Evidence map›Paper›PMID 40415981›Full record

ReviewHealth science reports2025

General Practitioners' Perspectives on Barriers to Communication With Specialists in the Referral System: A Systematic Review and Meta-Synthesis.

Hamed Fattahi, Faezeh Ghasemi Seproo, Arash Fattahi, Vahideh Rostami, Azad Shokri

Abstract readReview
In one paragraph

Review in Health science reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Hamed FattahiHealth Management and Economics Research Center, Health Management Research Institute Iran University of Medical Sciences Tehran Iran.ORCID 0000-0001-7011-3797
Faezeh Ghasemi SeprooCenter for Health Human Resources Research and Studies Ministry of Health and Medical Education Tehran Iran.
Arash FattahiDepartment of Neurosurgery, School of Medicine Iran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0002-1874-6527
Vahideh RostamiStudent Research Committee, School of Management and Medical Informatics Shiraz University of Medical Sciences Shiraz Iran.ORCID 0009-0005-9662-2748
Azad ShokriSocial Determinants of Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran.ORCID 0000-0003-2976-4488

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: For achieving an effective integrated primary health care, communication between healthcare providers is a key element. This study aimed to identify general practitioners' reported barriers to communication within referral systems and propose actionable strategies for improvement. Methods: Guided by PRISMA 2020 guidelines, 22 qualitative studies from PubMed, Web of Science, Scopus, and ProQuest were analyzed using inductive thematic synthesis. Quality assessment followed Standards for Reporting Qualitative Research (SRQR) criteria. Results: Four central themes emerged: structural barriers (subthemes: inefficient health system, shortages in the number of specialists and heavy workload), regulatory and procedural barriers (subthemes: lack of comprehensive communication protocols, unclear delineation of roles and responsibilities, inadequate economic incentives, lack of continuity between providers, lack of interest in specialists, time consuming communication process), technological barriers (subthemes: ineffective methods for communication, challenges in using electronic medical records), and personal and interpersonal barriers (subthemes: having different approaches to healthcare, inappropriate specialists' perceptions of general practitioners' roles, lack of professional trust and respect, social anxiety disorder in the workplace). Conclusion: Health policymakers must prioritize structural and procedural reforms, including standardized communication frameworks, interoperable digital infrastructure, and interprofessional training programs. Addressing these gaps can enhance referral system efficiency, reduce diagnostic delays, and strengthen health system resilience, particularly in low-resource settings. Trial Registration: The protocol of the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on December 20, 2023 (Supporting Information S1).

Indexed as

barrierscommunicationgeneral practitionersprimary healthcarereferral systemspecialist

Identifiers

PMID40415981
PMCPMC12098960

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.