Obtaining the family history for common, multifactorial diseases by family physicians. A descriptive systematic review

Abstract

Objective: To summarize the knowledge on the use of comprehensive family history taking for common, multifactorial diseases in primary health care. Design and data sources: Systematic review of MEDLINE (1966–2008), EMBASE (1986–2008) and Cochrane Library. Methods: Search terms reflected ‘primary care’, ‘family history’ and ‘genetics’. Included were original studies, published in the English language, from a primary care setting, investigating family history taking for multifactorial disorders. Methodological criteria (design, size, response rate) were not used to exclude papers. Out of 116 potentially eligible papers, 27 papers were selected: nine studies on opinions, eight studies on actual practice, seven studies on family history tools, and three studies on the patient perspective. Two authors independently extracted the data, and consequently discussed and summarized them. Given the heterogeneity of the studies, outcomes were presented in a qualitative way. Results: Among family physicians, the general opinion was that taking a family history is the task of the primary care physician. However, observational studies of consultations and analyses of medical records showed wide variability and low regular updating. There are no family history tools yet, that are sufficiently feasible and reproducible. Patients and doctors may perceive a positive family history differently, which may cause miscommunication.Conclusion: There is a need for research into feasible and high quality tools for detailed family history taking for multifactorial disorders.