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

OBJECTIVE: To investigate the use of canalith repositioning manoeuvres and vestibular rehabilitation (VR) by GPs and to assess reasons for not using these techniques in patients with vertigo. DESIGN: Online survey. SETTING: GPs in the western and central part of the Netherlands. SUBJECTS AND METHOD: Of GPs, 1169 were approached to participate in the survey. A sample of 426 GPs filled out the questionnaire (36.4% response rate). The 22-item questionnaire contained both multiple choice and free-text questions on the Epley manoeuvre, the Brandt-Daroff exercises and VR. Results of the survey were descriptively analyzed. MAIN OUTCOME MEASURES: The use of the Epley manoeuvre, the Brandt-Daroff exercises and VR by GPs; reasons that deter GPs from using these techniques. RESULTS: The repositioning manoeuvres (Epley manoeuvre and Brandt-Daroff exercises) were used by approximately half of all GPs (57.3 and 50.2%), while only a small group of GPs applied VR (6.8%). The most important reason for GPs not to use the Epley manoeuvre, Brandt-Daroff exercises and VR was that they did not know how to perform the technique (49.5, 89.6 and 92.4%). CONCLUSIONS: Despite the proven effectiveness, repositioning manoeuvres and VR are remarkably underused by Dutch GPs. Not knowing how to perform the technique is the most important reason for GPs not to use these techniques. Efforts should be made to increase the knowledge and skills of GPs regarding canalith repositioning manoeuvres and VR. KEY POINTS: Dizziness is a common symptom with limited therapeutic options. Canalith repositioning manoeuvres and vestibular rehabilitation represent the best treatment options currently available for vertigo. Canalith repositioning manoeuvres and vestibular rehabilitation are still widely underused by GPs. The most important reason for GPs not to use these techniques is that they do not know how to perform them. Efforts should be made to increase the knowledge and skills of GPs regarding canalith repositioning manoeuvres and vestibular rehabilitation.