scholarly journals Prevalence and Associations of General Practice Registrars’ Management of Atopic Dermatitis: A Cross-Sectional Analysis from the Registrar Clinical Encounters in Training Study

2021 ◽  
pp. e2021128
Author(s):  
Anneliese Willems ◽  
Amanda Tapley ◽  
Alison Fielding ◽  
Er Tsing Vivian Tng ◽  
Elizabeth Holliday ◽  
...  
Keyword(s):  
General Practice ◽  
Atopic Dermatitis ◽  
Response Rate ◽  
Learning Goals ◽  
Cross Sectional ◽  
Clinical Encounters ◽  
Chronic Inflammatory Condition ◽  
English Speaking ◽  
Recent Project ◽  
Sectional Analysis

Introduction: Atopic dermatitis (AD) is a chronic inflammatory condition which imposes substantial burden upon patients and their families. As a frequent primary care presentation, general practice (GP) trainees must develop adequate skills in AD diagnosis and management. Objectives: We aimed to explore the prevalence and associations of GP registrars’ management of patients with AD. Methods: This study used data from the Registrar Clinical Encounters in Training (ReCEnT) project, an ongoing cohort study of the clinical and educational experience of Australian GP registrars. Registrar, patient, and consultation factors were independent variables in multivariable logistic regression with outcome factor ‘diagnosis/problem being AD’. Results: From 2010-2019, 2,783 registrars (96% response rate) provided data from 381,180 consultations. AD was encountered in 0.6% of consults. AD was more likely to be seen in patients aged 0-1 years and patients from a non-English speaking background. AD was less likely to be seen in Aboriginal or Torres Strait Islander patients. Learning goals were more likely to be generated for AD and these consultations were associated with registrars seeking information or assistance. AD was strongly associated with a medication being prescribed, of which the most prescribed medications were mild or moderate potency topical corticosteroids.  Conclusions: Our findings suggest that, similar to other dermatological presentations, registrars find AD challenging to manage. There may be some gaps in AD management knowledge and application.

scholarly journals General Practice Registrars’ Management of and Specialist Referral Patterns for Atopic Dermatitis

2021 ◽  
pp. e2021118
Author(s):  
Anneliese Willems ◽  
Amanda Tapley ◽  
Alison Fielding ◽  
Vivian Tng ◽  
Elizabeth Holliday ◽  
...  
Keyword(s):  
General Practice ◽  
Atopic Dermatitis ◽  
Patient Care ◽  
Significant Proportion ◽  
Female Gender ◽  
Learning Goals ◽  
Cross Sectional ◽  
Referral Patterns ◽  
Clinical Encounters ◽  
Recent Project

Background: Atopic dermatitis (AD) is a common presentation in the general practice (GP) setting. Implementation of appropriate referral pathways is instrumental for best patient care and is an essential skill for Australian GP registrars. Objectives: We aimed to explore the prevalence and associations of GP registrar referrals to specialists for AD management. Methods: A cross-sectional analysis utilizing data from the Registrar Clinical Encounters in Training (ReCEnT) project, an ongoing cohort study that documents in-consultation clinical and educational experience of Australian GP registrars. Registrar, patient, and consultation factors associated with referrals for AD were established using logistic regression. Results: A A total of 3,285 (0.55%) of 595,412 diagnoses managed were AD, of which 222 (6.8%) resulted in referral. Of these referrals, 70% were to dermatologists, 17% to allergists/immunologists, and 10% to pediatricians. Associations of referral included registrar female gender, patient age, longer consultation duration; an established (rather than new) AD diagnosis; supervisor advice being sought; and learning goals being generated.  Conclusions: Both registrar and patient factors influence AD referral patterns. Registrars referred established rather than newly diagnosed AD, suggesting a level of comfort in initial management. Referral was associated with longer consultations, seeking supervisor advice, and generation of learning goals—suggesting these are more complex presentations and, possibly, registrar learning opportunities. A significant proportion of referrals were to non-dermatologist specialists. The implication of this for optimal patient care is a subject for further study.  

scholarly journals Australian general practice trainees’ exposure to ophthalmic problems and implications for training: a cross-sectional analysis

