Winceslaus J, Blount J, Cryer C
Department of Genitourinary Medicine, Kent and Sussex Hospital, Mount Ephraim, Tunbridge Wells, Kent.
Sex Transm Infect. 1999 Feb;75(1):45-8. doi: 10.1136/sti.75.1.45.
To devise a method of communicating with the general practitioners (GPs), overcoming the constraints imposed by patient confidentiality and the low levels of staffing in genitourinary medicine (GUM) clinics. To assess the GPs' responses to this method of communication.
GUM clinics at two centres in Kent-Maidstone and Tunbridge Wells.
Patients were recruited if they attended the clinic of their own accord without a letter of referral from their GPs; a definitive or provisional diagnosis was made and the patient was managed in the clinic; the patient's GP had received a conventional reply from the GUM clinic for other patients referred in the past. Separate GP letters were developed for male and female patients. These handwritten study letters were read by the patients who took the responsibility to deliver them to their GPs. This was followed by a questionnaire to the GPs.
75 patients were eligible. Seven patients refused to participate. All questionnaires were returned by the GPs for the 68 participating patients (100%). Seven GPs failed to receive the study letter. For these unreferred patients, this was an improvement in communication level from 0% to 80%. 79% (95% confidence interval: 67%-87%) preferred the study letter, 97% (89%-99%) would like to receive a similar letter for future patients. All GPs thought that the study letter was at least as good as the standard letter 52% (40%-64%) thought it was better. For 82% (70%-90%) it was the preferred format for future communication.
The study has shown a way of establishing communication with GPs for patients who do not object to this. The results also suggest that in the study districts neither the GPs nor the majority of study patients had any objection to the sharing of information between the GUM clinics and GPs.
设计一种与全科医生（GP）沟通的方法，克服患者保密规定和性传播疾病诊所（GUM）人员配备不足带来的限制。评估全科医生对这种沟通方式的反应。
肯特郡梅德斯通和汤布里奇韦尔斯两个中心的性传播疾病诊所。
招募那些自行前往诊所而没有全科医生转诊信的患者；做出明确或初步诊断，并在诊所对患者进行治疗；该患者的全科医生过去曾收到过性传播疾病诊所针对其他转诊患者的常规回复。为男性和女性患者分别编写了全科医生信件。这些手写的研究信件由患者阅读，患者负责将其交给自己的全科医生。随后向全科医生发放了一份问卷。
75名患者符合条件。7名患者拒绝参与。68名参与患者的所有问卷均由全科医生返回（100%）。7名全科医生未收到研究信件。对于这些未转诊患者，沟通水平从0%提高到了80%。79%（95%置信区间：67%-87%）的人更喜欢研究信件，97%（89%-99%）的人希望未来的患者也能收到类似的信件。所有全科医生都认为研究信件至少与标准信件一样好，52%（40%-64%）的人认为它更好。82%（70%-90%）的人认为这是未来沟通的首选形式。
该研究展示了一种为不反对的患者与全科医生建立沟通的方法。结果还表明，在研究地区，全科医生和大多数研究患者都不反对性传播疾病诊所和全科医生之间共享信息。
