Agnieszka Mastalerz-Migas

Background. Poland combines high preventable mortality with the lowest spending on prevention in the EU. Adult preventive services have been fragmented, disease-specific and poorly linked to follow-up care; the pilot ”Prevention 40 PLUS” programme (2021–2025) offered laboratory tests but no clinical interpretation.,Reform content. On 5 May 2025 ”My Health – the adult health check” became a guaranteed Primary Care benefit for all insured adults aged 20 and over, repeatable every five years (20–49) or three years (50+). It comprises an adaptive digital questionnaire; an individually tailored laboratory panel; a mandatory summary consultation with a physician, nurse or midwife, including cardiovascular risk assessment and a written Individual Health Plan; and funded educational counselling, vaccination advice and faecal immunochemical testing.,Preliminary results. In the first year 3.6 million adults submitted a questionnaire in the first year and 1.6 million completed a check in the first 9 months (72% of eligible questionnaires) of the program, at a cost of about EUR 185 million. Over one million people aged 20–39, previously outside any general check, took part; 62.6% of participants were women.,Conclusions. National e-health infrastructure converted a legal entitlement into unprecedented reach. Sustaining it requires disinvestment from redundant programmes, removal of low-value tests, attention to sex and digital gradients, downstream diagnostic capacity, and a real evaluation strategy.

Background: The COVID-19 pandemic transformed telemedicine in Poland from a niche service into a core mode of health care delivery, supported by nationwide eHealth infrastructure such as obligatory e-prescriptions and the central P1 platform. Despite this rapid expansion, concerns persist that the benefits of digital health are not shared equally, and that a digital divide limits equitable access to telemedicine services across sociodemographic and geographic groups. Objective: This study aimed to describe the patterns of telemedicine and eHealth tool use among Polish adults in the postpandemic era, to identify key sociodemographic, economic, and health-related predictors of their adoption, and to map digital inequalities in access to health care services. Methods: This cross-sectional study used data from the “National Test for Poles’ Health” (Narodowy Test Zdrowia Polaków), a nationwide online survey conducted annually in Poland between 2020 and 2024. The full surveyed sample comprised 1,196,102 adults, of whom 820,000 completed the telemedicine-use module and formed the analytic sample; detailed questions on 12 specific eHealth services were administered to a randomly assigned subsample of 120,000 respondents under a split-questionnaire design. Sociodemographic factors (age, gender, education level, and place of residence), health status, and barriers to accessing care were analyzed as predictors using ordered and binary logistic regression models, with results expressed as odds ratios (ORs) with 95% CIs, and statistical significance set at P ≤.05. Results: Overall, 49.7% (407,502/820,000) of respondents reported using a telemedicine visit at least once in the preceding 12 months. Telephone consultations were the most common form of remote visit (43,598/120,000, 36.3%), whereas video consultations were rare (8736/120,000, 7.3%). System-driven tools showed high adoption (e-prescriptions: 87,121/120,000, 72.6%; e-referrals: 64,083/120,000, 53.4%), while patient-driven tools, such as mobile health apps (24,341/120,000, 20.3%), were used less frequently. Education and place of residence were the strongest sociodemographic predictors: participants with a master’s degree were 2.2 times more likely than those with secondary education to use the Internet Patient Account (OR 2.2, 95% CI 2.1‐2.2), and residents of cities with over 500,000 inhabitants had higher odds of telemedicine use (OR 1.5, 95% CI 1.5‐1.6). Chronic disease was a strong health-related predictor (OR 1.8, 95% CI 1.7‐1.9). Gender differences were also observed: women used telephone consultations more often, whereas men more frequently used the Internet Patient Account. Conclusions: Telemedicine adoption in postpandemic Poland is driven more by pre-existing socioeconomic advantage, particularly higher education and urban residence, than by clinical need alone, indicating a persistent digital divide. Telemedicine functions largely as a tool of convenience for the already connected rather than a tool of necessity for underserved groups. Targeted interventions, including community-based digital literacy programs, investment in rural broadband infrastructure, and guaranteed hybrid in-person alternatives, are needed to ensure that Poland’s eHealth transformation promotes inclusion rather than exacerbating health inequalities.

