Patients\u2019 experiences of the use of point-of-care ultrasound in general practice \u2013 a cross-sectional study

Camilla Aakjær Andersen,Torsten Rahbek Rudbæk,Martin Bach Jensen,John Brodersen

doi:10.1186/s12875-021-01459-z

Camilla Aakjær Andersen, Torsten Rahbek Rudbæk + Show 2 more

Open Access

https://doi.org/10.1186/s12875-021-01459-z

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Abstract

BackgroundThe use of point-of-care ultrasonography (POCUS) performed by general practitioners (GPs) in primary care settings is increasing. Previous studies have focused on GP-reported outcomes and little is known about patients’ perspectives on the use of POCUS technology within the general practice consultation. The purpose of this study was to examine patients’ experiences with POCUS in general practice within the areas where GPs have indicated that POCUS affected aspects of the consultation.MethodsA questionnaire was developed using a mixed methods sequential design. Analytical themes from interviews with GPs were converted into items in a questionnaire by the research team. The questionnaire was then further developed in several rounds of pilot tests involving both patients and GPs. The final questionnaire was used in a cohort study conducted in 18 Danish office-based general practice clinics from January 2018 to August 2018. All patients examined with POCUS were asked to complete the questionnaire on tablets immediately after their consultation.ResultsOut of 691 patients examined, 564 (81.6%) questionnaires were available for analysis. The patients reported that they were well informed about the purpose (98%) and the results (97%) of the POCUS examination; however, 29% reported that they were not informed about the difference between POCUS and an imaging-specialist’s ultrasound examination. Almost all patients (99%) reported that POCUS was integrated naturally into the consultation, and 45% reported that POCUS improved the doctor-patient relationship.The majority of patients felt that they had been more thoroughly examined (92%) and taken more seriously (58%) when POCUS was part of the consultation. They felt POCUS gave them a better understanding of their health problem (82%), made them feel more secure (86%) and increased their trust in the physician’s assessment (65%). Moreover, the patients reported that POCUS use improved the level of service (95%) they experienced and the quality of care (94%) in general practice.ConclusionWe found that an examination including POCUS in general practice was a positive experience overall for the majority of patients. Future research should further explore reasons for patient confidence in POCUS and whether or not the reassuring value of POCUS is valid.Trial registrationClinicalTrials.gov Identifier: NCT03416608

Highlights

The use of point-of-care ultrasonography (POCUS) performed by general practitioners (GPs) in primary care settings is increasing
Information given to the patient Ninety-eight percent of patient participants reported that they felt very informed (N = 488) or informed to some extent (N = 65) about the purpose of the POCUS examination, whereas fewer than 2% felt informed to a lesser extent (N = 9) or not informed (N = 1)
Ninetyseven percent reported that they had been informed about the result of the POCUS examination, and only 1% reported that they were not informed about the results of the ultrasound examination (N = 5)

Summary

Introduction

The use of point-of-care ultrasonography (POCUS) performed by general practitioners (GPs) in primary care settings is increasing. Previous studies have focused on GP-reported outcomes and little is known about patients’ perspectives on the use of POCUS technology within the general practice consultation. Evaluating patients’ perspectives is paramount when offering health care services [1]. Patients may regard diagnostic POCUS as an improved service to ensure earlier and more correct diagnosis and treatment. Evidence for such positive effects from POCUS largely originates from hospital settings while the evidence from a general practice setting is scant [7,8,9,10]. Very few studies have explored the potential intended benefits and the potential unintended harms of POCUS use in general practice from the patient’s perspective, or the patient’s reaction to the introduction of POCUS technology in general practice [13,14,15,16,17]

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