Palpitation referrals from primary care to a secondary care cardiology outpatient clinic: assessing adherence to guidelines.

Abstract:

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.

journal_name

Fam Pract

journal_title

Family practice

authors

Pallikadavath S,Patel R,Sarania R,Ahmad T,Vali Z,Kandala NI,Sandilands A

doi

10.1093/fampra/cmaa094

subject

Has Abstract

pub_date

2020-09-12 00:00:00

eissn

0263-2136

issn

1460-2229

pii

5904788

pub_type

杂志文章
  • The assessment of genetic risk of breast cancer: a set of GP guidelines.

    abstract:BACKGROUND:Assessing a genetic risk for developing breast cancer is not an easy task for a GP. Current expert guidelines for referring and counselling women with a family history positive for breast cancer are complex and difficult to apply in general practice, and have only two strategies (to refer or not to refer for...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/16.1.71

    authors: de Bock GH,Vliet Vlieland TP,Hageman GC,Oosterwijk JC,Springer MP,Kievit J

    更新日期:1999-02-01 00:00:00

  • Achieving involvement: process outcomes from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice.

    abstract:BACKGROUND:A consulting method known as 'shared decision making' (SDM) has been described and operationalized in terms of several 'competences'. One of these competences concerns the discussion of the risks and benefits of treatment or care options-'risk communication'. Few data exist on clinicians' ability to acquire ...

    journal_title:Family practice

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/fampra/cmh401

    authors: Elwyn G,Edwards A,Hood K,Robling M,Atwell C,Russell I,Wensing M,Grol R,Study Steering Group.

    更新日期:2004-08-01 00:00:00

  • Incidence, patient characteristics and treatment initiated for GP-diagnosed depression in general practice: results of a 1-year nationwide surveillance study.

    abstract:BACKGROUND:Despite its public health significance, data about depression in general practice are often unavailable. OBJECTIVE:To study (i) the incidence of GP-diagnosed depression during 2008, (ii) associations between patient characteristics, appraised severity and initiated treatment, (iii) GPs' usual care compared ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cms024

    authors: Boffin N,Bossuyt N,Declercq T,Vanthomme K,Van Casteren V

    更新日期:2012-12-01 00:00:00

  • Variation in general practitioners' depression care following certification of sickness absence: a registry-based cohort study.

    abstract:BACKGROUND:Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients' social position. OBJECTIVE:To investigate associations between patients' gender and educational status combined and GP depression ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmaa120

    authors: Riiser S,Haukenes I,Baste V,Smith-Sivertsen T,Hetlevik Ø,Ruths S

    更新日期:2020-11-05 00:00:00

  • Shared care in gastroenterology: GPs' views of open access to out-patient follow-up for patients with inflammatory bowel disease.

    abstract:OBJECTIVE:The aim of this study was to ascertain GPs' views about open access to out-patient follow-up for patients with inflammatory bowel disease (IBD). METHODS:Semi-structured interviews and a postal survey were carried out in general practices in West Glamorgan UK, each with at least one IBD patient taking part in...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.1.53

    authors: Cheung WY,Dove J,Lervy B,Russell IT,Williams JG

    更新日期:2002-02-01 00:00:00

  • The search for person-related information in general practice: a qualitative study.

    abstract:BACKGROUND:General practice is person-focused. Contextual information influences the clinical decision-making process in primary care. Currently, person-related information (PeRI) is neither recorded in a systematic way nor coded in the electronic medical record (EMR), and therefore not usable for scientific use. AIM:...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmv099

    authors: Schrans D,Avonts D,Christiaens T,Willems S,de Smet K,van Boven K,Boeckxstaens P,Kühlein T

    更新日期:2016-02-01 00:00:00

  • The effectiveness of waiting room notice-boards as a vehicle for health education.

