The University of Southampton
University of Southampton Institutional Repository

A cluster-randomised factorial trial of a primary care specialist genetics service

A cluster-randomised factorial trial of a primary care specialist genetics service
A cluster-randomised factorial trial of a primary care specialist genetics service
Background: General Practitioners (GPs) do not have the confidence to identify patients at increased genetic risk. A specialist primary care clinical genetics service could support GPs in referral and provide local clinics for their patients.
Aim: Cluster-randomised factorial trial of a primary care clinical genetics service, education to improve referral rate and clinics to improve the patient pathway.
Setting: 73 general practices in the South of England.
Methods: Practices randomised to receive case scenario based seminar (intervention) or not (control), and referred patients a primary (intervention) or secondary (control) care genetic counsellor-led appointment. Outcome measures: GP referral and clinic attendance rates (primary), appropriate cancer and case scenario referral rates, patient satisfaction, clinic costs, case management (secondary).
Results: 89 and 68 referrals made by 36 intervention and 37 control practices respectively. A trend towards an overall higher referral rate amongst educated GPs (referral rate ratio 1•34, 95% confidence interval, 0•89-2•02; P=0•161), they made more appropriate cancer referrals (referral rate ratio 2?36, 95% confidence interval 1•07-5•24; P=0•035). No indication of difference in clinic attendance rates (odds ratio 0•91, 95% CI 0•43-1•95; P=0•802) or patient satisfaction (P=0•189). Patients spent 49% less travelling (£3•60 versus £6•62; P=0•000) and took 33% less time (39•7 versus 57•7 minutes; P=0•000) to attend a primary than secondary care appointment. 83% of genetic counsellor managed appointments met the 18-week referral to treatment NHS target.
Conclusion: An integrated primary care genetics service both supports GPs in appropriate cancer referral and provides care in the right place by the right person.
0960-1643
Westwood, Greta Patricia
371469db-5598-4c81-95b6-c17a3ed228f8
Pickering, Ruth
4a828314-7ddf-4f96-abed-3407017d4c90
Latter, S.
83f100a4-95ec-4f2e-99a5-186095de2f3b
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Gerard, Karen
1aef0321-add2-425f-8cd6-48f1adeef928
Lucassen, Anneke
2eb85efc-c6e8-4c3f-b963-0290f6c038a5
Temple, Karen
d63e7c66-9fb0-46c8-855d-ee2607e6c226
Westwood, Greta Patricia
371469db-5598-4c81-95b6-c17a3ed228f8
Pickering, Ruth
4a828314-7ddf-4f96-abed-3407017d4c90
Latter, S.
83f100a4-95ec-4f2e-99a5-186095de2f3b
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Gerard, Karen
1aef0321-add2-425f-8cd6-48f1adeef928
Lucassen, Anneke
2eb85efc-c6e8-4c3f-b963-0290f6c038a5
Temple, Karen
d63e7c66-9fb0-46c8-855d-ee2607e6c226

Westwood, Greta Patricia, Pickering, Ruth, Latter, S., Little, Paul, Gerard, Karen, Lucassen, Anneke and Temple, Karen (2012) A cluster-randomised factorial trial of a primary care specialist genetics service. British Journal of General Practice.

Record type: Article

Abstract

Background: General Practitioners (GPs) do not have the confidence to identify patients at increased genetic risk. A specialist primary care clinical genetics service could support GPs in referral and provide local clinics for their patients.
Aim: Cluster-randomised factorial trial of a primary care clinical genetics service, education to improve referral rate and clinics to improve the patient pathway.
Setting: 73 general practices in the South of England.
Methods: Practices randomised to receive case scenario based seminar (intervention) or not (control), and referred patients a primary (intervention) or secondary (control) care genetic counsellor-led appointment. Outcome measures: GP referral and clinic attendance rates (primary), appropriate cancer and case scenario referral rates, patient satisfaction, clinic costs, case management (secondary).
Results: 89 and 68 referrals made by 36 intervention and 37 control practices respectively. A trend towards an overall higher referral rate amongst educated GPs (referral rate ratio 1•34, 95% confidence interval, 0•89-2•02; P=0•161), they made more appropriate cancer referrals (referral rate ratio 2?36, 95% confidence interval 1•07-5•24; P=0•035). No indication of difference in clinic attendance rates (odds ratio 0•91, 95% CI 0•43-1•95; P=0•802) or patient satisfaction (P=0•189). Patients spent 49% less travelling (£3•60 versus £6•62; P=0•000) and took 33% less time (39•7 versus 57•7 minutes; P=0•000) to attend a primary than secondary care appointment. 83% of genetic counsellor managed appointments met the 18-week referral to treatment NHS target.
Conclusion: An integrated primary care genetics service both supports GPs in appropriate cancer referral and provides care in the right place by the right person.

Text
Westwood_et_al,_301011.pdf - Other
Restricted to Repository staff only
Request a copy

More information

Published date: March 2012
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 341365
URI: http://eprints.soton.ac.uk/id/eprint/341365
ISSN: 0960-1643
PURE UUID: 235f8580-1be7-4d8f-a788-8fdf08c4f034
ORCID for S. Latter: ORCID iD orcid.org/0000-0003-0973-0512
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Anneke Lucassen: ORCID iD orcid.org/0000-0003-3324-4338
ORCID for Karen Temple: ORCID iD orcid.org/0000-0002-6045-1781

Catalogue record

Date deposited: 20 Feb 2013 12:06
Last modified: 12 Jul 2024 01:40

Export record

Contributors

Author: Greta Patricia Westwood
Author: Ruth Pickering
Author: S. Latter ORCID iD
Author: Paul Little ORCID iD
Author: Karen Gerard
Author: Anneke Lucassen ORCID iD
Author: Karen Temple ORCID iD

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×