General practitioners’ adoption of a new diagnostic clinic for functional somatic disorders: build it and they will come - but only when invited
Abstract
Abstract Background. Functional somatic disorders (FSD) affect about one in six Danish adults by symptom questionnaires. Undiagnosed patients often cycle through repeated specialist referrals, with diagnosis delayed for years, prolonging patient suffering and raising healthcare costs. In 2019, a regional FSD track opened within the general medical Diagnostic Centre at Silkeborg Regional Hospital, Denmark: a single-visit assessment of suspected FSD earlier than the specialised FSD department's threshold. We evaluated how GP practices in the Central Denmark Region received this new offering during 2019 to 2026. Methods. Among all 340 eligible GP practices in the region, we examined adoption (time to first referral, 31 July 2019 to 22 October 2024), maintenance (continued referral over 19 months post-trial, November 2024 to May 2026) and GP-perceived barriers and facilitators (118 interviews across three rounds). Implementation activities included one-to-many channels (online updates and a physical mailout) and one-to-one telephone outreach. Adoption rates are per 100 practice-years (PY), each practice contributing time from catchment opening until first referral, closure or trial-window end. Results. 204 of 340 practices (60.0%) referred at least one patient during the trial window, generating 533 referrals (overall rate 37.4 per 100 PY, 95% CI 32.6 to 42.8). One-to-many channels reached the full cohort with no detectable change. Active telephone outreach was the only…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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