Safety-netting Advice in Out-of-Hours Primary Care
Author Information
Author(s): Peter J Edwards, Samuel Finnikin, Fay Wilson, Ian Bennett-Britton, Andrew Carson-Stevens, Rebecca K Barnes, Rupert A Payne
Primary Institution: University of Bristol
Hypothesis
How frequently is safety-netting advice documented in out-of-hours primary care?
Conclusion
The frequency of safety-netting advice documented in out-of-hours primary care was higher than previously reported during in-hours care.
Supporting Evidence
- The overall frequency of safety-netting advice was 78.0% per consultation.
- SNA was more frequently documented in face-to-face encounters compared to telephone consultations.
- Consultations for possible infections had a higher frequency of documented SNA.
- Only one in five consultations included a timeframe for reconsulting for persistent symptoms.
- Documentation of SNA increased from 75.7% in 2014 to 81.5% in 2019.
Takeaway
Doctors are telling patients more often what to watch for when they are sick, especially in face-to-face visits, but they still need to improve on giving specific advice for mental health issues.
Methodology
A retrospective cohort study using a stratified sample of 30 adult consultation records per month from July 2013 to February 2020, assessed with a safety-netting coding tool.
Potential Biases
All clinicians were from the same out-of-hours organization, which may limit the generalizability of the findings.
Limitations
The study only evaluated documented safety-netting advice, which may not fully represent verbalized advice given during consultations.
Participant Demographics
62.9% female, mean age 57.8 years, 37.3% from very deprived backgrounds.
Statistical Information
P-Value
0.02
Confidence Interval
1.09 to 2.85
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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