Patient presentatinon and physician management of upper respiratory tract infectinos-a retrospective - Kung et al BMC Family Practice 2014 15:95

Patient presentatinon and physician management of upper respiratory tract infectinos-a retrospective

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RESEARCH ARTICLE Open Access Patient presentation and physician management of upper respiratory tract infections: a retrospective review of over 5 million primary clinic consultations in Hong Kong Kenny Kung 1 , Carmen Ka Man Wong 1,4* , Samuel Yeung Shan Wong 1 , Augustine Lam 2 , Christy Ka Yan Chan 1 , Sian Griffiths 1 and Chris Butler 3 Abstract Background: Upper respiratory tract infection (URTI) has a significant healthcare burden worldwide. Considerable resources are consumed through health care consultations and prescribed treatment, despite evidence for little or no effect on recovery. Patterns of consultations and care including use of symptomatic medications and antibiotics for upper respiratory tract infections are poorly described. Methods: We performed a retrospective review of computerized clinical data on patients presenting to all public primary care clinics in Hong Kong with symptoms of respiratory tract infections. International Classification of Primary care (ICPC)codes used to identify patients included otitis media (H71), streptococcal pharyngitis (R72), acute URTI (R74), acute sinusitis (R75), acute tonsillitis (R76), acute laryngitis (R77), and influenza (R80). Sociodemographic variables such as gender, age, chronic illness status, attendance date, type and duration of drug prescribed were also collected. Results: Of the 5,529,755 primary care consultations for respiratory symptoms from 2005 to 2010, 98% resulted in a prescription. Prescription patterns of symptomatic medication were largely similar across the 5 years. In 2010 the mean number of drugs prescribed per consultation was 3.2, of which the commonly prescribed medication were sedating antihistamines (79.9%), analgesia (58.9%), throat lozenges (40.4%) and expectorant cough syrup (33.8%). During the study period, there was an overall decline in antibiotic prescription (8.1% to 5.1%). However, in consultations where the given diagnosis was otitis media (H71), streptococcal pharyngitis (R72), acute sinusitis (R75) or acute laryngitis (R76), over 90% resulted in antibiotic prescription. Conclusion: There was a decline in overall antibiotic prescription over the study period. However, the use of antibiotics was high in some conditions e.g. otitis media and acute laryngitis a. Multiple symptomatic medications were given for upper respiratory tract infections. Further research is needed to develop clinical and patients directed interventions to reduce the number of prescriptions of symptomatic medications and antibiotics that could reduce costs for health care services and iatrogenic risk to patients. Keywords: Upper respiratory tract infection, Primary care, Pharmacology * Correspondence: [email protected] 1 Division of Family Medicine, School of Public Health & Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong 4 Jockey School of Public Health, Prince of Wales Hospital, Room 408, 32 Ngan Shing Street, Shatin, NT, Hong Kong Full list of author information is available at the end of the article © 2014 Kung et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and
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