Christos Lionis

University of Crete | UOC · Clinic of Social and Family Medicine (CSFM)

Introduction: Despite the well-documented benefits of smoking cessation interventions, the implementation and success of these programs in primary care settings often encounter significant barriers. A primary care provider’s personal smoking status has been identified as a potential barrier to tobacco treatment delivery. The aim of this qualitative...

Background Point-of-care tests (POCT) can support diagnosis of patients with community acquired acute respiratory tract infections (CA-RTI) in primary care and thereby reduce uncertainty whether antibiotics may benefit patients. However, successful roll out of POCTs need to be built on a deep understanding of patients’ perspectives on the place of...

Background: The primary cause of antimicrobial resistance is excessive and non-indicated antibiotic use. Aim: To evaluate the impact of a multifaceted intervention aimed at various healthcare professionals (HCPs) on antibiotic prescribing and dispensing for common infections. Design and setting: Before-and-after study set in general practice,...

Introduction: Despite the well-documented benefits of smoking cessation interventions, the implementation and success of these programs in primary care settings often encounter significant barriers. A primary care provider’s personal smoking status has been identified as a potential barrier to tobacco treatment delivery. The aim of this qualitative...

Background: Excessive workload, premature burnout and shortages of primary care staff are a widespread problem and an urgent concern for the foreseeable future. Residents and young general practitioners (GPs) with less experience, usually GPs working in smaller practices, or who work with more vulnerable patient populations are at a higher risk of...

Background: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European research consortium led a project to design and evaluate a patient-...

Introduction: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European re-search consortium led a project to design and evaluate a patie...

BACKGROUND Despite the extensive utilization of antibiotics and the growing challenge of antimicrobial resistance, there has been a lack of substantial initiatives aimed at diminishing the prevalence of infections in nursing homes and enhancing the detection of urinary tract infections (UTIs). OBJECTIVE This study aims to systematise and enhance e...

Background Despite the extensive use of antibiotics and the growing challenge of antimicrobial resistance, there has been a lack of substantial initiatives aimed at diminishing the prevalence of infections in nursing homes and enhancing the detection of urinary tract infections (UTIs). Objective This study aims to systematize and enhance efforts t...

Aim This study aimed to assess time trends in behavioral risk factors (BRFs) for chronic diseases, including smoking, high body weight and physical inactivity among adults. Subjects and methods The study sample comprised 8,052 adults aged 18-99 years from various districts of Crete/Greece, who participated in 24 cross-sectional and longitudinal st...

Like many countries, Greece has faced resistance to coronavirus disease 2019 (COVID-19) vaccination among residents for both the initial and booster doses. Supporting healthcare professionals with delivering brief advice on COVID-19 vaccination may assist with reaching national vaccination targets. We sought to rapidly develop, pilot test, and depl...

Introduction: The need for effective therapeutic regimens for non-critically ill patients during the COVID-19 pandemic remained largely unmet. Previous work has shown that a combination of three aromatic plants' essential oils (CAPeo) (Thymbra capitata (L.) Cav., Origanum dictamnus L., Salvia fruticose Mill.) has remarkable in vitro antiviral acti...

Introduction: The need for therapeutic regimens for non-critically ill patients during the COVID-19 pandemic remains unmet. Previous work has shown that a combination of three aromatic plants’ essential oil (CAPeo) (Thymbra capitata (L.) Cav., Origanum dictamnus L., Salvia fruticosa Mill.) has remarkable in vitro antiviral activity. Given its prope...

Background: The literature shows that residents and young general practitioners (GPs) with less experience, in smaller practices, and with more vulnerable patient populations are at a higher risk of distress and burnout. Being female, resident and working in rural settings also appears to be associated with higher levels of anxiety and depression....

Background Primary care has a crucial role to play in the prevention, early detection, referral, and risk factor management of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NAFLD/NASH). In 2021, a team of European collaborators developed a continuing medical education (CME) program on NAFLD/NASH that consolidates evidence and...

BACKGROUND: Suboptimal control of blood pressure (BP) is a public health challenge in Greece. This educational intervention attempts to improve health literacy (HL) and nutrition literacy (NL) in primary healthcare (PHC) patients with hypertension (HTN). MATERIALS AND METHODS: This was a proof-of-concept (PoC) educational intervention. Twenty-four...

