The role of primary care in cancer diagnosis via emergency presentation: qualitative synthesis of significant event reports

British Journal of Cancer
Elizabeth D MitchellU Macleod

Abstract

Patients diagnosed with cancer in the context of an emergency presentation (EP) have poorer outcomes. It is often assumed that such patients present to the emergency department without consulting their general practitioner (GP). Little work has been done to identify primary care involvement before hospital attendance. Participating primary care practices completed a significant event audit (SEA) report for the last patient diagnosed with cancer as a result of an EP. Accounts were synthesised and a qualitative approach to analysis undertaken. SEAs for 222 patients were analysed. A range of cancers were included, the most common being lung (32.4%) and upper gastrointestinal (19.8%). In most cases, patients had contact with their practice before diagnosis, primarily in the period immediately before admission. In only eight cases had there been no input from primary care. Accounts of protracted primary care contact generally demonstrated complexity, often related to comorbidity, patient-mediated factors or reassurance provided by negative investigations. Learning points identified by practices centred on the themes of presentation and diagnosis, consultation and safety-netting, communication and system issues, patient factors and r...Continue Reading

References

Jan 28, 2009·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Milena SantUNKNOWN EUROCARE Working Group
Jan 23, 2013·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Elizabeth D MitchellUna Macleod
Sep 21, 2013·British Journal of Cancer·S McPhailM Richards

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Citations

Jan 20, 2016·Special Care in Dentistry : Official Publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry·Milda ChmieliauskaiteEric T Stoopler
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May 10, 2018·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Julie EvansBrian D Nicholson
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Feb 15, 2018·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Jane HeyhoeRebecca Lawton
May 27, 2017·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Ian Morgan, Scott Wilkes
May 27, 2015·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Ahmed Rashid
Dec 5, 2018·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Daniel JonesUna Macleod
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