Leone Ridsdale1, Jane Doherty, Paul McCrone, Paul Seed. 1. Unit of Neurology and General Practice, Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London. L.Ridsdale@iop.kcl.ac.uk
Abstract
BACKGROUND: There is poor access to neurology services for patients in the community. AIM: To describe the training of GPs with special interest (GPwSI) in headache and the setting up of a GPwSI clinic in general practice, and report on a comparison with the existing neurology service in terms of case severity, patient satisfaction, and cost. DESIGN OF STUDY: New service provision and evaluation by a questionnaire survey. SETTING: General practice and hospital neurology service in inner-city London. METHOD: The intervention involved training GPs as GPwSIs and setting up a GP headache service. A questionnaire survey was conducted, measuring headache impact, satisfaction, and cost estimates. RESULTS: Headache impact was not significantly different between the two groups of patients, referred to hospital and to a GPwSI. Patients were significantly more satisfied with the GPwSI service, particularly that the service was effective in helping to relieve their symptoms (89% versus 76%; adjusted odds ratio=7.7; 95% confidence interval=2.7 to 22.4). The cost per first appointment was estimated to be pound sterling 136, with pound sterling 68 for subsequent contacts. These are lower than costs for neurologist contacts. CONCLUSION: GPwSI services can satisfy the needs of patients with similar headache impact at costs that are lower than those for secondary care services.
BACKGROUND: There is poor access to neurology services for patients in the community. AIM: To describe the training of GPs with special interest (GPwSI) in headache and the setting up of a GPwSI clinic in general practice, and report on a comparison with the existing neurology service in terms of case severity, patient satisfaction, and cost. DESIGN OF STUDY: New service provision and evaluation by a questionnaire survey. SETTING: General practice and hospital neurology service in inner-city London. METHOD: The intervention involved training GPs as GPwSIs and setting up a GP headache service. A questionnaire survey was conducted, measuring headache impact, satisfaction, and cost estimates. RESULTS:Headache impact was not significantly different between the two groups of patients, referred to hospital and to a GPwSI. Patients were significantly more satisfied with the GPwSI service, particularly that the service was effective in helping to relieve their symptoms (89% versus 76%; adjusted odds ratio=7.7; 95% confidence interval=2.7 to 22.4). The cost per first appointment was estimated to be pound sterling 136, with pound sterling 68 for subsequent contacts. These are lower than costs for neurologist contacts. CONCLUSION: GPwSI services can satisfy the needs of patients with similar headache impact at costs that are lower than those for secondary care services.
Authors: M Kosinski; M S Bayliss; J B Bjorner; J E Ware; W H Garber; A Batenhorst; R Cady; C G H Dahlöf; A Dowson; S Tepper Journal: Qual Life Res Date: 2003-12 Impact factor: 4.147
Authors: Leone Ridsdale; Lucy V Clark; Andrew J Dowson; Laura H Goldstein; Linda Jenkins; Paul McCrone; Myfanwy Morgan; Paul T Seed Journal: Br J Gen Pract Date: 2007-05 Impact factor: 5.386
Authors: Lindsay Blank; Susan Baxter; Helen Buckley Woods; Elizabeth Goyder; Andrew Lee; Nick Payne; Melanie Rimmer Journal: Br J Gen Pract Date: 2014-12 Impact factor: 5.386
Authors: Paul McCrone; Paul T Seed; Andrew J Dowson; Lucy V Clark; Laura H Goldstein; Myfanwy Morgan; Leone Ridsdale Journal: J Headache Pain Date: 2011-07-09 Impact factor: 7.277