Oostrum, M. van (Maartje) (2021) GPs take into account age and comorbidities when referring patients with unexplained iron deficiency anemia. thesis, Medicine.
Full text available on request.Abstract
Background: GPs and patients are confronted with dilemmas when referring elderly patients with unexplained iron deficiency anemia (IDA) for follow-up diagnostics. Dutch guidelines advise referring every patient older than 50 years with unexplained IDA for colonoscopy, however, this also poses risks. This study aims to identify the characteristics, frequencies of GP contacts, and survival of patients that were not referred for follow-up diagnostics, and to compare these with patients that were referred. Furthermore, the type of follow-up diagnostic performed in patients that were referred is investigated. Methods: A historical prospective cohort study was conducted, using data from the Dutch Academic General practitioner Development Network (AHON). A random sample of patients aged 70 years and older that were diagnosed with a new code for IDA (ICPC B80) between 2016 and 2018 were selected. Results: Out of the 383 patients included in this research, 168 (43.9%) patients were not referred for follow-up diagnostics. These patients were significantly older (83.0 years, p < 0.001), had more cardiovascular disease (64.3%, p = 0.037) and diabetes (43.5%, p = 0.016), and they had lower survival rates (64.3%, p < 0.001) than patients that were referred for follow-up diagnostics. In 14% (30/215) of patients that were referred, GPs used a FOBT test as follow-up diagnostic and in 9.8% (21/215) colorectal cancer (CRC) was found. Conclusions: Although Dutch guidelines advise otherwise, it seems reasonable that GPs take age and comorbidities into account when deciding whether to refer patients with unexplained IDA for follow-up diagnostics, considering the risks of colonoscopy in these patients.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Brandenbarg, D. and Zonneveld-Heil, T. and Munster, B.C. van |
| Faculty: | Medical Sciences |
| Date Deposited: | 04 Jan 2022 11:05 |
| Last Modified: | 04 Jan 2022 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2935 |
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