1. Decision-making and referral processes for patients with motor neurone disease: a qualitative study of GP experiences and evaluation of a new decision-support tool.
- Author
-
Baxter, Susan and McDermott, Christopher J.
- Subjects
- *
MEDICAL decision making , *MEDICAL referrals , *MOTOR neuron diseases , *AMYOTROPHIC lateral sclerosis , *DISEASE relapse , *DIFFERENTIAL diagnosis , *PATIENTS , *CONFERENCES & conventions , *ATTITUDE (Psychology) , *DECISION making , *INTERVIEWING , *MEDICAL personnel , *GENERAL practitioners , *QUALITATIVE research , *DIAGNOSIS - Abstract
Background: The diagnosis of motor neurone disease (MND) is known to be challenging and there may be delay in patients receiving a correct diagnosis. This study investigated the referral process for patients who had been diagnosed with MND, and whether a newly-developed tool (The Red Flags checklist) might help General Practitioners (GPs) in making referral decisions.Methods: We carried out interviews with GPs who had recently referred a patient diagnosed with MND, and interviews/surveys with GPs who had not recently referred a patient with suspected MND. We collected data before the Red Flags checklist was introduced; and again one year later. We analysed the data to identify key recurring themes.Results: Forty two GPs took part in the study. The presence of fasciculation was the clinical feature that most commonly led to consideration of a potential MND diagnosis. GPs perceived that their role was to make onward referrals rather than attempting to make a diagnosis, and delays in correct diagnosis tended to occur at the specialist level. A quarter of participants had some awareness of the newly-developed tool; most considered it useful, if incorporated into existing systems.Conclusions: While fasciculation is the most common symptom associated with MND, other bulbar, limb or respiratory features, together with progression should be considered. There is a need for further research into how decision-support tools should be designed and provided, in order to best assist GPs with referral decisions. There is also a need for further work at the level of secondary care, in order that referrals made are re-directed appropriately. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF