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OtherFamily Medicine –World Perspective

A Family Medicine Training Program in the Republic of Georgia: Incorporating a Model of Chronic Disease Management

James Sanders
The Journal of the American Board of Family Medicine November 2007, 20 (6) 557-564; DOI: https://doi.org/10.3122/jabfm.2007.06.060220
James Sanders
MD, MPH
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    Figure 1.

    Map of The Republic of Georgia.4

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    Table 1.

    Republic of Georgia's Demographic Indicators4,13

    Current age of marrying is at an all time high
    Crude deaths rate is higher than anytime since 1980
    Total fertility rate is lower than anytime since 1958
    Infant mortality rate is 23.8% (2004)
    The country's population size is at its lowest point since 1959
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    Table 2.

    2006 Family Medicine Retraining Curriculum in the Republic of Georgia

    NumberModuleCurriculum ElementsHours (n)
    Small Group TeachingClinical Teaching
    IFamily medicine in Georgia1.1. Introduction, general overview, training methodology8
    1.2. Definition and elements of primary care16
    1.3. A patient-centered service
    1.4. Philosophy of primary care
    1.5. Role of primary care16
    1.6. Role of primary care team
    1.7. Role of family medicine physician
    IIPatient consultation2.1. The process, patients attitudes, flexibility, the diagnostic model, negotiations, dealing with patients168
    IIIBasic clinical skills: clinical theory and practice3.1. Prevention—general principles, cost effective health care skills, screening142
    3.2. Chronic disease management9640
    3.2.1. Evidence-based medicine, clinical practice guidelines
    3.2.2. Coronary heart disease
    3.2.3. Hypertension
    3.2.4. Diabetes mellitus
    3.2.5. Bronchial asthma
    3.2.6. Epilepsy
    3.2.7. Parkinson's disease
    Management of common medical problems in general practice
    3.3. The management of syndromes and symptoms with especially high prevalence in general practice3834
    3.3.1. Sore throat
    3.3.2. Headache
    3.3.3. Fatigue
    3.3.4. Diarrhea
    3.3.5. Abdominal pain
    3.3.6. Chest pain
    3.3.7. Back pain
    3.3.8. Dyspepsia
    3.3.9. Dizziness
    3.3.10. Jaundice
    3.4. Other systems
    3.4.1. Cardiovascular system84
    3.4.2. Respiratory system62
    3.4.3. Tuberculosis88
    3.4.4. Gastroenterology62
    3.4.5. Endocrinology168
    3.4.6. Neurological problems106
    3.4.7. Hematology62
    3.4.8. Rheumatology62
    3.4.9. Urinary system62
    3.4.10. Pediatrics6456
    3.4.11. Women's health6456
    3.4.12. Minor surgery1632
    3.4.13. Geriatrics124
    III3.4.14. Palliative surveillance124
    3.4.15. Psychiatry1616
    3.4.16. Ear-nose-throat816
    3.4.17. Ophthalmology816
    3.4.18. Dermatology816
    IVClinical epidemiology4.1. Incidence, prevalence, morbidity, mortality, risk-factors, relative and absolute risk, etc.
    4.2. Main types of research and their importance16
    VProfessional responsibilityMedical ethicsMedical legalClinical governance16
    VICenter managementPlanning, management, and financeInformation managementHuman resource managementOrganizational audit56
    VIIProject (audit and research)Determination of sphere of interest, problem formulation, search of literatureCollection of data, analysis of data32
    Total hours (n)604336
    • This training program was last accredited by the Republic of Georgia's State Continues Professional Development Board 16 June 2006.

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    Table 3.

    The Average Blood Pressure and the Percent of Patients Under Control in Various Subgroups

    GroupsBaseline*After 30 Months’ Follow-up
    Patients (n)Systolic BPDiastolic BPSystolic BPChange in Systolic BPDiastolic BPChange in Diastolic BPPatients Under Control† (%)
    Total25117095140−3082−1359
    Male6717398136−3780−1866
    Female18416994141−2883−1156
    Age <6012316695139−2782−1364
    Age ≥6012817496142−3283−1353
    Stage I of hypertension8115289138−1481−868
    Stage II of hypertension (JNC VI)10216893139−2981−1263
    Stage III of hypertension (JNC VI)68194106145−4985−2141
    Isolated systolic hypertension6315884139−1983−174
    Systolic BP ≥20025213112150−6387−2520
    Diastolic BP ≥11027201112152−4988−2417
    Patients with major comorbid conditions‡6817298148−2486−1230
    • Blood pressure values presented as mm Hg. BP, blood pressure; JNC VI, Joint National Committee VI.

    • * Baseline data are for all patients before the treatment; data shown in the category “After 30 Months’ Follow-up” are for those who continued participation after 30 months of follow-up.

    • † Blood pressure less than 140/90 mm Hg was considered as hypertension control.

    • ‡ Major comorbid conditions include congestive heart failure, stroke, myocardial infarction, diabetes, peripheral vascular diseases, and renal diseases.

    • This table has been reprinted with permission.

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The Journal of the American Board of Family Medicine: 20 (6)
The Journal of the American Board of Family Medicine
Vol. 20, Issue 6
November-December 2007
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A Family Medicine Training Program in the Republic of Georgia: Incorporating a Model of Chronic Disease Management
James Sanders
The Journal of the American Board of Family Medicine Nov 2007, 20 (6) 557-564; DOI: 10.3122/jabfm.2007.06.060220

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A Family Medicine Training Program in the Republic of Georgia: Incorporating a Model of Chronic Disease Management
James Sanders
The Journal of the American Board of Family Medicine Nov 2007, 20 (6) 557-564; DOI: 10.3122/jabfm.2007.06.060220
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