    abstract::To determine whether patients read and remembered health promotion messages displayed in waiting rooms, 600 patients in a UK general practice were given a self-complete questionnaire. Two notice-boards carried between 1 to 4 topics over four study periods. Three-hundred and twenty-seven (55%) of subjects responded. Tw...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/11.3.292

    authors: Wicke DM,Lorge RE,Coppin RJ,Jones KP

    更新日期:1994-09-01 00:00:00

  • Tests for Helicobacter pylori infection: a critical appraisal from primary care.

    abstract:BACKGROUND:Testing of patients for Helicobacter pylori infection is common in primary care settings. The accuracy of such tests has been assessed and critical appraisal of this literature can inform the clinical management of patients suspected of being infected with H. pylori METHODS:Literature evaluating the accurac...

    journal_title:Family practice

    pub_type: 杂志文章,评审

    doi:10.1093/fampra/17.suppl_2.s12

    authors: Roberts AP,Childs SM,Rubin G,de Wit NJ

    更新日期:2000-08-01 00:00:00

  • The impact of patients' influence on recovery in a group of patients with dyspepsia.

    abstract:BACKGROUND:The approach to health and disease can either be salutogenic (origins of health) or pathogenic (disease causing), which thus makes recovery a concept featuring several different angles. Antonovsky, with his concept of salutogenesis, tried to reach a more complete understanding of its favourable effects on he...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/16.5.515

    authors: Nilsson B,Westman G

    更新日期:1999-10-01 00:00:00

  • Association between unexplained hypoalbuminaemia and new cancer diagnoses in UK primary care patients.

    abstract:BACKGROUND:The association between hypoalbuminaemia and a new diagnosis of cancer is as yet unknown. OBJECTIVE:This study aimed to assess whether unexplained hypoalbuminaemia was associated with an increased risk of subsequent new cancer diagnosis within the next 12 months. METHODS:A cohort study was performed using ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmw051

    authors: Merriel SW,Carroll R,Hamilton F,Hamilton W

    更新日期:2016-10-01 00:00:00

  • Making the best of breast feeding.

    abstract::The practice of breast feeding has declined throughout the world, at first in the developed countries and now also in the developing countries. Although there is some return to breast feeding in industrialized countries, it is mostly by the privileged and better educated women. This article discusses the importance of...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/1.2.69

    authors: Cutting WA,Ludlam M

    更新日期:1984-06-01 00:00:00

  • Using focus groups in general practice research.

    abstract::Recent years have seen a growing recognition of the appropriateness of qualitative methods in family practice. This has been paralleled by an upsurge of interest in focus group discussions as a method. Drawing on the experience of using focus groups with general practice teams as one component of a multi-method study ...

    journal_title:Family practice

    pub_type: 杂志文章,评审

    doi:10.1093/fampra/12.3.328

    authors: Barbour RS

    更新日期:1995-09-01 00:00:00

  • The narrative approach as an effective single intervention in functional somatic symptoms in a multi-disciplinary referral clinic for primary care frequent attenders.

    abstract::Mental health problems are underdiagnosed in general practice, primarily because they are often somatized and the patient reports only physical symptoms. These somatized symptoms are responsible for a large percentage of the frequent attenders in general practice. Palpitations are among those somatized symptoms. Here ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmh618

    authors: Matalon A,Nachmani T,Rabin S,Maoz B

    更新日期:2005-02-01 00:00:00

  • Sampling for qualitative research using quantitative methods. 2. Characteristics of GPs who agree to video-taping of consultations.

    abstract:BACKGROUND AND OBJECTIVES:Studies using video-recordings of GPs' consultations have been important in investigating GPs' clinical behaviour. Unfortunately, the characteristics of participating GPs are rarely described, making it difficult to assess how representative they are or how generalizable the studies' results c...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/13.6.531

    authors: Coleman T

    更新日期:1996-12-01 00:00:00

  • The effectiveness of local adaptation of nationally produced clinical practice guidelines.

