Skip to main content
Top
Published in: BMC Primary Care 1/2021

Open Access 01-12-2021 | Ultrasound | Research

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

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

Published in: BMC Primary Care | Issue 1/2021

Login to get access

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
Appendix
Available only for authorised users
Literature
1.
go back to reference Kebede S. Ask patients “What matters to you?” rather than “What’s the matter?” BMJ. 2016;354:i4045.CrossRef Kebede S. Ask patients “What matters to you?” rather than “What’s the matter?” BMJ. 2016;354:i4045.CrossRef
4.
go back to reference Andersen CA, Jensen MBB, Toftegaard BS, Vedsted P, Harris M, Group ÖR. Primary care physicians’ access to in-house ultrasound examinations across Europe: a questionnaire study. BMJ Open. 2019;9(9):e030958.CrossRef Andersen CA, Jensen MBB, Toftegaard BS, Vedsted P, Harris M, Group ÖR. Primary care physicians’ access to in-house ultrasound examinations across Europe: a questionnaire study. BMJ Open. 2019;9(9):e030958.CrossRef
5.
go back to reference Bornemann P, Jayasekera N, Bergman K, et al. Point-of-care ultrasound: Coming soon to primary care? J Fam Pract. 2018;67(2):70–80. Bornemann P, Jayasekera N, Bergman K, et al. Point-of-care ultrasound: Coming soon to primary care? J Fam Pract. 2018;67(2):70–80.
6.
go back to reference Myklestul HC, Skonnord T, Brekke M. Point-of-care ultrasound (POCUS) in Norwegian general practice. Scand J Prim Health Care. 2020 Apr;21:1–7. Myklestul HC, Skonnord T, Brekke M. Point-of-care ultrasound (POCUS) in Norwegian general practice. Scand J Prim Health Care. 2020 Apr;21:1–7.
7.
go back to reference Via G, Hussain A, Wells M, et al. International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr. 2014;27(7):683.e1-683.e33.CrossRef Via G, Hussain A, Wells M, et al. International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr. 2014;27(7):683.e1-683.e33.CrossRef
8.
go back to reference Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38(4):577–91.CrossRef Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38(4):577–91.CrossRef
9.
go back to reference Olgers TJ, Azizi N, Blans MJ, et al. Point-of-care ultrasound (PoCUS) for the internist in acute medicine: a uniform curriculum. Neth J Med. 2019;77(5):168–76.PubMed Olgers TJ, Azizi N, Blans MJ, et al. Point-of-care ultrasound (PoCUS) for the internist in acute medicine: a uniform curriculum. Neth J Med. 2019;77(5):168–76.PubMed
11.
go back to reference Guyatt G, et al. Users’ Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. New York: McGraw-Hill Professional; 2015. Guyatt G, et al. Users’ Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. New York: McGraw-Hill Professional; 2015.
12.
go back to reference Andersen CA, Holden S, Vela J, et al. Point-of-care ultrasound in general practice: A systematic review. Ann Fam Med. 2019;17:61–9.CrossRef Andersen CA, Holden S, Vela J, et al. Point-of-care ultrasound in general practice: A systematic review. Ann Fam Med. 2019;17:61–9.CrossRef
13.
go back to reference Glaso M, Medias IB, Straand J. Diagnostic ultrasound in general practice. Tidsskr Nor Laegeforen. 2007;127(15):1924–7.PubMed Glaso M, Medias IB, Straand J. Diagnostic ultrasound in general practice. Tidsskr Nor Laegeforen. 2007;127(15):1924–7.PubMed
14.
go back to reference Rosenthal TC, Siepel T, Zubler J, et al. The use of ultrasonography to scan the abdomen of patients presenting for routine physical examinations. J Fam Pract. 1994;38(4):380–5.PubMed Rosenthal TC, Siepel T, Zubler J, et al. The use of ultrasonography to scan the abdomen of patients presenting for routine physical examinations. J Fam Pract. 1994;38(4):380–5.PubMed
