De uitvoerbaarheid van een allergiedienst voor de eerste lijn; resultaten van een pilot studie.

Klaver, E. (Ester) (2014) De uitvoerbaarheid van een allergiedienst voor de eerste lijn; resultaten van een pilot studie. thesis, Medicine.

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Abstract

Introduction Research shows that the prevalence of allergies is increasing worldwide. Because most patients with allergic symptoms first visit their GPs and because proper education on allergies is lacking in medical schools, the burden on GPs is increasing. In addition, GPs reported difficulties with the interpretation of sIgE and with managing anaphylactic allergies like food allergies. To support GPs with the management of allergic patients, an allergy management support system (AMSS) was developed by the IDEAL project. The AMSS is developed to advise GPs about diagnosis and management of allergic patients. The aim of this study was to test the feasibility of an allergy management support system for primary care. Study design All GPs from the North of the Netherlands were asked to participate in this pilot. The participating GPs were randomized to an advice and control group. The questionnaires of the AMSS were administered by GPs participating in this study to patients suspected of being allergic and in whom sIgE test were performed. In addition, GPs filled in a short questionnaire with their diagnosis and management of the patient (T1). With the consent of the patient sIgE results were obtained from Certe. The completed AMSS questionnaire together with the sIgE results were analyzed by the AMSS. A recommendation was made based on previous developed patterns and classifications, checked by an allergist. The recommendations were sent to the GPs in the advice group and the patients received specific quality of life questionnaires. GPs filled in another short questionnaire with their opinion about the advice and with their possibly renewed diagnosis and management (T2). The AMSS will consider feasible when >70% of the recommendations were send to the GPs within 10 workdays. Results In total 75 GPs participated in the study of which 27 (36%) (advicegroup, n=15; controlgroup, n=12) included patients. Together they included 99 patients of which 66 (66.7%) patients returned an AMSS questionnaire (advicegroup n=42; controlgroup n=22). Of all recommendations 39 (92.9%) were send to the GPs within 10 workdays. From the advicegroup GPs filled in 35 T2 questionnaires. At 28 (80%) questionnaires they filled in that they agreed with the advice and at 24 (68.6%) that they followed the advice. Reasons for not including patients were, an unneeded advice according to the GP or a treatment that was already in agreement with the treatment the AMSS advised. In addition, at T2 GPs in the advicegroup compared to GPs in the controlgroup prescribed significant more often different medication than at T1. Conclusion Because 92.9% of the recommendations were sent to the GP within 10 workdays the AMSS can be considered feasible. In addition, a majority of the GPs completely followed the recommendation. Follow-up research will focus on participating GPs that did not include patients in the pilot.

Item Type:	Thesis (Thesis)
Supervisor name:	Flokstra-de Blok, Dr. B.M.J.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:56
Last Modified:	25 Jun 2020 10:56
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1654

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