Do family physicans, emergency physicians and paediatricians give consistent sport-related concussion management advice?

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Abstract

Objective

To identify differences and gaps in the recommendations to patients for the management of sport-related concussion among family physicians (FPs), emergency physicians (ERs) and paediatricians (Peds).

Design

A self-administered multiple-choice survey, which had been validated for content validity.

Setting

Toronto East General Hospital and Markham Stouffville Hospital, both in Ontario, Canada.

Subjects

270 physicians were invited to participate; 104 surveys were completed (39%).

Intervention

The survey link was emailed to FPs, ERs and Peds from the above hospitals. Data were analysed using SPSS. Frequencies and percentages were calculated with cross-tabulation of data by specialty.

Outcome Measures

Key survey questions identified sources of concussion management information, usefulness of concussion diagnosis strategies, and whether physicians use common terminology when explaining cognitive rest strategies to patients after a sport-related concussion.

Results

For making a diagnosis of concussion, 54% of FPs, 86% of ERs and 78% of Peds never used the SCAT2; 49% of FPs, 57% of ERs and 36% of Peds always advised cognitive rest, the mainstay of early management for post-concussion symptoms; 65% of FPs, 71% of ERs and 55% of Peds always advised physical rest; and 49% of FPs, 52% of ERs and 27% of Peds reported no knowledge of any consensus statements on concussion in sport.

Conclusions

We identified large gaps in the implementation of recommendations for sport-related concussion patients. Although some physicians are recommending physical and cognitive rest, a large proportion fail to consistently advise this strategy. Better knowledge translation efforts should target all three groups of physicians.

Acknowledgements

Thank you to Babak Aliarzadeh for the statistical analysis. Special thanks go to Paul Krueger, Leigh Hayden and the other 18 participants in the validation of our survey.

Competing interests

None.

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