Σκοπός: Ο σκοπός της μελέτης ήταν ενήλικες ασθενείς με υπέρταση να συζητήσουν τις εμπειρίες και τα εμπόδια που αντιμετωπίζουν στη διαχείριση της υπέρτασης και να δώσουν προτάσεις για τη βελτίωση της παροχής υγειονομικής περίθαλψης. Υλικά – Μέθοδοι: Σε αυτή την ποιοτική μελέτη χρησιμοποιήθηκαν ομάδες εστιασμένης συζήτησης (focus groups). Συνολικά σ...

Σκοπός: Ο μη επαρκής έλεγχος της αρτηριακής πίεσης αποτελεί πρόκληση για τη δημόσια υγεία στην Ελλάδα. Αυτή η εκπαιδευτική παρέμβαση επιχειρεί να βελτιώσει την Εγγραμματοσύνη της Υγείας (ΕΥ) και την Εγγραμματοσύνη της Διατροφής (ΕΔ) σε ασθενείς της Πρωτοβάθμιας Φροντίδας Υγείας (ΠΦΥ) με υπέρταση. Υλικό‐Μέθοδοι: Πρόκειται για μια εκπαιδευτική παρέμ...

Purpose: The aim of the study was to have adults discuss experiences and barriers to managing hypertension and to provide suggestions to improve healthcare delivery. Methodology: Focus group discussions were employed in this qualitative study. A total of 14 hypertensive participants were recruited from 1st Local Health Unit of Nea Philadelphia, At...

(1) Background: Although spatial statistics are often used by cancer epidemiologists, there is not yet an established collection of methods to serve their needs. We aimed to develop an evidence-based cancer-oriented conceptual collection of methods for spatial analysis; (2) Methods: A triangulation of approaches was used; literature review, consens...

(1) Background: This is the first population-based study in Greece, with the aim to measure the changing trends of lung cancer (LC) and the associated risk factors before and after the economic crisis. Among the main objectives were the identification of LC hot spots and high-risk areas; (2) Methods: The study was conducted in Crete, the biggest is...

Background Oseltamivir is usually not often prescribed (or reimbursed) for non-high-risk patients consulting for influenza-like-illness (ILI) in primary care in Europe. We aimed to evaluate the cost-effectiveness of adding oseltamivir to usual primary care in adults/adolescents (13 years +) and children with ILI during seasonal influenza epidemics,...

Introduction/Rationale:Occupational therapy (OT) has been a poorly understood and unfamiliar discipline by policymakers, referrers, other professionals and the general public.Knowledge about OT is essential for the delivery of quality care, especially during the period of pandemic, where more synergy and interdisciplinarity is required towards a mo...

University students' health and well-being is critical, especially in the aftermath of the coronavirus disease 2019 pandemic; however, a comprehensive and integrated approach in academic institutions remains neglected. In this context, the local experience from a pilot university-based Student Health Center at an urban campus in Greece is presented...

Using exome sequencing, we analyzed 196 participants of the Cretan Aging Cohort (CAC; 95 with Alzheimer's disease [AD], 20 with mild cognitive impairment [MCI], 81 cognitively normal controls). The APOE ε4 allele was more common in AD patients (23.2%) than in controls (7.4%; p<0.01) and the PSEN2 p.Arg29His and p.Cys391Arg variants was found in thr...

Ethnopharmacology, through the description of the beneficial effects of plants, has provided an early framework for the therapeutic use of natural compounds. Natural products, either in their native form or after crude extraction of their active ingredients, have long been used by different populations and explored as invaluable sources for drug de...

Background Excessive and inappropriate use of antibiotics is the most important driver of antimicrobial resistance. The aim of the HAPPY PATIENT project is to evaluate the adaptation of European Union (EU) recommendations on the prudent use of antimicrobials in human health by evaluating the impact of a multifaceted intervention targeting different...

Background The global burden of chronic respiratory diseases (CRDs) disproportionally affects Roma populations. Health interventions addressing CRD among Roma or other vulnerable groups often fail to be effective, as their implementation strategy misaligns with the local context. To design context-driven strategies, we studied CRD-related beliefs,...

p>Background: there is little evidence about the relationship between aetiology, illness severity, and clinical course of respiratory tract infections (RTIs) in primary care. Understanding these associations would aid in the development of effective management strategies for these infections. Aim: to investigate whether clinical presentation and i...

Background The impact of the COVID-19 pandemic on patients’ and clinicians’ perceptions of healthcare-seeking behaviour and delivery of care is unclear. The pandemic accelerated the use of remote care and understanding its benefits and drawbacks may inform its implementation during this and future healthcare emergencies. Aim To explore patients’ a...

Background Effectiveness of health programmes can be undermined when the implementation misaligns with local beliefs and behaviours. To design context-driven implementation strategies, we explored beliefs and behaviours regarding chronic respiratory disease (CRD) in diverse low-resource settings. Methods This observational mixed-method study was c...

