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Medical management of acute upper respiratory infections in an urban primary care out-of-hours facility: cross-sectional study of patient presentations and expectations
  1. Raymond O’Connor1,
  2. Jane O’Doherty1,
  3. Andrew O’Regan1,
  4. Aoife O’Neill2,
  5. Claire McMahon3,
  6. Colum P Dunne1
  1. 1 Graduate Entry Medical School, University of Limerick Faculty of Education and Health Sciences, Limerick, Ireland
  2. 2 Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
  3. 3 Clinical Quality and Administration Department, Shannondoc Out of Hours General Practitioner Service, Limerick, Ireland
  1. Correspondence to Dr Raymond O’Connor; Raymond.OConnor{at}ul.ie

Abstract

Objectives The purpose of this study was to examine the expectations of patients attending an urban primary care out-of-hours (OOH) facility with acute upper respiratory tract infection (acute URTI) regarding clinical examination, symptom management, information on their condition, reassurance, antibiotic treatment and other possible options including referral.

Design Cross-sectional design.

Setting One urban primary care OOH facility located in the midwest of Ireland.

Participants 457 patients filled out a questionnaire while waiting in the OOH facility; 22 surveys were excluded as the patients did not present with symptoms of acute URTI resulting in 435 patients’ data being included in this study. There were 59.5% female participants and 40.5% male participants.

Results 435 patients with acute URTI symptoms participated in the survey, representing 25.4% of those attending the single branch where the survey was conducted (n=1715). Of the study participants, 43% were aged under 6 years and 60% were women. The most common presenting symptoms were cough (72%), throat ache (46%) and common cold (26%). The most common expectations were for further examination (53%), reassurance (51%), information (49%) and medication for cough (47%), with 34% expecting an antibiotic.

Conclusions Only one in three patients attending this primary care OOH facility with acute URTI symptoms had an expectation of antibiotics, with most seeking further assessment, information and reassurance. Recognition of such expectations may be important considerations for clinicians when deciding on management options for patients with acute URTI.

  • out-of-hours
  • upper respiratory tract infection
  • antibacterial agent
  • patient expectations
  • antibiotic prescription

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Patient consent for publication Not required.

  • Contributors ROC conceived the study. AOR, JOD, CMM and ROC were involved in the design of the study. ROC and CMM collected the data. JOD and ROC inputted the data. AON carried out statistical analysis. ROC, CD, AOR and JOD wrote the first draft of the paper. All authors made critical comments on all drafts of the paper, as well as read and approved the final manuscript.

  • Funding This research was part funded by the Irish College of General Practitioners Research and Education Foundation.

  • Competing interests None declared.

  • Ethics approval Ethical approval for the study was granted by the Health Service Executive Mid-West Research Ethics Committee. Ethics approval number: 068/17.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Deidentified participant data are available upon request from the principal author Dr Raymond O’Connor for a 6-month time period from publication. Reuse is permitted with the consent of all of the authors. The data sets generated and/or analysed during the current study are not publicly available due to variables that could identify GPs or patients through name of practice and location but are available from the corresponding author on reasonable request.

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