Management of hallux valgus by GP's

NewsBot · Sep 25, 2019

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Management of Hallux Valgus in General Practice in Australia
Hylton B. Menz Christopher Harrison Helena Britt Glen A. Whittaker Karl B. Landorf Shannon E. Munteanu
24 September 2019

Objective
To describe the management of hallux valgus by general practitioners (GPs) in Australia.

Design
We analysed data from the Bettering the Evaluation and Care of Health program April 2000 to March 2016 inclusive. Patient and GP encounter characteristics were extracted. Hallux valgus encounters were identified using the International Classification of Primary Care, Version 2 Plus terms hallux valgus and bunion. Data were summarised using descriptive statistics and 95% confidence intervals around point estimates.

Results
The dataset included 1,568,100 patient‐encounter records among which hallux valgus was managed 658 times (4.2 per 10,000 encounters). This management rate extrapolates to an estimated 60,000 GP‐patient encounters across Australia in the most recent year data were available (2015‐2016). The management rate was three times higher in female compared to male patients, and most frequent among patients aged 45 to 64 years. Hallux valgus was most frequently managed by referral to orthopaedic surgeons (28 per 100 management occasions), counselling or advice (25 per 100) and referral to podiatrists (16 per 100). Pharmacological management was also frequently used (20 per 100) and primarily involved prescription of non‐steroidal anti‐inflammatory drugs (7 per 100).

Conclusions
Hallux valgus is a commonly encountered problem in Australian general practice and is mostly managed by provision of advice and referral to orthopaedic surgeons and podiatrists. Further research is required to examine the factors that influence the selection of surgical and non‐surgical treatment pathways by GPs and their comparative effectiveness.
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