open access

Vol 19, No 1 (2012)
Original articles
Published online: 2012-02-02
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Evaluation of a direct access cardiac arrhythmia monitoring service

David A. Skipsey, Fiona M. Dawson, Cathal Breen, Stephen J. Leslie
Cardiol J 2012;19(1):70-78.

open access

Vol 19, No 1 (2012)
Original articles
Published online: 2012-02-02

Abstract

Background: This paper describes the clinical outcomes from a novel direct access arrhythmia monitoring service.
Methods:
The study was carried out in the north of Scotland. Data was collected over a 29 month period between 18 June 2008 and 8 November 2010 from consecutive cases from two groups of patients, general practitioner (GP) direct access and ‘redirected’ consultant referrals. Monitor test results, frequency of arrhythmias requiring further care and clinic attendances were recorded. Statistical differences were analyzed using Χ2, Fisher’s and Student’s t-test as appropriate with the significance taken at the 0.05 level.
Results:
239 patients were referred from 47 GP practices. There were 165 (69%) referrals through the ‘direct’ and 72 (31%) through the ‘redirected’ route. The average age was 55.5 ± ± 16.7 years with 84 (35.1%) males. 127 (53.1%) had a patient activated event recording and the remaining 112 (46.9%) had Holter monitoring. Of the 239 patients, only nine (3.8%) cases required referral to a consultant cardiologist. Of these, three were directly returned to GP care without consultant clinic review. Six patients with significant arrhythmias were reviewed at cardiology clinic. There were no adverse events.
Conclusions:
Direct access for cardiac arrhythmia monitoring seems to provide an effective mechanism for diverting inappropriate or non-essential referrals away from the cardiology clinic. (Cardiol J 2012; 19, 1: 70–75)

Abstract

Background: This paper describes the clinical outcomes from a novel direct access arrhythmia monitoring service.
Methods:
The study was carried out in the north of Scotland. Data was collected over a 29 month period between 18 June 2008 and 8 November 2010 from consecutive cases from two groups of patients, general practitioner (GP) direct access and ‘redirected’ consultant referrals. Monitor test results, frequency of arrhythmias requiring further care and clinic attendances were recorded. Statistical differences were analyzed using Χ2, Fisher’s and Student’s t-test as appropriate with the significance taken at the 0.05 level.
Results:
239 patients were referred from 47 GP practices. There were 165 (69%) referrals through the ‘direct’ and 72 (31%) through the ‘redirected’ route. The average age was 55.5 ± ± 16.7 years with 84 (35.1%) males. 127 (53.1%) had a patient activated event recording and the remaining 112 (46.9%) had Holter monitoring. Of the 239 patients, only nine (3.8%) cases required referral to a consultant cardiologist. Of these, three were directly returned to GP care without consultant clinic review. Six patients with significant arrhythmias were reviewed at cardiology clinic. There were no adverse events.
Conclusions:
Direct access for cardiac arrhythmia monitoring seems to provide an effective mechanism for diverting inappropriate or non-essential referrals away from the cardiology clinic. (Cardiol J 2012; 19, 1: 70–75)
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Keywords

direct access; arrhythmia monitoring; primary care

About this article
Title

Evaluation of a direct access cardiac arrhythmia monitoring service

Journal

Cardiology Journal

Issue

Vol 19, No 1 (2012)

Pages

70-78

Published online

2012-02-02

Bibliographic record

Cardiol J 2012;19(1):70-78.

Keywords

direct access
arrhythmia monitoring
primary care

Authors

David A. Skipsey
Fiona M. Dawson
Cathal Breen
Stephen J. Leslie

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