Trial reportBMC health services research2015
Impact of referral templates on the quality of referrals from primary to secondary care: a cluster randomised trial.
Trial report in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01470963 (Practical Health Co-operation - a Randomised Controlled Intervention Study. The Impact of a Referral Template on Quality of Care and Health Care Co-operation Between Primary and Secondary Care), which is not on this map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Practical Health Co-operation - a Randomised Controlled Intervention Study. The Impact of a Referral Template on Quality of Care and Health Care Co-operation Between Primary and Secondary Care
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care.The Cochrane database of systematic reviews · 2022Pooled it
- Electronic checklists improve referral letters in gastroenterology: a randomized vignette survey.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2018Trial
- Trial
- The effect of referral templates on out-patient quality of care in a hospital setting: a cluster randomized controlled trial.BMC health services research · 2017Trial
- Impact of referral templates on patient experience of the referral and care process: a cluster randomised trial.BMJ open · 2016Trial
- Article
- Determinants and strategies for implementing guideline-adherent physiotherapy: a scoping review.BMJ open · 2026Article
- Exploring plastic and reconstructive surgery referral pathways: Insights from primary care physicians in Bahrain.Journal of family medicine and primary care · 2026Article
- Co-designing a structured referral template to enhance dementia diagnosis: a modified e-Delphi study.Age and ageing · 2026Article
- Article
- Adequacy of electronic and in-person referrals to endocrinology: a prospective study of primary care and hospital consultations.Frontiers in endocrinology · 2026Article
- Asking the Right Questions: Benchmarking Large Language Models in the Development of Clinical Consultation Templates.Pacific Symposium on Biocomputing. Pacific Symposium on Biocomputing · 2026Article
- Observational
- Article
- Codesigned standardised referral form: simplifying the complexity.BMJ health & care informatics · 2024Observational
- Article
- Outpatient secondary care pathways for head and neck cancer referral result in patient delays for cancer treatment.Annals of the Royal College of Surgeons of England · 2023Article
- Audit of documentation accompanying referred maternity cases to a referral hospital in northern Ghana: a mixed-methods study.BMC health services research · 2022Article
- Essential information for transition of care for frail elderly patients in Japan: A qualitative study.Journal of general and family medicine · 2022Article
- Review of referrals reveal the impact of referral content on the triage and management of ophthalmology wait lists.BMJ open · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe referral letter is an important document facilitating the transfer of care from a general practitioner (GP) to secondary care. Hospital doctors have often criticised the quality and content of referral letters, and the effectiveness of improvement efforts remains uncertain.
methodsA cluster randomised trial was conducted using referral templates for patients in four diagnostic groups: dyspepsia, suspected colorectal cancer, chest pain and chronic obstructive pulmonary disease. The GP surgery was the unit of randomisation. Of the 14 surgeries served by the University Hospital of North Norway Harstad, seven were randomised to the intervention group. Intervention GPs used referral templates soliciting core clinical information when initiating a new referral in one of the four clinical areas. Intermittent surgery visits by study personnel were also carried out. A total of 500 patients were included, with 281 in the intervention and 219 in the control arm. Referral quality scoring was performed by three blinded raters. Data were analysed using multi-level regression modelling. All analyses were conducted on intention-to-treat basis.
resultsIn the final multilevel model, referrals in the intervention group scored 18% higher (95% CI (11%, 25%), p < 0.001) on the referral quality score than the control group. The model also showed that board certified GPs and GPs in larger surgeries produced referrals of significantly higher quality.
conclusionIn this study, the dissemination of referral templates coupled with intermittent surgery visits produced higher quality referrals.
trial registrationThis trial has been registered at ClinicalTrials.gov. The trial registration number is NCT01470963.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.