The Acquisition and Utility of the Family Medical History in Primary Care: A Cross-Sectional StudyReport as inadecuate




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Background: Acquisition of family medical history FMH is emphasized as a part of obtaining a complete medical history, but whether FMH is consistently documented and utilized in primary care, as well as how it can affect patient care in this context, remains unclear. Thus, the objectives of this study were to determine: 1 if FMH is regularly acquired in a representative primary care practice the Queen’s Family Health Team, QFHT; 2 what is included in the FMH obtained; 3 what the utility of FMH is with regards to patient management in primary care; and 4 to utilize healthcare practitioners’ perspectives in order to elucidate any findings regarding the acquisition and utility of FMH at the QFHT. Methods: Patients were interviewed in order to obtain their FMH. For each patient, the FMH obtained was compared to the FMH documented in the patient’s record to determine the record’s completeness. Each patient’s FMH was analyzed for significant history of coronary artery disease CAD, diabetes mellitus type II DMII, substance abuse SA and colorectal cancer CRC. Participants were patients scheduled for appointments at the QFHT between May and July 2011. Any patient of the QFHT older than 25 years was eligible to participate. Clinical staff of the QFHT completed an online questionnaire to determine healthcare practitioners’ perspectives regarding the acquisition and utility of FMH. Results: 83 patients participated in the study. Participants ranged in age from 25 - 86 years median: 63 years; 69% were female. FMH present in patients’ records was often either incomplete 42% of charts reviewed or not documented at all 51% of charts reviewed. Knowledge of FMH can affect patient management in primary care for the diseases assessed CAD, DMII, SA and CRC. HCP do consider FMH to be important in clinical practice and 86% of respondents stated that they regularly inquired about patients’ FMH. Interpretation: Despite the belief by HCP that FMH is important, there is a disparity between this belief and their practices regarding its documentation and utilization. Finally, analysis of the FMH of the representative population studied shows that information commonly missing in patients’ FMH can affect patient management at a primary care level.

KEYWORDS

Family Health, Medical History Taking, Prevention, Primary Health Care, Risk Assessment

Cite this paper

Abate, A. and Hall-Barber, K. 2014 The Acquisition and Utility of the Family Medical History in Primary Care: A Cross-Sectional Study. Open Journal of Preventive Medicine, 4, 760-770. doi: 10.4236-ojpm.2014.410086.





Author: Amanda Katherine Abate, Karen Hall-Barber

Source: http://www.scirp.org/



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