Necessity of office visits for acute respiratory infections in primary care

Renati, Sruthi; Linder, Jeffrey A.

doi:10.1093/fampra/cmw019

Cited by 33 publications

(29 citation statements)

References 27 publications

(20 reference statements)

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“…Most RTIs are self-limiting and the symptoms can improve with rest and OTC medicines. Yet, RTIs often result in unnecessary visits to primary care and imprudent antibiotic prescriptions (27). Considering our findings, it seems that physician visit and consultation is the first choice for the Korean general public in case of RTIs, with a consulting rate of 59.3%.…”

Section: Discussionmentioning

confidence: 99%

From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections

et al. 2017

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Antibiotic resistance is steadily rising worldwide. Respiratory tract infections (RTIs) are common indications, mostly imprudent, for antibiotic prescriptions in outpatient setting. In Korea, antibiotic prescription rate for RTIs is still high. As physician visit and antibiotic prescribing are influenced by patient's perceptions and beliefs, we aimed to explore the general public's perspectives and practices toward RTIs and to develop the ‘RTI clinical iceberg.’ A cross-sectional survey was conducted in Wonju Severance Christian Hospital (WSCH) among 550 adults attending outpatient departments during January 2016. Differences in distributions between groups were examined using two-tailed Pearson χ2 test. Using the Andersen's behavioral model as a conceptual framework, we constructed logistic regression models to assess factors associated with physician visit. Of 547 participants with complete questionnaires, 62.9% reported having experienced an RTI in the previous six months; 59.3% visited a physician for the illness, most commonly because the symptoms were severe or prolonged, and approximately 16% of them expected an antibiotic prescription from the visit. Perceptions of symptoms severity, the need factor, most strongly influenced physician visit. Predisposing and enabling factors such as inappropriate expectations for antibiotic for a sore throat or having national health insurance also influenced physician visit. Almost all participants who reported asking for an antibiotic were prescribed one, with a 37.1% non-adherence rate. Conclusively, public education on self-care for RTI symptoms that addresses their main concerns may reduce physician visits. Improving physician-patient relationship and informing patients about the lack of antibiotic benefit for most RTIs may also reduce antibiotic prescriptions.

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Section: Discussionmentioning

confidence: 99%

From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections

et al. 2017

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“…Despite URTIs generally being minor illnesses, they result in an appreciable number of medical consultations globally 87,[199][200][201][202][203] . The number of healthcare consultations combined with parental and patient pressure increases antibiotic use for URTIs including LMICs thereby increasing AMR rates 88,153,200,[204][205][206][207][208][209] . Patients or parents who are concerned about their or their child's respiratory illness are likely to seek treatment, and want an antibiotic, especially if they perceive the illness as severe 21,209,210 .…”

Section: Aetiology Of Urtis and Symptomsmentioning

confidence: 99%

Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

Godman

Haque

McKimm

et al. 2019

Current Medical Research and Opinion

128

170

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“…Acute respiratory infections (ARIs), which can be viral or bacterial, are one of the most common reasons for visits to primary and urgent care clinics [1]. Given their overlapping profiles of signs and symptoms, distinguishing between ARIs of bacterial and viral aetiology can be clinically challenging [2].…”

Section: Introductionmentioning

confidence: 99%

FebriDx®: A Rapid Diagnostic Test for Differentiating Bacterial and Viral Aetiologies in Acute Respiratory Infections

Shirley

2019

Mol Diagn Ther

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FebriDx ® is a rapid, point-of-care diagnostic test that is designed to aid in the differentiation of bacterial and viral acute respiratory infections (ARIs), thus helping to guide decisions regarding the prescription of antibiotics in the outpatient setting. FebriDx carries a CE mark for use in the EU and is also approved in several other countries, including Canada, Saudi Arabia and Singapore. It is indicated for use in patients > 2 years old with symptoms consistent with a community-acquired ARI. The test involves the use of an immunoassay on a fingerstick blood sample to provide simultaneous, qualitative measurement of elevated levels of C-reactive protein (CRP) and myxovirus resistance protein A (MxA). In two prospective, multicentre studies in patients with acute upper respiratory tract infections, FebriDx was shown to be both sensitive and specific in identifying patients with a clinically significant infection and in differentiating between infections of bacterial and viral aetiology. The test is simple, requires no additional equipment and produces actionable results in ~ 10 min. As was demonstrated in a small, retrospective analysis, FebriDx results can help guide (improve) antibiotic prescribing decisions. Reducing the unnecessary or inappropriate prescription of antibiotics for ARIs of probable viral aetiology is important for antibiotic stewardship and can also reduce the unnecessary exposure of patients to the risk of antibiotic-related adverse events. FebriDx thus represents a useful diagnostic tool in the outpatient setting. FebriDx®: a summaryA simple, all-in-one, diagnostic test to assist in the diagnosis of bacterial or viral ARIs by measuring the host response to infection Based on a rapid immunoassay that provides simultaneous, qualitative measurement of elevated levels of CRP and MxA Sensitive and specific in identifying patients with a clinically significant infection and in differentiating between infections of bacterial and viral aetiology Produces actionable results in ~ 10 min which can be used to help guide antibiotic prescribing decisions turer of FebriDx was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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Necessity of office visits for acute respiratory infections in primary care

Abstract: About two-thirds of primary care ARI visits may not be necessary for appropriate antibiotic management.

Cited by 33 publications

References 27 publications

From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections

From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections

Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

FebriDx®: A Rapid Diagnostic Test for Differentiating Bacterial and Viral Aetiologies in Acute Respiratory Infections

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