The one-stop dyspepsia clinic--an alternative to open-access endoscopy for patients with dyspepsia
Autor: | A F Michie, M D Rutter, Peter Trewby |
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Jazyk: | angličtina |
Rok vydání: | 1998 |
Předmět: |
medicine.medical_specialty
Outpatient Clinics Hospital Endoscopy Gastrointestinal Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Outcome Assessment Health Care Medicine Upper gastrointestinal Humans 030212 general & internal medicine Medical diagnosis Dyspepsia Laparoscopy Referral and Consultation Medical Audit Surgical approach medicine.diagnostic_test business.industry General surgery Attendance General Medicine 030227 psychiatry Surgery Endoscopy Duodenal ulcer Additional diagnoses business Family Practice Research Article |
Popis: | The most sensitive investigative tool for the upper gastrointestinal tract is endoscopy, and many gastroenterologists offer an open-access endoscopy service to general practitioners. However, for patients with dyspepsia, endoscopy is not always the most appropriate initial investigation, and the one-stop dyspepsia clinic allows for different approaches. We have audited, over one year, the management and outcomes of patients attending a one-stop dyspepsia clinic. All patients seen in the clinic were included, and for those not endoscoped the notes were reviewed one year after the end of the study to check for reattendances and diagnoses originally missed. Patients' and general practitioners' views of the service were assessed by questionnaire. 485 patients were seen, of whom 301 (62%) were endoscoped at first attendance. In 66 patients (14%), endoscopy was deemed inappropriate and only one of these returned subsequently for endoscopy. 118 patients (24%) were symptom-free when seen in the clinic and were asked to telephone for an appointment if and when symptoms recurred; half of these returned and were endoscoped. Oesophagitis and duodenal ulcer were significantly more common in this ‘telephone endoscopy' group than in those endoscoped straight from the clinic. Overall, 25% of patients referred were not endoscoped. Important additional diagnoses were made from the clinic consultation. General practitioners and patients valued the system, in particular the telephone endoscopy service. 84% of general practitioners said they would prefer the one-stop dyspepsia clinic to open-access endoscopy. |
Databáze: | OpenAIRE |
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