How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis

Background National European cancer survival rates vary widely. Prolonged diagnostic intervals are thought to be a key factor in explaining these variations. Primary care practitioners (PCPs) frequently play a crucial role during initial cancer diagnosis; their knowledge could be used to improve the planning of more effective approaches to earlier cancer diagnosis. Objectives This study sought the views of PCPs from across Europe on how they thought the timeliness of cancer diagnosis could be improved. Design In an online survey, a final open-ended question asked PCPs how they thought the speed of diagnosis of cancer in primary care could be improved. Thematic analysis was used to analyse the data. Setting A primary care study, with participating centres in 20 European countries. Participants A total of 1352 PCPs answered the final survey question, with a median of 48 per country. Results The main themes identified were: patient-related factors, including health education; care provider-related factors, including continuing medical education; improving communication and interprofessional partnership, particularly between primary and secondary care; factors relating to health system organisation and policies, including improving access to healthcare; easier primary care access to diagnostic tests; and use of information technology. Re-allocation of funding to support timely diagnosis was seen as an issue affecting all of these. Conclusions To achieve more timely cancer diagnosis, health systems need to facilitate earlier patient presentation through education and better access to care, have well-educated clinicians with good access to investigations and better information technology, and adequate primary care cancer diagnostic pathway funding

PREVENTION IN PRIMARY CARE – INTRAFAMILIAL PREDICTIVE MODEL (IPM)

The essence of the family medicine specialty remains surveillance of the health for the whole family: from pregnancy to child, from young to senior, from health to disease, from preventive to therapeutical interventions. The family doctor (GP) carries on two or even three generations of the same family, comes în contact with each family member, during many years of medical practice. The continuous clinical monitoring, will allow preparation of a “Risk Factors Map” (RFM). RFM is based on the high risk chronical pathology faced by a family over generations. Analising RFM and identifying major risk factors that act inside the family, GP can generate an intrafamilial predictive model (IPM). Having under medical care the whole family, developing în time a relationship of trust with the patients, based on serious profesional training, armed with good communication skils, GP has the possibility to implement personalized educational interventions inside the family for life style changing. This kind of intervention applied în early childhood, can slow down or delay the appearance and the evolution of the severe chronical diseases. În essence, IPM is an early preventive interventional mechanism în controlling the occurrence of major chronic diseases în future adults

MODELUL PREDICTIV INTRAFAMILIAL (MPI) – MECANISM PERSONALIZAT DE INTERVENŢIE PREVENTIVĂ ÎN CONTROLUL APARIŢIEI BOLILOR CRONICE MAJORE

Esenţa specialităţii de medicină de familie rămâne posibilitatea de a monitoriza starea de sănătate a întregii familii; de la gravidă la copil, de la tânăr la senior, de la starea de sănătate la starea de boală, de la intervenţii de tip preventiv la cele terapeutice. Medicul de familie (MF) are în îngrijire două sau chiar trei generaţii ale aceleiaşi familii, vine în contact cu fiecare membru din familie, pe parcursul multor ani de practică medicală. Monitorizarea clinică va permite întocmirea unei „hărţi a factorilor de risc“ (HFR), bazată pe patologia familiei de origine. Analizând HFR şi factorii de risc majori identificaţi care acţionează în interiorul familiei, MF poate genera un model predictiv intrafamilial (MPI). MF are posibilitatea aplicării unor intervenţii educative personalizate eficiente, adresate întregii familii. Acest tip de intervenţie aplicat în copilăria timpurie poate încetini sau întârzia apariţia şi evoluţia bolilor cronice grave. În esenţă, MPI reprezintă un mecanism de intervenţie preventivă precoce în controlul apariţiei bolilor cronice majore la viitorii adulţi