Chest pain: to refer or not?

Can the orientation of patients with general practitioner chest pain to the cardiologist be more effective? Researchers from Leiden University Medical Center (LUMC) and the University of Maastricht will answer this question in the near future. They receive more than 500,000 euros from the ZonMw Efficiency program.

Every day in the Netherlands, 1,400 people with chest pain present themselves to their general practitioner. For the general practitioner, it is sometimes difficult to determine if the complaints are caused by the heart. "A lot of the patients who are now referred to the cardiologist do not seem to have heart problems afterwards, which guarantees high health costs, high work pressure for cardiologists and creates unnecessary stress for the patient," explains Tobias Bonten, LUMC Research Leader

In the POB-HELP study, Bonten wonders if the so-called decision rule can help determine whether or not a person with chest pain should be shipped. He conducts research with colleagues from the LUMC Department of Heart Disease and researchers from the University of Maastricht, including GP Robert Willemsen

The rule of thumb states that a general practitioner scores points and if required a rapid test.According to the result, the general practitioner decides to wait, to consult a cardiologist or to send him directly to the hospital. The general practitioner can safely determine which strategy is best with such counseling, which would mean significant progress for general practitioners and patients, "says Willemsen

. Maastricht. Ninety general surgeons and five general practitioners are divided into two groups, half of whom use the new decision rule and the other half do not. The researchers measure the number of referrals, the costs, the reassurance of the patients and whether no cardiac infarction is missed with this method. Bonten: "If the decision rule works well, we expect ten percent fewer hospital referrals for chest pain.This would result in an annual saving of 60 million euros at the hospital. national scale. "

Source: LUMC