How do general practitioners manage patients with cancer symptoms? A video-vignette study
MetadataShow full item record
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.
This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by-nc/4.0/
Showing items related by title, author, creator and subject.
Supporting Patients Treated for Prostate Cancer: A Video Vignette Study With an Email-Based Educational Program in General PracticeJiwa, Moyez; Halkett, Georgia; Meng, Xingqiong; Pillai, Vinita; Berg, Melissa; Shaw, T. (2014)Background: Men who have been treated for prostate cancer in Australia can consult their general practitioner (GP) for advice about symptoms or side effects at any time following treatment. However, there is no evidence ...
Do patients treated for colorectal cancer benefit from general practitioner support? A video vignette studyNgune, I.; Jiwa, M.; McManus, Alexandra; Parsons, Richard; Pagey, G.; Hodder, R. (2015)Background: Patients who have been treated for colorectal cancer in Australia can consult their general practitioner (GP) for advice about symptoms or side effects at any time following their treatment. However, there is ...
Referring advanced cancer patients for palliative treatment: A national structured vignette survey of Australian GPsHalkett, Georgia; Jiwa, Moyez; Meng, Xingqiong (Rosie); Leong, E. (2013)Background: Although (general practitioners) GPs have a role in managing patients with advanced cancer, little is known about their referral decisions. Aim: The aim of this study was to explore, using structured vignettes, ...