15.
go back to reference Pertierra-Galindo N, Salvo-Donangelo L, Salcedo-Joven MI, Roman-Crespo B, Torres F. Study of patient satisfaction when performing an ultrasound in primary care. SEMERGEN. 2019;45(4):239–50.CrossRef Pertierra-Galindo N, Salvo-Donangelo L, Salcedo-Joven MI, Roman-Crespo B, Torres F. Study of patient satisfaction when performing an ultrasound in primary care. SEMERGEN. 2019;45(4):239–50.CrossRef
16.
go back to reference Wordsworth S, Scott A. Ultrasound scanning by general practitioners: Is it worthwhile? J Public Health Med. 2002;24(2):88–94.CrossRef Wordsworth S, Scott A. Ultrasound scanning by general practitioners: Is it worthwhile? J Public Health Med. 2002;24(2):88–94.CrossRef
17.
go back to reference Eggebo TM, Sorvang S, Dalaker K. Ultrasonic diagnosis of the upper abdomen performed in general practice. Tidsskr Nor Laegeforen. 1990;110(9):1096–8.PubMed Eggebo TM, Sorvang S, Dalaker K. Ultrasonic diagnosis of the upper abdomen performed in general practice. Tidsskr Nor Laegeforen. 1990;110(9):1096–8.PubMed
18.
go back to reference Lindelius A, Törngren S, Nilsson L, et al. Randomized clinical trial of bedside ultrasound among patients with abdominal pain in the emergency department: Impact on patient satisfaction and health care consumption. Scand J Trauma Resusc Emerg Med. 2009;17:60.CrossRef Lindelius A, Törngren S, Nilsson L, et al. Randomized clinical trial of bedside ultrasound among patients with abdominal pain in the emergency department: Impact on patient satisfaction and health care consumption. Scand J Trauma Resusc Emerg Med. 2009;17:60.CrossRef
19.
go back to reference Howard ZD, Noble VE, Marill KA, Sajad D, Rodrigues M, Bertyzzi B, LIteplo AS. Bedside ultrasound maximizes patient satisfaction. J Emerg Med. 2014;46(1):46–53.CrossRef Howard ZD, Noble VE, Marill KA, Sajad D, Rodrigues M, Bertyzzi B, LIteplo AS. Bedside ultrasound maximizes patient satisfaction. J Emerg Med. 2014;46(1):46–53.CrossRef
21.
go back to reference Williams S, Weinman J, Dale J, Newman S. Patient expectations: What do primary care patients want from the GP and how far does the meeting expectations affect patient satisfaction? Fam Prac. 1995;12(2):193–201.CrossRef Williams S, Weinman J, Dale J, Newman S. Patient expectations: What do primary care patients want from the GP and how far does the meeting expectations affect patient satisfaction? Fam Prac. 1995;12(2):193–201.CrossRef
23.
go back to reference Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices. Health Serv Res. 2013;48:2134–56.CrossRef Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices. Health Serv Res. 2013;48:2134–56.CrossRef
25.
go back to reference Pedersen KM, Andersen JS, Søndergaard J. General practice and primary health care in Denmark. J Am Board Fam Med. 2012;25(suppl 1):S34–8.CrossRef Pedersen KM, Andersen JS, Søndergaard J. General practice and primary health care in Denmark. J Am Board Fam Med. 2012;25(suppl 1):S34–8.CrossRef
27.
go back to reference Laurence CO, Gialamas A, Bubner T, Yelland L, Willson L, Ryan P, Beilby J, Point-of-care Testing in General Practice Trial Management Group. Patient satisfaction with point-of-care testing in general practice. Br J Gen Pract. 2010;60(572):e98–104. https://doi.org/10.3399/bjgp10X483508. Laurence CO, Gialamas A, Bubner T, Yelland L, Willson L, Ryan P, Beilby J, Point-of-care Testing in General Practice Trial Management Group. Patient satisfaction with point-of-care testing in general practice. Br J Gen Pract. 2010;60(572):e98–104. https://​doi.​org/​10.​3399/​bjgp10X483508.
