Scandinavian journal of primary health care
-
Scand J Prim Health Care · Jan 2015
Comparative StudyAppropriateness of antibiotic prescribing for upper respiratory tract infections in general practice: Comparison between Denmark and Iceland.
To compare the appropriateness of antibiotic prescribing for upper respiratory tract infections (URTIs) in two countries with different prevalence of antimicrobial resistance: Denmark and Iceland. ⋯ Icelandic GPs have a higher antibiotic prescribing rate compared with Danish GPs, but the percentage of inappropriate antibiotic prescribing is highest in Denmark for sinusitis, and in Iceland for pharyngotonsillitis. Key points Within the Nordic countries there are marked differences in antimicrobial resistance and antibiotic use. Iceland differs from Denmark by a higher antibiotic prescribing rate and a higher prevalence of antimicrobial resistance. The majority of antibiotics are prescribed in primary care and most often for upper respiratory infections (URTIs). Only a minor amount of antibiotic prescriptions for URTIs can be classified as appropriate; inappropriate antibiotic prescribing is higher in Denmark than in Iceland for sinusitis and the opposite for pharyngotonsillitis. The different antibiotic prescribing patterns between Denmark and Iceland cannot be fully explained by different clinical criteria among patients.
-
Scand J Prim Health Care · Jan 2015
What do patients bring up in consultations? An observational study in general practice.
The main aim of the study was to investigate how many and what kind of problems patients present in consultations with their general practitioner (GP). A secondary aim was to explore patients' views on what is important in consultations. ⋯ GPs deal with multiple and unrelated problems in daily consultations, which is highly valued by patients. Management of concurrent problems in brief encounters demands training and adequate working conditions, in order to sustain this core value of general practice.
-
Scand J Prim Health Care · Jan 2015
Observational StudyWhat a difference a CRP makes. A prospective observational study on how point-of-care C-reactive protein testing influences antibiotic prescription for respiratory tract infections in Swedish primary health care.
To explore how C-reactive protein (CRP) tests serve to support physicians in decisions concerning antibiotic prescription to patients with respiratory tract infections (RTI). ⋯ CRP is an important factor in the decision on whether to prescribe antibiotics for RTIs. Error estimates of CRP and willingness to measure CRP are important factors leading to physicians changing decisions on antibiotic treatment. Key points There is a generally low antibiotic prescription rate and a high frequency of C-reactive protein (CRP) testing for respiratory tract infections (RTIs) in Sweden. CRP testing was considered essential to further management in 38% of cases. In 86% of visits decisions concerning antibiotic prescription were unchanged. The strongest predictors for revised decisions on antibiotic treatment were error estimates of CRP and the physician's opinion that CRP measurement was crucial.
-
Scand J Prim Health Care · Jan 2015
Should pulse oximetry be included in GPs' assessment of patients with obstructive lung disease?
To explore the associations between decreased pulse oximetry values (SpO2) and clinical, laboratory, and demographic variables in general practice patients diagnosed with asthma or chronic obstructive pulmonary disease (COPD), including those with both COPD and asthma in combination. ⋯ Pulse oximetry represents a useful diagnostic adjunct for assessing the severity of obstructive pulmonary disease. Decreased pulse oximetry values in stable-phase patients with asthma and/or COPD should prompt the GP to consider revising the diagnosis and treatment and to look for co-morbidities. Key Points Despite its common use in general practice, the diagnostic benefits of pulse oximetry remain to be established. Decreased pulse oximetry values are associated with both reduced lung function (spirometry) and with a diagnosis of coronary heart disease. Decreased pulse oximetry values may reflect suboptimal treatment and/or undiagnosed comorbidity. Pulse oximetry may therefore be a useful measure in the follow-up of asthma and COPD patients in general practice.
-
Scand J Prim Health Care · Jan 2015
Swedish emergency medical services' identification of potential candidates for primary healthcare: Retrospective patient record study.
To investigate patients who called the emergency medical services (EMS) for primary healthcare (PHC) problems. ⋯ In the EMS, guidelines are needed to enable pre-hospital emergency nurses to assess and triage patients to the most appropriate level of healthcare. Key points Patients calling the emergency medical services do not always end up at an appropriate level of healthcare. In total, 16% of patients were identified by the Swedish emergency medical services as potential candidates for primary healthcare. These patients were younger and healthier than those needing care at the emergency department. They were found at all priority levels and within all symptom groups.