Occupational Medicine Advance Access first published online on March 14, 2008
This version published online on March 15, 2008
Occupational Medicine, doi:10.1093/occmed/kqn017
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A protocol improves GP recording of long-term sickness absence risk factors
1 Division of Clinical Methods and Public Health, Department of General Practice and Family Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
2 Horten Centre, University of Zurich, Zurich, Switzerland
3 Division of Clinical Methods and Public Health, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Background If general practitioners (GPs) were better informed about patients' risks of long-term sickness absence (LTSA), they could incorporate these risk assessments into their patient management plans and cooperate more with occupational physicians to prevent LTSA.
Aim To evaluate the effectiveness of a protocol helping GPs in recording risks of LTSA and in co-operating with occupational physicians (OPs).
Methods Twenty-six GPs (co-operating in four groups) in Amsterdam, The Netherlands, participated in a controlled intervention study. Fourteen GPs were the protocol-supported intervention group and twelve GPs were the reference group. Outcome measures were consultations containing work-related information, information about two risk factors for LTSA, referrals to OPs and contacts of OPs with GPs and patients. Outcomes were identified through an electronic search in the GPs' information systems. Entries containing information were independently scored by two investigators. The proportions of patients with consultations documenting LTSA-pertinent items were compared between the groups, accounting for differences at baseline.
Results There was no increase in consultations containing work-related information. Recording of risk factor information increased in the intervention group; the difference was 4.5% [95% CI 1.5–7.6] and 1.8% (95% CI –0.8 to 4.4) for the two risk factors. The referral rate to the OP increased by 2.9% (95% CI 1.2–4.5). There was no effect on contacts of OPs with GPs or with patients.
Conclusion Protocol-supported consultations may lead to a modest increase in information regarding two risk factors for LTSA in GPs' electronic records and to more referrals to OPs.
Keywords Family medicine; general practitioner; long-term sickness absence; risk factors; occupational health care; occupational physician; prevention
Correspondence to: Paul van Dijk, Division of Clinical Methods and Public Health, Department of General Practice and Family Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Tel: +3120 566 6692; fax: +3120 566 9186; e-mail: p.vandijk{at}amc.uva.nl