A case study of nurse management of upper respiratory tract infections in general practice

Abstract Background Upper respiratory tract infections (URTIs) are a common presentation in general practice and are linked to high rates of inappropriate antibiotic prescription. There is limited information about the trajectory of patients with this condition who have been prescribed antibiotics. Objective To document the symptom profile of patients receiving antibiotics for URTIs in Australian general practice using smartphone technology and online surveys. Methods In total, 8218 patients received antibiotics after attending one of the 32 general practice clinics in Australia from June to October 2017: 4089 were identified as URTI presentations and were the cohort studied. Patients completed the Wisconsin Upper Respiratory Symptom Survey (WURSS-24) 3 and 7 days after visiting their general practitioner (GP). Results Six hundred fourteen URTI-specific patients responded to at least one symptom survey (RR 15%). The majority of patients reported moderate to mild symptoms at 72 hours [median global symptom severity score 37 (IQR 19, 59)] post-GP visit which reduced to very mild symptoms or not sick by day 7 [11 (IQR 4, 27)]. Patients receiving antibiotics for URTI reported the same level of symptom severity as patients in previous studies receiving no treatment. Conclusions The recovery of most patients within days of receiving antibiotics for URTI mimics the trajectory of patients with viral URTIs without treatment. Antibiotics did not appear to hasten recovery. Monitoring of patients in this context using smart phone technology is feasible but limited by modest response rates.

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How does the duration of consults vary for upper respiratory tract infections in general practice where an antibiotic has been prescribed?

Family Practice ◽

10.1093/fampra/cmz058 ◽

2019 ◽

Author(s):

Phoebe R Darlison Shepherd ◽

Catherine J Krejany ◽

Moyez Jiwa

Keyword(s):

General Practice ◽

Respiratory Tract ◽

Respiratory Tract Infections ◽

Demographic Factors ◽

Economic Advantage ◽

Upper Respiratory Tract Infections ◽

National Study ◽

Upper Respiratory Tract ◽

Upper Respiratory ◽

Tract Infections

AbstractBackgroundThere is limited data on the duration of consults resulting in the prescription of antibiotics for upper respiratory tract infections (URTIs) in general practice.ObjectiveTo explore how demographic factors influence consult duration where antibiotics have been prescribed for URTI in Australian general practice.Methods2985 URTI-specific presentations were identified from a national study of patients who were prescribed an antibiotic after presenting to general practice between June and September 2017. Consult duration was analysed to assess for any variation in visit length based on demographic factors.ResultsThe overall median consult duration was 11.42 minutes [interquartile range (IQR) 7.95]. Longer consult duration was associated with areas of highest socio-economic advantage where patients living in postcodes of Index of Relative Socio-economic Advantage and Disadvantage (IRSAD) Quintile 5 (highest 20% on the IRSAD) had significantly longer consults [median 13.12 (IQR 8.01)] than all other quintiles (P < 0.001). Females [11.75 (IQR 8.13)] had significantly longer consults than males [10.87 (IQR 7.57); P < 0.001]. Clinics based in State C and State F had significantly shorter consults when compared with all other included states and territories (P < 0.001) and shorter consult duration was associated with visits on Sundays [median 8.18 (IQR 5.04)].ConclusionThere is evidence for the association of demographic and temporal factors with the duration of consultations for URTIs where an antibiotic has been prescribed. These factors warrant further research.

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