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Care of Transgender Patients: A General Practice Quality Improvement Approach

Primary care must ensure high quality lifelong care is offered to trans and gender minority patients who are known to have poor health and adverse healthcare experiences. This quality improvement project aimed to interrogate and audit the data of trans and gender minority patients in one primary car...

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Detalles Bibliográficos
Autores principales: Boyd, Isabel, Hackett, Thomas, Bewley, Susan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775415/
https://www.ncbi.nlm.nih.gov/pubmed/35052285
http://dx.doi.org/10.3390/healthcare10010121
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author Boyd, Isabel
Hackett, Thomas
Bewley, Susan
author_facet Boyd, Isabel
Hackett, Thomas
Bewley, Susan
author_sort Boyd, Isabel
collection PubMed
description Primary care must ensure high quality lifelong care is offered to trans and gender minority patients who are known to have poor health and adverse healthcare experiences. This quality improvement project aimed to interrogate and audit the data of trans and gender minority patients in one primary care population in England. A new data collection instrument was created examining pathways of care, assessments and interventions undertaken, monitoring, and complications. General practitioners identified a sample from the patient population and then performed an audit to examine against an established standard of care. No appropriate primary care audit standard was found. There was inconsistency between multiple UK gender identity clinics’ (GIC) individual recommended schedules of care and between specialty guidelines. Using an international, secondary care, evidence-informed guideline, it appeared that up to two-thirds of patients did not receive all recommended monitoring standards, largely due to inconsistencies between GIC and international guidance. It is imperative that an evidence-based primary care guideline is devised alongside measurable standards. Given the findings of long waits, high rates of medical complexity, and some undesired treatment outcomes (including a fifth of patients stopping hormones of whom more than half cited regret or detransition experiences), this small but population-based quality improvement approach should be replicated and expanded upon at scale.
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spelling pubmed-87754152022-01-21 Care of Transgender Patients: A General Practice Quality Improvement Approach Boyd, Isabel Hackett, Thomas Bewley, Susan Healthcare (Basel) Article Primary care must ensure high quality lifelong care is offered to trans and gender minority patients who are known to have poor health and adverse healthcare experiences. This quality improvement project aimed to interrogate and audit the data of trans and gender minority patients in one primary care population in England. A new data collection instrument was created examining pathways of care, assessments and interventions undertaken, monitoring, and complications. General practitioners identified a sample from the patient population and then performed an audit to examine against an established standard of care. No appropriate primary care audit standard was found. There was inconsistency between multiple UK gender identity clinics’ (GIC) individual recommended schedules of care and between specialty guidelines. Using an international, secondary care, evidence-informed guideline, it appeared that up to two-thirds of patients did not receive all recommended monitoring standards, largely due to inconsistencies between GIC and international guidance. It is imperative that an evidence-based primary care guideline is devised alongside measurable standards. Given the findings of long waits, high rates of medical complexity, and some undesired treatment outcomes (including a fifth of patients stopping hormones of whom more than half cited regret or detransition experiences), this small but population-based quality improvement approach should be replicated and expanded upon at scale. MDPI 2022-01-07 /pmc/articles/PMC8775415/ /pubmed/35052285 http://dx.doi.org/10.3390/healthcare10010121 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Boyd, Isabel
Hackett, Thomas
Bewley, Susan
Care of Transgender Patients: A General Practice Quality Improvement Approach
title Care of Transgender Patients: A General Practice Quality Improvement Approach
title_full Care of Transgender Patients: A General Practice Quality Improvement Approach
title_fullStr Care of Transgender Patients: A General Practice Quality Improvement Approach
title_full_unstemmed Care of Transgender Patients: A General Practice Quality Improvement Approach
title_short Care of Transgender Patients: A General Practice Quality Improvement Approach
title_sort care of transgender patients: a general practice quality improvement approach
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775415/
https://www.ncbi.nlm.nih.gov/pubmed/35052285
http://dx.doi.org/10.3390/healthcare10010121
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