DEVELOPMENT OF A LOCAL NEEDS-BASED GP CURRICULUM FOR SHARED CARE IN RHEUMATOLOGY.
O. Hussein, T. Duffy
Connolly Hospital Blanchardstown, Dublin
There is a role for shared care between rheumatologist and primary care for Musculoskeletal (MSK) disorders. General practitioners (GPs) are involved in monitoring of clinical status of patients and their management, in addition to psychosocial aspects of chronic pain and disability.
We aim to: 1) Identify knowledge and skill gaps in primary care related to MSK disorders and to develop a need-based curriculum to address these gaps. 2) Develop an implementation plan to deliver the curriculum components.
There are two rounds of questionnaires to reach a list of important areas to develop the curriculum. Initially we identify the needs and gaps in the current practice using survey in a small group of local GPs. The second round will include large number of GPs. Also, there will be meetings with GPs.
Thirty one out of 36 GPs (86%) returned questionnaires. One GP (3.2%) refer to rheumatology department twice a week, 4 GPs (13%) refer weekly, 23 GPs (74%) refer monthly and three GPs (9.7%) rarely refer to rheumatologist. Reasons for referral were diagnosis and long-term management (21), diagnosis and discharge back to GP (15) and patient’s request (4). Thirteen
GPs (42%) have interest in rheumatology conditions management. Long waiting time for rheumatology appointment was the major concern by 71% of GPs. Other issues were delayed clinic letter, need for clear instruction, patients not aware of appointment time, whether there is a fast track clinic. Nineteen GPs (61%) received undergraduate rheumatology training, 16 (52%) during GP training programme and 4 (13%) attended postgraduate courses. Topics of interest by GPs were variable rheumatology conditions in addition to joint injections (3), referral guidance (2) and update on DMARD. Preferred teaching methods to deliver the syllabus were small group tutorials (12), face-to-face lectures (8) and protocols and guidelines (5).
From this initial survey, we could identify that the major concern of local GPs is the long waiting time for rheumatology clinic. Some of GPs (42%) expressed their interest to have further training in rheumatology. When we reach an agreed curriculum with GPs, we aim to deliver the syllabus through preferred methods by GPs.