title: Implementing an action protocol on prostatic disease in primary care and impact on referrals to urology.
abstract: OBJECTIVE
  To determine the impact of implementing a joint action protocol on prostatic disease on the referrals to Urology from Primary Care in a health care area.
  
  
  METHODS
  We drafted a protocol for managing patients consulting for clinical signs and symptoms associated to benign prostatic hyperplasia (BPH) and to test PSA in asymptomatic males. At the same time, three e-mail addresses were opened for consultations  generated from Primary  Care, and joint sessions were carried out in the primary health care centers. We measured the impact of the protocol by assessing the adequacy of prostatic disease referrals to Urology, as well as by determining the course of the total number of referrals in three peripheral specialized health care centers (PSHCC).
  
  
  RESULTS
  From January 2011, a better compliance to the referrals to Urology protocol for prostatic disease has been produced, going from 47% (assessment prior to  implementing the protocol) to 64%. These results are especially good when we consider referrals associated to PSA, which went from a compliance of 33% to 84%. Regarding the course of the referrals to Urology, the referral rate (referrals per 1000 inhabitants) has decreased by 15% (from 13,8 to 11,7).
  
  
  CONCLUSIONS
  The collaboration between Urology and Primary health care, by means of implementing joint protocols, and also by establishing new communication channels  (e-mail, joint sessions), achieves a better adequacy of patients referred for prostatic disease, as well as a reduction in the total number of referrals.
authors.affiliation: Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España. a_tejido@yahoo.com
authors.forename: Angel
authors.initials: A
authors.lastname: Tejido-Sánchez
authors.forename: Felipe
authors.initials: F
authors.lastname: Villacampa-Aubá
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Molero-García
authors.forename: Gabriela
authors.initials: G
authors.lastname: García-Alvarez
authors.forename: Juan
authors.initials: J
authors.lastname: Passas-Martínez
authors.forename: Rafael
authors.initials: R
authors.lastname: Díaz-González
mesh_terms: D002985:Clinical Protocols; D034742:Electronic Mail; D019983:Guideline Adherence; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D011320:Primary Health Care / Q000379:methods*; D017430:Prostate-Specific Antigen; D011469:Prostatic Diseases / Q000175:diagnosis* / Q000628:therapy*; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013030:Spain; D014570:Urologic Diseases / Q000175:diagnosis / Q000628:therapy; D014572:Urology
chemical_list: D017430:Prostate-Specific Antigen