Referrals to dietitians/nutritionists: A cross-sectional analysis of Australian GP registrars' clinical practice

Katie J Mulquiney; Amanda Tapley; Mieke L van Driel; Simon Morgan; Andrew R Davey; Kim M Henderson; Neil A Spike; Rohan H Kerr; Jane F Watson; Nigel F Catzikiris; Parker J Magin

doi:10.1111/1747-0080.12377

Referrals to dietitians/nutritionists: A cross-sectional analysis of Australian GP registrars' clinical practice

Nutr Diet. 2018 Feb;75(1):98-105. doi: 10.1111/1747-0080.12377. Epub 2017 Sep 14.

Authors

Katie J Mulquiney^{1

2}, Amanda Tapley^{1

2}, Mieke L van Driel³, Simon Morgan⁴, Andrew R Davey¹, Kim M Henderson^{1

2}, Neil A Spike^{5

6}, Rohan H Kerr⁷, Jane F Watson⁸, Nigel F Catzikiris^{1

2}, Parker J Magin^{1

2}

Affiliations

¹ NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, New South Wales, Australia.
² School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
³ General Practice and Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia.
⁴ Elermore Vale General Practice, Newcastle, New South Wales, Australia.
⁵ Eastern Victoria General Practice Training, Melbourne, Victoria, Australia.
⁶ Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.
⁷ General Practice Training Tasmania, Hobart, Tasmania, Australia.
⁸ Ethos Health, Newcastle West, New South Wales, Australia.

PMID: 28905462
DOI: 10.1111/1747-0080.12377

Abstract

Aim: The present study aimed to describe referral patterns of general practitioner (GP) registrars to dietitians/nutritionists. There is a paucity of research regarding GP referral patterns to dietitians/nutritionists. Limited data show increasing referrals from established GPs to dietitians/nutritionists. There are no data on GP registrar (trainee) referrals.

Methods: This was a cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. ReCEnT is an ongoing, multicentre, prospective cohort study of registrars, which documents 60 consecutive consultations of each registrar in each of the three six-month GP training terms. The outcome factor in this analysis was a problem/diagnosis resulting in dietitian/nutritionist referral (2010-2015). Independent variables were related to registrar, patient, practice and consultation.

Results: A total of 1124 registrars contributed data from 145 708 consultations. Of 227 190 problems/diagnoses, 587 (0.26% (confidence interval: 0.23-0.29)) resulted in dietitian/nutritionist referral. The most common problems/diagnoses referred related to overweight/obesity (27.1%) and type 2 diabetes (21.1%). Of referrals to a dietitian/nutritionist, 60.8% were for a chronic disease, and 38.8% were related to a Chronic Disease Management plan. Dietitian/nutritionist referral was significantly associated with a number of independent variables reflecting continuity of care, patient complexity, chronic disease, health equity and registrar engagement.

Conclusions: Established patients with chronic disease and complex care needs are more likely than other patients to be referred by registrars to dietitians/nutritionists. Nutrition behaviours are a major risk factor in chronic disease, and we have found evidence for dietitian/nutritionist referrals representing one facet of engagement by registrars with patients' complex care needs.

Keywords: chronic disease; education; general practice; medical graduate; nutritionist; referral.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Cross-Sectional Studies
General Practice / organization & administration*
Humans
Nutritionists*
Practice Patterns, Physicians' / statistics & numerical data*
Referral and Consultation*