French guidelines for the outpatient management of Ebola virus disease: Applicability by family physicians

Abstract

Background: During the last alarming Ebola Virus Disease (EVD) outbreak, the French Ministry of Health developed guidelines for the outpatient management of EVD. We aimed to assess family physicians' (FP) knowledge of EVD, to assess their working conditions, and to collect their opinion about the applicability of these guidelines in France.

Methods: Cross-sectional quantitative study (telephone or email) performed (November 2014-June 2015) during the EVD outbreak. Relevant results were further analyzed with a qualitative study (interviews) based on grounded theory (June-September 2016), after the end of the EVD outbreak.

Results: Thirty-three FPs out of 100contacted answered our survey (response rate: 33%). We interviewed five FPs. Their knowledge of EVD was good. Information sent by post, especially from the national medical association, was considered the best means of information and was preferred to emails. Compliance with guidelines was based on their ease of understanding and application (common sense). The main difficulty in applying these guidelines was the unusual recommended equipment that seemed unnecessary as the management of these patients was based on their interview (anamnesis) and isolation without examination. EVD had little impact on the FPs' practice, they only trained their secretaries to screen for suspected EVD patients and refer them to the mobile emergency unit.

Conclusion: FPs had good knowledge of EVD and guidelines. This seemed important to prevent the outbreak in France as they were ready to cope with such a situation, thanks to guidelines they could easily adjust to their practice.

Keywords: Ambulatoire; Ebola virus disease; Guidelines; Maladie à virus Ebola; Outpatient management; Recommandations.