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dc.contributor.authorHassoun, Omar
dc.contributor.authorStarostka, Matt
dc.contributor.authorShearer, Heather
dc.contributor.authorMillar, Angela
dc.contributor.authorHassoun, Salman
dc.contributor.authorIsles, Chris
dc.date.accessioned2022-08-10T12:30:13Z
dc.date.available2022-08-10T12:30:13Z
dc.date.issued2022-08-01
dc.identifier280812450
dc.identifier80bb92c5-8f4b-4314-a164-7262effaad40
dc.identifier85135337425
dc.identifier000835366200001
dc.identifier.citationHassoun , O , Starostka , M , Shearer , H , Millar , A , Hassoun , S & Isles , C 2022 , ' Improving the annual monitoring rates of testosterone replacement therapy patients in primary care ' , BMJ Open Quality , vol. 11 , no. 3 , e001784 . https://doi.org/10.1136/bmjoq-2021-001784en
dc.identifier.issn2399-6641
dc.identifier.otherJisc: 499744
dc.identifier.otherpublisher-id: bmjoq-2021-001784
dc.identifier.urihttps://hdl.handle.net/10023/25810
dc.description.abstractIntroduction Testosterone replacement therapy (TRT) is the treatment of choice for male hypogonadism. British Society for Sexual Medicine (BSSM) guidelines on adult testosterone deficiency recommend that TRT patients undergo annual monitoring of their testosterone levels and potential complications of treatment; though evidence suggests that substantial numbers of men on TRT are not monitored adequately. Methods Review of the electronic patient record from a single general practice in southwest Scotland revealed that only 1 of 26 (4%) TRT patients had been monitored as per BSSM guidelines in the previous 12 months. Additionally, when monitoring was undertaken there was inconsistency in the blood tests requested. The use of quality improvement (QI) tools including process mapping and cause-and-effect diagram identified staff and patient knowledge of monitoring requirements and the lack of an effective recall system as areas for improvement. We tested three change ideas: the utilisation of an existing recall system for long-term therapies; a TRT Ordercomms blood group template (OBGT) to standardise monitoring; and a patient information leaflet (PIL) to improve patient education. The aim of this project was to achieve 60% annual monitoring rate. Results The percentage of patients monitored for testosterone levels and potential TRT complications increased from 4% (1/26) to 65% (17/26) over a 7-week test period. The utilisation of the existing recall system was a particularly effective intervention, leading to an increase from 4% (1/26) to 31% (8/26) in the first 2 weeks. Conclusion The use of QI tools was associated with over 60% of male TRT patients receiving comprehensive annual monitoring, as per BSSM guidelines. Our findings support the hypothesis that a patient recall system, combined with an OBGT and a PIL led to this increase.
dc.format.extent6
dc.format.extent711526
dc.language.isoeng
dc.relation.ispartofBMJ Open Qualityen
dc.subjectRA Public aspects of medicineen
dc.subjectNDASen
dc.subject.lccRAen
dc.titleImproving the annual monitoring rates of testosterone replacement therapy patients in primary careen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Education Divisionen
dc.identifier.doi10.1136/bmjoq-2021-001784
dc.description.statusPeer revieweden


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