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A randomised controlled trial of joint consultations with general practitioners and cardiologists in primary care

J F Vlek1, W P M Vierhout, J A Knottnerus

  • 1Centre for Diagnostics and Consultation (SCDC), Helmond. Hans.Vlek@wxs.nl

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|June 24, 2003
PubMed

Insights

Joint consultations between general practitioners and cardiologists significantly reduced patient referrals and diagnostic procedures for cardiac complaints. This approach maintained quality of care while improving patient selection for specialist services.

Area of Science:

  • Cardiology
  • General Practice
  • Health Services Research

Background:

  • High referral rates for cardiac complaints impact healthcare resources.
  • Previous studies showed joint consultations reduce orthopaedic referrals.

Purpose of the Study:

  • To evaluate the impact of joint consultations on care quality and referral patterns for cardiac patients.
  • To assess the effectiveness of collaborative primary and specialist care models.

Main Methods:

  • Randomized controlled trial involving 49 general practitioners and 13 cardiologists over 18 months.
  • Monthly joint consultations for selected patients; random assignment to intervention or usual care.
  • Outcome assessment included referral rates, diagnostic procedures, and patient/clinician satisfaction.

Main Results:

  • Referral rates decreased from 55% in the control group to 34% in the joint consultation group (P=0.001).
  • Fewer diagnostic procedures were performed in the intervention group (7% vs. 16%, P=0.013).
  • Referrals to cardiology decreased proportionally in participating general practices.

Conclusions:

  • Joint consultation effectively reduces referrals and diagnostic procedures for cardiac complaints.
  • This collaborative model ensures quality of care comparable to usual care.
  • Joint consultations improve patient selection for specialist cardiac care.
Abstract

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