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    How do general practitioners manage patients with cancer symptoms? A video-vignette study

    234426_234426.pdf (735.0Kb)
    Access Status
    Open access
    Authors
    Jiwa, Moyez
    Meng, X.
    O'Shea, C.
    Magin, P.
    Dadich, A.
    Pillai, V.
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Jiwa, M. and Meng, X. and O'Shea, C. and Magin, P. and Dadich, A. and Pillai, V. 2015. How do general practitioners manage patients with cancer symptoms? A video-vignette study. BMJ Open. 5 (9): e008525.
    Source Title
    BMJ Open
    DOI
    10.1136/bmjopen-2015-008525
    School
    School of Biomedical Sciences
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by-nc/4.0/

    URI
    http://hdl.handle.net/20.500.11937/25751
    Collection
    • Curtin Research Publications
    Abstract

    OBJECTIVES: Determine how general practitioners (GPs) manage patients with cancer symptoms. DESIGN: GPs reviewed 24 video-vignettes and case notes on patients with cancer symptoms and indicated whether they would refer the patient and/or prescribe medication, and/or undertake further investigation. According to available guidelines, all cases warranted a referral to a specialist or further investigations. SETTING: Australian primary care sector. PARTICIPANTS: 102 practising GPs participated in this study, including trainees. INTERVENTIONS: The research was part of a larger randomised controlled trial testing a referral pro forma; however, this paper reports on management decisions made throughout the study. PRIMARY AND SECONDARY OUTCOME MEASURES: This paper reports on how the participants would manage the patients depicted in each vignette. RESULTS: In more than one-in-eight cases, the patient was not investigated or referred. Patient management varied significantly by cancer type (p<0.001). For two key reasons, colorectal cancer was the chosen referent category. First, it represents a prevalent type of cancer. Second, in this study, colorectal cancer symptoms were managed in a similar proportion of options-that is, prescription, referral or investigation. Compared with vignettes featuring colorectal cancer participants were less likely to manage breast, bladder, endometrial, and lung cancers with a 'prescription only' or 'referral only' option. They were less likely to manage prostate cancer with a 'prescription only', yet more likely to manage it with a 'referral with investigation'. With regard to pancreatic and cervical cancers, participants were more likely to manage these with a 'referral only' or a 'referral with investigation'. CONCLUSIONS: Some patients may receive a delayed cancer diagnosis, even when they present with typical cancer symptoms to a GP who can access relevant diagnostic tests.

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