Back to Search
Start Over
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.
- Source :
-
BMC Health Services Research . 5/8/2017, Vol. 17, p1-7. 7p. 1 Diagram, 1 Chart. - Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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]
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 17
- Database :
- Academic Search Index
- Journal :
- BMC Health Services Research
- Publication Type :
- Academic Journal
- Accession number :
- 122953309
- Full Text :
- https://doi.org/10.1186/s12913-017-2286-0