Internal medicine journal · 2025
Outcomes of rheumatology referrals seen in a general medicine clinic.
СтатьяНазвание и аннотация: Перевод в очереди
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Shan Sam, Oon Shereen, Foote Andrew
Аннотация
BACKGROUND: Rheumatology outpatient clinics are facing increasing referral volumes, including new and long-term patients. International studies suggest that initial assessments by non-rheumatologists can be effective.
AIM: This study evaluates the role of a general medicine clinic in managing patients initially referred to rheumatology at an Australian tertiary hospital.
METHODS: We retrospectively reviewed rheumatology referrals diverted to the general medicine clinic at The Northern Hospital, Victoria, from 1 January 2023 to 30 June 2024. Data included patient demographics, referral reasons, investigations and clinical outcomes. Multiple indications were recorded where applicable. Ethics approval was obtained.
RESULTS: Fifty-three referrals were redirected to general medicine. Common referral reasons included arthritis (41.5%) and abnormal pathology (17%). Rheumatology-specific histories were documented in 86.3% of patients, with 34.1% showing positive findings. Rheumatological exams were performed in 60%, with positive findings in 19.2%. Two patients did not attend appointments. Following review, 60.8% underwent repeat pathology and 45.1% had radiology. Ten (19.6%) patients were initiated on treatment in general medicine. Nine (17%) were referred to rheumatology, with seven receiving a rheumatological diagnosis. The most common diagnoses made in general medicine were benign conditions such as musculoskeletal injuries (34%) and fibromyalgia (20.8%).
CONCLUSION: General medicine clinics may effectively triage and manage patients initially referred to rheumatology, potentially reducing unnecessary specialist consultations. In our cohort, only 17% required rheumatology referral, supporting the role of general medicine in preliminary rheumatologic evaluation within the Australian healthcare context.
AIM: This study evaluates the role of a general medicine clinic in managing patients initially referred to rheumatology at an Australian tertiary hospital.
METHODS: We retrospectively reviewed rheumatology referrals diverted to the general medicine clinic at The Northern Hospital, Victoria, from 1 January 2023 to 30 June 2024. Data included patient demographics, referral reasons, investigations and clinical outcomes. Multiple indications were recorded where applicable. Ethics approval was obtained.
RESULTS: Fifty-three referrals were redirected to general medicine. Common referral reasons included arthritis (41.5%) and abnormal pathology (17%). Rheumatology-specific histories were documented in 86.3% of patients, with 34.1% showing positive findings. Rheumatological exams were performed in 60%, with positive findings in 19.2%. Two patients did not attend appointments. Following review, 60.8% underwent repeat pathology and 45.1% had radiology. Ten (19.6%) patients were initiated on treatment in general medicine. Nine (17%) were referred to rheumatology, with seven receiving a rheumatological diagnosis. The most common diagnoses made in general medicine were benign conditions such as musculoskeletal injuries (34%) and fibromyalgia (20.8%).
CONCLUSION: General medicine clinics may effectively triage and manage patients initially referred to rheumatology, potentially reducing unnecessary specialist consultations. In our cohort, only 17% required rheumatology referral, supporting the role of general medicine in preliminary rheumatologic evaluation within the Australian healthcare context.