General Practice Registrars' Management of and Specialist Referral Patterns for Atopic Dermatitis.

Autor:	Willems A; Eastern Victoria GP Training, General Practice Training Organisation, Melbourne, VIC, Australia.; The University of Melbourne, Department of General Practice, Melbourne, VIC, Australia., Tapley A; The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, Australia.; GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Newcastle, NSW, Australia., Fielding A; The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, Australia.; GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Newcastle, NSW, Australia., Tng V; Department of Dermatology, John Hunter Hospital, Newcastle, NSW, Australia., Holliday EG; The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, Australia., van Driel ML; The University of Queensland Faculty of Medicine, Primary Care Clinical Unit, Brisbane, QLD, Australia., Ball JI; Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton, NSW, Australia., Davey AR; The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, Australia.; GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Newcastle, NSW, Australia., FitzGerald K; University of Tasmania, School of Medicine, Hobart, TAS, Australia.; General Practice Training Tasmania (GPTT), Regional Training Organisation, Hobart, TAS, Australia., Spike NA; Eastern Victoria GP Training, General Practice Training Organisation, Melbourne, VIC, Australia.; The University of Melbourne, Department of General Practice, Melbourne, VIC, Australia., Magin PJ; The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, Australia.; GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Newcastle, NSW, Australia.
Jazyk:	angličtina
Zdroj:	Dermatology practical & conceptual [Dermatol Pract Concept] 2021 Jan 29; Vol. 11 (1), pp. e2021118. Date of Electronic Publication: 2021 Jan 29 (Print Publication: 2021).
DOI:	10.5826/dpc.1101a118
Abstrakt:	Background: Atopic dermatitis (AD) is a common presentation in the general practice (GP) setting. Implementation of appropriate referral pathways is instrumental for best patient care and is an essential skill for Australian GP registrars. Objectives: We aimed to explore the prevalence and associations of GP registrar referrals to specialists for AD management. Methods: A cross-sectional analysis utilizing data from the Registrar Clinical Encounters in Training (ReCEnT) project, an ongoing cohort study that documents in-consultation clinical and educational experience of Australian GP registrars. Registrar, patient, and consultation factors associated with referrals for AD were established using logistic regression. Results: A total of 2,783 registrars (96% response rate) provided data from 381,180 consultations from 2010 to 2019. A total of 3,285 (0.55%) of 595,412 diagnoses managed were AD, of which 222 (6.8%) resulted in referral. Of these referrals, 70% were to dermatologists, 17% to allergists/immunologists, and 10% to pediatricians. Associations of referral included registrar female gender, patient age, longer consultation duration; an established (rather than new) AD diagnosis; supervisor advice being sought; and learning goals being generated. Conclusions: Both registrar and patient factors influence AD referral patterns. Registrars referred established rather than newly diagnosed AD, suggesting a level of comfort in initial management. Referral was associated with longer consultations, seeking supervisor advice, and generation of learning goals-suggesting these are more complex presentations and, possibly, registrar learning opportunities. A significant proportion of referrals were to non-dermatologist specialists. The implication of this for optimal patient care is a subject for further study. Competing Interests: Competing interests: The authors have no conflicts of interest to disclose. (©2021 Willems et al.)
Databáze:	MEDLINE
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