Factors affecting point-of-care ultrasound implementation in general practice: a survey in Danish primary care clinics

Abstract

ObjectiveThe implementation of point-of-care ultrasound (POCUS) in general practice varies, but it is unknown what determines this variation. The purpose of this study was to explore (1) the overall proportion of POCUS-users among general practitioners (GPs), (2) the current use of POCUS by GPs, (3) factors related to the implementation of POCUS in general practice and (4) GPs’ concerns related to POCUS use in general practice.DesignAn online survey was distributed in June 2019.SettingGeneral practice.ParticipantsGPs working in office-based primary care clinics in Denmark.Main outcome measuresThe questionnaire was developed using mixed methods and included questions about participants’ characteristics, past POCUS training and experience, capability, opportunity and motivation for using POCUS in the primary care setting. Results were summarised using descriptive statistics. Association between GPs’ background characteristics and POCUS use was tested using logistics regression.ResultsResponses were analysed from 1216 questionnaires corresponding to 36.4% of all GPs in Denmark. The majority (72.3%) of participants had previous POCUS experience, 14.7% had access to a POCUS device and 11.5% used POCUS. Several factors motivated participants to use POCUS. However, barriers existed such as lack of remuneration and high workload. Additionally, many GPs questioned their ability to scan with sufficient diagnostic accuracy and the impact of POCUS on the consultation. Of non-users, 28.7% believed they would be using POCUS in the future.ConclusionAlthough, the majority of GPs had past experience with POCUS and felt motivated to use it, few had implemented POCUS. Several factors influenced the GPs’ capability, opportunity and motivation for using POCUS and several concerns were registered by non-users.

Facilitators, barriers, and changes in POCUS use: longitudinal follow-up after participation in a national point-of-care ultrasound training course in Japan

“…Point-of-care Ultrasound (POCUS) is an effective bedside diagnostic tool that has been shown to improve patient outcomes in recent years [ 1 ]. As more physicians learn about POCUS, its usage continues to expand across nearly all clinical specialties and settings, including acute care hospitals, primary care clinics, and resource-limited and rural settings [ 2 – 4 ].…”

“…Despite its potential advantages, widespread adoption of POCUS use has been slow, with reports suggesting that only about 10% of general physicians use POCUS [ 4 ]. Several studies have revealed important barriers to POCUS use [ 3 , 5 – 9 ].…”