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The Transition Project

MIPC has supported the Transition Project internationally, and has supported a Maltese arm of

the data collection 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).


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