The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA study
AbstractBackground Most symptomatic SARS-CoV-2 infections produce mild to moderate symptoms. Although most patients are managed in the outpatient setting, little is known about the effect of general practitioners’ (GP) management strategies on the outcomes of COVID-19 outpatients in Italy.Objectives...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | European Journal of General Practice |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/13814788.2023.2186395 |
| _version_ | 1827931702016606208 |
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| author | Alice Serafini Lucia Palandri Peter Konstantin Kurotschka Chiara Giansante Maria Rita Sabattini Martina Alfina Lavenia Marina Scarpa Davide Fornaciari Matteo Morandi Francesco Bellelli Maria Stella Padula Elena Righi Giulia Ugolini Silvia Riccomi |
| author_facet | Alice Serafini Lucia Palandri Peter Konstantin Kurotschka Chiara Giansante Maria Rita Sabattini Martina Alfina Lavenia Marina Scarpa Davide Fornaciari Matteo Morandi Francesco Bellelli Maria Stella Padula Elena Righi Giulia Ugolini Silvia Riccomi |
| author_sort | Alice Serafini |
| collection | DOAJ |
| description | AbstractBackground Most symptomatic SARS-CoV-2 infections produce mild to moderate symptoms. Although most patients are managed in the outpatient setting, little is known about the effect of general practitioners’ (GP) management strategies on the outcomes of COVID-19 outpatients in Italy.Objectives Describe the management of Italian GPs of SARS-CoV-2 infected adult patients and explore whether GP active care and monitoring are associated with reducing hospitalisation and death.Methods Retrospective observational study of SARS-CoV-2 infected adult outpatients managed by GPs in Modena (Italy) from March 2020 to April 2021. Information on management and monitoring strategies, patients’ socio-demographic characteristics, comorbidities, and outcomes (hospitalisation and death due to COVID-19) were retrieved through an electronic medical record review and analysed descriptively and through multiple logistic regression.Results Out of the 5340 patients from 46 GPs included in the study, 3014 (56%) received remote monitoring, and 840 (16%) had at least one home visit. More than 85% of severe or critical patients were actively monitored (73% daily) and 52% were visited at home. Changes over time in patients’ therapeutic management were observed in concordance with the guidelines’ release. Active daily remote monitoring and home visits were strongly associated with reduced hospitalisation rate (OR 0.52, 95% CI 0.33–0.80 and OR 0.50, 95% CI 0.33–0.78 respectively).Conclusion GPs effectively managed an increasing number of outpatients during the first waves of the pandemic. Active monitoring and home visits were associated with reduced hospitalisation in COVID-19 outpatients. |
| first_indexed | 2024-03-13T06:56:23Z |
| format | Article |
| id | doaj.art-f5687448307b402da23791400210bbbc |
| institution | Directory Open Access Journal |
| issn | 1381-4788 1751-1402 |
| language | English |
| last_indexed | 2024-03-13T06:56:23Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of General Practice |
| spelling | doaj.art-f5687448307b402da23791400210bbbc2023-06-07T08:32:33ZengTaylor & Francis GroupEuropean Journal of General Practice1381-47881751-14022023-12-0129210.1080/13814788.2023.2186395The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA studyAlice Serafini0Lucia Palandri1Peter Konstantin Kurotschka2Chiara Giansante3Maria Rita Sabattini4Martina Alfina Lavenia5Marina Scarpa6Davide Fornaciari7Matteo Morandi8Francesco Bellelli9Maria Stella Padula10Elena Righi11Giulia Ugolini12Silvia Riccomi13Department of Primary Care, Local Health Authority of Modena, Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, ItalyDepartment of General Practice, University Hospital Wuerzburg, Wuerzburg, GermanyDepartment of Public Health, Local Health Authority of Bologna, Bologna, ItalyLocal Health Authority of Romagna, Ravenna, ItalyDepartment of Primary Care, Local Health Authority of Modena, Modena, ItalyDepartment of Primary Care, Local Health Authority of Modena, Modena, ItalyDepartment of Primary Care, Local Health Authority of Modena, Modena, ItalyDepartment of Primary Care, Local Health Authority of Modena, Modena, ItalyDepartment of Primary Care, Local Health Authority of Modena, Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Primary Care, Local Health Authority of Modena, Modena, ItalyDepartment of Primary Care, Local Health Authority of Modena, Modena, ItalyAbstractBackground Most symptomatic SARS-CoV-2 infections produce mild to moderate symptoms. Although most patients are managed in the outpatient setting, little is known about the effect of general practitioners’ (GP) management strategies on the outcomes of COVID-19 outpatients in Italy.Objectives Describe the management of Italian GPs of SARS-CoV-2 infected adult patients and explore whether GP active care and monitoring are associated with reducing hospitalisation and death.Methods Retrospective observational study of SARS-CoV-2 infected adult outpatients managed by GPs in Modena (Italy) from March 2020 to April 2021. Information on management and monitoring strategies, patients’ socio-demographic characteristics, comorbidities, and outcomes (hospitalisation and death due to COVID-19) were retrieved through an electronic medical record review and analysed descriptively and through multiple logistic regression.Results Out of the 5340 patients from 46 GPs included in the study, 3014 (56%) received remote monitoring, and 840 (16%) had at least one home visit. More than 85% of severe or critical patients were actively monitored (73% daily) and 52% were visited at home. Changes over time in patients’ therapeutic management were observed in concordance with the guidelines’ release. Active daily remote monitoring and home visits were strongly associated with reduced hospitalisation rate (OR 0.52, 95% CI 0.33–0.80 and OR 0.50, 95% CI 0.33–0.78 respectively).Conclusion GPs effectively managed an increasing number of outpatients during the first waves of the pandemic. Active monitoring and home visits were associated with reduced hospitalisation in COVID-19 outpatients.https://www.tandfonline.com/doi/10.1080/13814788.2023.2186395COVID-19general practicehospitalisationtelemedicinedrug therapy |
| spellingShingle | Alice Serafini Lucia Palandri Peter Konstantin Kurotschka Chiara Giansante Maria Rita Sabattini Martina Alfina Lavenia Marina Scarpa Davide Fornaciari Matteo Morandi Francesco Bellelli Maria Stella Padula Elena Righi Giulia Ugolini Silvia Riccomi The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA study European Journal of General Practice COVID-19 general practice hospitalisation telemedicine drug therapy |
| title | The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA study |
| title_full | The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA study |
| title_fullStr | The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA study |
| title_full_unstemmed | The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA study |
| title_short | The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA study |
| title_sort | effects of primary care monitoring strategies on covid 19 related hospitalisation and mortality a retrospective electronic medical records review in a northern italian province the magma study |
| topic | COVID-19 general practice hospitalisation telemedicine drug therapy |
| url | https://www.tandfonline.com/doi/10.1080/13814788.2023.2186395 |
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