Cancer Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, Northern Ireland.
School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
BMC Fam Pract. 2019 May 14;20(1):61. doi: 10.1186/s12875-019-0944-5.
While multiple myeloma (MM) is a rare diagnosis within primary care, its precursor MGUS (monoclonal gammopathy of undetermined significance) is more common, particularly among older populations. Upon first detection, the majority of MGUS patients will be under the care of their General Practitioner (GP)/Family Doctor who is also often the first healthcare professional that patients report symptoms of progression to. However, our previous work with MGUS patients and haematology healthcare professionals has suggested that knowledge and awareness of MGUS is low among GPs.
An online survey was undertaken to investigate knowledge and awareness of MGUS and services needed by GPs/GP trainees to support these patients. The survey was promoted at a large European primary care conference and via social media. Descriptive statistics were utilised to compare participant responses.
In total 58 GPs (n = 35 GPs and n = 23 GP trainees) from 24 countries responded. Overall, self-reported familiarity with the term MGUS was low (mean score: 2.21/5, standard deviation (SD): 1.09), but higher among GPs who reported having at least one MGUS patient (mean score: 2.83/5, SD 0.99). The majority (88.2%) of GPs/GP trainees stated they would feel uncomfortable discussing MGUS with patients. The increased risk of haematological malignancies was identified by 62.1% of GPs/GP trainees with MM, lymphoma and myelodysplastic syndromes the most commonly reported cancers associated with MGUS. The majority (81.6%) of GPs/GP trainees were supportive of patient follow-up via telephone clinics (phlebotomy performed in GP practice with patient management maintained by haematology) but only 27.1% stated they would be happy to solely manage all low/low-intermediate risk MGUS patients. A laboratory report alerting to the possibility of MGUS or a haematological malignancy was reported as the most useful service which could be implemented to help GPs manage MGUS patients. The need for MGUS focused information and education resources for GPs was also highlighted.
The findings of this study highlight a lack of knowledge and awareness of MGUS among GPs/ GP trainees. The majority of GPs/GP trainees are happy to support haematology in managing these patients but require assistance and support in providing these services.
多发性骨髓瘤（MM）在初级保健中是一种罕见的诊断，但它的前体单克隆丙种球蛋白病（MGUS）更为常见，尤其是在老年人群中。在首次发现时，大多数 MGUS 患者将由他们的全科医生（GP）/家庭医生负责，全科医生也是患者病情进展时首先报告症状的医疗保健专业人员。然而，我们之前对 MGUS 患者和血液学医疗保健专业人员的工作表明，全科医生对 MGUS 的了解和认识程度较低。
我们进行了一项在线调查，以调查全科医生/全科医生培训生对 MGUS 的知识和认识，以及支持这些患者所需的服务。该调查在一次大型欧洲初级保健会议上以及通过社交媒体进行推广。利用描述性统计方法比较参与者的反应。
共有来自 24 个国家的 58 名全科医生（n=35 名全科医生和 n=23 名全科医生培训生）做出了回应。总体而言，他们对术语 MGUS 的自我报告熟悉程度较低（平均得分为 2.21/5，标准差（SD）：1.09），但在报告至少有一名 MGUS 患者的全科医生中得分较高（平均得分为 2.83/5，SD0.99）。大多数（88.2%）全科医生/全科医生培训生表示，他们在与患者讨论 MGUS 时会感到不舒服。62.1%的全科医生/全科医生培训生认为 MM、淋巴瘤和骨髓增生异常综合征是与 MGUS 最常相关的癌症，增加了发生血液系统恶性肿瘤的风险。大多数（81.6%）全科医生/全科医生培训生支持通过电话诊所进行患者随访（在全科医生诊所进行采血，由血液科管理患者），但只有 27.1%的人表示愿意仅管理所有低/低中度风险 MGUS 患者。报告称，实验室报告提示 MGUS 或血液系统恶性肿瘤的可能性是帮助全科医生管理 MGUS 患者的最有用的服务之一。还强调了需要为全科医生提供专门针对 MGUS 的信息和教育资源。
本研究结果表明，全科医生/全科医生培训生对 MGUS 的了解和认识程度较低。大多数全科医生/全科医生培训生愿意支持血液科管理这些患者，但在提供这些服务时需要帮助和支持。
