TY - JOUR
T1 - Healthcare utilisation of patients with cholecystolithiasis in primary care
T2 - A multipractice comparative analysis
AU - Thunnissen, Floris Martijn
AU - Drager, Luuk David
AU - Braak, Breg
AU - Drenth, Joost P. H.
AU - van Laarhoven, Cornelis J. H. M.
AU - Schers, Henk J.
AU - de Reuver, Philip R.
PY - 2021/11/3
Y1 - 2021/11/3
N2 - Objectives To examine general practitioners' (GP) management of cholecystolithiasis and to evaluate persisting abdominal complaints in the years after the diagnosis. Design Retrospective analysis of registry data and a subset of individual medical records. Setting Seventeen primary care practices affiliated with the Radboudumc Practice Based Research Network in the Netherlands. Participants 633 patients with cholecystolithiasis diagnosed between 2012 and 2016. Primary and secondary outcome measures The primary outcome of this study was the healthcare utilisation of patients with cholecystolithiasis diagnosed by the GP in terms of referrals to secondary care, laboratory diagnostics, prescribed medication and the prevalence of concomitant abdominal-related diagnoses in a time interval of 3 years before and 3 years after diagnosis of cholecystolithiasis. For secondary outcomes, electronic medical records were studied from seven practices to assess emergency department visits, operation rates and repeat visits for persistent abdominal symptoms. We compared the non-referred group with the referred group. Results In 57% of patients, concomitant abdominal-related diagnoses were recorded besides the diagnosis cholecystolithiasis. In-depth analyses of 294 patients showed a referral rate of 79.3% (n=233); 62.9% (n=185) underwent cholecystectomy. After referral, 55.4% (129/233) returned to the GP for persistent abdominal symptoms. Patients returning after referral were more often treated for another abdominal-related diagnosis before cholecystolithiasis was recorded (51.9% vs 28.8%, p<0.001). Conclusions The majority of patients in general practice with gallstones are referred and undergo cholecystectomy. Patients with concomitant abdominal-related diagnoses are likely to return to their physician. GPs should inform patients about these outcomes to improve the shared decision-making process before gallbladder surgery.
AB - Objectives To examine general practitioners' (GP) management of cholecystolithiasis and to evaluate persisting abdominal complaints in the years after the diagnosis. Design Retrospective analysis of registry data and a subset of individual medical records. Setting Seventeen primary care practices affiliated with the Radboudumc Practice Based Research Network in the Netherlands. Participants 633 patients with cholecystolithiasis diagnosed between 2012 and 2016. Primary and secondary outcome measures The primary outcome of this study was the healthcare utilisation of patients with cholecystolithiasis diagnosed by the GP in terms of referrals to secondary care, laboratory diagnostics, prescribed medication and the prevalence of concomitant abdominal-related diagnoses in a time interval of 3 years before and 3 years after diagnosis of cholecystolithiasis. For secondary outcomes, electronic medical records were studied from seven practices to assess emergency department visits, operation rates and repeat visits for persistent abdominal symptoms. We compared the non-referred group with the referred group. Results In 57% of patients, concomitant abdominal-related diagnoses were recorded besides the diagnosis cholecystolithiasis. In-depth analyses of 294 patients showed a referral rate of 79.3% (n=233); 62.9% (n=185) underwent cholecystectomy. After referral, 55.4% (129/233) returned to the GP for persistent abdominal symptoms. Patients returning after referral were more often treated for another abdominal-related diagnosis before cholecystolithiasis was recorded (51.9% vs 28.8%, p<0.001). Conclusions The majority of patients in general practice with gallstones are referred and undergo cholecystectomy. Patients with concomitant abdominal-related diagnoses are likely to return to their physician. GPs should inform patients about these outcomes to improve the shared decision-making process before gallbladder surgery.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85118996643&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/34732495
U2 - https://doi.org/10.1136/bmjopen-2021-053188
DO - https://doi.org/10.1136/bmjopen-2021-053188
M3 - Article
C2 - 34732495
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - e053188
ER -