Use of canalith repositioning manoeuvres and vestibular rehabilitation: a GP survey

Figures & data

Table 1. Characteristics of responding GPs, N = 426.

Characteristic	N = 426	N (%)
Sex	Female	241 (56.6)
	Male	185 (43.4)
Age category (years)	<35	63 (14.8)
	35–45	139 (32.6)
	46–55	120 (28.2)
	>55	104 (24.4)
GP trainer	Yes	252 (59.2)
	No	174 (40.8)
Work experience (years)	0–5	130 (30.5)
	6–10	63 (14.8)
	11–15	56 (13.1)
	16–20	60 (14.1)
	21–25	35 (8.2)
	26–30	43 (10.1)
	>30	39 (9.2)

Table 2. Use of the Epley manoeuvre, Brandt-Daroff exercises and VR by responding GPs.

	Total populationof GPs (N = 426)	GP trainer (N = 252)	Non-trainer (N = 174)	p Value
Epley manoeuvre, %	57.3	62.7	49.4	0.006^a
Brandt-Daroff exercises, %	50.2	48.4	52.9	0.365
VR, %	6.8	9.1	3.4	0.022^a

^a Significant difference in use between GP trainers and non-trainers (p < 0.05).

Table 3. GPs using vestibular treatment: medical indications, form of treatment and referral strategy.

Treatment modalities	Epley manoeuvre(N = 244 users)	Brandt-Daroff exercises(N = 214 users)	VR (N = 29 users)
Medical indication
Patients with Ménière’s disease, %	2.9	2.8	6.9
Patients with benign paroxysmal positional vertigo, %	97.5	97.2	82.8
Patients with vestibular neuronitis, %	17.2	17.3	41.4
Patients with chronic dizziness, %	10.7	16.8	41.4
Patients with dizziness of unknown origin, %	33.6	25.2	41.4
Elderly patients (>65 years) with vestibular dizziness, %	22.5	21.0	58.6
Treatment without referral, N (%)	181 (74.2%)	191 (89.3%)	19 (65.5%)
Form of treatment
I perform the treatment myself, %	82.3	24.1	15.8
I give the patient oral instructions during the consultation, %	54.1	74.9	73.7
I provide the patient with written instructions, %	30.4	41.4	57.9
I provide the patient with the name of a website which explains how to perform the treatment, %	16.6	21.5	10.5
Other, %	9.4	8.4	5.3
Referral for treatment, N (%)	63 (25.8%)	23 (10.7%)	10 (34.5%)
Choice of referral
Physical therapist, %	85.7	95.6	80.0
Neurologist, %	9.5	0.0	10.0
ENT-doctor, %	15.9	4.3	10.0
Specialized clinic for dizziness, %	0.0	0.0	0.0
Other, %	14.3	21.7	40.0

Table 4. GPs’ reasons for not using vestibular treatment.

Treatment modalities	Epley manoeuvre(N = 182 nonusers)	Brandt-Daroff exercises(N = 212 nonusers)	VR (N = 397non-users)
Reasons not to use the treatment
This takes too much time, %	19.2	4.2	7.1
I do not know how to perform the treatment, %	49.5	89.6	92.4
I am not convinced by the effectiveness of this treatment, %	29.7	11.8	6.3
Our national guidelines do not recommend the treatment, %	11.5	6.1	4.5
This treatment does not belong in primary care, %	0.0	0.0	0.8
Other, %	31.3	8.0	4.0