Benefits of an open access echocardiography service: a Dutch prospective cohort study |
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Authors: | N. van Gurp L. J. M. Boonman-De Winter D. W. Meijer Timmerman Thijssen H. E. J. H. Stoffers |
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Affiliation: | 1. Department of General Practice/Family Medicine, Maastricht University Medical Centre, School for Public Health and Primary Care (CAPHRI), P.O. Box 616, 6200 MD, Maastricht, the Netherlands 2. Scientific Research, SHL-groep, Trivium 76, 4873 LP, Etten-Leur, the Netherlands 3. SHL-groep, Trivium 76, 4873 LP, Etten-Leur, the Netherlands
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Abstract: | BackgroundOpen access echocardiography has been evaluated in the United Kingdom, but hardly in the Netherlands. The echocardiography service of the SHL-Groep in Etten-Leur was set up independently from the regional hospitals. Cardiologists not involved in the direct care of the participating patients evaluated the echocardiograms taken by ultrasound technicians.AimsWe estimated the reduction in the number of referrals to regional cardiologists, the adherence of the general practitioners (GPs) to the advice of the evaluating cardiologist, GPs’ opinion on the benefit of the echocardiography service and GPs’ adherence to the diagnostic protocol advocated in the Dutch clinical guideline for heart failure.MethodsA prospective cohort study was performed. Patients were included from April 2011 to April 2012 (N = 155). Data from application forms (N = 155), echocardiography results (N = 155) and telephone interviews with GPs (N = 138) were analysed.ResultsGPs referred less patients to the cardiologist than they would have done without echocardiography available (92 % vs. 34 %, p < 0.001). They treated more patients by themselves (62 % vs. 10 %, p < 0.001). Most GPs (81 %) followed the advice presented on the echocardiogram result. Most GPs (82 %) found the service had clinical benefit for the patient. Sixty two percent of echocardiography requests met the criteria of the Dutch clinical guideline for heart failure.ConclusionOpen access echocardiography saved referrals to the cardiology department, saved time, and enabled GPs to treat more patients by themselves. Adherence to diagnostic guidelines for heart failure was suboptimal. |
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Keywords: | Echocardiography General practice Heart failure Heart valve diseases Prospective studies Cohort studies |
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