Multiple Screening in General Practice

Abstract

Female patients aged 15 years and over in a general practice were invited to take part in a multiple-screening programme. The procedures comprised a questionary relating to urinary symptomatology, the recording of height, weight, and blood pressure, and the results of a straight x-ray film of the chest. Breasts were palpated and a cervical smear was taken. Total viable bacterial counts were carried out on midstream urine specimens. Biochemical tests included estimation of urea, cholesterol, and P.B.I. Blood glucose was estimated by the Dextrostix method. Haematological tests included estimation of haemoglobin, P.C.V., M.C.H.C., E.S.R., and W.B.C. Of the 2,158 female patients on the practice list the patients' doctors excluded 358 from this survey. The remaining 1,800 were offered the multiple-screening examination. The acceptance rate was 43%. The most common conditions found at examination were anaemia, bacteriuria, raised blood pressure, obesity, and hyper-cholesterolaemia. Three subsidiary studies which have been undertaken as a result of this experience are an assessment of the Dextrostix method of blood glucose estimation in the setting of general practice, the use of the E.S.R. as a screening procedure, and a study of the factors associated with acceptance or nonacceptance of the offer of a health overhaul offered to patients in a general practice. In this presentation of the first results emphasis is placed on methodology. The advantages and disadvantages of carrying out this kind of exercise in the setting of general practice are discussed. The role of the nurse in accepting a major personal responsibility for a screening programme is emphasized. Areas in which further studies are required are indicated. © 1968, British Medical Journal Publishing Group. All rights reserved.