Predictors of patient-initiated reconsultation for lower respiratory tract infections in general practice.

Reconsultation for lower respiratory tract infection (LRTI) is common in general practice, but those who reconsult rarely have more significant illness warranting antibiotics. Knowledge of factors that predict patient-initiated reconsultation may allow clinicians to address specific issues during the initial consultation that could reduce reconsultations. Thirty-three per cent of a cohort of 431 LRTI patients in a randomised controlled trial reconsulted. Excluding 35 patients with GP-requested reconsultation left 28% (112/396) with a patient-initiated reconsultation during 28-day follow-up. Patient-reported dyspnoea and concerns that persisted after the initial consultation independently predicted patient-initiated reconsultation.

[1]  T. Fahey,et al.  Effect of antibiotic prescribing strategies and an information leaflet on longer-term reconsultation for acute lower respiratory tract infection. , 2009, The British journal of general practice : the journal of the Royal College of General Practitioners.

[2]  F. Wood,et al.  Effect of using an interactive booklet about childhood respiratory tract infections in primary care consultations on reconsulting and antibiotic prescribing: a cluster randomised controlled trial , 2009, BMJ : British Medical Journal.

[3]  Kerenza Hood,et al.  Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial , 2009, BMJ : British Medical Journal.

[4]  A. Hay,et al.  Antibiotics for acute cough in primary care , 2009, BMJ : British Medical Journal.

[5]  R. Hopstaken,et al.  Improving management of patients with acute cough by C-reactive protein point of care testing and communication training (IMPAC3T): study protocol of a cluster randomised controlled trial , 2007, BMC family practice.

[6]  Eugene Demidenko,et al.  Sample size determination for logistic regression revisited , 2006, Statistics in medicine.

[7]  J. De Maeseneer,et al.  Are Sore Throat Patients Who Hope for Antibiotics Actually Asking for Pain Relief? , 2006, The Annals of Family Medicine.

[8]  P. Bailey The Dyspnea-Anxiety-Dyspnea Cycle—COPD Patients’ Stories of Breathlessness: “It’s Scary /When you Can’t Breathe” , 2004, Qualitative health research.

[9]  A. Hoes,et al.  Antibiotics for acute respiratory tract symptoms: patients' expectations, GPs' management and patient satisfaction. , 2004, Family practice.

[10]  M. Leinonen,et al.  Prospective study of the incidence, aetiology and outcome of adult lower respiratory tract illness in the community , 2001, Thorax.

[11]  J T Macfarlane,et al.  The influence of antibiotics and other factors on reconsultation for acute lower respiratory tract illness in primary care. , 1997, The British journal of general practice : the journal of the Royal College of General Practitioners.

[12]  Richard Cunningham,et al.  Prospective case-control study of role of infection in patients who reconsult after initial antibiotic treatment for lower respiratory tract infection in primary care , 1997, BMJ.

[13]  R. Holder,et al.  Reliability and feasibility of a near patient test for C-reactive protein in primary care. , 1996, The British journal of general practice : the journal of the Royal College of General Practitioners.

[14]  G. Elwyn,et al.  Patients' ideas, concerns, and expectations (ICE) in general practice: impact on prescribing. , 2009, The British journal of general practice : the journal of the Royal College of General Practitioners.