28.
go back to reference Lauridsen GB, Sørensen MS, Hansen MP, Rathe JØ, Jarbøl DE. Consultation expectations among patients with respiratory tract infection symptoms. Dan Med J. 2017;64(6):A5385.PubMed Lauridsen GB, Sørensen MS, Hansen MP, Rathe JØ, Jarbøl DE. Consultation expectations among patients with respiratory tract infection symptoms. Dan Med J. 2017;64(6):A5385.PubMed
29.
go back to reference Kenten C, Bowling A, Lambert N, Howe A, Rowe G. A study of patient expectations in a Norfolk general practice. Health Expect. 2010;13:273–84.PubMedPubMedCentral Kenten C, Bowling A, Lambert N, Howe A, Rowe G. A study of patient expectations in a Norfolk general practice. Health Expect. 2010;13:273–84.PubMedPubMedCentral
30.
go back to reference Weile J, Brix J, Moellekaer AB. Is point-of-care ultrasound disruptive innovation? F0rmulating why POCUS is different from conventional comprehensive ultrasound. Crit Ultrasound J. 2018;10(1):25–33.CrossRef Weile J, Brix J, Moellekaer AB. Is point-of-care ultrasound disruptive innovation? F0rmulating why POCUS is different from conventional comprehensive ultrasound. Crit Ultrasound J. 2018;10(1):25–33.CrossRef
31.
go back to reference Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011;364(8):749–57.CrossRef Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011;364(8):749–57.CrossRef
34.
go back to reference Roberts J, Griffiths FE, Verran A, Ayre C. Why do women seek ultrasound scans from commercial providers during pregnancy? Sociol Health Illn. 2015;37(4):594–609.CrossRef Roberts J, Griffiths FE, Verran A, Ayre C. Why do women seek ultrasound scans from commercial providers during pregnancy? Sociol Health Illn. 2015;37(4):594–609.CrossRef
35.
go back to reference van der Weijden T, van Bokhoven MA, Dinant G, et al. Understanding laboratory testing in diagnostic uncertainty: a qualitative study in general practice. Br J Gen Pract. 2002;52(485):974–80.PubMedPubMedCentral van der Weijden T, van Bokhoven MA, Dinant G, et al. Understanding laboratory testing in diagnostic uncertainty: a qualitative study in general practice. Br J Gen Pract. 2002;52(485):974–80.PubMedPubMedCentral
36.
go back to reference Jauhar S. The demise of the physical exam. N Engl J Med. 2006;354(6):548–51.CrossRef Jauhar S. The demise of the physical exam. N Engl J Med. 2006;354(6):548–51.CrossRef
37.
go back to reference Kugler J, Verghese A. The physical exam and other forms of fiction. J Gen Intern Med. 2010;25(8):756–7.CrossRef Kugler J, Verghese A. The physical exam and other forms of fiction. J Gen Intern Med. 2010;25(8):756–7.CrossRef
38.
go back to reference Asscher ECA, Bolt I, Schermer M. Wish-fulfilling medicine in practice: a qualitative study of physician arguments. J Med Ethics. 2012;38:327–31.CrossRef Asscher ECA, Bolt I, Schermer M. Wish-fulfilling medicine in practice: a qualitative study of physician arguments. J Med Ethics. 2012;38:327–31.CrossRef
39.
go back to reference Giroldi E, Veldhuijzen W, Leijten C, Welter D, van der Weijden T, Muris J, van der Vleuten C. No need to worry: an exploration of general practitioners’ reassuring strategies. BMC Fam Prac. 2014;15:133.CrossRef Giroldi E, Veldhuijzen W, Leijten C, Welter D, van der Weijden T, Muris J, van der Vleuten C. No need to worry: an exploration of general practitioners’ reassuring strategies. BMC Fam Prac. 2014;15:133.CrossRef
40.
go back to reference Michael-Corsten M, Donner-Banzhoff N. Beyond accuracy: hidden motives in diagnostic testing. Fam Prac. 2018;35(2):222–7.CrossRef Michael-Corsten M, Donner-Banzhoff N. Beyond accuracy: hidden motives in diagnostic testing. Fam Prac. 2018;35(2):222–7.CrossRef
