditions. The project partners include institutions, companies and organizations known for their innovativeness, including Medtronic, Samsung, Hewlett Packard, HL7 International Foundation, ECHAlliance, EIP on AHA That the application is available free of charge, both for Android and iOS phones, at www.mojezdrowie.umed.pl Prof. Przemyslaw Kardas MD, PhD Head of the Department of Family Medicine Medical University of Lodz

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C O N F E R E N C E S

WONCA WORLD CONFERENCE

WONCA SYDNEY 2023 WILL OPEN CALL FOR SUBMISSIONS IN OCTOBER

WONCA CONFERENCES

SYDNEY, AUSTRALIA | 26 OCT - 29 OCT , 2023

You’re invited to be a part of history at WONCA’s 50th anniversary conference in Sydney on 26–29 October 2023. WONCA began in Australia all those years ago, so its return is certainly worth celebrating.

The call for submissions will open on 3 October 2022, so save the date and don’t miss out on this opportunity to contribute to this landmark event.

Sign up for the WONCA mailing list to receive details when they’re released in October.

Start planning your visit to Australia now to see some of the spectacular sights

Click here for more information: https://www.racgp.org.au/wonca2023/home

CHECK THE KEY DATES

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C O N F E R E N C E S WONCA CONFERENCES

7TH WONCA AFRICA REGION CONFERENCE 2022 ABUJA, NIGERIA | 24 - 26 NOVEMBER 2022

WELCOME MESSAGE My dear Friends and Colleagues, I am Dr Dan Abubakar, the WONCA Africa Region President and the Chairman of the Host Organising Committee for the 7th WONCA Africa Region conference taking place in Abuja, Nigeria from 24th to 26th November 2022 at the NAF Conference Centre. The conference is tagged “WONCA Abuja 2022” I welcome you all to the event which promises to be very exciting and afford us the opportunity to meet physically, network, discuss and implement positive changes. It will be the second time Nigeria is hosting this event, the first was held here in Abuja 21 years ago. The conference will be [HYBRID] both physical and virtual and will afford colleagues who are unable to travel to Nigeria, the opportunity to fully participate in the event.

The theme of the conference is: Africa’s Health Systems and Preparedness for Global Health Emergencies.

The Sub-themes of the Conference are: 1. Psychosocial and economic burden of global health emergencies: The African perspective.

2. Challenges to providing effective frontline healthcare in Africa.

3. Ensuring health personnel safety during epidemics and pandemics.

4. Sustaining health professionals’ mentorship and education during epidemics and pandemics.

The topics were painstakingly selected to reflect and address the present day healthcare challenges facing African family physicians.

I invite you all to register for the conference and join us in Abuja in November 2022. Abuja is the administrative and political capital of the Federal Republic of Nigeria, a serene city with modern facilities for learning and a city known for culture and hospitality. A city with many monuments, historical sites and attractions.

Abuja is defined by Aso Rock, a 400 metre monolith left by water erosion. The Presidential Complex, National Assembly, Supreme Court and much of the city extend to the south of the rock.

Zuma Rock, a 792 metre monolith, lies just north of the city.

We look forward to welcoming you and hundreds of family doctors from around the world to the conference 24-26 NOV 2022. We promise to make the event exciting, interesting and educationally rewarding.

DR DAN ABUBAKAR Chairman, LOC woncaafricaregion@gmail.com

VISIT WEBSITE

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WONCA ASIA PACIFIC REGIONAL CONFERENCE

WONCA CONFERENCES

BALI, INDONESIA | 5 - 7 DECEMBER

WELCOME MESSAGE Dear Friends and Colleagues, I am Isti Ilmiati Fujiati, on behalf of the Host Organizing Chair would like to extend to you a warm invitation for The Wonca Asia Pacific Regional Conference coming up in Bali, the Island of Gods, in 5-7 December 2022.

The Wonca Asia Pacific Regional Conference this time will be the first face to face international conference held after the two years period of Covid-19 pandemic. It will be a great opportunities to share our experiences in family medicine and primary care which play important roles in most parts of the world during the pandemic. This conference will give us all chances to meet, discuss and implement positive change under the theme primary health care transformation, challenges and opportunities for family medicine. Knowing Bali as one of awesome destination with numerous beautiful beaches and sites will be an additional pleasure to all participants. In addition, the hospitality of Balinese is also a hallmark and can make us feel at home.

sessions, symposiums, oral and poster presentations. We will have as well credible speakers from well-known institutes. We are really proud to host and present this incredible event. We sincerely hope that the event will be beneficial for all of us and we surely are looking forward to see you all in Bali.

Isti Ilmiati Fujiati Chair of Wonca Asia Pacific Regional Conference

The Wonca Asia Pacific Regional Conference will consist of pre-conference, workshops, plenary VISIT WEBSITE

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7TH WONCA EMR REGIONAL CONFERENCE

WONCA CONFERENCES

MUSCAT, OMAN 10 -12 NOVEMBER 2022

Join us in Oman this November as we discus the future of family medicine in the Eastern Mediterranean Region: Connect with some of the greatest minds in family medicine.