Background Between-country differences have been described in antibiotic prescribing for RTI in primary care, but not yet for diagnostic testing procedures and prescribing confidence. Aim To describe between-country differences in RTI management, particularly diagnostic testing and antibiotic prescribing, and investigate which factors relate to an...

Background: There is little evidence about the relation between aetiology, illness severity and clinical course of respiratory tract infections (RTI) in primary care. Understanding these associations would aid to develop effective management strategies for these infections. Aim: To investigate whether the clinical presentation and illness course...

The current Opinion explores the concept of solidarity from both theoretical and implementation perspectives with a focus on health emergencies. Focusing on how the principle of solidarity is enshrined in European Union (EU) law, it critically examines relevant implemented and proposed actions of solidarity towards EU Member States and towards...

Breathing polluted air is a risk to respiratory conditions. During the Greek financial crisis, the use of household fireplaces/wood stoves shifted from mostly decorative to actual domestic heating, resulting in increased indoor smoke production. We aimed to evaluate household air pollution (HAP), fuel use and respiratory symptoms in rural Crete, Gr...

Objective: Mental stress, low Health Literacy (HL) and Nutrition Literacy (NL) are associated with serious negative health outcomes. The aim of this study was to investigate HL and NL levels, in relation to levels of perceived stress, in adults. Methods: This cross-sectional study was conducted in the urban area of the Attica region, in Greece. The...

Background: Clinical findings do not accurately predict laboratory diagnosis of influenza. Early identification of influenza is considered useful for proper management decisions in primary care. Objective: We evaluated the diagnostic value of the presence and the severity of symptoms for the diagnosis of laboratory-confirmed influenza infection...

Background: Minimising primary care professionals' (PCPs) risk of SARS-CoV-2 infection is crucial to ensure their safety as well as functioning health care system. PCPs' perspectives on the support they needed in the early stages of a public health crisis can inform future preparedness. Aim: To understand PCPs' experiences of providing care during...

In line with World Health Organization policy (WHO, 2016; 2019), primary care services need to be adapted to effectively meet the needs of diverse patient populations. Drawing from a European participatory implementation study, we present an Irish case study. In a hybrid participatory space, migrants, general practice staff and service planners (n...

Polymyalgia Rheumatica (PMR) is a syndrome characterized by chronic pain and/or stiffness in the neck, shoulders or upper arms and hips. It affects adult patients usually over 50 years old and is treated with low-dose oral corticosteroids. In this case, a 68-year-old female with a history of PMR, diagnosed by a specialist sporadically seen in the p...

Therapeutic regimens for the COVID‐19 pandemics remain unmet. In this line, repurposing of existing drugs against known or predicted SARS‐CoV‐2 protein actions have been advanced, while natural products have also been tested. Here, we propose that p‐cymene, a natural monoterpene, can act as a potential novel agent for the treatment of SARS‐CoV‐2‐in...

Therapeutic regimens for the COVID-19 pandemics remain unmet. In this line, repurposing of existing drugs against known or predicted SARS-CoV-2 protein actions have been advanced, while natural products have also been tested. Here, we propose that p-cymene, a natural monoterpene, can act as a potential novel agent for the treatment of SARS-CoV-2-in...

Η ικανοποιητική ρύθμιση της υπέρτασης είναι μια απαιτητική διαδικασία και προϋποθέτει την κατανόηση της νόσου από τον ασθενή, καθώς επίσης και την ενδυνάμωση του, προκειμένου να κινητοποιηθεί και να εφαρμόσει σωστά τις οδηγίες του θεράποντα ιατρού του και των άλλων επαγγελματιών υγείας, για τη σωστή διαχείριση της νόσου. Οι ασκήσεις που ακολουθούν...

Background: Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. Aim: To understand the experiences of European PCPs w...

Background and aims Since cardiometabolic diseases (CMD) are a frequent cause of death worldwide, preventive strategies are needed. Recruiting adults for a health check could facilitate the identification of individuals at risk for CMD. For successful results, participation is crucial. We aimed to identify factors related to unwillingness to partic...

Background: Health literacy (HL) and nutrition literacy (NL) are important issues to consider, in the provision of health-care to children and the establishment of healthy eating behaviours. Aim: The study investigates the possible role of HL and NL levels of Greek parents, in parental Feeding Practices (PFP). Methods: This is a cross-sectional stu...

