Why do patients with cancer access out-of-hours primary care?

A retrospective study

Rosalind Adam, Patrick Wassell, Peter Murchie

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Abstract
Background
Identifying why patients with cancer seek out-of-hours (OOH) primary medical care could highlight potential gaps in anticipatory cancer care.

Aim
To explore the reasons for contact and the range and prevalence of presenting symptoms in patients with established cancer who presented to a primary care OOH department.

Design and setting
A retrospective review of 950 anonymous case records for patients with cancer who contacted the OOH general practice service in Grampian, Scotland between 1 January 2010 and 31 December 2011.

Method
Subjects were identified by filtering the OOH computer database using the Read Codes ‘neoplasm’, ‘terminal care’, and ‘terminal illness’. Consultations by patients without cancer and repeated consultations by the same patient were excluded. Data were anonymised. Case records were read independently by two authors who determined the presenting symptom(s).

Results
Anonymous case records were reviewed for 950 individuals. Eight hundred and fifty-two patients made contact because of a symptom. The remaining 97 were mostly administrative and data were missing for one patient. The most frequent symptoms were pain (n = 262/852, 30.8%); nausea/vomiting (n = 102/852, 12.0%); agitation (n = 53/852, 6.2%); breathlessness (n = 51/852, 6.0%); and fatigue (n = 48/852, 5.6%). Of the 262 patients who presented with pain, at least 127 (48.5%) had metastatic disease and 141 (53.8%) were already prescribed strong opiate medication.

Conclusion
Almost one-third of patients with cancer seeking OOH primary medical care did
so because of poorly controlled pain. Pain management should specifically be addressed during routine anticipatory care planning.
Original languageEnglish
Pages (from-to)84-85
Number of pages2
JournalThe British Journal of General Practice
Volume64
Issue number619
DOIs
Publication statusPublished - 1 Feb 2014

Fingerprint

Primary Health Care
Retrospective Studies
Neoplasms
After-Hours Care
Pain
Opiate Alkaloids
Referral and Consultation
Terminal Care
Scotland
Pain Management
General Practice
Dyspnea
Nausea
Vomiting
Fatigue
Databases

Keywords

  • cancer
  • pain
  • palliative care
  • primary health care
  • signs and symptoms
  • symptom management

Cite this

Why do patients with cancer access out-of-hours primary care? A retrospective study. / Adam, Rosalind; Wassell, Patrick; Murchie, Peter.

In: The British Journal of General Practice, Vol. 64, No. 619, 01.02.2014, p. 84-85.

Research output: Contribution to journalArticle

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abstract = "AbstractBackgroundIdentifying why patients with cancer seek out-of-hours (OOH) primary medical care could highlight potential gaps in anticipatory cancer care.AimTo explore the reasons for contact and the range and prevalence of presenting symptoms in patients with established cancer who presented to a primary care OOH department.Design and settingA retrospective review of 950 anonymous case records for patients with cancer who contacted the OOH general practice service in Grampian, Scotland between 1 January 2010 and 31 December 2011.MethodSubjects were identified by filtering the OOH computer database using the Read Codes ‘neoplasm’, ‘terminal care’, and ‘terminal illness’. Consultations by patients without cancer and repeated consultations by the same patient were excluded. Data were anonymised. Case records were read independently by two authors who determined the presenting symptom(s).ResultsAnonymous case records were reviewed for 950 individuals. Eight hundred and fifty-two patients made contact because of a symptom. The remaining 97 were mostly administrative and data were missing for one patient. The most frequent symptoms were pain (n = 262/852, 30.8{\%}); nausea/vomiting (n = 102/852, 12.0{\%}); agitation (n = 53/852, 6.2{\%}); breathlessness (n = 51/852, 6.0{\%}); and fatigue (n = 48/852, 5.6{\%}). Of the 262 patients who presented with pain, at least 127 (48.5{\%}) had metastatic disease and 141 (53.8{\%}) were already prescribed strong opiate medication.ConclusionAlmost one-third of patients with cancer seeking OOH primary medical care didso because of poorly controlled pain. Pain management should specifically be addressed during routine anticipatory care planning.",
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N2 - AbstractBackgroundIdentifying why patients with cancer seek out-of-hours (OOH) primary medical care could highlight potential gaps in anticipatory cancer care.AimTo explore the reasons for contact and the range and prevalence of presenting symptoms in patients with established cancer who presented to a primary care OOH department.Design and settingA retrospective review of 950 anonymous case records for patients with cancer who contacted the OOH general practice service in Grampian, Scotland between 1 January 2010 and 31 December 2011.MethodSubjects were identified by filtering the OOH computer database using the Read Codes ‘neoplasm’, ‘terminal care’, and ‘terminal illness’. Consultations by patients without cancer and repeated consultations by the same patient were excluded. Data were anonymised. Case records were read independently by two authors who determined the presenting symptom(s).ResultsAnonymous case records were reviewed for 950 individuals. Eight hundred and fifty-two patients made contact because of a symptom. The remaining 97 were mostly administrative and data were missing for one patient. The most frequent symptoms were pain (n = 262/852, 30.8%); nausea/vomiting (n = 102/852, 12.0%); agitation (n = 53/852, 6.2%); breathlessness (n = 51/852, 6.0%); and fatigue (n = 48/852, 5.6%). Of the 262 patients who presented with pain, at least 127 (48.5%) had metastatic disease and 141 (53.8%) were already prescribed strong opiate medication.ConclusionAlmost one-third of patients with cancer seeking OOH primary medical care didso because of poorly controlled pain. Pain management should specifically be addressed during routine anticipatory care planning.

AB - AbstractBackgroundIdentifying why patients with cancer seek out-of-hours (OOH) primary medical care could highlight potential gaps in anticipatory cancer care.AimTo explore the reasons for contact and the range and prevalence of presenting symptoms in patients with established cancer who presented to a primary care OOH department.Design and settingA retrospective review of 950 anonymous case records for patients with cancer who contacted the OOH general practice service in Grampian, Scotland between 1 January 2010 and 31 December 2011.MethodSubjects were identified by filtering the OOH computer database using the Read Codes ‘neoplasm’, ‘terminal care’, and ‘terminal illness’. Consultations by patients without cancer and repeated consultations by the same patient were excluded. Data were anonymised. Case records were read independently by two authors who determined the presenting symptom(s).ResultsAnonymous case records were reviewed for 950 individuals. Eight hundred and fifty-two patients made contact because of a symptom. The remaining 97 were mostly administrative and data were missing for one patient. The most frequent symptoms were pain (n = 262/852, 30.8%); nausea/vomiting (n = 102/852, 12.0%); agitation (n = 53/852, 6.2%); breathlessness (n = 51/852, 6.0%); and fatigue (n = 48/852, 5.6%). Of the 262 patients who presented with pain, at least 127 (48.5%) had metastatic disease and 141 (53.8%) were already prescribed strong opiate medication.ConclusionAlmost one-third of patients with cancer seeking OOH primary medical care didso because of poorly controlled pain. Pain management should specifically be addressed during routine anticipatory care planning.

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