Influences on general practitioner referral to allied health professionals for fall prevention in primary care

Liddle, Jeannine; Clemson, Lindy; Mackenzie, Lynette; Lovarini, Meryl; Tan, Amy; Pit, Sabrina; Roberts, Chris; Tiedemann, Anne; Sherrington, Catherine; Willis, Karen

doi:10.1111/ajag.12680

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…GPs not actively creating networks with local NPHPs [48] or GPs and NPHPs not working together in multiprofessional centres [49] have been previously suggested as potential barriers to multiprofessional practice. In our study, co-location seemed to have a limited influence, if any, on referral frequency, since *Indicates statistically significant results a Includes professions such as farmers, retailers, craftspeople, and senior managers b Includes children, unemployed people, stay at home parents, students etc.…”

Section: Discussionmentioning

confidence: 99%

To which non-physician health professionals do French general practitioners refer their patients to and what factors are associated with these referrals? Secondary analysis of the French national cross-sectional ECOGEN study

Peurois

Chopin

Texier-Legendre

et al. 2022

BMC Health Serv Res

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Background Multiprofessional practice is a key component in primary care. Examining general practitioner (GP) referral frequency to non-physician health professionals (NPHP) can provide information about how primary care is organised and works which is useful for policymakers. Our study aimed to describe French GP referral frequency to various NPHPs in France and identify associated factors. Methods This is an ancillary study to the observational, cross-sectional (ECOGEN) study conducted in 2011/2012 in France among 128 GPs. Data about consultations using the standardised International Classification of Primary Care (ICPC-2), and patient and GP characteristics were collected from 20,613 GP consultations. Referrals were identified through inductive and deductive approaches using ICPC-2 codes, keywords, and deep, open manual searches. Referral frequency was described overall and per NPHP. Patient, GP, and consultation-related factors associated with referral rates were described for the three most frequently identified NPHPs. To minimise potential sources of bias, this observational study followed the STROBE guidelines. Results French GPs referred 6.8% of patients to NPHPs, with physiotherapists, podiatrists, and nurses accounting for 85.2% of referrals. Older patients, retired patients, multiple health problems managed, and longer consultation durations were found to be associated with higher referral rates (p < 0.001). Specific trends were observed for nurse, physiotherapist, and podiatrist referrals. Women (p < 0.001) and regular patients (p = 0.002) were more likely to receive physiotherapy referrals while people with no professional activity were less likely (p < 0.001). Female GPs and those working in urban practices were more likely to issue a physiotherapy referral (p < 0.001), while GPs working in rural practices (p < 0.001) and those with higher annual consultation numbers (p = 0.002) were more likely to refer to a nurse. Working in multiprofessional centres appeared to have little impact on referral rates, being only slightly associated with podiatrist referrals (p = 0.003). Conclusions Referral frequency is more associated with patient characteristics and clinical situations than GP-related factors suggesting patients needing referral most are most often referred. Furthermore, the three NPHPs that GPs refer to the most are those for which a referral is required for reimbursement in France, suggesting that health system legislation and NPHP reimbursement are strong determinants for referrals.

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Section: Discussionmentioning

confidence: 99%

To which non-physician health professionals do French general practitioners refer their patients to and what factors are associated with these referrals? Secondary analysis of the French national cross-sectional ECOGEN study

Peurois

Chopin

Texier-Legendre

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

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“…The aged may perceive fall prevention as a threat to their ability to fulfil their daily tasks or activities that they have always performed. Besides, modifying risky behaviours and maintaining motivation for protective attitudes and activities such as daily or weekly physical exercises are difficult (Anderson & Lane, 2020;Liddle et al, 2020).…”

Section: Implication and Reflection For Nursing Practicementioning

confidence: 99%

Falls Prevention in Community-dwelling Elderly in Brazil: Strategies and Difficulties in Primary Health Care

Fonseca,

Matumoto

2024

Acta Sci. Health Sci.

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The ageing world population has inspired the current care model to incorporate health promotion. The health of the elderly within primary health care aims to maintain functionality in old age. Thus, the prevention of falls by the elderly ensures health promotion by preventing various damages and health problems. Though, effective preventive action is a complex task that health workers have to face. It aims to highlight the difficulties encountered and describe the strategies used to achieve health promotion in the elderly to prevent falls. This is a qualitative research with Hegelian dialectics based on the methodological approach. The Focus group technique was made with community health agents from a municipality in the state of São Paulo, Brazil. The Content Thematic Analysis was used to process verbal discourses and retrieve in its entirety factors from data to classify and categorize all aspects of fall prevention. Findings point to difficulties related to the personal beliefs of the elderly, the difficulty of adapting to daily activities, and deficiencies in social support. Among the strategies adopted were multi-professional teams, family and social networks, and longitudinal approaches. The elements and factors described should be incorporated into primary care by health professionals, especially the nurse as a care manager, to encourage protective attitudes, behaviours, and activities with the elderly to maintain healthy ageing. Any related aspect can be partially or totally generalized, in different socioeconomic statuses, because they reflect daily life and potentially explain the incidence of falls under multidimensional issues.

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Perspectives of Australian GPs on tailoring fall risk management: a qualitative study

Mackenzie

Liddle²,

Clemson³

et al. 2021

Aust. J. Primary Health

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Falls among older people are highly prevalent, serious and costly, and translation of evidence about falls prevention needs to occur urgently. GPs can identify older people at risk of falling and put preventative measures in place before a fall. Because GPs are key to identifying older people at risk of falls and managing falls risk, this study explored how GPs adapted to the iSOLVE (Integrated SOLutions for sustainable falls preVEntion) process to embed evidence-based falls prevention strategies within primary care, and whether and how they changed their practice. A theoretically informed qualitative study using normalisation process theory was conducted in parallel to the iSOLVE trial to elicit GPs’ views about the iSOLVE process. Data were coded and a thematic analysis of interview transcripts was conducted using constant comparison between the data and themes as they developed. In all, 24 of 32 eligible GPs (75%) from general practices located in the North Sydney Primary Health Network, Australia, were interviewed. Six themes were identified: (1) making it easy to ask the iSOLVE questions; (2) internalising the process; (3) integrating the iSOLVE into routine practice; (4) addressing assumptions about patients and fall prevention; (5) the degree of change in practice; and (6) contextual issues influencing uptake. The iSOLVE project focused on practice change, and the present study indicates that practice change is possible. How GPs addressed falls prevention in their practice determined the translation of evidence into everyday practice. Support tools for falls prevention must meet the needs of GPs and help with decision making and referral. Fall prevention can be integrated into routine GP practice through the iSOLVE process to tailor fall risk management. Trial Registry.This trial was registered with the Australian New Zealand Clinical Trial Registry (www.anzctr.org.au; Trial ID: ACTRN12615000401550).

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Influences on general practitioner referral to allied health professionals for fall prevention in primary care

Cited by 5 publications

References 28 publications

To which non-physician health professionals do French general practitioners refer their patients to and what factors are associated with these referrals? Secondary analysis of the French national cross-sectional ECOGEN study

To which non-physician health professionals do French general practitioners refer their patients to and what factors are associated with these referrals? Secondary analysis of the French national cross-sectional ECOGEN study

Falls Prevention in Community-dwelling Elderly in Brazil: Strategies and Difficulties in Primary Health Care

Perspectives of Australian GPs on tailoring fall risk management: a qualitative study

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