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Consultations and referrals for dyspepsia in general practice--a one year database survey
M J van Bommel1, M E Numans, N J de Wit
1Julius Centre for General Practice and Patient Oriented Research, University Medical Centre, Utrecht, P O Box 85060, 3508 AB Utrecht, The Netherlands.
Postgraduate Medical Journal
|July 27, 2001
Summary
Dyspepsia is common in primary care, with most patients managed by their general practitioner (GP). However, factors like irritable bowel syndrome increase referral risk to secondary care.
Area of Science:
- Gastroenterology
- General Practice
- Epidemiology
Background:
- Dyspepsia is a common primary care presentation.
- Referral patterns to secondary care can skew research data used for guidelines.
- Understanding primary care dyspepsia is crucial for accurate guideline development.
Purpose of the Study:
- To determine the prevalence of dyspepsia in general practice.
- To characterize patients presenting with dyspepsia in primary care.
- To identify clinical and non-clinical determinants of referral for dyspepsia.
Main Methods:
- Cross-sectional survey of primary care consultation records.
- Utilized International Classification of Primary Care codes for patient identification.
- Employed logistic regression analysis to identify referral determinants.
Main Results:
- Dyspepsia prevalence in primary care was 3.4% in 1997.
- Most patients were initially managed in primary care.
- Referral was more frequent for men, elderly patients, those with prior dyspepsia, and those with co-existing irritable bowel syndrome.
Conclusions:
- Dyspepsia is a frequent primary care complaint, typically managed by GPs.
- Irritable bowel syndrome is associated with a higher risk of referral.
- Differences between primary and secondary care dyspepsia populations must be considered for guideline research.