WELCOME MESSAGE FROM PRESIDENT WONCA EMR As the President of The Wonca EMR Organization, it is my great honour and pleasure to welcome you to the 7th edition of The Wonca East Mediterranean Region Family Medicine Congress 2022, which will be held from 10th – 12th November 2022 in Muscat – Oman.​ This year’s conference has been designed to provide an innovative and comprehensive overview of the latest research developments in Family Medicine and Primary Health Care. Over the course of three days, the conference will feature symposia, keynote sessions, parallel workshops and abstract presentations.​ We hereby invite you all to share the results of your scientific research with us by submitting an abstract of your work, and by joining us in sharing our vision of The 7th Wonca EMR Family Medicine Congress 2022: a vision to provide high quality educational resources and to enable Family Practitioners to provide optimal care for patients.​

We welcome you to the beautiful country of Oman, and wish you three days of education, knowledge sharing and unforgettable experinces.​ I look forward to meeting you at Wonca EMR 2022!

PROF TAGHREED FARAHAT PRESIDENT – WONCA EMR

MESSAGE FROM PRESIDENT, OMAN FAMILY MEDICINE SOCIETY On behalf of the Oman Family Medicine Society, I am delighted to invite you to the 7th WONCA EMR Family Medicine Congress, taking place in Muscat, Oman on 10th – 12th November 2022.​

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We are committed to offer you all our warmest welcome, following the tradition of hospitality that distinguishes the Arab world and Muscat in particular, a city universally known for its incredible capacity of offering unforgettable memories to all its guests.​ The scientific meeting is being formulated to include well renowned experts in family medicine that will share their expertise. We are strongly convinced that all participants will contribute to the success of the event by sharing their knowhow and integrating their experience in a lively and useful exchange.

WONCA CONFERENCES

A commercial exhibition where companies will showcase their latest products and services will also be present, and we look forward to welcoming our industry’s innovations.​ We look forward to seeing you in this beautiful city of Muscat!​

DR ABDULAZIZ AL-MAHREZI PRESIDENT – OMAN FAMILY MEDICINE SOCIETY PRESIDENT-ELECT – WONCA EMR

The conference will be CME accredited and we encourage the submissions of abstracts, which will be reviewed by our scientific committee, included in the program and thus empower its scientific value.​

VISIT WONCAEMR2022.COM FOR MORE INFORMATION

VIII CUMBRE IBEROAMERICANA DE MEDICINA FAMILIAR Y COMUNITARIA 10- 11 NOVEMBER, GUATEMALA

"Medicina Familiar y Comunitaria, especialidad esencial para la transformación de los sitemas de salud en el siglo XXI"

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HEALTHY LUNG MASTERCLASS ASIA WEBINAR SEVERE ASTHMA – IS IT TIME TO REFER? The next Healthy Lung Masterclass Asia (HLMA) webinar, entitled “Is it time to refer to tertiary care?”, will take place on 22 September 2022, 19:00–20:25 (UTC+8).

Prof Alberto Papi (Italy) will be discussing the assessment of difficult-to-treat and severe asthma and when to refer patients to tertiary care. Dr Fu Pin-Kuei (Taiwan) will provide a casebased discussion on how to maintain continuity of care for referred patients. The session will be chaired by Dr Budhi Antariksa (Indonesia).

We look forward to seeing you there!

IS IT TIME TO REFER TO TERTIARY CARE? 22 SEPT 2022, 19:00–20:25 (UTC+8) REGISTER NOW

HLMA is an educational programme focused on asthma care, developed especially for primary care physicians across Asia in collaboration with WONCA.

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THE BESROUR CENTRE FOR GLOBAL FAMILY MEDICINE: YEAR IN REVIEW The Besrour Centre for Global Family Medicine: Year in Review The Centre is pleased to share our Year in Review Report.

The idea of the Besrour Centre for Global Family Medicine was born out of the tragedies of the humanitarian crisis in Darfur Sudan that began in 2003, the Banda Aceh tsunami in Indonesia in 2004 and the Haitian earthquake of 2010.

Since the official opening of the Besrour Centre in 2015, it has matured both as a discipline and as a centre. Today, it doens't only advocate for family medicine and its role in improving patient care, but also for the models of care throughout the health system that are based on family medicine principles. Over the last six years, their focus has shifted from building family medicine capacity in low- and middle-income countries to studying and promoting family medicine-led models around the world.

The global COVID-19 pandemic has reinforced the importance of our work. It continues to highlight that global problems require global solutions—it is not just an urgent moral issue, it’s a global public health issue. The pandemic also highlighted gaps in and between health systems around the world. Capacity has been stretched everywhere, revealing areas where access remains problematic, and where integration at the system level is still lacking. At the same time, it revealed incredible innovation and perseverance.

As the pandemic continues to vacillate between infectious and chronic impacts, improved integration and the adaptability of family medicine will be key in all health system contexts, including Canada. All of Besrour Centre’s initiatives are exploring or demonstrating how family doctors are leading at this time.

