Primary care clinical provider knowledge and experiences in the diagnosis and treatment of tick-borne illness: a qualitative assessment from a Lyme disease endemic community.

Autor: Mattoon S; Department of Population Medicine and Diagnostic Sciences, Cornell University, 618 Tower Road, Ithaca, NY, 14853, USA.; Environment, Health and Safety, Cornell University, 395 Pine Tree Road, Suite 210, Ithaca, NY, 14850, USA., Baumhart C; Department of Population Medicine and Diagnostic Sciences, Cornell University, 618 Tower Road, Ithaca, NY, 14853, USA.; Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland Baltimore School of Medicine, Baltimore, USA., Barsallo Cochez AC; Department of Population Medicine and Diagnostic Sciences, Cornell University, 618 Tower Road, Ithaca, NY, 14853, USA.; Pan American Health Organization, Ancón, Avenida Gorgas, Building 261, Panama, Panamá., MacQueen D; Cayuga Center for Infectious Diseases, 1301 Trumansburg Road, Suite 6, Ithaca, NY, 14850, USA., Snedeker J; Northeast Pediatrics and Adolescent Medicine, 10 Graham Road West, Ithaca, NY, 14850, USA., Yancey CB; Department of Population Medicine and Diagnostic Sciences, Cornell University, 618 Tower Road, Ithaca, NY, 14853, USA., Gatch M; Tompkins County Health Department, 55 Brown Road, Ithaca, NY, 14850, USA., Mader EM; Department of Entomology, Cornell University, 2126 Comstock Hall, Ithaca, NY, 14853, USA. emm367@cornell.edu.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2021 Aug 31; Vol. 21 (1), pp. 894. Date of Electronic Publication: 2021 Aug 31.
DOI: 10.1186/s12879-021-06622-6
Abstrakt: Background: Primary care and frontline healthcare providers are often the first point of contact for patients experiencing tick-borne disease (TBD) but face challenges when recognizing and diagnosing these diseases. The specific aim of this study was to gain a qualitative understanding of frontline and primary care providers' knowledge and practices for identifying TBDs in patients.
Methods: From fall 2018 to spring 2019, three focus groups were conducted with primary care providers practicing in a small-town community endemic to Lyme disease (LD) and with emerging incidence of additional TBDs. A follow up online survey was distributed to urgent and emergency care providers in the small-town community and an academic medical center within the referral network of the local clinical community in spring and summer 2019. Qualitative analysis of focus group data was performed following a grounded theory approach and survey responses were analyzed through the calculation of descriptive statistics.
Results: Fourteen clinicians from three primary care practices participated in focus groups, and 24 urgent and emergency care clinicians completed the survey questionnaire. Four overarching themes emerged from focus group data which were corroborated by survey data. Themes highlighted a moderate level of awareness on diagnosis and treatment of LD among participants and limited knowledge of diagnosis and treatment for two other regionally relevant TBDs, anaplasmosis and babesiosis. Providers described challenges and frustrations in counseling patients with strong preconceptions of LD diagnosis and treatment in the context of chronic infection. Providers desired additional point-of-care resources to facilitate patient education and correct misinformation on the diagnosis and treatment of TBDs.
Conclusions: Through this small study, it appears that clinicians in the small-town and academic medical center settings are experiencing uncertainties related to TBD recognition, diagnosis, and patient communication. These findings can inform the development of point-of-care resources to aid in patient-provider communication regarding TBDs and inform the development of continuing medical education programs for frontline and primary care providers.
(© 2021. The Author(s).)
Databáze: MEDLINE
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