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• The burden of respiratory infections in primary care – the missing piece of the puzzle?
  Sandra Lucas, Saravana Kumar and Matthew Leach
  Published on: 14 September 2017

• Published on: 14 September 2017

  The burden of respiratory infections in primary care – the missing piece of the puzzle?

  • Sandra Lucas, PhD candidate School of Health Sciences, University of South Australia
  • Other Contributors:
    • Saravana Kumar, Senior Lecture
    • Matthew Leach, Senior Research Fellow

  We would like to thank the authors for their informative and innovative research, which interrogated electronic medical record free text, to demonstrate the significant impact of childhood respiratory illness on primary care workload in New Zealand. The findings indicate that almost half (46%) of all child-general practitioner consultations between January 2008 and December 2013 were attributed to the management of respiratory conditions.

  The findings of this research are not surprising given that children in developed and developing countries report six to eight episodes of acute respiratory tract infection every year (1). The high rate of consultations may be partly explained by the fact that there is no cure for acute respiratory infections, only symptomatic relief (1). For some parents, this might necessitate frequent and repeat consultations with general practitioners.

  While this research sheds light on the role of general practitioners in the management of childhood respiratory illness, there continues to persist ongoing knowledge gaps in an equally important field. There is some evidence to indicate that many parents manage their child’s acute respiratory infections at home, using a range of therapies, including complementary and alternative medicines (CAM)(2). With the increasing popularity of CAM and emerging high level evidence to support the role of CAM therapies for acute respiratory tract infection (e.g. Sambucus nigra (3), Pelargonium sidoides...

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  We would like to thank the authors for their informative and innovative research, which interrogated electronic medical record free text, to demonstrate the significant impact of childhood respiratory illness on primary care workload in New Zealand. The findings indicate that almost half (46%) of all child-general practitioner consultations between January 2008 and December 2013 were attributed to the management of respiratory conditions.

  The findings of this research are not surprising given that children in developed and developing countries report six to eight episodes of acute respiratory tract infection every year (1). The high rate of consultations may be partly explained by the fact that there is no cure for acute respiratory infections, only symptomatic relief (1). For some parents, this might necessitate frequent and repeat consultations with general practitioners.

  While this research sheds light on the role of general practitioners in the management of childhood respiratory illness, there continues to persist ongoing knowledge gaps in an equally important field. There is some evidence to indicate that many parents manage their child’s acute respiratory infections at home, using a range of therapies, including complementary and alternative medicines (CAM)(2). With the increasing popularity of CAM and emerging high level evidence to support the role of CAM therapies for acute respiratory tract infection (e.g. Sambucus nigra (3), Pelargonium sidoides (4), probiotics(5), Echinacea spp.(6)), it is probable that parents also may be accessing CAM through primary care settings, with practitioners of CAM typically based in primary care settings and readily accessible to parents. Notwithstanding, there is little to no robust data regarding this activity.

  Primary care is a complex puzzle and it is important to recognise the diverse and varied services provided by a range of practitioners. Research such as this helps to solve crucial parts of this complex puzzle. But missing pieces of the puzzle remain and this requires similar concerted efforts in other areas of primary care. Dowell and colleagues have demonstrated the usefulness and impact of “big data” from primary care in understanding general practitioner workload. It is imperative that similar research explore other commonly utilised, increasingly popular services in primary care, such as CAM. In doing so, we will be able to move one step closer to solving the complex puzzle of primary care.

  References
  1. World Health Organization (WHO). Coughs and cold remedies for the treatment of acute respiratory infections in young children. Geneva, Switzerland:: WHO; 2001.
  2. MacLennan A, Myers S, Taylor A. The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004. Medical Journal Australia. 2006;184(1):27-31.
  3. Ulbricht C, Basch E, Cheung L, Goldberg H, Hammerness P, Isaac R, et al. An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration. . Journal of Dietary Supplements. 2014;11(1):80-120.
  4. Timmer A, Günther J, Motschall E, Rücker G, Antes G, Kern WV. Pelargonium sidoides extract for treating acute respiratory tract infections. Cochrane Database Syst Rev. 2013;10:CD006323.
  5. Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015;2:CD006895.
  6. Shah SA, Sander S, White CM, Rinaldi M, Coleman CI. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. The Lancet Infectious Diseases. 2007;7(9):580.

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  Conflict of Interest:
  None declared.

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