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BMC Primary Care
Published in: BMC Primary Care 1/2013

Open Access 01-12-2013 | Research article

Improving the management of people with a family history of breast cancer in primary care: before and after study of audit-based education

Authors: Imran Rafi, Susmita Chowdhury, Tom Chan, Ibrahim Jubber, Mohammad Tahir, Simon de Lusignan

Published in: BMC Primary Care | Issue 1/2013

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Abstract

Background

In England, guidance from National Institute for Clinical Excellence (NICE) states women with a family history of breast cancer presenting to primary care should be reassured or referred.
We reviewed the evidence for interventions that might be applied in primary care and conducted an audit of whether low risk women are correctly advised and flagged.

Methods

We conducted a literature review to identify modifiable risk factors. We extracted routinely collected data from the computerised medical record systems of 6 general practices (population approximately 30,000); of the variables identified in the guidance. We implemented a quality improvement (QI) intervention called audit-based education (ABE) comparing participant practices with guidelines and each other before and after; we report odds ratios (OR) of any change in data recording.

Results

The review revealed evidence for advising on: diet, weight control, physical exercise, and alcohol. The proportion of patients with recordings of family history of: disease, neoplasms, and breast cancer were: 39.3%, 5.1% and 1.3% respectively. There was no significant change in the recording of family history of disease or cancer; OR 1.02 (95% CI 0.98-1.06); and 1.08 (95% CI 0.99-1.17) respectively. Recording of alcohol consumption and smoking both increased significantly; OR 1.36 (95% CI 1.30-1.43); and 1.42 (95% CI 1.27-1.60) respectively. Recording lifestyle advice fell; OR 0.84 (95% CI 0.81-0.88).

Conclusions

The study informs about current data recording and willingness to engage in ABE. Recording of risk factors improved after the intervention. Further QI is needed to achieve adherence to current guidance.
Appendix
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Metadata
Title
Improving the management of people with a family history of breast cancer in primary care: before and after study of audit-based education
Authors
Imran Rafi
Susmita Chowdhury
Tom Chan
Ibrahim Jubber
Mohammad Tahir
Simon de Lusignan
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2013
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-14-105

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