Implementation and evaluation of early gastroscopy for patients with dyspepsia and warning signs in Primary Care

Area of Science:

• Gastroenterology
• Primary Care Medicine
• Healthcare Management

Background:

• Dyspepsia is a prevalent condition managed in both primary and specialized care settings.
• Early gastroscopy is recommended for patients with warning signs but often lacks availability in primary care.
• This study addresses the gap in primary care access to timely gastroscopy for dyspeptic patients.

Purpose of the Study:

• To develop and evaluate an early gastroscopy program for dyspepsia patients with warning signs in primary care.
• To assess the requirements, impact, and physician satisfaction with the new primary care-based gastroscopy service.
• To determine the program's effect on referrals to specialized care.

Main Methods:

• A pilot project was implemented, establishing an early gastroscopy program in primary care.
• Demographic, symptomatic, and endoscopic data were collected for referred patients.
• Physician satisfaction was assessed via a survey following program implementation.

Main Results:

• The program included 355 patients (median age 56.4 years, 61.2% women) with a 1.5-week waiting time for gastroscopy.
• Gastroscopy was appropriately indicated in 82.7% of cases, with a median of 1.1 requests per 10,000 adults monthly.
• Referrals to specialized care from the pilot center decreased by 11 patients per month, and 98.4% of physicians found the program useful.

Conclusions:

• Implementing an early gastroscopy program in primary care effectively reduces referrals to specialized care for dyspepsia.
• The program demonstrates feasibility and positive physician reception within the primary care setting.
• Early access to gastroscopy in primary care improves patient management pathways for dyspepsia.