
TY  - JOUR
A1  - Morgan, Simon 
A1  - Henderson, Kim 
A1  - Tapley, Amanda 
A1  - Thomson, Allison 
A1  - Wilson, Jessica 
A1  - Scott, John 
A1  - Spike, Neil 
A1  - McArthur, Lawrie 
A1  - van Driel, Mieke 
A1  - Magin, Parker 
T1  - Investigation of fatigue by Australian general practice registrars: a cross-sectional study
JF  - Journal of Primary Health Care
JO  - J Prim Health Care
Y1  - 2015
VL  - 7
IS  - 2
SP  - 109
EP  - 116
KW  - 
UR  - https://doi.org/10.1071/HC15109 
N2  - INTRODUCTION: Fatigue is the most common undifferentiated problem presenting in general practice. Previous studies have shown that this presentation leads to multiple investigations. There is no published literature describing the management of patients with fatigue by general practice (GP) registrars. AIM: To document the investigation-ordering behaviour of GP registrars in managing patients with a new diagnosis of unexplained fatigue. METHODS: This was a cross-sectional analysis of data from Registrar Clinical Encounters in Training (ReCEnT), an ongoing cohort study of GP registrars? consultations. We established the prevalence of new diagnoses of unexplained fatigue and associations with that diagnosis, the rate of test ordering and the number and types of investigations ordered. RESULTS: 644 registrars contributed data from 68 986 encounters. In 0.78% of patient encounters, a new diagnosis of unexplained fatigue was made. Pathology was ordered in 78.4% of these problems (versus 18.1% in non-fatigue problems), at a rate of 488 tests per 100 new fatigue problems. DISCUSSION: Our study suggests that unexplained fatigue elicits a non-rational approach to test ordering by registrars. These findings contribute to the understanding of GP registrar management of fatigue, and undifferentiated presentations more broadly, and suggest educational approaches to improve practice, including dealing with uncertainty. KEYWORDS: Diagnostic tests, routine; education, medical; family practice; fatigue; general practice 
ER  -

