Missed opportunities for diagnosing brain tumours in primary care

This qualitative study aimed to explore patients’ experiences of symptom appraisal, help seeking, and routes to diagnosis for brain tumours. The Model of Pathways to Treatment was used as a conceptual framework to analyse interviews with 39 adult patients recently diagnosed with a primary brain tumour and their family members. Most participants had one (38%), two (23%), or more (21%) GP consultations, with only 18% presenting as an emergency without any previous consultations. It was identified that patients experienced many subtle ‘changes’ rather than symptoms, often noticed by others rather than the patient. The most common changes were in cognition, sleep and other ‘head feelings’ such as dizziness, frequently leading to loss of interest or ability to engage in daily activities. Quality of communication in GP consultations played a key role in patients’ subsequent symptom appraisal and the timing of their decision to re-consult. Being aware of these subtle and intermittent changes, and effective patient–GP communication with follow-up as safety netting, could alert GPs to more rapid investigation and referral.

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