Willems, A and Tapley, A and Fielding, A and Tng, V and Holliday, EG and van Driel, ML and Ball, JI and Davey, AR and FitzGerald, K and Spike, NA and Magin, PJ, General practice registrars' management of and specialist referral patterns for atopic dermatitis, Dermatology Practical & Conceptual, 11, (1) pp. 1-9. ISSN 2160-9381 (2021) [Refereed Article]
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.
|Item Type:||Refereed Article|
|Keywords:||atopic dermatitis, eczema, referral and consultation, general practice, dermatologist|
|Research Division:||Health Sciences|
|Research Group:||Health services and systems|
|Research Field:||General practice|
|Objective Group:||Clinical health|
|Objective Field:||Treatment of human diseases and conditions|
|UTAS Author:||FitzGerald, K (Dr Kristen FitzGerald)|
|Web of Science® Times Cited:||1|
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