Use of sentinel practices to obtain data regarding common clinical conditions and presentations in small animal consultations

Robinson, Natalie Jane (2014) Use of sentinel practices to obtain data regarding common clinical conditions and presentations in small animal consultations. PhD thesis, University of Nottingham.

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Gathering data on the veterinary caseload will be useful in directing both future research and the veterinary curriculum. Previous studies have used clinical records to gather this data, but the validity of these methods remains unclear. Direct observation has been used to collect similar data in medicine and may be better able to capture the complexities of the consultation. The aim of the study was to determine the common patients, presentations, diagnoses and interventions during small animal veterinary consultations using direct observation.

A network of 8 sentinel practices in England and Scotland was recruited. A tool allowing collection of data during direct observation of consultations was developed and piloted. The tool was used to gather data on patient characteristics, problems discussed, diagnoses made and outcomes selected. Practice visits were conducted to feedback results and stimulate discussion.

Consultations were highly complex, with discussion of multiple problems, leading to a wide range of diagnoses and outcomes. Discussion of several problems appeared to be associated with increased consultation length. Preventive medicine was a common reason for presentation, and these consultations were amongst the most complex. A definitive diagnosis was not reached for most problems, yet actions were frequently taken. Feedback from the practices involved was positive, and discussions surrounding priorities for future research echoed the findings of the study.

Direct observation of consultations allows caseload to be recorded in great detail, which may not be possible with other collection methods. The results are the first step in directing future research towards areas relevant to practitioners and will also be useful in guiding the veterinary curriculum. The way in which future research is conducted should take into account the realities of first opinion practice, such as the high frequency of comorbidity and polypharmacy, and low frequency of definitive diagnosis.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Dean, R.
Brennan, M.
Cobb, M.A.
Keywords: sentinel practices, small animal consultations, veterinary practice, evidence-based medicine
Subjects: S Agriculture > SF Animal culture
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Veterinary Medicine and Science
Item ID: 14285
Depositing User: EP, Services
Date Deposited: 18 Dec 2014 15:53
Last Modified: 17 Dec 2017 09:27

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