Obesity management, whether lifestyle-based, pharmacological, or surgical, is frequently associated with gastrointestinal adverse effects (GI AEs) that may impact treatment adherence and patient quality of life. With the increasing use of incretin-based anti-obesity medications (AOMs), they have gained particular clinical relevance. This review aims to explore current evidence on the prevalence, underlying mechanisms, and management strategies for GI AEs associated with obesity therapies, with a particular focus on nausea, diarrhea, constipation, gastroesophageal reflux and cholelithiasis. A search of PubMed and Scopus was conducted for articles published between 2006 and 2025. Eligible studies included randomized controlled trials, observational studies, and narrative or systematic reviews reporting on GI AEs in the context of obesity treatments, especially those involving incretin-based AOMs. Clinical trial data on AOMs indicate that GI AEs are reported in 65–84% of patients treated with liraglutide, semaglutide or tirzepatide, with the most common being nausea and diarrhea. These symptoms are primarily attributed to altered gastric motility and hormone-mediated changes in appetite signaling. Preventive strategies such as slow dose titration, dietary counseling, and supportive medications are commonly recommended to support tolerability and treatment continuation. GI AEs remain a common and often underestimated barrier to effective obesity management. Early recognition and structured management are essential to long-term success. Clinicians should incorporate anticipatory counseling and shared decision-making at treatment initiation to set realistic expectations, optimize tolerability, and support adherence.

Background: Dietary habits are key determinants of physical and mental health, yet large-scale, contemporary data on these behaviors and their health correlates are crucial for effective public health policy. This study leverages a uniquely large dataset to quantify the eating behaviors of Polish adults and examines how these behaviors relate to socio-demographic characteristics, health status, and subjective well-being. Methods: We analyzed data from 1,196,102 adult respondents who participated in the National Poles’ Health Test, a recurring online survey, between 2019 and 2024. The study used self-reported data on dietary habits, socio-demographic variables, chronic conditions, and self-assessed physical and mental health. Descriptive statistics and comparative analyses, such as the chi-square test, Student’s t-test, or ANOVA, were used. Results: Our findings reveal stark socio-demographic disparities in nutrition. Younger respondents and lower educational attainment were strongly correlated with more frequent consumption of fast food and sugar-sweetened beverages. Crucially, these unhealthy eating patterns were significantly associated with poorer self-rated physical and, notably, mental health (among people who consumed fast food every day, as many as 16.6% rated their mental health as bad, and 6.7% as very bad). In contrast, higher vegetable and fruit consumption correlated with markedly better health outcomes and greater subjective well-being. Conclusions: This large-scale study provides evidence of the profound link between diet and both physical and mental well-being in Poland. The results underscore the urgent need for targeted public health strategies aimed at improving dietary behaviors, particularly among younger and less-educated populations. The strong associations between diet, health status, and well-being highlight the importance of integrating nutritional education into both general healthcare and mental health services.

Background: Insomnia and excessive sleepiness are significant health problems with a complex etiology, increasingly affecting young people, especially students. This study aimed to assess the prevalence of sleep disturbances and patterns of psychoactive drug use among female Polish students. We also explored the potential impact of the COVID-19 pandemic on sleep behaviors. We hypothesized that sleep disorders are common in this group, that medical students are more likely to experience insomnia and excessive sleepiness, and that the pandemic has exacerbated both sleep disturbances and substance use. Methods: This cross-sectional study utilized a custom survey designed using standardized questionnaires—the Athens Insomnia Scale and Epworth Sleepiness Scale—that was distributed online using the Computer-Assisted Web Interviewing method. A total of 11,988 responses were collected from 31 January 2016 to 1 January 2021. Inclusion criteria were being female, having a college student status, and giving informed consent. Results: Among the 11,988 participants, alcohol use declined after the pandemic began (p = 0.001), while sedative use increased (p < 0.001). Insomnia (AIS) was associated with study year, university profile, and field of study (p < 0.001), with the highest rates in first-year and non-medical students. It was more common among users of sedatives, psychostimulants, and multiple substances. No significant change in insomnia was found before and after the pandemic. Excessive sleepiness (ESS) peaked in first-year and medical students. It decreased during the pandemic (p < 0.001) and was linked to the use of alcohol, psychostimulants, cannabinoids, and multiple substances. Conclusions: These findings highlight that female students are particularly vulnerable to sleep disorders. The influence of the COVID-19 pandemic on sleep disturbances remains inconclusive. Given the varied results in the existing literature, further research is needed.

Background/Objectives: Chronic kidney disease (CKD) affects 10 to 15% of the world population. Currently, there are no reliable epidemiological data on the prevalence of CKD in Poland. The aim of this study was to determine the prevalence of CKD in the population of high-risk primary health care patients without a prior diagnosis of CKD in the Polish population. Methods: This multicenter retrospective study examined 5100 patients from 28 medical institutions. Patients were eligible for the study if they were 60–75 years old or had a history of the risk factors such as hypertension, kidney disease other than CKD, diabetes, cardiovascular disease, or obesity. The study was carried out in two stages, each of which included a determination of serum creatinine levels along with an estimation of eGFR and a determination of albuminuria in a urine sample. Results: In total, 5100 patients were included in the final analysis. In the univariate analysis, it was found that as age and body mass index values increased, the risk of developing CKD increased; the same correlation was observed when assessing the presence of hypertension, diabetes, or heart failure. In the multivariate analysis, the negative effects of hypertension, age 60–75 years, diabetes, heart failure, cardiovascular diseases, and kidney disease other than CKD on the development of CKD were confirmed. Conclusions: The results indicate that CKD is a significant social problem among the Polish population with risk factors.