41.
go back to reference Thomas GM, Roberts J, Griffiths FE. Ultrasound as a technology of reassurance? How pregnant women and health care professionals articulate ultrasound reassurance and its limitations. Sociel Helath Illn. 2017;39(6):893–907.CrossRef Thomas GM, Roberts J, Griffiths FE. Ultrasound as a technology of reassurance? How pregnant women and health care professionals articulate ultrasound reassurance and its limitations. Sociel Helath Illn. 2017;39(6):893–907.CrossRef
42.
go back to reference Rolfe A, Burton C. Reassurance after diagnostic testing with a low pretest probability of serious disease: Systematic review and meta-analysis. JAMA Intern Med. 2013;173(6):407–16.CrossRef Rolfe A, Burton C. Reassurance after diagnostic testing with a low pretest probability of serious disease: Systematic review and meta-analysis. JAMA Intern Med. 2013;173(6):407–16.CrossRef
43.
go back to reference van Ravesteijn H, van Dijk I, Darmon D, et al. The reassuring value of diagnostic tests: a systematic review. Patient Educ Couns. 2012;86(1):3–8.CrossRef van Ravesteijn H, van Dijk I, Darmon D, et al. The reassuring value of diagnostic tests: a systematic review. Patient Educ Couns. 2012;86(1):3–8.CrossRef
44.
go back to reference Austin LC, Reventlow S, Sandøe P, et al. The structure of medical decisions: uncertainty, probability and risk in five common choice situations. Health Risk Soc. 2013;15(1):27–50.CrossRef Austin LC, Reventlow S, Sandøe P, et al. The structure of medical decisions: uncertainty, probability and risk in five common choice situations. Health Risk Soc. 2013;15(1):27–50.CrossRef
45.
go back to reference Lumbreras B, Donat L, Hernández-Aguado I. Incidental findings in imaging diagnostic tests: a systematic review. Br J Radiol. 2010;83(988):276–89.CrossRef Lumbreras B, Donat L, Hernández-Aguado I. Incidental findings in imaging diagnostic tests: a systematic review. Br J Radiol. 2010;83(988):276–89.CrossRef
46.
go back to reference Shabanzadeh DM, Sørensen LT, Jørgensen T. A prediction rule for risk stratification of incidentally discovered gallstones: results from a large cohort study. Gastroenterology. 2016;150:156–67.CrossRef Shabanzadeh DM, Sørensen LT, Jørgensen T. A prediction rule for risk stratification of incidentally discovered gallstones: results from a large cohort study. Gastroenterology. 2016;150:156–67.CrossRef
47.
go back to reference Baltarowich OH, Di Salvo DN, Scoutt LM, et al. National ultrasound curriculum for medical students. Ultrasound Q. 2014;30(1):13–9.CrossRef Baltarowich OH, Di Salvo DN, Scoutt LM, et al. National ultrasound curriculum for medical students. Ultrasound Q. 2014;30(1):13–9.CrossRef
48.
go back to reference Dietrich CF, Hoffmann B, Abramowicz J, et al. Medical student ultrasound education: a WFUMB position paper, part I. Ultrasound Med Biol. 2019;45(2):271–81.CrossRef Dietrich CF, Hoffmann B, Abramowicz J, et al. Medical student ultrasound education: a WFUMB position paper, part I. Ultrasound Med Biol. 2019;45(2):271–81.CrossRef
50.
go back to reference Berwick DM, Nolan TW, Whittington J. The triple aim: care, health and cost. Health Affairs. 2008;27(3):759–69.CrossRef Berwick DM, Nolan TW, Whittington J. The triple aim: care, health and cost. Health Affairs. 2008;27(3):759–69.CrossRef
Metadata
Title
Patients’ experiences of the use of point-of-care ultrasound in general practice – a cross-sectional study
Authors
Camilla Aakjær Andersen
John Brodersen
Torsten Rahbek Rudbæk
Martin Bach Jensen
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-021-01459-z

Other articles of this Issue 1/2021

BMC Primary Care 1/2021 Go to the issue