Many Patients With Palpitations Are Referred, Despite Guidelines

More than half of patients with palpitations who are referred from primary care to a secondary care cardiologist are referred without meeting guideline referral thresholds, according to the results of a recent study.

To better understand adherence to referral guidelines, the researchers conducted an audit of 66 patient referrals. The characteristics of those patients referred to this single cardiology outpatient clinic were also assessed.

The results indicated that 51.5% (n = 34) of patients who were referred for palpitations were referred inappropriately. These patients were 91.2% more likely to have a benign diagnosis after cardiologist assessment and had significantly fewer investigations. In addition, specialist investigations such as cardiac event recorders and cardiac magnetic resonance imaging were less likely to be used in these patients.

“The results from this audit provide early evidence that there are a significant number of patients who are being referred that could be managed in primary care,” the study authors concluded. “Further studies are needed to confirm our findings in larger cohorts and to establish the underlying reasons for inappropriate referrals.”

—Leigh Precopio

Reference:

Pallikadavath S, Patel R, Sarania R, et al. Palpitation referrals from primary care to a secondary care cardiology outpatient clinic: assessing adherence to guidelines. Family Practice. 2021; 38(2):127-131. doi: /10.1093/fampra/cmaa094