Palpitation referrals from primary care to a secondary care cardiology outpatient clinic: assessing adherence to guidelines
| Autor: | Roshan Patel, Zakariyya Vali, Susil Pallikadavath, Talal Ahmad, Rishi Sarania, Ngianga Ii Kandala, Alastair Sandilands |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Referral Cardiology Audit Ambulatory Care Facilities Secondary Care Secondary care 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Internal medicine medicine Palpitations Outpatient clinic Humans 030212 general & internal medicine Referral and Consultation medicine.diagnostic_test Primary Health Care business.industry Guideline Confidence interval 030221 ophthalmology & optometry Guideline Adherence medicine.symptom Family Practice business |
| Zdroj: | Family practice. 38(2) |
| ISSN: | 1460-2229 |
| Popis: | Background and aims Palpitations are a common presentation in primary care. Guidelines have been developed to identify patients with palpitations who require further assessment by a cardiologist in secondary care. However, patients that do not meet guideline thresholds for referrals are still referred to secondary care services. This audit evaluated the adherence to referral guidelines at our trust and assessed the characteristics of patients who were referred appropriately versus those referred without meeting guideline referral thresholds (inappropriate referral). Results Palpitation referrals to a single cardiology outpatient clinic were assessed (n = 66). Half the patients referred for palpitations were referred inappropriately (n = 34, 51.5%). Patients referred inappropriately were more likely to have a benign diagnosis after assessment (91.2%). These patients also had significantly fewer investigations [mean difference of 1.1 (confidence interval: 0.6–1.6)]. Specialist investigations, such as cardiac event recorders (P < 0.05) and cardiac magnetic resonance imaging (P < 0.05) were less likely to be used in inappropriately referred patients. Conclusions The results from this audit provide early evidence that there are a significant number of patients who are being referred that could be managed in primary care. Further studies are needed to confirm our findings in larger cohorts and to establish the underlying reasons for inappropriate referrals. |
| Databáze: | OpenAIRE |
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