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Impact of a dietitian in general practice: paediatric food allergy
Avril Collinson1, Lisa Waddell2, Amy Freeman-Hughes3
1Plymouth Institute of Health Research, University of Plymouth, Plymouth, UK.
Insights
A new dietetic-led service for infant food allergy reduces GP visits and secondary care needs. This model offers faster diagnosis and treatment, easing the burden on primary care.
Area of Science:
- Pediatrics
- Allergy and Immunology
- Dietetics and Nutrition
Background:
- Infant food allergy presents a significant challenge to primary healthcare systems.
- Existing models often lead to delays in diagnosis and treatment, increasing healthcare utilization.
Purpose of the Study:
- To evaluate a dietetic-led pediatric food allergy service.
- To assess the service's impact on general practitioner (GP) and secondary care appointments.
- To determine if the service improves access to dietetic care and reduces patient waiting times.
Main Methods:
- A comparative study of two community dietetic services for pediatric food allergy referrals.
- Dietetic-led care involved nurses trained by dietitians for initial assessment.
- Traditional care involved referrals predominantly from GPs and secondary care.
Main Results:
- Dietetic-led care saw fewer GP referrals (36% vs. 67%) and reduced GP appointments (3 vs. 6 visits).
- Secondary care involvement was significantly lower in the dietetic-led group (8 vs. 25 patients).
- Children in the dietetic-led group were younger (78% <6 months vs. 40%).
Conclusions:
- The dietetic-led model can decrease GP and secondary care appointments.
- This integrated care approach facilitates quicker patient identification and dietetic input.
- The service shows potential for reducing GP workload while enhancing patient care and outcomes.
Background:
Food allergy in infants and young children places a significant burden on primary care. This study evaluated a dietetic-led paediatric food allergy service, which attempts to provide more rapid access to the dietitian and reduce the need for general practitioner (GP) and secondary care appointments.
Methods:
Two community dietetic services for children referred with food allergy were compared. The first was dietetic-led care where dietitians train community children's nurses to recognise potential cases of food allergy, undertake basic diagnostic assessment and subsequently refer to the dietitian. The other was a more traditional dietetic community service where patients were referred predominantly by the GP or secondary care.
Results:
In dietetic-led care 86 patients were seen, compared to 96 in dietetic community care. Dietetic-led care received fewer referrals from the GP, 36% versus 67% (p < 0.001); GP appointments for allergy-related conditions prior to dietetic referral were lower, 3 versus 6 visits (p = 0.001); and input from secondary care was also lower, 8 versus 25 patients (p = 0.002) compared with dietetic community care. Children referred to dietetic-led care were younger, 78% <6 months versus 40% (p < 0.001) in dietetic community care.
Conclusions:
Dietetic-led care describes a model that has the potential to reduce GP and secondary care appointments, identify patients more quickly and reduce the time to receive dietetic input, thereby resolving symptoms more quickly and reducing prescribed medications. This model demonstrates the importance of integrated care and multidisciplinary working, offering a solution to reducing GP workload while maintaining or improving patient care.
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