General Practice Registrars’ Management of and Specialist Referral Patterns for Atopic Dermatitis

General Practice Registrars’ Management of and Specialist Referral Patterns for Atopic Dermatitis

Authors

  • Anneliese Willems Eastern Victoria GP Training, General Practice Training Organisation & The University of Melbourne, Department of General Practice Melbourne, VIC, Australia https://orcid.org/0000-0002-3546-648X
  • Amanda Tapley 3. The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, AUS. 4. GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Newcastle, NSW, AUS. https://orcid.org/0000-0002-1536-5518
  • Alison Fielding 3. The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, AUS. 4. GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Newcastle, NSW, AUS. https://orcid.org/0000-0001-5884-3068
  • Vivian Tng 5. Department of Dermatology, John Hunter Hospital, Newcastle, NSW, Australia. https://orcid.org/0000-0002-8861-4773
  • Elizabeth Holliday 3. The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, AUS. https://orcid.org/0000-0002-4066-6224
  • Mieke van Driel 6. The University of Queensland Faculty of Medicine, Primary Care Clinical Unit, Brisbane, QLD, AUS. https://orcid.org/0000-0003-1711-9553
  • Jean Ball 7. Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton, NSW, AUS. https://orcid.org/0000-0001-5402-6415
  • Andrew Davey 3. The University of Newcastle, School of Public Health and Medicine, Callaghan, NSW, AUS. 4. GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Newcastle, NSW, AUS. https://orcid.org/0000-0002-7547-779X
  • Kristen FitzGerald 8. University of Tasmania, School of Medicine, Hobart, TAS, AUS. 9. General Practice Training Tasmania (GPTT), Regional Training Organisation, Hobart, TAS, AUS.
  • Neil A. Spike Eastern Victoria GP Training, General Practice Training Organisation, Melbourne & The University of Melbourne, Department of General Practice Melbourne, VIC, Australia https://orcid.org/0000-0002-9694-8642
  • Parker J. Magin The University of Newcastle, School of Public Health and Medicine, Callaghan & GP Synergy, Regional Training Organization & ACT Research and Evaluation Unit, Newcastle, NSW, Australia

Keywords:

atopic dermatitis, eczema, referral and consultation, general practice, dermatologists

Abstract

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 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.  

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Published

2021-01-29

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Section

Research

How to Cite

1.
General Practice Registrars’ Management of and Specialist Referral Patterns for Atopic Dermatitis. Dermatol Pract Concept [Internet]. 2021 Jan. 29 [cited 2024 Mar. 29];11(1):e2021118. Available from: https://www.dpcj.org/index.php/dpc/article/view/dermatol-pract-concept-articleid-dp1101a118