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The Use of Family History in Primary Health Care: A Qualitative Study

DOI: 10.1155/2013/695763

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Abstract:

The aim of this study is to describe how Belgian family physicians register and use the family history data of their patients in daily practice. Qualitative in-depth semistructured one-to-one interviews were conducted including 16 family physicians in Belgium. These interviews were recorded, transcribed, and analysed. Recurring themes were identified and compared with findings from the existing literature. All interviewed family physicians considered the family history as an important part of the medical records. Half of the surveyed physicians confirmed knowing the family history of at least 50% of their patients. The data on family history were mainly collected during the first consultations with the patient. The majority of physicians did not use a standardised questionnaire or form to collect and to record the family history. To estimate the impact of a family history, physicians seldom use official guidance or resources. Physicians perceived a lack of time and unreliable information provided by their patients as obstacles to collect and interpret the family history. Solutions that foster the use of family history data were identified at the level of the physician and also included the development of specific instruments integrated within the electronic medical record. 1. Introduction 1.1. Medical Genetics and Family History Medical genetics is a rapidly evolving area of medicine. Including the completion of the Human Genome Project in 2003, our knowledge about the hereditary aspect of various diseases has vastly increased. This genetic background is important not only for single-gene disorders such as cystic fibrosis, but also for multifactorial diseases such as hypertension, diabetes mellitus, cardiovascular problems, mental disorders, and various malignancies [1, 2]. For many frequently occurring multifactorial disorders, a positive family history is a known risk factor [3, 4]. A family history for a frequently occurring disorder such as diabetes, cardiovascular disease, and various cancers is associated with a relative risk that is two to five times higher than that of the general population [4–6]. A positive family history reflects an inherited genetic susceptibility and also shared common environmental factors and behaviour within the family [4, 5, 7–9]. Family history is associated with a higher risk of disease when multiple family members are affected, when the affected family members are first or second degree relatives, and when the disease occurs at a young age [4, 5]. Basic or more specific risk provisions can be used to develop specific

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