Implementing referral guidelines: lessons from a negative outcome cluster randomised factorial trial in general practice.

ABSTRACT:

Background

Few patients with lower bowel symptoms who consult their general practitioner need a specialist opinion. However data from referred patients suggest that those who are referred would benefit from detailed assessment before referral.

Methods

A cluster randomised factorial trial. 44 general practices in North Trent, UK. Practices were offered either an electronic interactive referral pro forma, an educational outreach visit by a local colorectal surgeon, both or neither. The main outcome measure was the proportion of cases with severe diverticular disease, cancer or precancerous lesions and inflammatory bowel disease in those referred by each group. A secondary outcome was a referral letter quality score. Semi-structured interviews were conducted to identify key the

SUBMITTER: Jiwa M 

PROVIDER: S-EPMC1635053 | biostudies-literature | 2006 Nov

REPOSITORIES: biostudies-literature