The study examines Parental Feeding Practices (PFP) in relation to adherence to the Mediterranean Diet (MD) and children’s weight status. It’s a cross-sectional study of 402 parents (68.4% mothers), with children aged 2-12 years. Parents completed the Comprehensive Parental Feeding Questionnaire and the Mediterranean Diet Quality Index for childr...

Background Depression is a frequent and serious disease often undiagnosed in elderly. We aimed to examine (1) the prevalence/correlates associated with depression and (2) the magnitude of depression underdiagnosis/related factors, in a large community-dwelling elderly population in Crete/Greece visiting Primary Health Care (PHC) settings. Methods...

The need for therapeutic regimens for the non-critically ill patients of the COVID-19 pandemic remains unmet. In this line, repurposing existing drugs, against known or predicted SARS-CoV-2 protein actions, has been advanced, while natural products have also been tested. Previous work has shown that a Cretan Aromatic Plant (Thymbra capitata (L.) Ca...

Background Metabolic Syndrome (MetS) is a clustering of abdominal obesity, hypertriglyceridaemia, low HDL cholesterol, hyperglycaemia and hypertension. Early identification of MetS is important for preventing cardiovascular disease (CVD). MetS has not been systematically explored in Greek primary care. Objectives To examine MetS frequency among pr...

Background: Low Health Literacy (HL) and Nutrition Literacy (NL) are associated with serious negative health outcomes. Objectives: The aim of this study was to investigate certain lifestyle factors and obesity, in relation to HL and NL. Methods: This cross-sectional study was conducted in the urban area of the Attica region, in Greece. The sample...

Background: Cardiometabolic diseases are the most common cause of death worldwide. As part of a collaborative European study, this paper aims to explore the implementation of primary care selective-prevention services in five European countries. We assessed the implementation process of the selective-prevention services, participants’ cardiometabol...

The importance of herbal extracts on health, which was initially based on ethnopharmacological and traditional knowledge, becomes increasingly well documented by numerous experimental and intervention studies. The daily use of beverages from different aromatic plants which becomes more popular nowadays, has been a tradition in Crete, and a habit th...

This review performs a comprehensive assessment of the therapeutic potential of three native herbs of Crete (Thymbra capitata (L.) Cav., Salvia fruticosa Mill. and Origanum dictamnus L.), their phytochemical constituents, health benefits and issues relevant to their safety, within a translational context. Issues discussed comprise: 1) Ethnopharmaco...

Introduction: Dementia severely affects the quality of life of patients and their caregivers; however, it is often not adequately addressed in the context of a primary care consultation, especially in patients with multi-morbidity. Study Population and Methods: A cross-sectional study was conducted between March-2013 and December-2014 among 3,140 c...

Objectives: This study aimed to assess satisfaction and report on perceptions of General Practice (GP) residents during residency in Greece, through an online questionnaire at a national level. Material and methods: A mixed type method study was shaped. Both quantitative analysis and a quasiqualitative approach were used, while information from an...

COVID-19 pandemic is a reality. This study extracted information from a case in Italy and a case in South Korea during COVID-19 pandemic. Epidemic threat evolved differently in Italy compared to that in South Korea. Case fatality ratios from Italy and South Korea were consistently diverging over time. It appears that 'epi-epidemic' determinants can...

Objectives: Cognitive impairment is known to have a significant impact on the quality of life of individuals and their caregivers, yet it is often underdiagnosed. The objective of this study is to assess the extent of cognitive impairment among elders visiting primary healthcare (PHC) practice settings, to explore associated risk factors and discu...

Background: Pulmonary rehabilitation (PR) is a non-pharmaceutical intervention for people with chronic respiratory diseases (CRDs). No studies have looked at the effects of PR on chest pains in low-resource settings. Aims: This study aimed to assess whether PR had an effect on various respiratory symptoms among CRD patients in primary care in Gree...

Poor Health Literacy (HL) and Nutrition Literacy (NL) are associated with negative health outcomes and they comprise an emerging field for health policy, practice and research. The aim of this study was to investigate the effect of sex and age in HL and NL levels in Greece. A cross-sectional study was conducted in the urban area of the Attica regio...

Purpose Multiple behavioral risk factors (MBRFs) related to lifestyle have been associated with non-communicable diseases, but there is limited evidence on their prevalence in undergraduate medical students and their association with academic performance. Methods During 1989–2017, data from 1447 medical students of the University of Crete, Greece...

Introduction Recent austerity experiences in Greece suggest a plausible link between extensive use of over-the-counter (OTC) medicines and socio-economic peculiarities of life. Commentary During the economic crisis in Greece, accessibility to healthcare services has been impacted, particularly for people with low income. However, this fact has not...