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Scand J Prim Health Care · Sep 2023
Management of children with non-acute abdominal pain and diarrhea in Dutch primary care: a retrospective cohort study based on a routine primary care database (AHON).
- Sophie M Ansems, Marjolein Y Berger, Elaine Pieterse, Sjaantje Nanne, Gina G Beugel, Ria P E Couwenberg, and Gea A Holtman.
- Department of Primary and Long-term Care, University Medical Center Groningen, Groningen, the Netherlands.
- Scand J Prim Health Care. 2023 Sep 1; 41 (3): 267275267-275.
ObjectiveTo describe the testing, prescription, referral, and follow-up management by general practitioners (GPs) for children presenting with non-acute abdominal pain and/or diarrhea in primary care.DesignRetrospective cohort study with one-year follow-up.SettingRegistry data from a Dutch primary care database (AHON) between 2015 and 2019.SubjectsChildren aged 4-18 years old who presented by face-to-face consultation in primary care for non-acute abdominal pain and/or diarrhea (>7 days).Main Outcome MeasuresWe recorded the proportions of children who received (1) diagnostic testing, medicine prescriptions, follow-up consultations, and referrals at their first visit and (2) repeat consultations and referrals by one-year of follow-up.ResultsAmong the 2200 children (median age, 10.5 years; interquartile range, 7.0-14.6) presenting to a GP with non-acute abdominal pain and/or diarrhea, most reported abdominal pain (78.7%). At the first visit, GPs performed diagnostic testing for 32.2%, provided a prescription to 34.5%, and referred 2.5% to secondary care. Twenty-five percent of the children had a follow-up consultation within four weeks and 20.8% had a repeat consultation between four weeks and one year. Thirteen percent of the children were referred to secondary care by one year. However, only 1% of all children had documentation of an organic diagnosis needing management in secondary care.ConclusionOne-third of children received diagnostic testing or a medicine prescription. Few had a follow-up consultation and >10% was referred to pediatric care. Future research should explore the motivations of GPs why and which children receive diagnostic and medical interventions.
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