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Alamri, Alsulami, and Al-zahrani: Haematuria assessment among primary health care providers in Eastern Province of Saudi Arabia

Introduction: Haematuria is a serious and alarming symptom and may indicate significant underlying urological disease.

Objectives: To assess current primary health care provider (PHCP) practice in management of patients with haematuria.

Materials and methods: A written questionnaire was distributed to PHCPs. The questionnaire consisted of clinical scenarios of patients with either microscopic or gross haematuria with multiple option management. PHCPs included family physicians, general practitioners and emergency physicians. Continuous variables were analysed using t-test. Categorical variables were analysed using the chi-squared test. The study was approved by the local institution ethics committee.

Results: Out of 258 questionnaires, 184 were included in the analysis. The study period was from October to February 2014. PHCPs were asked about elderly women with persistent microscopic haematuria and only 30.1% recommended further evaluation by a urologist while 54.1% recommended assuring the patient without any further measures. In patients with gross haematuria, 44.8% of PHCPs recommended referring the patient to the urologist but only 7.1% of PHCPs would follow the patient after 6 months. The majority of PHCPs preferred to evaluate patients with haematuria with either abdominal radiography (61.2%) or ultrasound (57%).

Conclusions: Haematuria should be thoroughly evaluated by PHCPs. The referral pattern of haematuria patients to urology is suboptimal. In our study, there was a tendency for overlooking patients with significant haematuria and inappropriate use of imaging modalities. Therefore, awareness and education should be implemented among PHCPs in relation to haematuria patients.




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