Publications by authors named "Ryuki Kassai"

14 Publications

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Co-creation and collaboration: A promising approach towards successful implementation. Experience from an integrated communication and mental health skills training programme for Japanese General Practice.

Patient Educ Couns 2021 Jul 15. Epub 2021 Jul 15.

Department of Community and Family Medicine, Fukushima Medical University, Japan; Working Party for Mental Health, World Organisation of Family Doctors (WONCA), Belgium.

Introduction: This paper describes the co-creation and delivery of an integrated training programme in communication and depression assessment & management for Japanese GPs.

Methods: Experts in communication and depression from EACH and WONCA developed a framework and filled it with content. Through iterative discussions with the Japanese participants and experts during delivery, the training was further adjusted to match local needs. It included didactic and experiential training methods with an emphasis on practicing and feedback. A "train-the-trainer" component helped participants develop their own trainer skills to enhance dissemination of the training in Japan.

Results: Six Japanese GPs participated in two one week training-modules in May and November 2018. To aid implementation participants received online supervision on depression management and on teaching between the two modules and after the second module. Evaluation of the content of the training, the teaching methods and the participatory approach was positive. More than two years after the training, many elements of the training continue to be used in daily practice with the GPs teaching communication as well as depression management skills.

Conclusion: The method of co-creation is promising. Research is needed to confirm that it is effective in transfer to clinical practice.
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http://dx.doi.org/10.1016/j.pec.2021.07.027DOI Listing
July 2021

Integrating public health and primary care: the response of six Asia-Pacific countries to the COVID-19 pandemic.

Br J Gen Pract 2021 07 24;71(708):326-329. Epub 2021 Jun 24.

Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.

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http://dx.doi.org/10.3399/bjgp21X716417DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8249005PMC
July 2021

Developing measures to capture the true value of primary care.

BJGP Open 2021 Apr 26;5(2). Epub 2021 Apr 26.

Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand.

Primary care (PC) is an essential building block for any high quality healthcare system, and has a particularly positive impact on vulnerable patients. It contributes to the overall performance of health systems, and countries that reorient their health system towards PC are better prepared to achieve universal health coverage. Monitoring the actual performance of PC in health systems is essential health policy to support PC. However, current indicators are often too narrowly defined to account for quality of care in the complex populations with which PC deals. This article reviews a number of conceptual frameworks developed to capture PC values in robust measures and indicators that can inform policy and practice performance. Each have benefits and limitations. Further work is needed to develop meaningful primary health care (PHC) and PC measures to inform strategic action by policymakers and governments for improved overall performance of health systems.
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http://dx.doi.org/10.3399/BJGPO.2020.0152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170610PMC
April 2021

The APEC Digital Hub-WONCA Collaborative Framework on Integration of Mental Health into Primary Care in the Asia Pacific.

J Multidiscip Healthc 2020 25;13:1693-1704. Epub 2020 Nov 25.

World Organization of Family Doctors (WONCA), Bangkok, Thailand.

Mental ill health affects individual well-being and national economic prosperity and makes up a substantial portion of the burden of disease globally, especially in the Asia-Pacific region. Integrating mental health into primary care is widely considered a key strategy to improve access to mental health care. Integration, however, is a complex process that needs to be addressed at multiple levels. A collaboration between the Asia-Pacific Economic Cooperation (APEC) Digital Hub for Mental Health and the World Organization of Family Doctors (WONCA) is described in this paper, which outlines a framework and next steps to improve the mental health of communities in APEC economies. This paper notes gaps related to the integration of mental health into primary care across the region and identifies enablers and current best practices from several APEC economies. The potential of digital technology to benefit primary mental health care for populations in the APEC region, including delivery of training programs for healthcare staff and access to resources for patients, is described. Finally, key next steps are proposed to promote enhanced integration into primary care and improve mental health care throughout the APEC region.
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http://dx.doi.org/10.2147/JMDH.S271070DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701136PMC
November 2020

Priorities for primary health care policy implementation: recommendations from the combined experience of six countries in the Asia-Pacific.

Aust J Prim Health 2020 Oct;26(5):351-357

Department of General Practice and Primary Health Care, University of Auckland, PB 92 019, Auckland 1142, New Zealand.

Primary health care is essential for equitable, cost-effective and sustainable health care. It is the cornerstone to achieving universal health coverage against a backdrop of rising health expenditure and aging populations. Implementing strong primary health care requires grassroots understanding of health system performance. Comparing successes and barriers between countries may help identify mutual challenges and possible solutions. This paper compares and analyses primary health care policy in Australia, Malaysia, Mongolia, Myanmar, Thailand and Vietnam. Data were collected at the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Asia-Pacific regional conference in November 2017 using a predetermined framework. The six countries varied in maturity of their primary health care systems, including the extent to which family doctors contribute to care delivery. Challenges included an insufficient trained and competent workforce, particularly in rural and remote communities, and deficits in coordination within primary health care, as well as between primary and secondary care. Asia-Pacific regional policy needs to: (1) focus on better collaboration between public and private sectors; (2) take a structured approach to information sharing by bridging gaps in technology, health literacy and interprofessional working; (3) build systems that can evaluate and improve quality of care; and (4) promote community-based, high-quality training programs.
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http://dx.doi.org/10.1071/PY19194DOI Listing
October 2020

Primary healthcare policy implementation in the Eastern Mediterranean region: Experiences of six countries.

Eur J Gen Pract 2018 Dec 23;24(1):39-44. Epub 2017 Nov 23.

m Department of Community and Family Medicine , Fukushima Medical University , Fukushima , Japan.

