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The Transition Project
The Transition Project uses the standard classification for
primary care, the International
Classification of Primary Care (ICPC), which is designed for the
capture of primary care data and is published by the world organisation of
family doctors (Wonca) and included in the World Health Organisation’s
International Family of Classifications (WHO-FIC). ICPC allows capture of
all elements of the doctor-patient encounter, i.e. the patient’s reason
for encounter (RfE), the doctor’s interventions and the diagnostic label
of the episode of care (EoC).
Data
The public-domain EMR TransHis (www.transitieproject.nl
), designed for use with the International Classification of Primary Care
(Wonca International Classification Committee, 1998), was used to collect
data from participating family doctors (FDs) who recorded details
(reason/s for encounter, diagnosis/es and intervention/s) of all their
patient contacts in an episode of care structure using ICPC.
Reasons for encounter presented by the patient, all FD
interventions, and the diagnostic labels recorded for each encounter were
classified with ICPC (ICPC-2-E in Malta and Serbia, ICPC-1 in the
Netherlands). All prescriptions were coded with the Anatomical Therapeutic
and Chemical (ATC, 2003) and ICPC drug classifications (including
information on prescribed defined daily doses (DDDs). All encounter data
(face to face encounters in the office and at home, telephone
consultations, repeat prescriptions, etc.) were analysed to obtain
complete data on incidence and prevalence, including patients presenting
for a repeat prescription only.
Data collection
Doctors recording data for the Transition Project (www.transitieproject.nl
) were trained to record RfEs according to the definitions above,
reflecting the patient’s understanding as expressed during the
consultation. Symptoms elicited during history-taking (i.e. history of the
presenting complaint) were recorded in a separate cell in the EPR
Transhis, and were not used for the analyses in this study.
The databases encompass a defined time period: an average of
9,896 patients and 43,577 patient years of observation over 5 years in
Malta (2001-2005), 15,318 patients and 158,370 patient years over 11 years
in the Netherlands (1995-2005), 72,673 patient years over 1 year in Serbia
(2003). The practice populations in the Netherlands and Serbia represent
registered patient populations (the Serbs only those over 15 years of
age), whilst the population in Malta represents patients consulting over a
five year period. The databases were analysed using a one-year data-frame.
An EoC open over a number of years of observation would be re-coded as
rest-prevalent (to distinguish it from new) in subsequent years, but only
for those years when a consultation for that same EoC occurred.
| ICPC-ICD-10 Thesaurus installer | Top 20 data viewer for ICPC databases |
| A newer version of the Top 20 program, now called Top 100, includes data from the Dutch and Maltese Transition Project data collection networks to the end of 2014 and 2013 respectively. This program is compatible with later versions of Windows | Top 100 data viewer for ICPC databases |