Primary care clinical provider knowledge and experiences in the diagnosis and treatment of tick-borne illness: a qualitative assessment from a Lyme disease endemic community

Abstract

Background Primary care and frontline healthcare providers are often the first point of contact for patients experiencing tick-borne disease (TBD) but face challenges when recognizing and diagnosing these diseases. The specific aim of this study was to gain a qualitative understanding of frontline and primary care providers’ knowledge and practices for identifying TBDs in patients. Methods From fall 2018 to spring 2019, three focus groups were conducted with primary care providers practicing in a small-town community endemic to Lyme disease (LD) and with emerging incidence of additional TBDs. A follow up online survey was distributed to urgent and emergency care providers in the small-town community and an academic medical center within the referral network of the local clinical community in spring and summer 2019. Qualitative analysis of focus group data was performed following a grounded theory approach and survey responses were analyzed through the calculation of descriptive statistics. Results Fourteen clinicians from three primary care practices participated in focus groups, and 24 urgent and emergency care clinicians completed the survey questionnaire. Four overarching themes emerged from focus group data which were corroborated by survey data. Themes highlighted a moderate level of awareness on diagnosis and treatment of LD among participants and limited knowledge of diagnosis and treatment for two other regionally relevant TBDs, anaplasmosis and babesiosis. Providers described challenges and frustrations in counseling patients with strong preconceptions of LD diagnosis and treatment in the context of chronic infection. Providers desired additional point-of-care resources to facilitate patient education and correct misinformation on the diagnosis and treatment of TBDs. Conclusions Through this small study, it appears that clinicians in the small-town and academic medical center settings are experiencing uncertainties related to TBD recognition, diagnosis, and patient communication. These findings can inform the development of point-of-care resources to aid in patient-provider communication regarding TBDs and inform the development of continuing medical education programs for frontline and primary care providers.

Knowledge, attitudes, and practices of Illinois medical professionals related to ticks and tick-borne disease

“…In this survey most respondents were knowledgeable about Lyme disease. These results are consistent with findings in other states where Lyme is endemic [ 20 , 21 , 33 , 34 ]. While physicians were generally familiar with diagnostic testing for RMSF and ehrlichiosis, most did not believe either disease to be endemic to Illinois.…”

Evaluating spatial and temporal patterns of tick encounters using community science data submitted through a smartphone application

“…Furthermore, while several papers remark on the importance of community science tick surveillance in addressing data gaps, we find it to be imperative given the current socio-scientific context in the United States. Specifically, there is a landscape of unfamiliarity, misconception, and contentiousness surrounding ticks and tick-borne disease information (situated within sentiments towards public health and scientific institutions more broadly) (Beck et al, 2022;Hook et al, 2015;Mattoon et al, 2021). For example, Kopsco et al, found that some survey respondents are more likely to trust non-traditional sources of tick-borne disease prevention information (e.g., online forums) compared to established public health sources (e.g., the Centers for Disease Control and Prevention) (Kopsco et al, 2022).…”