Unintentional weight loss

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Useful Management Information

Unintentional weight loss <5% can be managed in primary care.
If patient has iron deficiency anaemia, please refer to Gastroenterology.
Available depression tools include:
- PHQ-2  – 2 question screening tool
- K-10  – 10 question screening tool
If an eating disorder is suspected or confirmed consider referring to the Queensland Eating Disorder Service document: A guide to admission and inpatient treatment for people with eating disorders in Queensland

Minimum Referral Criteria

Category 1	Significant weight loss (≥10% of body weight in previous 6 months) without anaemia* Clinical features or test results suggestive of disseminated malignancy Marked cachexia or malnutrition (BMI <15)* Suspected malabsorption syndromes Post-prandial angina Uncontrolled anxiety or depression or pain syndromes causing marked loss of appetite * Suspected or confirmed eating disorders should be managed in accordance with the Queensland Eating Disorder Service:  A guide to admission and inpatient treatment for people with eating disorders in Queensland
Category 2	Unexplained weight loss (5-10% of body weight in previous 6 months)* * Suspected or confirmed eating disorders should be managed in accordance with the Queensland Eating Disorder Service:  A guide to admission and inpatient treatment for people with eating disorders in Queensland
Category 3	No category 3 criteria
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Relevant medical history and co-morbidities
Full list of current medications including non-prescription medications
Weight, height and BMI
Exact weight loss and time period of loss
Any associated symptoms (e.g. cough, abdominal pain, change in bowel habits)
Alcohol and drug history (including smoking)
Assessment of mood and social situation (depression is a common cause of weight loss)
Appetite and recent dietary changes
FBC
ELFT
ESR/CRP
TSH
Iron studies
Vitamin B12 & folate
Antitransglutaminase antibodies for coeliac disease in younger patients (aged < 40 years old) with associated iron deficiency

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

HbA1c results (if diabetic)
Chest X-Ray (if indicated)
Food intolerances or avoidances and abnormal eating behaviours
Gastrointestinal or oral symptoms especially dysphagia, diarrhoea, gum disease, poor dentition, loss of taste

Send Referrals To

Smart Referrals

Coming Soon

Internal Referrals

Internal Medicine (E-Blueslips)

Fax

5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.