A cross-sectional study reporting concussion exposure, assessment and management in Western Australian general practice

Abstract

Background General Practitioners (GPs) may be called upon to assess patients who have sustained a concussion despite limited information being available at this assessment. Information relating to how concussion is actually being assessed and managed in General Practice is scarce. This study aimed to identify characteristics of current Western Australian (WA) GP exposure to patients with concussion, factors associated with GPs’ knowledge of concussion, confidence of GPs in diagnosing and managing patients with concussion, typical referral practices and familiarity of GPs with guidelines. Methods In this cross-sectional study, GPs in WA were recruited via the RACGP WA newsletter and shareGP and the consented GPs completed an electronic survey. Associations were performed using Chi-squared tests or Fisher’s Exact test. Results Sixty-six GPs in WA responded to the survey (response rate = 1.7%). Demographics, usual practice, knowledge, confidence, identification of prolonged recovery as well as guideline and resource awareness of GPs who practised in regional and metropolitan areas were comparable (p > 0.05). Characteristics of GPs were similar between those who identified all symptoms of concussion and distractors correctly and those who did not (p > 0.05). However, 84% of the respondents who had never heard of concussion guidelines were less likely to answer all symptoms and distractors correctly (p = 0.039). Whilst 78% of the GPs who were confident in their diagnoses had heard of guidelines (p = 0.029), confidence in managing concussion was not significantly associated with GPs exposure to guidelines. It should be noted that none of the respondents correctly identified signs of concussion and excluded the distractors. Conclusions Knowledge surrounding concussion guidelines, diagnosis and management varied across GPs in WA. Promotion of available concussion guidelines may assist GPs who lack confidence in making a diagnosis. The lack of association between GPs exposure to guidelines and confidence managing concussion highlights that concussion management may be an area where GPs could benefit from additional education and support.

Healthcare choices following mild traumatic brain injury in Australia

“…Information such as this would assist healthcare providers in planning for the provision of appropriate healthcare resources, as well as the need for more specialised services such as ‘concussion clinics’. Given that a large proportion of respondents in this study attended hospital ED’s and primary care physicians (GP’s) it is also important to ensure that practitioners in these healthcare environments have the relevant skills, resources and confidence in assessing and managing mTBI [ 39 , 40 ].…”

A supported primary health pathway for mild traumatic brain injury quality improvement report

“…A challenge for health professionals in primary care is confidence in how to support a person's recovery. 7,8 This is particularly the case as 40% of GPs see <5 mTBIs per year. 7 International mTBI guidelines recommend that patients should be followed up routinely by a medical professional to check if the patient has recovered or not.…”

Awareness and understanding of concussion among Aboriginal Australians with high health literacy

“…This study investigates awareness and understanding of concussion and the factors that may impact presentation for assessment after a potential concussion injury among Indigenous Australians with high health literacy (background in healthcare or first response) living in Perth, Western Australia. Although it is assumed that persons with a background in healthcare or first response will have undertaken concussion-related training, literature reports health professionals are not adequately educated nor confident in concussion diagnosis or management [ 17 ]. Findings from this study will provide information to inform future work looking to improve concussion education and presentation rates for concussion assessment and management in Indigenous Australians.…”