Impact of a continuing medical education meeting on the use and timing of urgent cancer referrals among general practitioners - a before-after study

Table 5 The CME-M impact on patients’ prior contacts with general practice

	Reference group N = 240 practices				CME-M group N = 144 practices
N patients	Before CME-M 7,659	After CME-M 7,731	Before vs. after		Before CME-M 7,121	After CME-M 7,417	Before vs. after		Comparison between groups
Prior contacts			IRR0^a (95% CI)	P			IRR1^a (95% CI)	P	IRR1/IRR0^a (95% CI)	P
F2F contacts (mean)
0–1 month	1.91	1.89	1.00 (0.98;1.02)	0.662	1.92	1.90	0.99 (0.97;1.01)	0.190	0.99 (0.96;1.02)	0.525
0–3 months	3.24	3.20	1.00 (0.98;1.02)	0.868	3.23	3.22	1.00 (0.98;1.02)	0.950	1.00 (0.97;1.03)	0.872
4–6 months	1.82	1.81	1.01 (0.98;1.05)	0.536	1.84	1.83	0.99 (0.96;1.03)	0.870	0.99 (0.94;1.04)	0.583
Total contacts (mean)
0–1 month	2.84	2.87	1.01 (0.99;1.03)	0.189	2.95	2.87	0.98 (0.94;0.99)	0.044	0.97 (0.94;0.99)	0.019
0–3 months	5.17	5.21	1.01 (0.99;1.03)	0.233	5.31	5.19	0.99 (0.97;1.02)	0.369	0.98 (0.95;1.01)	0.137
4–6 months	3.22	3.24	1.00^b (0.97;1.04)	0.980	3.27	3.21	0.97^b (0.94; 1.01)	0.138	0.97^b (0.93;1.02)	0.296
Most contacting patients in the month preceding referral			OR0^a (95% CI)	P			OR1^a (95% CI)	P	OR1/OR0^a (95% CI)	P
F2F contacts ≥ 4^c (%)	10.4	10.4	1.02 (0.92;1.14)	0.726	10.8	10.8	0.99 (0.89;1.11)	0.911	0.97 (0.84;1.14)	0.745
Total contacts ≥ 5^c (%)	16.9	17.2	1.04 (0.95;1.13)	0.426	18.5	17.5	0.94 (0.86;1.02)	0.148	0.90 (0.86;1.02)	0.112

Prior contacts are shown as face-to-face and total contacts for three time periods: 0–1, 0–3 and 4–6 months and as the proportions of patients who had most contacts within the last month before referral. Practices are divided into CME-M group and reference group. The effect within a group is shown as an incidence rate ratio (IRR0: Reference group; IRR1: CME-M group), and comparisons between groups are shown as a ratio of incidence rate ratios. The effect on the proportion of the most attending patients within a group is shown as an odds ratio (OR0: Reference group; OR1: CME-M group), and comparisons between groups are shown as a ratio of odds ratios
Abbreviations: CME-M continuing medical education meeting, F2F face-to-face, IRR incidence rate ratio, OR odds ratio, CI confidence interval
Face-to-face (F2F) contacts include contacts with GP and patient in same room. Total contacts include face-to-face contacts, e-mails and phone contacts
^aAdjusted for cluster, practice type, patient’s age, gender and habitual contact rate, Charlson Comorbidity Index
^bAdjusted for cluster, patient age and gender, Charlson Comorbidity Index
^c90^th centile based on all data for F2F contacts and for total contacts
Bold = significance level of p ≤ 0.05

ISSN: 2731-4553