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Lookup NU author(s): Dr Lorraine McSweeneyORCiD, Emerita Professor Janet WilsonORCiD, Dr Scott Wilkes, Dr Katie Haighton
This is the authors' accepted manuscript of an article that has been published in its final definitive form by Oxford University Press, 2018.
For re-use rights please refer to the publisher's terms and conditions.
Background The Scottish Intercollegiate Guidelines Network developed guidelines for the management of sore throat and indications for tonsillectomy in 1999 to address concerns of unnecessary surgery. Emergency admissions to hospital for tonsillitis have since increased. Adults experience an average of 27 episodes of tonsillitis before undergoing tonsillectomy. We wished to explore the appropriateness of the guidance and/or its implementation in primary care Aim To explore the attitudes of GPs to the referral criteria they use when managing adults presenting with acute tonsillitis. Design Secondary analysis of qualitative data from the NAtional Trial of Tonsillectomy in Adults (NATTINA) feasibility and process evaluation. Participants and setting Twenty-one GPs from practices throughout the UK. Method In-depth interviews GPs concerning both the feasibility and process evaluation phases of NATTINA. Analysis was conducted using the Framework method. Results General practitioners felt it was rarely necessary to refer patients. They were aware of guidelines and would refer if requested by a patient who fulfilled the guidelines criteria and/or who were missing considerable amounts of work. Conclusion The introduction of the guidelines appears to coincide with what some may have hoped to be a desired effect of reducing adult sore throat referrals and subsequent tonsillectomies by increasing the number of episodes a patient must suffer before the referral threshold is met. GPs may find equipoise for tonsillectomy referral challenging as many patients, express a strong preference for surgery.We believe this paper reinforces GP professionalism, patient-centred consultations and challenges the role of clinical guidelines.
Author(s): McSweeney LA, Wilson JA, Wilkes S, Haighton CA
Publication type: Article
Publication status: Published
Journal: Family Practice
Year: 2018
Volume: 35
Issue: 5
Pages: 633-637
Print publication date: 18/09/2018
Online publication date: 24/03/2018
Acceptance date: 26/02/2018
Date deposited: 14/08/2019
ISSN (print): 0263-2136
ISSN (electronic): 1460-2229
Publisher: Oxford University Press
URL: https://doi.org/10.1093/fampra/cmy017
DOI: 10.1093/fampra/cmy017
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