Needs and supporting tools for primary care physicians to improve care of patients with vertigo and dizziness: a national survey

Frontiers in Neurology

Neurology

Dierik Heg¹  Hassen Kerkeni²  Roger Kalla²  Athanasia Korda³  Georgios Mantokoudis³  Claudia Candreia⁴  Antje Welge-Lüssen⁵  Andreas Zwergal⁶  Alexander Andrea Tarnutzer⁷  Suzie Diener⁸ 

[1] CTU Bern, University of Bern, Bern, Switzerland;Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland;Department of Otorhinolaryngology, Head and Neck Surgery, Bern University Hospital, University of Bern, Bern, Switzerland;Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland;Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Basel, Basel, Switzerland;German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, Munich, Germany;Department of Neurology, LMU University Hospital, Munich, Germany;Neurology, Cantonal Hospital of Baden, Baden, Switzerland;Faculty of Medicine, University of Zurich, Zurich, Switzerland;Practice Neurology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland;

关键词: vertigo;    dizziness;    survey;    challenges;    limitations;    education;   

DOI  :  10.3389/fneur.2023.1254105

 received in 2023-07-06, accepted in 2023-08-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe diagnostic workup and treatment decisions for vertigo or dizziness in primary care can be challenging due to the broad range of possible causes and limited time and expertise of physicians. This can lead to delays in treatment and unnecessary tests. We aimed to identify the unmet needs of primary care physicians (PCPs) and strategies to improve care for dizzy patients.Materials and methodsAn online survey was conducted among board-certified PCPs in Switzerland to explore needs in caring for dizzy patients and potential educational approaches.ResultsBased on responses from 152 participating PCPs, satisfaction and confidence were higher in diagnosing (82%) and treating (76%) acute dizziness compared to episodic/chronic cases (63 and 59%, respectively). Younger PCPs had lower diagnostic yield and confidence. Areas for improvement in specialist interactions included communication between physicians (23%/36%; always/often true), shorter waiting times for consultations (19%/40%), more detailed feedback (36%/35%), and consistent patient back referrals (31%/30%). PCPs expressed interest in hands-on courses, workshops, practical guidelines, web-based algorithms, and digital tools such as printed dizzy diaries and apps for follow-up.ConclusionEnhanced dialog between PCPs and specialists is crucial to address the most common unmet needs. Reducing waiting times for referrals and providing clear instructions to specialists for triage are essential. The findings from this survey will guide the development of tools to improve the diagnosis and treatment of dizzy patients. Younger PCPs, who face higher diagnostic uncertainty, should be prioritized for educational approaches such as hands-on courses, workshops, and practical recommendations.

【 授权许可】

Unknown   
Copyright © 2023 Mantokoudis, Zwergal, Heg, Kerkeni, Diener, Kalla, Korda, Candreia, Welge-Lüssen and Tarnutzer.