Table 2 Study characteristics
Type of publication | Lead author | Title | Country | Study design | Clinical specialty | Intervention type | Immediate effect | Predictors of referral behavior | Intervention outcomes/intended impact |
|---|---|---|---|---|---|---|---|---|---|
Abstract | Bhamra, 2019 | Food as medicine: medical nutrition therapy for patients living with diabetes | USA | Cross-sectional study | Diabetes | Process change System change | Referral behavior | Service factors | Referral rate |
Abstract | Chow, 2015 | A multidisciplinary effort to improve utilization of resources for patients with morbid obesity in the primary care clinic | USA | Quality improvement | Morbid obesity | HCP education System change Patient intervention | HCP knowledge Referral behavior | HCP factors Service factors | Referral rate Mortality and morbidity outcomes |
Abstract | Lavenbur, 2023 | Primary care provider perceptions of a population health management program to improve kidney care | USA | Qualitative research | Chronic kidney disease—nephrology | Process change | HCP attitudes and beliefs Referral behavior | HCP factors Service factors | Impact on existing service provision Staff satisfaction |
Abstract | Liao, 2023 | Can a Multidisciplinary Virtual Educational Seminar Change Resident Physician Attitudes and Referral Practices to Complementary and Integrative Health? | USA | Survey, qualitative research, and cohort study | Physiotherapy—low back pain | HCP education | HCP knowledge HCP attitudes and beliefs Referral behavior | HCP factors | Referral rate Staff satisfaction |
Abstract | Shrivastava, 2018 | An allied health professional-led annual health clinic to improve standards of care | UK | Cross-sectional study | HIV | Process change | Referral behavior | HCP factors Service factors | Referral rate Referral quality Appropriateness of referral |
Abstract & full text | Filippini, 2014 and 2022 | Implementation of an Integrated Care Pathway for dementia in the clinical practice: rationale, design, and methodology. The REMIND Study | Italy | Cohort study | Neurology—dementia decline detection | HCP education Process change | HCP knowledge HCP attitudes and beliefs Referral behavior | HCP factors Service factors | Referral rate Referral quality Appropriateness of referral |
Full text | Barnett, 2015 | Implementation of an electronic referral system in a large academic medical center | USA | Cohort study | Various clinical specialities | Process change System change | Referral behavior | HCP factors Service factors | Referral rate Referral quality Appropriateness of referral Staff satisfaction |
Full text | Bishop, 2015 | A pilot cluster randomized controlled trial to investigate the addition of direct access to physiotherapy to usual GP-led primary care for adults with musculoskeletal pain: the STEMS trial | UK | Pilot pragmatic, non-inferiority, cluster randomized controlled trial | Physiotherapy—musculoskeletal pain | Process change HCP education | HCP—patient interaction Patient attitudes and beliefs | Patient factors | Referral rate Referral quality Appropriateness of referral Impact on existing service provision Costs Quality of life Effectiveness Patient satisfaction |
Full text | Disler, 2022 | A new model for general practice-led, regional, community-based, memory clinics | Australia | Cross-sectional study | Dementia | HCP education Process change System change | Referral behavior | Service factors | Referral rate Referral quality |
Full text | Haley, 2015 | Improving care coordination between nephrology and primary care: a quality improvement initiative using the Renal Physicians Association toolkit | USA | Other: qualitative research/longitudinal cohort study | Nephrology | HCP education Process change | HCP knowledge HCP attitudes and beliefs Referral behavior | HCP factors Service factors | Referral rate Referral quality Appropriateness of referral |
Full text | Jamal, 2020 | The IMPACT study: a clustered randomized controlled trial to assess the effect of a referral algorithm for axial spondyloarthritis | Netherlands | Randomized controlled trial | Rheumatology—chronic lower back pain | Process change | Referral behavior | HCP factors | Referral rate Effectiveness |
Full text | Keck, 2020 | Primary care cluster RCT to increase diabetes prevention program referrals | USA | Other: randomized controlled trial and qualitative research | Diabetes | HCP education System change | HCP knowledge HCP attitudes and beliefs Referral behavior | HCP factors Service factors | Referral rate |
Full text | Fonseca, 2018 | Effectiveness of a referral program for early arthritis diagnosis at primary care centers in Portugal-final results from the SIARA study | Portugal | Randomized controlled trial | Rheumatoid arthritis (RA) | HCP education Process change System change | HCP knowledge HCP attitudes and beliefs Referral behavior | HCP factors | Referral rate |
Full text | Mallett, 2014 | Is physiotherapy self-referral with telephone triage viable, cost-effective, and beneficial to musculoskeletal outpatients in a primary care setting? | UK | Cohort study | Musculoskeletal/physiotherapy | Process change Patient intervention | Patient attitudes and beliefs | Patient factors | Referral rate Impact on existing service provision—improved waiting times, attendance rates Costs Patient satisfaction Patient experience process measures |
Full text | McKay, 2019 | Inter-professional integration improves the primary care to physical therapy referral process | USA | Non-randomized experimental study | Physiotherapy—musculoskeletal pain | System change | HCP knowledge HCP attitudes and beliefs Referral behavior Other: HCP collaboration | HCP factors Service factors | Referral rate Impact on existing service provision |
Full text | Olayiwola, 2016 | Electronic consultations to improve the primary care-specialty care interface for cardiology in the medically underserved: a cluster-randomized controlled trial | USA | Randomized controlled trial | Cardiology | Process change | HCP attitudes and beliefs Referral behavior | HCP factors Service factors | Referral rate Appropriateness of referral Staff satisfaction |
Full text | Osteras, 2019 | Implementing a structured model for osteoarthritis care in primary healthcare: a stepped-wedge cluster-randomized trial | Norway | Cluster-randomized controlled trial | Physiotherapy—Osteoarthritis | HCP education Process change System change | HCP knowledge HCP attitudes and beliefs Referral behavior HCP and patient interaction | HCP factors Patient factors Service factors | Referral rate Patient satisfaction |
Full text | Perez, 2016 | Understanding the causes of and developing effective interventions for schizophrenia and other psychoses | UK | Randomized controlled trial | Psychiatry | HCP education | HCP knowledge HCP attitudes and beliefs Referral behavior | HCP factors | Referral rate Referral quality Appropriateness of referral Costs |
Full text | Pfeil 2023 | A telemedicine strategy to reduce waiting lists and time to specialist care: a retrospective cohort study | Brazil | Retrospective cohort study | Mixed – nephrology Pulmonology Urology Neurology neuro- surgery rheumatology | Process change System change | Referral behavior | Service factors | Referral rate Impact on existing service provision Effectiveness Patient satisfaction |
Full text | Quinlan, 2017 | Implementing integrated care—lessons from the national implementation of general eReferrals in Ireland | Ireland | Qualitative research | All clinical specialties | Process change | Referral behavior | Service factors | Appropriateness of referral Impact on existing service provision |
Full text | Rugkasa, 2020 | Collaborative care for mental health: a qualitative study of the experiences of patients and health professionals | Norway | Qualitative research | Mental health | System change | HCP attitudes and beliefs Referral behavior HCP—patient interaction | HCP factors Patient factors Service factors | Referral quality Appropriateness of referral Impact on existing service provision Patient Satisfaction Staff satisfaction |
Full text | Takashima, 2019 | The impact of physician-directed versus patient-directed education on referral patterns to urogynecology | USA | Prospective, multi-phase, before-and-after study | Urogynecology | HCP education Patient intervention | HCP knowledge Referral behavior Patient knowledge | HCP factors Patient factors | Referral rate Referral quality |