    abstract:BACKGROUND:Local adaptation is often reported in the literature to be an important strategy in achieving local ownership and relevance of guidelines in order to increase the likelihood of their uptake and implementation. However, the process is also potentially time-consuming and costly. OBJECTIVE:The aim of this stud...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.3.223

    authors: Silagy CA,Weller DP,Lapsley H,Middleton P,Shelby-James T,Fazekas B

    更新日期:2002-06-01 00:00:00

  • Relationship among team dynamics, care coordination and perception of safety culture in primary care.

    abstract:Background:There remains a need to improve patient safety in primary care settings. Studies have demonstrated that creating high-performing teams can improve patient safety and encourage a safety culture within hospital settings, but little is known about this relationship in primary care. Objective:To examine how tea...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmy029

    authors: Blumenthal KJ,Chien AT,Singer SJ

    更新日期:2018-12-12 00:00:00

  • An overview of training curricula for diabetes peer educators.

    abstract::Global community members who experience similar health problems gravitate to each other for information and support. Peers may be more approachable and can relate to the particular living circumstances one experiences. In well-resourced countries, people have opportunities for learning diabetes self-management; howeve...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmn102

    authors: Nettles A,Belton A

    更新日期:2010-06-01 00:00:00

  • Primary care practice a la carte among GPs: using organizational diversity to increase job satisfaction.

    abstract:BACKGROUND:Primary care revival in Canada and elsewhere is viewed by many as conditional to the introduction of new organizational models. Endorsement by GPs is a key factor in the success of these models, and increasing GPs' job satisfaction is often one of the desired outcomes of the reforms currently underway. OBJE...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cml073

    authors: Geneau R,Lehoux P,Pineault R,Lamarche PA

    更新日期:2007-04-01 00:00:00

  • A cross-sectional survey of the pharmacy workforce in general practice in Scotland.

    abstract:BACKGROUND:In Scotland, there has been significant investment in pharmacy teams in general medical practices over recent years, aligned to current government policy. OBJECTIVES:To characterize the national pharmacy workforce including activities undertaken, perceived competence and confidence, as well as perception of...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmz052

    authors: Stewart D,Maclure K,Newham R,Gibson-Smith K,Bruce R,Cunningham S,Maclure A,Fry S,Mackerrow J,Bennie M

    更新日期:2020-03-25 00:00:00

  • The clinical and economic burden of fibromyalgia compared with diabetes mellitus and hypertension among Bedouin women in the Negev.

    abstract:BACKGROUND:Fibromyalgia (FM) is a common idiopathic chronic, widespread pain syndrome with tenderness in anatomically defined tender points. OBJECTIVES:The purpose of the present study was to describe and characterize the economic and daily work burden of FM compared with diabetes mellitus and hypertension. METHODS:A...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmh411

    authors: Doron Y,Peleg R,Peleg A,Neumann L,Buskila D

    更新日期:2004-08-01 00:00:00

  • Barriers to general practitioners caring for patients with HIV/AIDS.

    abstract::This paper describes some of the barriers to caring for people with HIV and AIDS by general practitioners. It is based on a review of the literature and on interviews with individuals. The first section examines the reasons given by interviewees for their involvement in HIV and AIDS care. The next section discusses th...

    journal_title:Family practice

    pub_type: 杂志文章,评审

    doi:10.1093/fampra/10.1.8

    authors: Clarke AE

    更新日期:1993-03-01 00:00:00

  • What dimensions underlie patient responses to the General Practice Assessment Survey? A factor analytic study.

    abstract:BACKGROUND:Patient self-report measures of primary care are being used increasingly for quality assessment and improvement. The General Practice Assessment Survey (GPAS) is a widely used measure. However, it is important that the measures used are valid and interpretable. Factor analysis is a useful method to assist in...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.5.489

    authors: Bower P,Mead N,Roland M

    更新日期:2002-10-01 00:00:00

  • Diagnostic performance of retinal digital photography for diabetic retinopathy screening in primary care.

