An evaluation of the management of patients with sore throats by practice nurses and GPs.

BACKGROUND

Practice nurses are increasingly involved in the management of minor illnesses in primary care. However, there has been little work published that evaluates the quality of the service they offer to patients. In our practice (semi-rural, 14,000 patients) a nursing triage system for minor illnesses has been established since 1992.

AIM

To compare the quality of management of sore throats by practice nurses and general practitioners (GPs) in a routine nursing triage system.

METHOD

An observational study assessing all patients over the age of two years presenting over a six-month period (February-August 1997) to either the practice nurse or GP with a sore throat as the chief presenting complaint. Patients were followed up at five to seven days by a researcher and recovery rates, analgesic requirements, reconsultation rates, and satisfaction rates were recorded. Patients who were still symptomatic at five to seven days were followed up again at 28 days and outcomes recorded.

RESULTS

A total of 44% of patients consulted the practice nurse and 56% consulted the GP. Severity of presenting illness was similar in the two groups. The number of patients whose sore throats had settled, reconsultation rates, antibiotic prescription, and dissatisfaction rates were the same for both groups. However, the patients consulting the nurse had a more favourable outcome on indices such as patients' perception of being back to normal health (64% versus 53%) and median number of days for the sore throat to settle (four versus five). Nurses tended to see younger patients (mean age = 22.5 years versus 28.3 years) and more patients seeing the practice nurse recalled receiving advice about home remedies (76% versus 54%).

CONCLUSION

Practice nurses can establish a safe and effective service for treatment of sore throats in a time-restricted triage system.