Missed opportunities for diagnosing brain tumours in primary care

  • Walter FM & al.
  • Br J Gen Pract
  • 11 Mar 2019

  • curated by Dawn O'Shea
  • UK Medical News
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New research published in the British Journal of General Practice suggests opportunities for the early diagnosis of brain tumours are being missed in primary care.

The qualitative study, set in the East and North West of England, is based on in-depth interviews with 39 adult patients recently diagnosed with a primary brain tumour and their family members. The information was analysed thematically, using the Model of Pathways to Treatment as a conceptual framework.

The researchers found that, although some patients present with headaches or major seizures, most experience subtle, intermittent and multiple changes in their cognitive functioning, sleep and other ‘head feelings’ for many months, suggesting possible missed diagnostic opportunities.

Few participants (18%) presented as an emergency without having had a previous GP consultation, with most patients having had 1 consultation (38%) but others having 2 (23%) or more (21%) GP consultations.

Participants experienced multiple subtle ‘changes’ rather than ‘symptoms’, often noticed by others rather than the patient, which frequently led to loss of interest or less ability to engage with daily living activities.

The most common changes were in cognition (speaking, writing, comprehension, memory, concentration and multitasking), sleep and other ‘head feelings’ such as dizziness.

Quality of communication in GP consultations played a key role in patients’ subsequent symptom appraisal and the timing of their decision to re-consult.

The authors say being aware of these subtle and intermittent changes or symptoms combined with effective patient-GP communication and follow-up, “could alert GPs to more rapid investigation and referral, and possibly reduce development of the significant and major symptoms associated with brain tumours.”