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Br J Gen Pract. 2014 Feb;64(619):e99-104. doi: 10.3399/bjgp14X677158.

Why do patients with cancer access out-of-hours primary care? A retrospective study.

Author information

1
Centre for Academic Primary Care, University of Aberdeen, Foresterhill, Aberdeen.

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.

KEYWORDS:

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

PMID:
24567623
PMCID:
PMC3905436
DOI:
10.3399/bjgp14X677158
[Indexed for MEDLINE]
Free PMC Article

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