Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries
<strong>Objective</strong> To describe primary health care (consultation characteristics and management) for patients contacting their general practitioner (GP) with a respiratory tract infection (RTI) early on in the COVID-19 pandemic in contrasting European countries, with comparison t...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021
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| _version_ | 1797084634626916352 |
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| author | van der Velden, AW Bax, EA Bongard, E Munck Aabenhus, R Anastasaki, M Anthierens, S Balan, A Böhmer, F Bruno, P Chlabicz, S Coenen, S Colliers, A Emmerich, S Garcia-Sangenis, A Ghazaryan, H van der Linde, SR Malania, L Pauer, J Tomacinschii, A Tonkin-Crine, S Vellinga, A Zastavnyy, I Verheij, T Goossens, H Butler, CC |
| author_facet | van der Velden, AW Bax, EA Bongard, E Munck Aabenhus, R Anastasaki, M Anthierens, S Balan, A Böhmer, F Bruno, P Chlabicz, S Coenen, S Colliers, A Emmerich, S Garcia-Sangenis, A Ghazaryan, H van der Linde, SR Malania, L Pauer, J Tomacinschii, A Tonkin-Crine, S Vellinga, A Zastavnyy, I Verheij, T Goossens, H Butler, CC |
| author_sort | van der Velden, AW |
| collection | OXFORD |
| description | <strong>Objective</strong> To describe primary health care (consultation characteristics and management) for patients contacting their general practitioner (GP) with a respiratory tract infection (RTI) early on in the COVID-19 pandemic in contrasting European countries, with comparison to prepandemic findings.
<br>
<strong>Setting</strong> Primary care in 16 countries (79 practices), when no routine SARS-CoV-2 testing was generally available.
<br>
<strong>Design and participants</strong> Before (n=4376) and early in the pandemic (n=3301), patients with RTI symptoms were registered in this prospective audit study.
<br>
<strong>Outcome measures</strong> Consultation characteristics (type of contact and use of PPE) and management characteristics (clinical assessments, diagnostic testing, prescribing, advice and referral) were registered. Differences in these characteristics between countries and between pandemic and prepandemic care are described.
<br>
<strong>Results</strong> Care for patients with RTIs rapidly switched to telephone/video consultations (10% in Armenia, 91% in Denmark), and when consultations were face-to-face, GPs used PPE during 97% (95% CI 96% to 98%) of contacts. Laboratory testing for SARS-CoV-2 in primary care patients with RTIs was rapidly implemented in Denmark (59%) and Germany (31%), while overall testing for C reactive protein decreased. The proportion of patients prescribed antibiotics varied considerably between countries (3% in Belgium, 48% in UK) and was lower during the pandemic compared with the months before, except for Greece, Poland and UK. GPs provided frequent and varied COVID-related advice and more frequently scheduled a follow-up contact (50%, 95% CI 48% to 52%). GPs reported a slightly higher degree of confidence in the likely effectiveness of their management in face-to-face (73% (very) confident, 95% CI 71% to 76%) than in virtual consultations (69%, 95% CI 67% to 71%).
<br>
<strong>Conclusions</strong> Despite between-country variation in consultation characteristics, access to SARS-CoV-2 laboratory testing and medication prescribing, GPs reported a high degree of confidence in managing their patients with RTIs in the emerging pandemic. Insight in the highly variable pandemic responses, as measured in this multicountry audit, can aid in fine-tuning national action and in coordinating a pan-European response during future pandemic threats. |
| first_indexed | 2024-03-07T01:57:51Z |
| format | Journal article |
| id | oxford-uuid:9c532a03-8388-4cff-99a5-abc77323b3f7 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:57:51Z |
| publishDate | 2021 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:9c532a03-8388-4cff-99a5-abc77323b3f72022-03-27T00:35:19ZPrimary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countriesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9c532a03-8388-4cff-99a5-abc77323b3f7EnglishSymplectic ElementsBMJ Publishing Group2021van der Velden, AWBax, EABongard, EMunck Aabenhus, RAnastasaki, MAnthierens, SBalan, ABöhmer, FBruno, PChlabicz, SCoenen, SColliers, AEmmerich, SGarcia-Sangenis, AGhazaryan, Hvan der Linde, SRMalania, LPauer, JTomacinschii, ATonkin-Crine, SVellinga, AZastavnyy, IVerheij, TGoossens, HButler, CC<strong>Objective</strong> To describe primary health care (consultation characteristics and management) for patients contacting their general practitioner (GP) with a respiratory tract infection (RTI) early on in the COVID-19 pandemic in contrasting European countries, with comparison to prepandemic findings. <br> <strong>Setting</strong> Primary care in 16 countries (79 practices), when no routine SARS-CoV-2 testing was generally available. <br> <strong>Design and participants</strong> Before (n=4376) and early in the pandemic (n=3301), patients with RTI symptoms were registered in this prospective audit study. <br> <strong>Outcome measures</strong> Consultation characteristics (type of contact and use of PPE) and management characteristics (clinical assessments, diagnostic testing, prescribing, advice and referral) were registered. Differences in these characteristics between countries and between pandemic and prepandemic care are described. <br> <strong>Results</strong> Care for patients with RTIs rapidly switched to telephone/video consultations (10% in Armenia, 91% in Denmark), and when consultations were face-to-face, GPs used PPE during 97% (95% CI 96% to 98%) of contacts. Laboratory testing for SARS-CoV-2 in primary care patients with RTIs was rapidly implemented in Denmark (59%) and Germany (31%), while overall testing for C reactive protein decreased. The proportion of patients prescribed antibiotics varied considerably between countries (3% in Belgium, 48% in UK) and was lower during the pandemic compared with the months before, except for Greece, Poland and UK. GPs provided frequent and varied COVID-related advice and more frequently scheduled a follow-up contact (50%, 95% CI 48% to 52%). GPs reported a slightly higher degree of confidence in the likely effectiveness of their management in face-to-face (73% (very) confident, 95% CI 71% to 76%) than in virtual consultations (69%, 95% CI 67% to 71%). <br> <strong>Conclusions</strong> Despite between-country variation in consultation characteristics, access to SARS-CoV-2 laboratory testing and medication prescribing, GPs reported a high degree of confidence in managing their patients with RTIs in the emerging pandemic. Insight in the highly variable pandemic responses, as measured in this multicountry audit, can aid in fine-tuning national action and in coordinating a pan-European response during future pandemic threats. |
| spellingShingle | van der Velden, AW Bax, EA Bongard, E Munck Aabenhus, R Anastasaki, M Anthierens, S Balan, A Böhmer, F Bruno, P Chlabicz, S Coenen, S Colliers, A Emmerich, S Garcia-Sangenis, A Ghazaryan, H van der Linde, SR Malania, L Pauer, J Tomacinschii, A Tonkin-Crine, S Vellinga, A Zastavnyy, I Verheij, T Goossens, H Butler, CC Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries |
| title | Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries |
| title_full | Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries |
| title_fullStr | Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries |
| title_full_unstemmed | Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries |
| title_short | Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries |
| title_sort | primary care for patients with respiratory tract infection before and early on in the covid 19 pandemic an observational study in 16 european countries |
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