{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:37:52Z","timestamp":1747186672304,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015539","name":"Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015539","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Functional bowel (constipation and faecal incontinence) and bladder (urinary incontinence and enuresis) problems in children are often treated by paediatricians yet should mostly be managed by general practitioners (GPs). To understand whether the necessary skills and knowledge are being built in general practice, this study aimed to establish the prevalence and associated skills of Australian general practice registrars managing children with functional bowel and bladder problems. Together as paediatricians and GPs, we use these data to determine how best to ensure high quality, equitable care for children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We drew on 16 rounds of data collection from the Registrar Clinical Encounters in Training (ReCEnT) multi\u2010site cohort study (2010\u20132017) of general practice registrars' in\u2010consultation experience. It included a measure of paediatric consultations in which a functional bowel or bladder problem was managed, as well as demographic information.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 62\u2009721 problems\/diagnoses for paediatric patients (0\u201317\u2009years), 844 (1.4%) were coded as functional bowel (<jats:italic>n<\/jats:italic>\u2009=\u2009709; 1.13% (95% confidence interval, CI: 1.05\u20131.22)) and\/or bladder (<jats:italic>n<\/jats:italic>\u2009=\u2009135; 0.22% (95% CI: 0.18\u20130.25)) presentations. Registrars were more likely to prescribe medication for bowel problems (odds ratio (OR)\u2009=\u20092.22 (95% CI: 1.86\u20132.64)) than for all other problems, but less likely to prescribe medication (OR\u2009=\u20090.31 (95% CI: 0.18\u20130.52)) for night\u2010time wetting and more likely to make a specialist referral (OR\u2009=\u20091.99 (95% CI: 1.22\u20133.25)) compared to all other problems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Only a small proportion of children with functional bowel and bladder problems were seen by registrars despite high prevalence in the community and amenability to management in the general practice setting (i.e. generally low morbidity and low complexity) versus need for specialists. Registrars appeared to be managing functional bowel and bladder problems according to evidence\u2010based guidelines, but with relatively high levels of referral. Given the inequitable access to specialist care, paediatricians should support local general practice management of these problems. This might include (i) engaging with training programs to ensure appropriate education and (ii) liaising with individual registrars\/practices to provide management advice for individual or example cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16444","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T07:10:08Z","timestamp":1685085008000},"page":"979-986","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and associated skills of Australian general practice registrars seeing children with functional bowel and bladder problems"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6520-7094","authenticated-orcid":false,"given":"Sharon","family":"Goldfeld","sequence":"first","affiliation":[{"name":"Centre for Community Child Health, Murdoch Children's Research Institute Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Tapley","sequence":"additional","affiliation":[{"name":"NSW and ACT Research and Evaluation Unit GP Synergy  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elodie","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Centre for Community Child Health, Murdoch Children's Research Institute Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Spike","sequence":"additional","affiliation":[{"name":"Eastern Victoria General Practice Training  Melbourne Victoria Australia"},{"name":"Department of General Practice University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Morgan","sequence":"additional","affiliation":[{"name":"NSW and ACT Research and Evaluation Unit GP Synergy  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary L","family":"Freed","sequence":"additional","affiliation":[{"name":"Child Health Evaluation and Research Center University of Michigan  Ann Arbor Michigan USA"},{"name":"Centre for Health Policy, Melbourne School of Population and Global Health University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Davey","sequence":"additional","affiliation":[{"name":"NSW and ACT Research and Evaluation Unit GP Synergy  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Holliday","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Ball","sequence":"additional","affiliation":[{"name":"Clinical Research Design and Statistical Support Unit (CReDITSS) Hunter Medical Research Institute  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parker","family":"Magin","sequence":"additional","affiliation":[{"name":"NSW and ACT Research and Evaluation Unit GP Synergy  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/14739879.2016.1266697"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2005.00409.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.04.037"},{"key":"e_1_2_9_5_1","first-page":"529","article-title":"The paediatric clinical experiences of general practice registrars","volume":"41","author":"Freed G","year":"2012","journal-title":"Aust. 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Pract."},{"volume-title":"LSAC Annual Statistical Report 2017","year":"2018","author":"Warren D","key":"e_1_2_9_29_1"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.16444","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T22:11:46Z","timestamp":1692223906000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.16444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,26]]},"references-count":28,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/jpc.16444"],"URL":"https:\/\/doi.org\/10.1111\/jpc.16444","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"type":"print","value":"1034-4810"},{"type":"electronic","value":"1440-1754"}],"subject":[],"published":{"date-parts":[[2023,5,26]]},"assertion":[{"value":"2022-11-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}