Referrals of women with a family history of breast cancer from primary care to cancer genetics services in South East Scotland
Referrals of women with a family history of breast cancer from primary care to cancer genetics services in South East Scotland
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DOI：
10.1038/sj.bjc.6601348
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发表时间：
2003-11-03
影响因子：
8.8
通讯作者：
Porteous, M
中科院分区：
文献类型：
--
作者：
Campbell, H;Holloway, S;Porteous, M
作为评估癌症遗传学服务替代模式的群集随机试验的一部分，我们收集了苏格兰东南部4年内全科医生（GP）向癌症遗传学服务转诊的所有数据。每1000名患者的转诊率从试验前2年的0.21上升到试验期间的0.31，上升了48%。在提供全科医生诊所服务的试验组中，这一增幅要大得多（64%的增幅高于转介到区域服务的38%）。因此，提供更多的本地服务似乎对这些妇女的全科医生管理有显着影响。转介率癌症遗传学服务从一般的做法差异很大，较高的转介率从实践中有更多的女性伴侣。转介率和实践领域剥夺分数之间呈负相关。然而，在提供全科诊所的试验组中没有发现这一点，在更接近社会贫困妇女家庭的地方提供诊所预约，改善了贫困地区妇女的就医机会。与GP的互动似乎与对基因检测的适当性的不适当的兴趣和期望水平有关。在全科医生中提供诊所并没有提高全科医生对管理这些妇女的信心。
As part of a cluster randomised trial to assess an alternative model of cancer genetics services, we gathered data on all referrals from general practitioners (GPs) to cancer genetics services in South East Scotland over a 4-year period. The referral rate per 1000 patients rose by 48% from 0.21 in the 2-year period before the trial to 0.31 during the trial. This increase was much greater in the trial group offered the GP clinic service (64% increase compared to a 38% increase in those referred to the regional service). Thus, the offer of a more local service appeared to have a marked effect on GP management of these women. Referral rates to cancer genetics services from general practices varied widely with higher referral rates from practices with more female partners. There was a negative correlation between referral rates and practice area deprivation scores. However, this was not found during the trial in the group which offered clinics in general practice, the provision of clinic appointments nearer to the homes of more socially deprived women resulting in improved access to women from deprived areas. The interaction with the GP appears to be associated with an inappropriate level of interest in and expectation of the appropriateness of genetic testing. The provision of the clinics within general practice did not result in higher levels of confidence among GPs in managing these women.