How do Dutch general practitioners detect and diagnose atrial fibrillation? Results of an online case vignette study
| Autor: | Henri E J H Stoffers, H. A. M. van Kesteren, N. Verbiest van Gurp, D. van Mil, J. A. Knottnerus |
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| Přispěvatelé: | Promovendi PHPC, Family Medicine, RS: CAPHRI - R5 - Optimising Patient Care, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R6 - Promoting Health & Personalised Care |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male ACCURACY Case vignette 030204 cardiovascular system & hematology 03 medical and health sciences Electrocardiography 0302 clinical medicine General Practitioners Symptom frequency Surveys and Questionnaires Diagnosis Ambulatory Humans Medicine 030212 general & internal medicine Practice Patterns Physicians' Opportunistic screening Aged Netherlands lcsh:R5-920 ARRHYTHMIAS business.industry Correction Atrial fibrillation Health care surveys Guideline Middle Aged medicine.disease Current practice Electrocardiography Ambulatory Global Positioning System Female Medical emergency lcsh:Medicine (General) Family Practice business General practice STROKE Research Article |
| Zdroj: | BMC Family Practice BMC Family Practice, 20(1):175. BioMed Central Ltd BMC Family Practice, Vol 20, Iss 1, Pp 1-7 (2019) |
| ISSN: | 1471-2296 |
| Popis: | Background Detection and treatment of atrial fibrillation (AF) are important given the serious health consequences. AF may be silent or paroxysmal and remain undetected. It is unclear whether general practitioners (GPs) have appropriate equipment and optimally utilise it to detect AF. This case vignette study aimed to describe current practice and to explore possible improvements to optimise AF detection. Methods Between June and July 2017, we performed an online case vignette study among Dutch GPs. We aimed at obtaining at least 75 responses to the questionnaire. We collected demographics and asked GPs’ opinion on their knowledge and experience in diagnosing AF. GPs could indicate which diagnostic tools they have for AF. In six case vignettes with varying symptom frequency and physical signs, they could make diagnostic choices. The last questions covered screening and actions after diagnosing AF. We compared the answers to the Dutch guideline for GPs on AF. Results Seventy-six GPs completed the questionnaire. Seventy-four GPs (97%) thought they have enough knowledge and 72 (95%) enough experience to diagnose AF. Seventy-four GPs (97%) could order or perform ECGs without the interference of a cardiologist. In case of frequent symptoms of AF, 36–40% would choose short-term (i.e. 24–48 h) and 11–19% long-term (i.e. 7 days, 14 days or 1 month) monitoring. In case of non-frequent symptoms, 29–31% would choose short-term and 21–30% long-term monitoring. If opportunistic screening in primary care proves to be effective, 83% (58/70) will support it. Conclusions Responding GPs report to have adequate equipment, knowledge, and experience to detect and diagnose AF. Almost all participants can order ECGs. Reported monitoring duration was shorter than recommended by the guideline. AF detection could improve by increasing the monitoring duration. |
| Databáze: | OpenAIRE |
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