2016 ◽  
Vol 8 (4) ◽  
pp. 295 ◽  
Author(s):  
Simon Morgan ◽  
Amanda Tapley ◽  
Kim M Henderson ◽  
Neil A Spike ◽  
Lawrie A McArthur ◽  
...  
Keyword(s):  
General Practice ◽  
Information Seeking ◽  
Learning Goals ◽  
Training Methods ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Australian General Practice ◽  
Simple Logistic ◽  
Sectional Analysis

ABSTRACT INTRODUCTION Eye conditions are common presentations in Australian general practice, with the potential for serious sequelae. Pre-vocational ophthalmology training for General Practitioner (GP) trainees is limited. AIM To describe the rate, nature and associations of ophthalmic problems managed by Australian GP trainees, and derive implications for education and training. METHODS Cross-sectional analysis from an ongoing cohort study of GP trainees’ clinical consultations. Trainees recorded demographic, clinical and educational details of consecutive patient consultations. Descriptive analyses report trainee, patient and practice demographics. Proportions of all problems managed in these consultations that were ophthalmology-related were calculated with 95% confidence intervals (CI). Associations were tested using simple logistic regression within the generalised estimating equations (GEE) framework. RESULTS In total, 884 trainees returned data on 184,476 individual problems or diagnoses from 118,541 encounters. There were 2649 ophthalmology-related problems, equating to 1.4% (95% CI: 1.38–1.49) of all problems managed. The most common eye presentations were conjunctivitis (32.5% of total problems), eyelid problems (14.9%), foreign body (5.3%) and dry eye (4.7%). Statistically significant associations were male trainee; male patient and patient aged 14 years or under; the problem being new and the patient being new to both trainee and practice; urban and of higher socioeconomic status practice location; the practice nurse not being involved; planned follow up not arranged; referral made; in-consultation information sought; and learning goals generated. DISCUSSION Trainees have comparable ophthalmology exposure to established GPs. However, associations with referral and information-seeking suggest GP trainees find ophthalmic problems challenging, reinforcing the critical importance of appropriate training.

scholarly journals Prevalence and Associations of General Practice Registrars’ Management of Impetigo: A Cross-Sectional Analysis From the Registrar Clinical Encounters in Training (ReCEnT) Study

2020 ◽  
pp. e2020043
Author(s):  
Hilary Gorges ◽  
Clare Heal ◽  
Mieke Van Driel ◽  
Amanda Tapley ◽  
Joshua Davis ◽  
...  
Keyword(s):  
General Practice ◽  
Information Seeking ◽  
Study Data ◽  
Health Seeking ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Clinical Encounters ◽  
Seeking Behavior ◽  
Patient Variables ◽  
Sectional Analysis

Background: Impetigo is a mild bacterial skin infection of childhood that is usually managed empirically in primary care. Objective: To establish the prevalence and associations of impetigo in general practice (GP) registrars’ consultations. Methods: Cross-sectional analysis of the Registrar Clinical Encounters in Training (ReCEnT) study data. Results: Impetigo was managed in 0.24% of problems and 0.43% of consultations. Patient variables associated with impetigo presentations were younger age and impetigo as a new problem, while patients with non–English-speaking backgrounds were less likely to present with impetigo. Associated registrar variables were being new to the registrar and practicing in outer regional/remote locations. Compared with all other problems/diagnoses, impetigo more often involved information seeking, ordering pathology, and prescription of medication, but less often involved follow-up or referral. Conclusions: Impetigo accounts for 0.43 per 100 GP registrar consultations in Australia. Association with outer regional/remote areas may reflect climate and socioeconomic factors that predispose to impetigo. Associated pathology requests may reflect a lack of confidence in GP registrars’ management of impetigo. Cultural differences may exist regarding health-seeking behavior relating to impetigo.

scholarly journals Investigation of fatigue by Australian general practice registrars: a cross-sectional study

2015 ◽  
Vol 7 (2) ◽  
pp. 109 ◽  
Author(s):  
Simon Morgan ◽  
Kim Henderson ◽  
Amanda Tapley ◽  
Allison Thomson ◽  
Jessica Wilson ◽  
...  
Keyword(s):  
General Practice ◽  
Cross Sectional Study ◽  
Rational Approach ◽  
Cross Sectional ◽  
Clinical Encounters ◽  
Australian General Practice ◽  
Education Medical ◽  
New Diagnosis ◽  
Sectional Analysis ◽  
Test Ordering

