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Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners

General practitioners (GPs) are qualified and trained to administer therapeutic musculoskeletal injections when indicated. However, it is unknown to what extend Dutch GPs feel competent to administer these injections in clinical practice. Reluctance among GPs to inject might lead to unnecessary and...

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Autores principales: Spruit, Emely, Mol, Marianne F., Bos, P. Koen, Bierma-Zeinstra, Sita M.A., Krastman, Patrick, Runhaar, Jos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356219/
https://www.ncbi.nlm.nih.gov/pubmed/32560156
http://dx.doi.org/10.3390/jcm9061880
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author Spruit, Emely
Mol, Marianne F.
Bos, P. Koen
Bierma-Zeinstra, Sita M.A.
Krastman, Patrick
Runhaar, Jos
author_facet Spruit, Emely
Mol, Marianne F.
Bos, P. Koen
Bierma-Zeinstra, Sita M.A.
Krastman, Patrick
Runhaar, Jos
author_sort Spruit, Emely
collection PubMed
description General practitioners (GPs) are qualified and trained to administer therapeutic musculoskeletal injections when indicated. However, it is unknown to what extend Dutch GPs feel competent to administer these injections in clinical practice. Reluctance among GPs to inject might lead to unnecessary and costly referral to secondary care. An online and offline questionnaire was spread among Dutch GPs, querying demographics, GPs’ self-assessment of injection competence, the number of administered/referred injections and management strategy for musculoskeletal injections. A total of 355 GPs responded. In total, 81% of the GPs considered themselves competent in administering musculoskeletal injections. Self-assessed incompetent GPs performed less injections the last month than self-assessed competent GPs (1.2 ± 1.4 vs 4.8 ± 4.6 injections, P < 0.001). Additionally, they referred four times more often to a colleague GP (0.4 ± 1.0 vs 0.1 ± 0.6 injections per month, P < 0.001) and twice as often to secondary care (1.0 ± 1.3 vs 0.5 ± 0.9 injections per month, P = 0.001). Self-assessed incompetence was associated with female sex (OR [95% CI] = 4.94 [2.39, 10.21]) and part-time work (OR [95% CI] = 2.58 [1.43, 4.66]). The most frequently addressed barriers were a lack of confidence in injection skills, lack of practical training, and uncertainty about the effectiveness and diagnosis of musculoskeletal injections. Although most GPs considered themselves competent to administer musculoskeletal injections, the referral rate to secondary care for several injections was strikingly high. To decrease secondary care referrals, addressing some of the most frequently indicated barriers is highly recommended.
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spelling pubmed-73562192020-07-31 Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners Spruit, Emely Mol, Marianne F. Bos, P. Koen Bierma-Zeinstra, Sita M.A. Krastman, Patrick Runhaar, Jos J Clin Med Article General practitioners (GPs) are qualified and trained to administer therapeutic musculoskeletal injections when indicated. However, it is unknown to what extend Dutch GPs feel competent to administer these injections in clinical practice. Reluctance among GPs to inject might lead to unnecessary and costly referral to secondary care. An online and offline questionnaire was spread among Dutch GPs, querying demographics, GPs’ self-assessment of injection competence, the number of administered/referred injections and management strategy for musculoskeletal injections. A total of 355 GPs responded. In total, 81% of the GPs considered themselves competent in administering musculoskeletal injections. Self-assessed incompetent GPs performed less injections the last month than self-assessed competent GPs (1.2 ± 1.4 vs 4.8 ± 4.6 injections, P < 0.001). Additionally, they referred four times more often to a colleague GP (0.4 ± 1.0 vs 0.1 ± 0.6 injections per month, P < 0.001) and twice as often to secondary care (1.0 ± 1.3 vs 0.5 ± 0.9 injections per month, P = 0.001). Self-assessed incompetence was associated with female sex (OR [95% CI] = 4.94 [2.39, 10.21]) and part-time work (OR [95% CI] = 2.58 [1.43, 4.66]). The most frequently addressed barriers were a lack of confidence in injection skills, lack of practical training, and uncertainty about the effectiveness and diagnosis of musculoskeletal injections. Although most GPs considered themselves competent to administer musculoskeletal injections, the referral rate to secondary care for several injections was strikingly high. To decrease secondary care referrals, addressing some of the most frequently indicated barriers is highly recommended. MDPI 2020-06-16 /pmc/articles/PMC7356219/ /pubmed/32560156 http://dx.doi.org/10.3390/jcm9061880 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Spruit, Emely
Mol, Marianne F.
Bos, P. Koen
Bierma-Zeinstra, Sita M.A.
Krastman, Patrick
Runhaar, Jos
Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners
title Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners
title_full Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners
title_fullStr Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners
title_full_unstemmed Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners
title_short Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners
title_sort self-assessment of competence and referral behavior for musculoskeletal injections among dutch general practitioners
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356219/
https://www.ncbi.nlm.nih.gov/pubmed/32560156
http://dx.doi.org/10.3390/jcm9061880
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