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic, debilitating skin disease primarily diagnosed through clinical examination. Despite its characteristic clinical features, HS remains under-recognized and frequently misclassified, especially by non-dermatologist clinicians. This study aims to evaluate the diagnostic accuracy of HS across various specialties, identify knowledge gaps, and inform targeted educational strategies to reduce diagnostic delays. Methods: A cross-sectional survey was conducted during multidisciplinary scientific conferences, enrolling 655 clinicians including dermatologists, gynecologists, urologists, general surgeons, and general practitioners. Participants were presented with clinical images representing HS lesions at Hurley stages I–III and responded to open-ended and closed-ended diagnostic questions. Data were analyzed to assess diagnostic accuracy and compare recognition patterns across specialties. Results: The recognition of HS varied significantly by specialty and disease stage. For Hurley stage III axillary disease, correct identification was highest among dermatologists (96.56%) compared to general practitioners (48.91%), gynecologists (31.25%), urologists (40%), and general surgeons (63.64%). In a Hurley II genital case in a male patient, only 34.5% diagnosed HS, while 25.65% suggested furunculosis and 16.18% venereal granuloma. For a Hurley I genital case in a female patient, 29.92% diagnosed HS, with furunculosis (23.36%) and steatocystoma multiplex (14.35%) as common misdiagnoses. A Hurley III buttock case was correctly identified by only 29.77% of participants. Conclusions: This large, first-of-its-kind global survey highlights substantial gaps in HS recognition, particularly among non-dermatologist clinicians. The findings underscore the urgent need for targeted, multidisciplinary educational interventions to improve diagnostic accuracy, reduce delays, and ultimately enhance patient outcomes in HS.

Introduction: Statins are the primary medications used to treat lipid disorders. However, numerous myths surrounding statin therapy lead to patient non-adherence and therapy discontinuation. The aim of this study was to assess the most common patient concerns regarding statin use.Material and methods: A survey was conducted targeting doctors using an online questionnaire The first section included questions regarding socio-economic status, while the second focused on patient experiences related to refusing statin treatment due to fears of specific side effects, encounters with side effects during therapy, and estimates of the percentage of patients who discontinue treatment. The concluding section addressed the most common reasons for treatment termination from the perspective of practitioners, along with efforts to educate their patients.Results: 260 questionnaires were collected. Notably, 84% and 81% of doctors reported encountering refusals of statin treatment due to patients’ fears of liver and muscle damage, respectively. The majority of respondents indicated that 10-20% of patients discontinue treatment on their own, despite significant side effects occurring in less than 10% of cases. Muscular symptoms were cited as the reason for discontinuing therapy in 75% of cases, while misinformation regarding statin side effects contributed to 53% of discontinuations. Additionally, 96.5% of doctors acknowledged efforts to educate their patients about statins.Conclusions: Many harmful beliefs about the side effects of statins persist among patients, resulting in non-adherence to treatment. The most prevalent concerns involve fears related to muscle and liver damage. These issues can be mitigated through targeted education for both patients and healthcare professionals.

Introduction: Antibiotic resistance is a major public health problem in Europe. Most antibiotics are sold only by prescription in Poland, and it is mainly up to physicians to decide whether to start antibiotic treatment. Therefore, we analyzed the factors influencing the prescribing of antibiotics for upper respiratory tract infections by primary care physicians in Poland, attitudes toward antibiotic resistance, and knowledge of the principles of antibiotic use. Methods: We conducted a CAWI (Computer-Assisted Web Interview) survey, carried out using a proprietary survey distributed online. Results: A total of 528 doctors participated in the study. The result of the physical examination and additional tests, as well as the recommendations of scientific societies are the most important in deciding whether to start antibiotic therapy. Patient pressure (p < 0.011) and workload (p = 0.021) significantly influenced the decision to prescribe an antibiotic among primary care physicians and physicians in the course of specialization, who fear of legal consequences (p < 0.001). The habits of other physicians (p < 0.001) working at the same facility appeared to be additionally important. Conclusions: The decision to implement antibiotic therapy in upper respiratory tract infections is influenced by several factors that depend on the doctor (including place of work and seniority) and the patient (clinical symptoms, expectation of antibiotic prescription). The physician’s level of knowledge contributes to reducing antibiotic prescribing. Considering the factors associated with the level of knowledge and awareness, together with a high prevalence of self-medication with antibiotics in Polish population, there is a strong need to design educational interventions aimed at reducing inappropriate antibiotic prescribing and preventing antibiotic resistance in Poland.