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01-02-2010 | Onderzoek
Teledermatologie en minder bezoeken aan de dermatoloog
Een clustergewijs, gerandomiseerd onderzoek
Auteurs: dr. N. Eminovi´c, dr. N. F. de Keizer, dr. N. Peek, prof.dr. J. C. Wyatt, prof.dr. P. J. E. Bindels, dr. H. C. van Weert, dr. G. ter Riet, prof.dr. C. A. Bruijnzeel-Koomen
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Samenvatting
Eminović N, De Keizer NF, Wyatt JC, Ter Riet G, Peek N, Van Weert HC, Bruijnzeel-Koomen CA, Bindels PJE. Teledermatologie en minder bezoeken aan de dermatoloog. Een clustergewijs, gerandomiseerd onderzoek. Huisarts Wet 2010;53(2):76-83.
Doel
Wij wilden in een clustergewijs, gerandomiseerd onderzoek bepalen of teledermatologische consulten het aantal verwijzingen naar de dermatoloog kunnen verlagen.
Methode
Daartoe rekruteerden wij 85 huisartsen uit 35 praktijken in twee regio's (Almere en Zeist) en vijf dermatologen uit perifere ziekenhuizen. De huisartsen sloten patiënten in als verwijzing naar de dermatoloog geïndiceerd was. Wij randomiseerden de huisartsen in een interventiegroep, die via een teledermatologisch consult overlegde met een dermatoloog, en een controlegroep die de patiënt rechtstreeks naar de dermatoloog verwees. Alle patiënten bezochten na ongeveer een maand de dermatoloog, zodat deze kon beoordelen of rechtstreekse verwijzing inderdaad gewenst zou zijn geweest. Het aantal aldus voorkomen bezoeken was onze primaire uitkomstmaat. Onze secundaire uitkomstmaat was patiënttevredenheid, zoals gemeten met Ware's Patient Satisfaction Questionnaire.
Resultaten
De huisartsen sloten 631 patiënten in: 46 huisartsen includeerden 327 patiënten in de interventiegroep en 39 huisartsen includeerden 304 patiënten in de controlegroep. Naar het oordeel van de dermatologen was voor 39,0% van de patiënten in de interventiegroep het teleconsult voldoende. In de controlegroep gold dit voor 18,3%, een verschil van 20,7% (95%-betrouwbaarheidsinterval 8,5-32,9%). Tijdens het beoordelingsbezoek bleek 20,0% van de patiënten in de interventiegroep hersteld, tegen 4,1% van de patiënten in de controlegroep. We vonden geen significante verschillen in patiënttevredenheid.
Conclusies
Teledermatologische consulten beloven het aantal verwijzingen naar de dermatoloog met 20,7% te reduceren. Bij huisartsen met meer dermatologische kennis zou de behoefte aan verwijzingen zelfs nog verder kunnen afnemen.
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Metagegevens
- Titel
-
Teledermatologie en minder bezoeken aan de dermatoloog
Een clustergewijs, gerandomiseerd onderzoek - Auteurs
-
dr. N. Eminovi´c
dr. N. F. de Keizer
dr. N. Peek
prof.dr. J. C. Wyatt
prof.dr. P. J. E. Bindels
dr. H. C. van Weert
dr. G. ter Riet
prof.dr. C. A. Bruijnzeel-Koomen
- Publicatiedatum
- 01-02-2010
- Uitgeverij
- Bohn Stafleu van Loghum
- DOI
- https://doi.org/10.1007/s12445-010-0034-3