8961 - URTI Dr Bruce Davies www.bradfordvts.co.uk Scope...

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URTI Dr Bruce Davies www.bradfordvts.co.uk
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Scope Throats. Noses. Coughs. Sinuses. Otitis media. Otitis externa.
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Points to Consider Frequency. Alterable? Manageable? Why? Costs. To patients. To NHS. To GPs. Treatment. Abx or not. Other  treatments. Research. Uncertainties. Empiricism.
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Opportunities Education. Future  consultations. Self management. Empowerment. Other stuff  (opportunistically).
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Role of Investigation Swabs. X-rays. Examination  findings. PCR. Temperature.
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Inequality Different doctors. Different patients. Different standards. Expectations. The doctors state of  mind. The doctors  experiences.
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Research Heaps and  heaps. A lot still leaves  questions un- answered. What follows is  a personal  selection.
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Research: Sore Throats Satisfaction with the consultation was  independent predictor of illness duration. 700 patients: randomised to no Abx, Abx  immediately, delayed Abx. Consultation satisfaction better predictor  of patient satisfaction than prescribing  decision. Psychosocial factors better predictor of  duration than physical findings. BMJ 1999; 319: 736-7.
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Research: Sore Throats and Nephritis ANTIBIOTICS, SORE THROATS AND ACUTE NEPHRITIS No effect JL Taylor and JGR Howie   JRCGP  1983; 33: 783-6  
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You can’t tell from appearances. Remains a clinical decision.
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8961 - URTI Dr Bruce Davies www.bradfordvts.co.uk Scope...

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