ArticleBMJ open2021
Healthcare utilisation of patients with cholecystolithiasis in primary care: a multipractice comparative analysis.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Features of Metabolite Changes in Disease Evolution in Cholecystolithiasis.Digestive diseases and sciences · 2024Article
- Patients with Clinically Suspected Gallstone Disease: A More Selective Ultrasound May Improve Treatment Related Outcomes.Journal of clinical medicine · 2023Article
- Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey.World journal of emergency surgery : WJES · 2023Article
- Tailoring diagnosis and treatment in symptomatic gallstone disease.The British journal of surgery · 2022Review
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine general practitioners' (GP) management of cholecystolithiasis and to evaluate persisting abdominal complaints in the years after the diagnosis.
designRetrospective analysis of registry data and a subset of individual medical records.
settingSeventeen primary care practices affiliated with the Radboudumc Practice Based Research Network in the Netherlands.
participants633 patients with cholecystolithiasis diagnosed between 2012 and 2016. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome of this study was the healthcare utilisation of patients with cholecystolithiasis diagnosed by the GP in terms of referrals to secondary care, laboratory diagnostics, prescribed medication and the prevalence of concomitant abdominal-related diagnoses in a time interval of 3 years before and 3 years after diagnosis of cholecystolithiasis. For secondary outcomes, electronic medical records were studied from seven practices to assess emergency department visits, operation rates and repeat visits for persistent abdominal symptoms. We compared the non-referred group with the referred group.
resultsIn 57% of patients, concomitant abdominal-related diagnoses were recorded besides the diagnosis cholecystolithiasis. In-depth analyses of 294 patients showed a referral rate of 79.3% (n=233); 62.9% (n=185) underwent cholecystectomy. After referral, 55.4% (129/233) returned to the GP for persistent abdominal symptoms. Patients returning after referral were more often treated for another abdominal-related diagnosis before cholecystolithiasis was recorded (51.9% vs 28.8%, p<0.001).
conclusionsThe majority of patients in general practice with gallstones are referred and undergo cholecystectomy. Patients with concomitant abdominal-related diagnoses are likely to return to their physician. GPs should inform patients about these outcomes to improve the shared decision-making process before gallbladder surgery.
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