Haastrup Peter, Søndergaard Jens, Bjørsum-Meyer Thomas, Schelde-Olesen Benedicte, Baatrup Gunnar
Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Department of Surgery, Odense University Hospital, Odense, Denmark.
BMC Prim Care. 2025 May 14;26(1):159. doi: 10.1186/s12875-025-02864-4.
Bowel symptoms are common in general practice and though most often benign they can also indicate colorectal cancer where a colonoscopy often is required to rule out malignant disease. Colon capsule endoscopy (CCE) is suggested as a more patient-friendly alternative to colonoscopy but its application in symptomatic patients in general practice needs further investigation.
We present a feasibility study of integrating initial triage for CCE into general practice. The technical success of CCE, patient acceptance, and the experiences of general practitioners (GPs) are assessed through qualitative interviews with participating GPs.
We were able to recruit some general practices from the area of interest, but inclusion of patients was low. The participating GPs welcomed the concept of CCE as a more patient-friendly procedure and most patients invited by the GP accepted inclusion. Difficulties remembering the project in the diverse everyday of general practice, GP shortage and general time restraints were reported as barriers for patient recruitment by the GPs.
Before conducting large-scale implementation studies of CCE, our investigation highlighted critical barriers that need addressing: (1) Time Constraints and GP Shortages: The design of task divisions between sectors should carefully consider time limitations and the scarcity of GPs. (2) Low reinvestigation rates: Minimizing reinvestigation rates is crucial to reduce strain on both patients and healthcare systems.
肠道症状在全科医疗中很常见，虽然大多数情况下是良性的，但也可能提示需要进行结肠镜检查以排除恶性疾病的结直肠癌。结肠胶囊内镜检查（CCE）被认为是一种比结肠镜检查对患者更友好的替代方法，但其在全科医疗中有症状患者中的应用需要进一步研究。
我们展示了一项将CCE初始分诊纳入全科医疗的可行性研究。通过对参与的全科医生进行定性访谈，评估CCE的技术成功率、患者接受度以及全科医生（GP）的经验。
我们能够从感兴趣的地区招募一些全科医疗机构，但患者纳入率较低。参与的全科医生欢迎CCE作为一种对患者更友好的检查方法的概念，并且大多数被全科医生邀请的患者接受了纳入。全科医生报告说，在全科医疗的日常工作中难以记住该项目、全科医生短缺以及普遍的时间限制是患者招募的障碍。
在对CCE进行大规模实施研究之前，我们的调查突出了需要解决的关键障碍：（1）时间限制和全科医生短缺：部门间任务分工的设计应仔细考虑时间限制和全科医生的稀缺性。（2）低复查率：将复查率降至最低对于减轻患者和医疗系统的负担至关重要。
