Urine analysis assessment among primary health care providers in Eastern Province, Saudi Arabia

Abstract

Introduction: Urine analysis is often ordered by primary health care providers (PHCPs) during routine general assessment of their patients. A major application for urine analysis is early detection of urothelial cancer. This condition is highly suspected in the presence of microscopic haematuria. Early detection increases the chances of complete tumour removal and cure. Objectives: To evaluate the preference of the PHCP to perform urine analysis as a screening test for urothelial cancer and referral preference to the urologist or to another specialist. Materials and methods: A written questionnaire was completed by the PHCP, which included family physicians, general practitioners and emergency physicians. The questionnaire consisted of true/false questions and multiple-choice questions. This study was approved by the Local Institution Research. Results: The study was completed over a 4-month period, between October 2013 and February 2014. Out of 258 questionnaires, 184 were accepted for analysis. Forty-five per cent of PHCPs stated that urine analysis was carried out as routine procedure in all patients and 45.7% did not know the risk factors of urothelial cancer. Only 44.6% of PHCPs had facilities available to perform microscopic urine examination. PHCPs that performed urine analysis when a risk factor was present did not agree on the nature of those risk factors. Only 3.8% considered smoking to be a risk factor, the remainder believed that age was the major risk factor. Both old age (28.8%) and young age (20.1%) were considered to be risk factors by PHCPs. When PHCPs were asked to define microscopic haematuria, 32.6% were able to provide a correct answer. Conclusions: PHCP use of urine analysis to effectively screen for early detection of urothelial cancer is deficient. This is largely because of a lack of knowledge about the risk factors involved. It is recommended that educational courses by specialized urologists be implemented.