Family history of Breast Cancer Audit

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Background:

Women with a family history of breast cancer have varying levels of risk of suffering from breast cancer.  UK guidance (National Institute for Health and Clinical Excellence –  http://www.nice.org.uk/CG41 ) suggests:

  • People with low risk can be managed in primary care and take action to reduce modifiable risk factors.
  • Increased surveillance is needed for people at increased risk
  • Genetic advice and intervention is required for some high risk patients


Audit tools:

This page provides information and audit tools to brand advair diskus buy online check whether your practice/group of practices is recording the relevant information and taking action to improve the management of people with a family history of breast cancer.


Approach:

We are developing an audit-based education (ABE) programme which can be used provide groups of practices feedback as to their data recording levels.

  • The first step is a baseline data collection to inform about recording of statistics levitra cialis key risk factors and if any interventions have taken place.
  • We then recommend a “Data Quality Workshop (DQW)” is held to share baseline data with all practices so that an action plan is developed to improve quality. The action plan is likely to have two elements:
    • Improving data quality and data recording
    • Meeting educational needs about managing people with a family history of breast cancer
  • A further data collection and www.polzeathcamping.co.uk feedback session – a second DQW – is held to provide further feedback.
  • There can be as many subsequent rounds of data collection and feedback as required.


Project team:

RCGP lead:            Dr. Imran Rafi
Informatics:           Prof Simon de Lusignan

Paper reporting this project:

Rafi I, Chowdhury S, Chan T, Jubber I, Tahir M, de Lusignan S. Improving the management of people with a family history of breast cancer in primary care:

before and after study of audit-based education. BMC Fam Pract. 2013 Jul 24;14:105. doi: 10.1186/1471-2296-14-105.

Medline:              http://www.ncbi.nlm.nih.gov/pubmed/23879178

Free full text:       http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734209/

                          http://www.biomedcentral.com/1471-2296/14/105

Full literature review:

Chowdhury S. Review of Lifestyle and Environmental Risk Factors for Breast Cancer:

Literature Review:    Click Here to Download 


Funding:

Macmillan Cancer Support: www.macmillan.org.uk/

Further information:

About audit-based education (ABE):
Methods Inf Med. 2007;46(1):57-62                http://www.ncbi.nlm.nih.gov/pubmed/17224982

An observational study using Audit-based education (ABE):
J Public Health (Oxf). 2006;28(4):361-9           http://www.ncbi.nlm.nih.gov/pubmed/17038329

A quality improvement trial using Audit Based Education (ABE) to improve the management of chronic kidney disease (CKD):
Kidney Int. 2013 Mar 27. doi: 10.1038/ki.2013.96. [Epub ahead of print]

                                                                  http://www.ncbi.nlm.nih.gov/pubmed/23536132

                              http://www.nature.com/ki/journal/vaop/ncurrent/full/ki201396a.html

Example of individual practiced self-audit programme in diabetes:
Diabetes self-audit tools                               https://clininf.eu/cod
Diabet Med. 2012;29(2):181-9                       http://www.ncbi.nlm.nih.gov/pubmed/21883428

Example baseline DQW presentation:

Download exemplar data presentation:               FH_Breast_Cancer_DQW_Exemplar.pdf