Towards reducing diagnostic delay in endometriosis in primary care: a qualitative study.

Diagnostic delay Endometriosis Primary care

Journal

BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531

Informations de publication

Date de publication:
15 Apr 2024
Historique:
received: 23 01 2024
accepted: 23 02 2024
revised: 23 02 2024
medline: 16 4 2024
pubmed: 16 4 2024
entrez: 15 4 2024
Statut: aheadofprint

Résumé

Due to a heterogeneity of symptoms, a lack of an adequate diagnostic test and a lack of awareness, diagnostic delay in endometriosis in primary care on average amounts to 35 months. To determine which interventions are most feasible to reduce time to diagnosis in primary care, focusing on GPs' preferences, the intervention's content, design and implementation. We conducted a qualitative study by performing focus groups with GPs and GP trainees between July and October 2021. Data collection was continued until saturation was obtained. Focus groups were transcribed and openly encoded. Themes were formulated by three independent researchers. Divided over five focus groups 22 GPs and 13 GP trainees participated. Three themes were formulated: increasing awareness, combined intervention and reaching unaware GPs.Suggestions for a combined intervention strategy were adaptation of guidelines, a diagnostic support tool and compulsory education. To reach unaware GPs, participants felt that education should be offered in regional networks and education for GP trainees should be mandatory. A guideline on menstrual symptoms should be considered, and the term endometriosis should be added to the differential diagnosis paragraphs of existing guidelines. A diagnostic support tool should be linked to a guideline and consist of a flowchart with steps starting with the first presentation of symptoms leading to the diagnosis of endometriosis. According to GPs, a combined intervention strategy consisting of an adapted guideline, a diagnostic support tool and education might be successful interventions in reduction of diagnostic delay in endometriosis.

Sections du résumé

BACKGROUND BACKGROUND
Due to a heterogeneity of symptoms, a lack of an adequate diagnostic test and a lack of awareness, diagnostic delay in endometriosis in primary care on average amounts to 35 months.
AIM OBJECTIVE
To determine which interventions are most feasible to reduce time to diagnosis in primary care, focusing on GPs' preferences, the intervention's content, design and implementation.
DESIGN & SETTING METHODS
We conducted a qualitative study by performing focus groups with GPs and GP trainees between July and October 2021.
METHOD METHODS
Data collection was continued until saturation was obtained. Focus groups were transcribed and openly encoded. Themes were formulated by three independent researchers.
RESULTS RESULTS
Divided over five focus groups 22 GPs and 13 GP trainees participated. Three themes were formulated: increasing awareness, combined intervention and reaching unaware GPs.Suggestions for a combined intervention strategy were adaptation of guidelines, a diagnostic support tool and compulsory education. To reach unaware GPs, participants felt that education should be offered in regional networks and education for GP trainees should be mandatory. A guideline on menstrual symptoms should be considered, and the term endometriosis should be added to the differential diagnosis paragraphs of existing guidelines. A diagnostic support tool should be linked to a guideline and consist of a flowchart with steps starting with the first presentation of symptoms leading to the diagnosis of endometriosis.
CONCLUSION CONCLUSIONS
According to GPs, a combined intervention strategy consisting of an adapted guideline, a diagnostic support tool and education might be successful interventions in reduction of diagnostic delay in endometriosis.

Identifiants

pubmed: 38621791
pii: BJGPO.2024.0019
doi: 10.3399/BJGPO.2024.0019
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright © 2024, The Authors.

Auteurs

Laura M de Kok (LM)

Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, Netherlands laura.dekok@radboudumc.nl.

Henk Schers (H)

Department of Primary Care Medicine, Radboud University Medical Center, Nijmegen, Netherlands.

Zoë Boersen (Z)

Department of Obstetrics and Gynaecology, Rijnstate Hospital, Wagnerlaan 55, Arnhem, Netherlands.

Didi Braat (D)

Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, Netherlands.

Doreth Teunissen (D)

Department of Primary Care Medicine, Radboud University Medical Center, Nijmegen, Netherlands.

Annemiek Nap (A)

Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, Netherlands.

Classifications MeSH