INTRODUCTION: Fatigue is the most common undifferentiated problem presenting in general practice. Previous studies have shown that this presentation leads to multiple investigations. There is no published literature describing the management of patients with fatigue by general practice (GP) registrars. AIM: To document the investigation-ordering behaviour of GP registrars in managing patients with a new diagnosis of unexplained fatigue. METHODS: This was a cross-sectional analysis of data from Registrar Clinical Encounters in Training (ReCEnT), an ongoing cohort study of GP registrars? consultations. We established the prevalence of new diagnoses of unexplained fatigue and associations with that diagnosis, the rate of test ordering and the number and types of investigations ordered. RESULTS: 644 registrars contributed data from 68 986 encounters. In 0.78% of patient encounters, a new diagnosis of unexplained fatigue was made. Pathology was ordered in 78.4% of these problems (versus 18.1% in non-fatigue problems), at a rate of 488 tests per 100 new fatigue problems. DISCUSSION: Our study suggests that unexplained fatigue elicits a non-rational approach to test ordering by registrars. These findings contribute to the understanding of GP registrar management of fatigue, and undifferentiated presentations more broadly, and suggest educational approaches to improve practice, including dealing with uncertainty. KEYWORDS: Diagnostic tests, routine; education, medical; family practice; fatigue; general practice

General practice registrars’ clinical exposure to dermatological procedures during general practice training: a cross-sectional analysis

2018 ◽  
Vol 29 (6) ◽  
pp. 357-366 ◽  
Author(s):  
Er Tsing Vivian Tng ◽  
Amanda Tapley ◽  
Andrew Davey ◽  
Sally De Zwaan ◽  
Simon Morgan ◽  
...  
Keyword(s):  
General Practice ◽  
Cross Sectional ◽  
Clinical Exposure ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
General Practice Training

scholarly journals Childhood atopic dermatitis as a precursor for developing attention deficit/hyperactivity disorder

2020 ◽  
Vol 34 ◽  
pp. 205873842096290
Author(s):  
Yang-chun Xu ◽  
Jin-peng Wang ◽  
Wen-jing Zhu ◽  
Ping Li
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Atopic Dermatitis ◽  
Attention Deficit ◽  
Sleep Disturbances ◽  
Positive Association ◽  
Temporal Association ◽  
Cross Sectional ◽  
Definitive Answer ◽  
Hyperactivity Disorder ◽  
Chronic Inflammatory Condition

Atopic dermatitis (AD) is a skin disease characterized by chronic inflammatory condition that shows hallmark presentations in terms of sleep disturbances, pruritus, and psychological stress, and an association with increased attention deficit/hyperactivity disorder (ADHD) risk. A number of studies have suggested for the co-occurrence of the two diseased conditions. In terms of global prevalence, AD and ADHD almost exhibit a parallel increment according to epidemiological data. In addition, recent reports indicate AD to show a temporal association with later onset of ADHD. Although several studies suggest for the potential link between AD and ADHD, currently there is no definitive answer to this regard. Furthermore, epidemiological evidence of co-occurrence does not ascertain a pathophysiological link between the two conditions. The pathophysiological basis behind the association of AD and ADHD also remain poorly elucidated. The objective of this review is to present an extensive account of AD and associated comorbidities with a special attention toward ADHD as well as to elaborate on the mechanisms underlying their association. The review can provide healthcare providers with the recent updates on AD-ADHD association and help them while dealing with such patients. In general, AD and ADHD show a positive association in majority of the cross-sectional studies. However, large longitudinal studies are required to draw any conclusion on the temporal nature of such association.

scholarly journals Responses to clinical uncertainty in Australian general practice trainees: a cross-sectional analysis

2017 ◽  
Vol 51 (12) ◽  
pp. 1277-1288 ◽  
Author(s):  
Georga Cooke ◽  
Amanda Tapley ◽  
Elizabeth Holliday ◽  
Simon Morgan ◽  
Kim Henderson ◽  
...  
Keyword(s):  
General Practice ◽  
Cross Sectional ◽  
Clinical Uncertainty ◽  
Cross Sectional Analysis ◽  
Australian General Practice ◽  
Sectional Analysis
Sign in / Sign up

Export Citation Format

Share Document