[Appropriateness of indications for upper gastrointestinal endoscopy in open-access endoscopy units].
BACKGROUND
The indication for upper gastrointestinal endoscopy (UGE) by the general practitioner may significantly reduce the waiting time list for the exploration and accelerates the process of taking decisions in patients with upper gastrointestinal pathology. The objective of this study is to compare the appropriateness of indications for diagnostic UGE between general practitioners and gastroenterologists in open-access endoscopy units.


METHODS
General practitioners were previously updated on the main indications, risks and benefits for UGE, and instructions for submitting patients to open-access units were given. The indications for UGE were analysed by means of the ASGE 1997 and EPAGE guidelines for the appropriate use of upper gastrointestinal endoscopy.


RESULTS
There were no statistical differences between patients referred by general practitioners or gastroenterologists with respect to gender, age, indication of UGE or the presence of alarm symptoms. According to the ASGE guidelines overuse of UGE was observed in 25 (18.4%) of 136 patients submitted by general practitioners and in 32 (18.6%) of 172 patients submitted by gastroenterologists (NS). According to the EPAGE guidelines a non-appropriated UGE was present in 16 (11.8%) of patients referred by general practitioners and by 19 (11%) of patients submitted by gastroenterologists (NS).


CONCLUSIONS
The level of appropriateness for UGE indication obtained by general practitioners is similar to that reached by gastroenterologists. This finding should be considered for the implementation of open-access endoscopy units in our country.
Unidad de Aparato Digestivo, Hospiten, Tenerife, Spain.
A
A
Sánchez-del Río
E
E
Quintero
O
O
Alarcón
D000328:Adult; D001266:Atlantic Islands; D001471:Barrett Esophagus / Q000175:diagnosis; D004415:Dyspepsia / Q000175:diagnosis; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005762:Gastroenterology / Q000706:statistics & numerical data*; D005764:Gastroesophageal Reflux / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012040:Regional Health Planning; D013030:Spain