Abstract
Background: Acquisition of family medical history (FMH) is emphasized as a part of obtaining a complete medical history, but whether FMH is consistently documented and utilized in primary care, as well as how it can affect patient care in this context, remains unclear. Thus, the objectives of this study were to determine: 1) if FMH is regularly acquired in a representative primary care practice (the Queen’s Family Health Team, QFHT); 2) what is included in the FMH obtained; 3) what the utility of FMH is with regards to patient management in primary care; and 4) to utilize healthcare practitioners’ perspectives in order to elucidate any findings regarding the acquisition and utility of FMH at the QFHT. Methods: Patients were interviewed in order to obtain their FMH. For each patient, the FMH obtained was compared to the FMH documented in the patient’s record to determine the record’s completeness. Each patient’s FMH was analyzed for significant history of coronary artery disease (CAD), diabetes mellitus type II (DMII), substance abuse (SA) and colorectal cancer (CRC). Participants were patients scheduled for appointments at the QFHT between May and July 2011. Any patient of the QFHT older than 25 years was eligible to participate. Clinical staff of the QFHT completed an online questionnaire to determine healthcare practitioners’ perspectives regarding the acquisition and utility of FMH. Results: 83 patients participated in the study. Participants ranged in age from 25 - 86 years (median: 63 years); 69% were female. FMH present in patients’ records was often either incomplete (42% of charts reviewed) or not documented at all (51% of charts reviewed). Knowledge of FMH can affect patient management in primary care for the diseases assessed (CAD, DMII, SA and CRC). HCP do consider FMH to be important in clinical practice and 86% of respondents stated that they regularly inquired about patients’ FMH. Interpretation: Despite the belief by HCP that FMH is important, there is a disparity between this belief and their practices regarding its documentation and utilization. Finally, analysis of the FMH of the representative population studied shows that information commonly missing in patients’ FMH can affect patient management at a primary care level.
Highlights
From the start of one’s medical education, the importance of obtaining a complete medical history is emphasized as an essential tool for patient care, and family medical history (FMH) is often included within the construct of a complete medical history
The objectives of this study were to assess the practices of a representative primary care practice in order to determine if: 1) FMH is regularly acquired, 2) the methods of acquisition of FMH results in the greatest yield of accurate information (i.e. FMH for first-degree family members), 3) the acquisition of a generalized FMH could result in alteration of patient management at a primary care level for a variety diseases and 4) what the perspectives of healthcare practitioners in primary care are in regards to the acquisition and utility of FMH to determine if there is any disparity between the self-report of practices and what is documented in patients’ records
Results of this study showed that a standardized method of acquiring a general FMH, could lead to alteration in patient care for a variety of diseases (CAD, diabetes mellitus type II (DMII), substance abuse (SA) and colorectal cancer (CRC))
Summary
From the start of one’s medical education, the importance of obtaining a complete medical history is emphasized as an essential tool for patient care, and family medical history (FMH) is often included within the construct of a complete medical history. Acquisition of family medical history (FMH) is emphasized as a part of obtaining a complete medical history, but whether FMH is consistently documented and utilized in primary care, as well as how it can affect patient care in this context, remains unclear. The objectives of this study were to determine: 1) if FMH is regularly acquired in a representative primary care practice (the Queen’s Family Health Team, QFHT); 2) what is included in the FMH obtained; 3) what the utility of FMH is with regards to patient management in primary care; and 4) to utilize healthcare practitioners’ perspectives in order to elucidate any findings regarding the acquisition and utility of FMH at the QFHT. Analysis of the FMH of the representative population studied shows that information commonly missing in patients’ FMH can affect patient management at a primary care level
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