Patterns and Impact of Consultations to an Endocrinology Unit in a Tertiary Hospital in Southwestern Nigeria

BACKGROUND: The dearth of endocrinologists in Nigeria, coupled with a paucity of data on patterns of endocrine consultations pose a challenge in evaluating the impact of consultations on patients' management and eventual outcomes. The objectives of this study were to determine the frequency, sources of referrals, the common cases referred, the reasons for consultation requests, and the outcome of patients who benefitted from endocrine consultations. MATERIALS AND METHODS: This study was carried out in the Endocrinology unit of Babcock University Teaching Hospital, over 9 months. All patients referred to the unit were sampled (total sampling). Their sociodemographic parameters, sources, and reasons for consultations were documented. The patients' case notes were then retrospectively reviewed, to determine the impact of the consultation on their management and outcome. RESULTS: A total of 108 consults were received throughout the study. Most consultations were requested by the general outpatient clinic (37%) followed by cardiology clinic (12%). The most common reason was to take over management of the patients. Diabetes mellitus accounted for 68.7% of the cases seen. Diagnosis made by the referring physician was confirmed in most cases, new diagnoses or change in diagnosis was reached in 9.3% and 3.7%, respectively. About 39.8% of the patients were lost to follow-up, while 53.8% were in good and fair clinical condition. CONCLUSION: Most of the cases referred for specialist care were from the general outpatient clinic, had diabetes mellitus, and benefitted from specialist care by the way of advanced investigations and treatments, though about a third were lost to follow-up. It is imperative that a good referral system is maintained among physicians, to ensure that patients get the best care available. Attention must be paid to common causes of patient attrition such as lack of widespread health insurance coverage, to ensure continuity of care.