The collective journey highlights that capacity building takes time and determination. To continue this work, we need your ongoing engagement, partnership, and help. "We are deeply appreciative of the funding provided by the Foundation for Advancing Family Medicine (FAFM) and all our partners that helps fuel our work. As always, we are indebted to Dr. Sadok Besrour for his vision and perennial support to build the Centre".

"Together, we are a vibrant network of community-based leaders and partners that continue to learn from one another. Our collective efforts are strengthening family medicine-led models that are at the heart of health systems around the world and, in turn, improve equitable access to care'.

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JOIN THE 11TH EURIPA RURAL HEALTH FORUM The 11th EURIPA Rural Health Forum will take place from 6th to 8th October 2022 at Catania, Sicily.

The venue for the Forum is the Diocesan Museum on via Etnea 8, in Catania.

Programme details It is anticipated that the programme will consist of two parallel sessions, made up of oral communications, workshops and posters. An outline of the programme is available here.

Practice visits will be arranged for Saturday morning 8th October but capacity will be limited so please sign up when you register for the Forum.

The registration fee includes coffee breaks and the welcome reception on the terrace of the Diocesan Museum. But please note that lunches are not included in the registration fee – delegates will be free to ‘do their own thing’ at lunch time. There are many cafes and hotels in the vicinity of the museum for lunches.

The lunch breaks will enable you to enjoy this time visiting the characteristic fish market or tasting typical Sicilian food in the restaurants and bars nearby which offer also a variety of specialties such as arancini, the refreshing granita and the unique ricotta flavour of the famous cannoli. During the break, you can take a stroll in via Etnea – the high street facing the event’s venue – and enjoy the view of the baroque palaces, go shopping, have a glass of wine al fresco or take a rest in one of the hotels located at walking distance. For the sea enthusiasts, just 2 km from the city centre, there is a pleasant seaside promenade going from the golden sand beaches to the black volcanic lava stone cliffs.

The welcome reception and coffee breaks will take place on the terrace of the Diocesan Museum, featuring an amazing view of the city and Mount Etna.

We will hold the Rural Dinner with typical Sicilian dishes at the “Dimora De Mauro” a building from the beginning of the nineteenth century located in the baroque heart of the historical centre of Catania. It is on Via Gesualdo Clementi, a ten minute walk from the Forum venue.

Places at the Rural Dinner are limited. When you register to attend the Forum you can reserve your place at the Rural Dinner (including wine) and payment of 40 euro will be required at the same time as you make your payment to attend the Forum.

There is an opportunity to explore more of Sicily by taking part in our ‘Tourist Offer’: a bus trip to Syracuse and Ortigia on the afternoon of Saturday 8th October. You can find out more here. You will need to pay for the 'Tourist Offer' at the same time as you make your payment to attend the Forum.

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MCGILL FMER: INTERNATIONAL AWARDS IN FAMILY MEDICINE EDUCATION RESEARCH The McGill Family Medicine Education Research Group (FMER) is proud to announce the sponsorship of ‘The Pierre Pluye International Mixed Methods Thesis and Dissertations Awards in Family Medicine Education’ to celebrate the original and influential contribution of Dr. Pierre Pluye, founding member of the FMER, to the advancement of mixed methods research and mixed studies reviews in general, and of the family medicine education field of inquiry in particular.

These awards are aimed to distinguish the work of promising new researchers committed to the advancement of science in family medicine education research around the world.

As of the academic year 2021-2022, two academic awards – one for the best MSc thesis, and one for the best PhD dissertation – will therefore be granted by an Award FMER Evaluation Committee chaired by Dr. Pluye.

The committee will include at least two other FMER researchers, and two FMER-affiliated graduate students (one MSc student and one PhD student or candidate).

ELIGIBILITY

Submission period: May 1st to August 31st, 2022. Candidates must have completed their thesis or dissertation no earlier than two academic years prior submission, i.e., before August 31st, 2020.

The thesis or dissertation must meet 3 criteria: a)be related to research in family medicine education; b)must uses mixed methods in empirical research and/or literature review; c)be written in English or French.

APPLICATION – PROCEDURE

Applications must include the five documents detailed below. Incomplete applications will be disregarded: • A cover letter in which the candidate clearly indicates the award s/he is applying for (thesis or dissertation);introduces him/herself, the program and institution in which s/he graduated, as well as his/her research supervisors; and briefly describes the investigation conducted.

• An abstract of maximum 500 words that summarizes the thesis/dissertation. Particular attention should be given to the description and justification of the mixed methods (empirical research and/or review) adopted in accordance with GRAMMS (Good Reporting of Mixed Methods Studies), and of the major theoretical, empirical, methodological, and practical contributions to the sciences of family medicine education.

• A copy of the thesis in PDF format.

• An updated version of the candidate’s Curriculum Vitae.

• A letter of support from the candidate’s principal research supervisor (specifying that the thesis has been approved to obtein a PHD Degree.

Read the complete information here.

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