| アブストラクト | BACKGROUND: Providing safety-netting advice (SNA) in out-of-hours primary care is a recognised standard of safe care but it is not known how frequently this occurs in practice. AIM: Assess the frequency and type of SNA documented in out-of-hours primary care and explore factors associated with its presence. DESIGN AND SETTING: Retrospective cohort using the Birmingham Out-of-hours General Practice Research Database. METHOD: A stratified sample of 30 adult consultation records per month from July 2013 to February 2020 were assessed using a safety-netting coding tool. Associations were tested using linear and logistic regression. RESULTS: The overall frequency of SNA per consultation was 78.0%, increasing from 75.7% (2014) to 81.5% (2019). The proportion of specific SNA and the average number of symptoms patients were told to look out for increased with time. The most common symptom to look out for was if the patients' condition worsened followed by if their symptoms persisted, but only one in five consultations included a time-frame to reconsult for persistent symptoms. SNA was more frequently documented in face-to-face treatment-centre encounters compared to telephone-consultations (Odds Ratio [OR]=1.77, p=0.02), for possible infections (OR=1.53, p=0.006), and less frequently for mental (vs. physical) health consultations (OR=0.33, p=0.002) and where follow-up was planned (OR=0.34, p<0.001). CONCLUSION: The frequency of SNA documented in OOH was higher than previously reported during in-hours care. Over time, the frequency of SNA and proportion that contained specific advice increased, however this study highlights potential consultations where SNA could be improved, such as mental health and telephone consultations. |
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| ジャーナル名 | The British journal of general practice : the journal of the Royal College of General Practitioners |
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| 投稿日 | 2024/7/2 |
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| 投稿者 | Edwards, Peter Jonathan; Finnikin, Samuel J; Wilson, Fay; Bennett-Britton, Ian; Carson-Stevens, Andrew; Barnes, Rebecca; Payne, Rupert A |
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| 組織名 | University of Birmingham Institute of Applied Health Research, Birmingham, United;Kingdom peter.edwards@bristol.ac.uk.;Kingdom.;Badger Group, Birmingham, United Kingdom.;University of Bristol Centre for Academic Primary Care, Bristol Medical School,;Bristol, United Kingdom.;Cardiff University School of Medicine, Division of Population Medicine, Cardiff,;United Kingdom.;University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford,;University of Exeter, Exeter, United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38950945/ |
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