    abstract:Introduction:We must study alternatives to structure an effective diabetic retinopathy screening program for Brazilian public health system. Objectives:Evaluate the diagnostic performance of retinal digital photography for diabetic retinopathy screening in primary care, accuracy of the family physician in diabetic ret...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmx020

    authors: Rosses APO,Ben ÂJ,Souza CF,Skortika A,Araújo AL,Carvalho G,Locatelli F,Neumann CR

    更新日期:2017-09-01 00:00:00

  • Qualitative research and the problem of judgement: lessons from interviewing fellow professionals.

    abstract:BACKGROUND:Qualitative research methods are recognized increasingly as valuable tools for primary care research, and add an extra dimension to quantitative work. OBJECTIVE:The aim of this study was to illustrate the benefits and problems attending the dual role of clinician/qualitative researcher. METHODS:As part of ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.3.285

    authors: Chew-Graham CA,May CR,Perry MS

    更新日期:2002-06-01 00:00:00

  • Consultations involving people with congenital disabilities: factors that help or hinder giving care.

    abstract:BACKGROUND:Previous studies have suggested that the attitudes of health professionals towards people with disability may be as negative as those of society. Further, even positive attitudes may not always be reflected in the health professional's behaviour. OBJECTIVE:The aim of this study was to examine GPs' (registra...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.4.419

    authors: Muir EH,Ogden J

    更新日期:2001-08-01 00:00:00

  • 'Can I come off the tablets now?' A qualitative analysis of heart failure patients' understanding of their medication.

    abstract:OBJECTIVE:To examine whether heart failure patients' awareness of the purpose and side effects of their medicines equips them to participate in informed discussions about treatments. DESIGN:Qualitative interviews using a maximum variation sample were collected. Interviews were analysed using constant comparison. SETT...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cml036

    authors: Field K,Ziebland S,McPherson A,Lehman R

    更新日期:2006-12-01 00:00:00

  • Pathways from symptoms to medical care: a descriptive study of symptom development and obstacles to early diagnosis in brain tumour patients.

    abstract:BACKGROUND:The time between experiencing symptoms and treatment in cancer diseases is a time of insecurity and despair. Brain tumour disease is a severe disease with dramatic manifestations and it is important that this time be kept as short as possible. METHODS:A consecutive sample of 28 patients with malignant gliom...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/16.2.143

    authors: Salander P,Bergenheim AT,Hamberg K,Henriksson R

    更新日期:1999-04-01 00:00:00

  • Development of hypertension in obese subjects seen in general practice.

    abstract::A group of 317 overweight men and 565 overweight women was compared with an age-matched normal control group of 444 men and 627 women in order to establish whether hypertension was more often recorded in the obese group. This was done by analysing the continuous morbidity registration of four general practices with a ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/4.1.11

    authors: Bakx JC,Seidell JC,Deurenberg P,van den Hoogen HJ

    更新日期:1987-03-01 00:00:00

  • Sources of information about new drugs and attitudes towards drug prescribing: an international study of differences between primary care physicians.

    abstract::Doctors in different countries completed a questionnaire relating to the importance they attributed to eight possible sources of information about a new drug, their estimation of patients' expectations of the doctor prescribing drugs under specific circumstances and their therapeutic response to common clinical genera...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/4.2.123

    authors: Hull FM,Marshall T

    更新日期:1987-06-01 00:00:00

  • A randomized controlled trial of direct access for laparoscopic sterilization.

    abstract:OBJECTIVES:The aim of this study was to establish and evaluate a direct access service for laparoscopic sterilization. METHODS:A pragmatic randomized controlled trial was carried out on a total of 232 women referred to Aberdeen Royal Infirmary for sterilization between 1 June 1996 and 31 March 1997, from 57 general pr...

    journal_title:Family practice

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/fampra/18.1.1

    authors: McKessock L,Smith BH,Scott A,Graham W,Terry PB,Templeton A,Fitzmaurice AE

    更新日期:2001-02-01 00:00:00