Affecting patients with work-related problems by educational training of their GPs: a cost-effectiveness study

Abstract

Background Assessing the cost effectiveness of training aimed at increasing general practitioners’ (GP) work awareness and patients’ work-related self-efficacy and quality of life. Methods A cluster randomized controlled trial in twenty-six GP practices in the southeast of the Netherlands with 32 participating GPs. GPs working in an intervention group practice received training and GPs working in a control group practice delivered usual care. The training intervention consisted of lectures and workshops aimed at increasing GPs’ work awareness and more proactive counseling for patients with work-related problems (WRP). Subjects were working age patients with paid work for at least 12 h per week, who visited one of the participating GPs during the study period. As outcome measures we used the Return to Work Self Efficacy scale to assess patients’ work-related self-efficacy and the Euroquol to assess quality of life. We also measured health care costs and productivity costs. With a 4-item questionnaire we asked patients to assess their GPs’ work awareness. Data were collected at baseline, after 6 and 12 months. Results Data of 280 patients could be analyzed. The patient related outcomes did not improve after GP training. The change in GP work awareness and the overall mean cost difference (of €770) in favor of the intervention group were not significant. Conclusions The training intervention presented in this paper was not cost-effective. Training which is further personalized and targeted at high risk groups with respect to WRP, is more likely to be cost effective. Electronic supplementary material The online version of this article (10.1186/s12875-019-0924-9) contains supplementary material, which is available to authorized users.

Physicians' Knowledge, Attitudes, and Practice of Occupational Diseases Diagnosis and Occupational History Taking

“…Furthermore, almost all research investigating physicians' opinions regarding barriers to taking an adequate occupational history by different specialty physicians agreed with the current study. The main barriers were the lack of knowledge and expertise in recognizing occupational diseases and the absence of training on occupational diseases' diagnosis procedures and related legislation, time constraints, and patient load 5,13,14,16,19,27,31,32,36 …”

“…The main barriers were the lack of knowledge and expertise in recognizing occupational diseases and the absence of training on occupational diseases' diagnosis procedures and related legislation, time constraints, and patient load. 5,13,14,16,19,27,31,32,36 The nonuse of a standard history form among participant physicians was the significant independent predictor of low knowledge.…”

“…Furthermore, physicians would be able to provide advice to patients, enabling them to continue their work. 3,7,9,10,[12][13][14] Despite the importance of occupational history in diagnosing occupational diseases, several studies have shown that many physicians do not take an occupational history and rarely ask about details other than the patient's current occupation, with few taking an adequate occupational history from all patients. [14][15][16][17][18] However, to our knowledge, no research has been conducted on Egyptian physicians' knowledge and attitudes toward occupational diseases or their practice of occupational history taking.…”

“…Moreover, it will also benefit the patients' coworkers by initiating their assessments, investigating workplace preventive measures, and applying corrective actions. Furthermore, physicians would be able to provide advice to patients, enabling them to continue their work 3,7,9,10,12–14 …”