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

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

Abstract

Background: 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. 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.

Methods: A 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.

Results: Out 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.

Conclusion: We 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 registration: ClinicalTrials.gov Identifier: NCT03416608.

Keywords: Family medicine; General practice; Patient-reported outcome measures; Point-of-Care testing; Primary care; Ultrasonography.

Conflict of interest statement

The authors have no competing interests.

Figures

Fig. 1
Fig. 1
Developing the questionnaire. GP = general practitioner, POCUS = point-of-care ultrasonography
Fig. 2
Fig. 2
Patients included in the study. GP = general practitioner. * For the variables Patient’s trust in the GP’s judgement, Patient’s feeling of being taken seriously, and Patient’s feeling of security there were two missing values. For the variable Patient’s understanding of their health problem there was one missing value
Fig. 3
Fig. 3
Dimensions of patient reassurance measured in the questionnaire. Number of patients: Patient’s feeling of being thoroughly examined (N = 546), Patient’s trust in the GP’s judgement (N = 544), Patient’s understanding of their health problem (N = 545), Patient’s feeling of being taken seriously (N = 544), and Patient’s feeling of security (N = 544)
Fig. 4
Fig. 4
Associations between patient reassurance and general practitioners’ confidence in diagnosis. POCUS = point-of-care ultrasonography, GP = general practitioner. * Distribution tested using Fisher’s exact test. ** Associations tested using Goodmann Kruscals gamma

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