Background: Primary healthcare (PHC) is essential for equitable access and cost-effective healthcare. This makes PHC a key factor in the global strategy for universal health coverage (UHC). Implementing PHC requires an understanding of the health system under prevailing circumstances, but for most countries, no data are available.

Objectives: This paper describes and analyses the health systems of Bahrain, Egypt, Lebanon, Qatar, Sudan and the United Arab Emirates, in relation to PHC.

Methods: Data were collected during a workshop at the WONCA East Mediterranean Regional Conference in 2017. Academic family physicians (FP) presented their country, using the WONCA framework of 11 PowerPoint slides with queries of the country demographics, main health challenges, and the position of PHC in the health system.

Results: All six countries have improved the health of their populations, but currently face challenges of non-communicable diseases, aging populations and increasing costs. Main concerns were a lack of trained FPs in community settings, underuse of prevention and of equitable access to care. Countries differed in the extent to which this had resulted in coherent policy.

Conclusion: Priorities were (i) advocacy for community-based PHC to policymakers, including the importance of coordination of healthcare at the community level, and UHC to respond to the needs of populations; (ii) collaboration with universities to include PHC as a core component of every medical curriculum; (iii) collaboration with communities to improve public understanding of PHC; (iv) engagement with the private sector to focus on PHC and UHC.
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http://dx.doi.org/10.1080/13814788.2017.1397624DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5795637PMC
December 2018

Primary healthcare policy implementation in South Asia.

BMJ Glob Health 2016 6;1(2):e000057. Epub 2016 Sep 6.

Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK.

Primary healthcare is considered an essential feature of health systems to secure population health and contain costs of healthcare while universal health coverage forms a key to secure access to care. This paper is based on a workshop at the 2016 World Organization of Family Doctors (WONCA) South Asia regional conference, where the health systems of Bangladesh, India, Nepal, Pakistan and Sri Lanka were presented in relation to their provision of primary healthcare. The five countries have in recent years improved the health of their populations, but currently face the challenges of non-communicable diseases and ageing populations. Primary healthcare should be a core component in restructuring health systems. However, there is a lack of understanding among policymakers of the unique contribution of primary healthcare to the health of populations. This results in insufficient investment in facilities and low priority of specialty training in the community setting. Regional collaboration could strengthen the advocacy for primary healthcare to policymakers and other stakeholders. Priorities were investment in community-based health facilities, and access to healthcare through professionals specialty-trained in the primary healthcare setting. This development fits the strategy of the WHO South East Asian Region to use community-based healthcare in achieving universal health coverage for the Asian populations.
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http://dx.doi.org/10.1136/bmjgh-2016-000057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321321PMC
September 2016

Expanding primary care in South and East Asia.

BMJ 2017 02 27;356:j634. Epub 2017 Feb 27.

Department of Community and Family Medicine, Fukushima Medical University, Fukushima, Japan.

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http://dx.doi.org/10.1136/bmj.j634DOI Listing
February 2017

Cinemeducation in GP training.

Authors:
Ryuki Kassai

Educ Prim Care 2016 May 23;27(3):239-40. Epub 2016 Mar 23.

a Department of Community and Family Medicine , Fukushima Medical University , Fukushima , Japan.

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http://dx.doi.org/10.1080/14739879.2016.1163515DOI Listing
May 2016

Interventions for body weight reduction in obese patients during short consultations: an open-label randomized controlled trial in the Japanese primary care setting.

Asia Pac Fam Med 2015 21;14(1). Epub 2015 May 21.

Department of Community and Family Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima Prefecture Japan.

Background: Family physicians should maintain regular contact with obese patients to ensure they effectively reduce their body weight. However, family physicians in Japan have on average only 6 (min) per consultation, and conventional interventions for body weight reduction require a longer consultation or additional manpower. A brief intervention within the limited consultation time available is therefore needed. Here we investigated the effectiveness of a brief weight reduction intervention for obese patients and the related factors for reducing body weight during routine consultations in the primary care setting.

Method: We conducted an open-label randomized controlled trial at a family medicine clinic in Fukushima, Japan from January 2010 to June 2011. Patients aged 30 to 69 years with body mass index ā‰„25 who were diagnosed with hypertension, dyslipidemia, and/or type 2 diabetes mellitus were randomly assigned to the intervention or control group. At every consultation, body weight in the intervention group was measured by a family physician who provided weight reduction advice in addition to usual care. The primary outcome was body weight change at 1-year follow up. Analysis was done by intention to treat.

Result: We randomly assigned 29 participants to the intervention group and 21 to the control group. Forty participants (80 %) remained in the trial until the 1-year follow up. At follow up, the median body weight change from baseline was not significantly different between the groups (pā€‰=ā€‰0.68), at -0.8 (interquartile range [IQR] -2.5 to 1.0) kg in the intervention group and 0.2 (IQR -2.4 to 0.8) kg in the control group.

Conclusion: We devised an intervention method for physicians to measure body weight and advise on weight reduction during routine consultations. In our setting, this method did not extend the consultation time, but also had no significant additional effects on body weight reduction in moderately obese patients.

Trial Registration: This trial is registered with the UMIN Clinical Trial Registry (UMIN000002967).
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http://dx.doi.org/10.1186/s12930-015-0022-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443656PMC
May 2015

International primary care snapshots: New Zealand and Japan.

Br J Gen Pract 2015 Mar;65(632):142-3

Department of Community and Family Medicine, Fukushima Medical University, Fukushima, Japan. E-mail:

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http://dx.doi.org/10.3399/bjgp15X684109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337291PMC
March 2015
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