Referral Guidelines in General Practice
Author Information
Author(s): Moyez Jiwa, Paul Skinner, Akinoso Olujimi Coker, Lindsey Shaw, Michael J Campbell, Joanne Thompson
Primary Institution: Curtin University of Technology
Hypothesis
Can the introduction of an electronic interactive referral pro forma or educational outreach visits by a colorectal surgeon alter the case mix of patients referred to lower bowel specialists?
Conclusion
The study found no evidence that either intervention increased the proportion of patients with significant pathology among those referred.
Supporting Evidence
- 14% of patients in the software arms had significant pathology compared to 19% in the non-software arms.
- Educational outreach did not improve the quality of referral letters.
- Only 18.1% of referrals in the software arm were processed using the software.
Takeaway
The study tried to help doctors make better referrals for bowel problems, but it didn't really work as planned.
Methodology
A cluster randomised factorial trial involving 44 general practices in North Trent, UK, comparing the effects of an electronic referral pro forma and educational outreach visits.
Potential Biases
Potential bias due to the self-reported nature of the data and the limited participation of practices.
Limitations
Limited uptake of the interventions and inability to confirm their effectiveness due to low engagement from practitioners.
Participant Demographics
180 general practitioners serving 265,707 patients.
Statistical Information
P-Value
0.18
Confidence Interval
0.46 to 1.15
Statistical Significance
p = 0.18
Digital Object Identifier (DOI)
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