Stuhr Janni Katharina, Lykkegaard Jesper, Kristensen Jette Kolding, Kornum Jette Brommann, Hansen Malene Plejdrup
Research Unit for General Practice, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Audit Project Odense, Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Fam Pract. 2019 Mar 20;36(2):192-198. doi: 10.1093/fampra/cmy059.
Sore throat is a frequent presentation of acute respiratory tract infections in general practice. Though these infections are often harmless and self-limiting, antibiotics are frequently prescribed. In Denmark, practice nurses manage an increasing part of patients with acute minor illnesses.
We aimed (i) to investigate Danish practice nurses' and GPs' management of patients presenting with a sore throat and (ii) to explore to what extent management is according to current Danish guidelines.
A cross-sectional study was conducted during winter 2017, involving GPs and practice nurses in Danish general practices. Patients with a sore throat were registered according to the Audit Project Odense method.
A total of 44 practices participated with the registration of 1503 patients presenting with a sore throat. Most patients had a strep A test performed, especially when managed by a practice nurse (84.6% versus 61.8%, χ2 = 90.1, P < 0.05). In total, 40.6% of performed strep A tests were not according to guideline recommendations. Antibiotics were prescribed for about one-third of patients, regardless whether managed by a practice nurse or a GP (χ2 = 0.33, P = 0.57). However, 32.4% of these prescriptions were not in line with Danish guidelines.
Patients with acute sore throat were managed similarly by GPs and practice nurses, apart from a higher use of strep A tests in patients seen by practice nurses. Importantly, this study demonstrated that there is still room for improvement of the management of these patients in Danish general practice.
在全科医疗中,喉咙痛是急性呼吸道感染的常见症状。尽管这些感染通常无害且具有自限性,但抗生素的处方却很常见。在丹麦,执业护士管理着越来越多患有急性轻症的患者。
我们旨在(i)调查丹麦执业护士和全科医生对喉咙痛患者的管理情况,以及(ii)探讨管理在多大程度上符合丹麦现行指南。
在2017年冬季进行了一项横断面研究,涉及丹麦全科医疗中的全科医生和执业护士。根据奥登塞审计项目方法对喉咙痛患者进行登记。
共有44家医疗机构参与,登记了1503例喉咙痛患者。大多数患者进行了A组链球菌检测,尤其是由执业护士管理的患者(84.6%对61.8%,χ2 = 90.1,P < 0.05)。总共40.6%的A组链球菌检测未按照指南建议进行。约三分之一的患者开具了抗生素处方,无论由执业护士还是全科医生管理(χ2 = 0.33,P = 0.57)。然而,这些处方中有32.4%不符合丹麦指南。
全科医生和执业护士对急性喉咙痛患者的管理方式相似,只是执业护士管理的患者中A组链球菌检测的使用频率更高。重要的是,这项研究表明丹麦全科医疗中这些患者的管理仍有改进空间。