A recent review revealed that few family health questionnaires (FHQs) have been formally evaluated and that there were no-simple, short-generic FHQs suitable for use in primary care practice ( Citation9). A family history tool should collect more data than a simple question (‘Does disease X run in your family?’) yet practically, it cannot be as comprehensive as a complete pedigree-interview. Tools overcoming these barriers might help family physicians in adequate family history taking. We confirmed the findings of the review by Rich et al., that lack of time, limited knowledge and skills and poor reimbursement are experienced as barriers to family history taking in primary care ( Citation2, Citation8). However, observational studies of consultations and analyses of medical records showed wide variability and a low degree of regular updating ( Citation8). In a previous systematic review our group has shown that family physicians consider taking a family history to be their responsibility. Higher family risk may lead to customized interventions and the improvement of patient's motivation to change their behaviour ( Citation5–7). The collection of family history data may also be used in risk-assessment for the prevention of common chronic diseases such as cardiovascular disease. Traditionally, information on family health is mainly used for diagnostic objectives, referral to specialist care and insight into family dynamics ( Citation4). In primary care, family history is an inexpensive, non-invasive aid for diagnosis and risk-assessment in medical genetics ( Citation2, Citation3).
The family history reflects genetic, environmental and behavioural aspects of family health ( Citation1). Use of a family history tool improved identification of patients at risk for disease.Ĭonclusion: Several promising family history tools for primary care have been developed but large-scale implementation cannot be advised yet, based on available validation studies. No family history tool allows electronic transfer of family history information to electronic medical record systems. Of the five specific tools studied in primary care, none was validated.
#Family care medicine panzarella plus#
The six generic tools were partly tested in primary care (3x), are mainly computerized (4x), rarely include management recommendations for the physician (1x) and were partly validated against a reference standard (genetic counsellor) (3x, plus one planned). Results: Eighteen family history tools were identified: six generic, two on cardiovascular disease and ten on cancer. We reviewed diseases for which family history information was collected, study setting, tool design, type of family history collection, presence of risk-assessment and recommendations for management, and assessment (categorized as either validity or benefit). All authors independently screened studies and included original research papers on family history tools of which assessment had been performed or was planned. Methods: Studies were identified through searches of PubMed, Embase and Cinahl from 1 January 2002 until May 2012. Objective: To review systematically the characteristics of existing family history tools and discuss their potential use in primary care. Tools overcoming these barriers might support family physicians in this task. However, significant barriers to obtaining adequate family history information remain. Background: Taking the family history helps the doctor in estimating the probability of disease in individual patients.
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