Verwijzing van patiënten met een polyneuropathie door de huisarts: geen invloed van de leeftijd, maar wel van de aard van de klachten

To investigate the influence of the age of the patient and the nature of a polyneuropathy on the referral behaviour of general practitioners (GPs).

Design

Written questionnaire sent to GPs regarding paper case records of polyneuropathy.

Setting

University Hospital Utrecht, the Netherlands.

Methods

1590 GPs were asked about their differential diagnosis regarding a paper case record of a patient with polyneuropathy. There were six case records, differing in age (53, 64 and 73 years) and nature of the disease (sensory or sensorimotor polyneuropathy). The GPs were divided into six groups with similar demographic characteristics and type of practice. To avoid focus on polyneuropathy, all GPs also received questions about three other neurological cases (amaurosis fugax, radicular syndrome and vasovagal collapse).

Results

The mean response of the questionnaire was 54 (n = 844). Most GPs diagnosed the polyneuropathy (analysis of variance; p < 0.0001). The age of the patient did not influence the diagnosis nor the referral behaviour. At least 73 of the patients with a sensory and 81 of the patients with a sen sorimotor polyneuropathy were referred to neurologists for further investigations (χ²-test; p < 0.05).

Conclusion

At least 73 of the GPs referred a patient wit polyneuropathy to a neurologist; patients with muscle weakness were referred more often than patients with only sensory disturbances. Referral was not influenced by the age of the patient.