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Observational Study
. 2017 May;40(5):331-338.
doi: 10.1016/j.gastrohep.2016.10.004. Epub 2016 Dec 20.

Implementation and evaluation of early gastroscopy for patients with dyspepsia and warning signs in Primary Care

[Article in English, Spanish]
Francisco Javier García-Alonso  1 , María Hernández Tejero  2 , Elvira Rubio Benito  3 , Paz Valer  2 , Iván Guerra  2 , Victoria Gema García Ceballos  3 , Mar Noguerol  4 , Victoria Llinares  5 , Fernando Bermejo  2
Affiliations
Observational Study

Implementation and evaluation of early gastroscopy for patients with dyspepsia and warning signs in Primary Care

[Article in English, Spanish]
Francisco Javier García-Alonso et al. Gastroenterol Hepatol. 2017 May.

Erratum in

Abstract

Introduction: Dyspepsia is a common disorder in both Primary (PC) and Specialised Care (SC). Gastroscopy is recommended at the start of the study if there are warning signs, although it is not always available in PC.

Objectives and methods: We developed a pilot project establishing an early gastroscopy programme for patients with dyspepsia and warning signs in PC, subsequently extending it to the entire healthcare area. The aim was to evaluate the requirements, impact and opinion of this service at the PC level. Demographic, symptomatic and endoscopic variables on the patients referred to SC from the pilot centre were recorded. A satisfaction survey was conducted among the PC physicians.

Results: The one-year pilot study and the first year of implementation of the programme were evaluated. A total of 355 patients were included (median age 56.4 years; IQR 45.5-64.3); 61.2% (56.1-66.3%) were women. The waiting time for examination was 1.5 weeks (IQR 1.5-2.5). Gastroscopy was correctly indicated in 82.7% (78.4-86.3%) of patients. The median number of requests per month was 1.1 per 10,000 adults (range 0.8-1.6). Monthly referrals to SC clinics from the pilot centre fell by 11 subjects (95% CI 5.9-16) with respect to the previous median of 58 (IQR 48-64.5). Almost all those polled (98.4%) considered the programme useful in routine practice.

Conclusions: The availability of an early gastroscopy programme in PC for patients with dyspepsia and warning signs reduced the number of referrals to SC.

Keywords: Adult; Adulto; Ambulatory care/economics; Ambulatory care/organization & administration; Diagnostic techniques of the digestive system; Dispepsia; Dyspepsia; Endoscopia gastrointestinal; Endoscopy gastrointestinal; Referral and consultation; Remisión y consulta; Servicio ambulatorio en hospital/economía; Servicio ambulatorio en hospital/organización y administración; Técnicas de diagnóstico del sistema digestivo.

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