Primary care for patients with respiratory tract infection before and early on in the COVID-19 pandemic: an observational study in 16 European countries
BMJ Open
; 11(7), 2021.
Article
in English
| ProQuest Central | ID: covidwho-1842606
ABSTRACT
ObjectiveTo describe primary health care (consultation characteristics and management) for patients contacting their general practitioner (GP) with a respiratory tract infection (RTI) early on in the COVID-19 pandemic in contrasting European countries, with comparison to prepandemic findings.SettingPrimary care in 16 countries (79 practices), when no routine SARS-CoV-2 testing was generally available.Design and participantsBefore (n=4376) and early in the pandemic (n=3301), patients with RTI symptoms were registered in this prospective audit study.Outcome measuresConsultation characteristics (type of contact and use of PPE) and management characteristics (clinical assessments, diagnostic testing, prescribing, advice and referral) were registered. Differences in these characteristics between countries and between pandemic and prepandemic care are described.ResultsCare for patients with RTIs rapidly switched to telephone/video consultations (10% in Armenia, 91% in Denmark), and when consultations were face-to-face, GPs used PPE during 97% (95% CI 96% to 98%) of contacts. Laboratory testing for SARS-CoV-2 in primary care patients with RTIs was rapidly implemented in Denmark (59%) and Germany (31%), while overall testing for C reactive protein decreased. The proportion of patients prescribed antibiotics varied considerably between countries (3% in Belgium, 48% in UK) and was lower during the pandemic compared with the months before, except for Greece, Poland and UK. GPs provided frequent and varied COVID-related advice and more frequently scheduled a follow-up contact (50%, 95% CI 48% to 52%). GPs reported a slightly higher degree of confidence in the likely effectiveness of their management in face-to-face (73% (very) confident, 95% CI 71% to 76%) than in virtual consultations (69%, 95% CI 67% to 71%).ConclusionsDespite between-country variation in consultation characteristics, access to SARS-CoV-2 laboratory testing and medication prescribing, GPs reported a high degree of confidence in managing their patients with RTIs in the emerging pandemic. Insight in the highly variable pandemic responses, as measured in this multicountry audit, can aid in fine-tuning national action and in coordinating a pan-European response during future pandemic threats.
Medical Sciences; COVID-19; primary care; respiratory infections; audit; quality in healthcare; Infections; Personal protective equipment; Severe acute respiratory syndrome coronavirus 2; Diagnostic tests; Registration; Patients; Antibiotics; Audits; Pandemics; Medical research; Variables; Coronaviruses; Disease transmission; Romania; United Kingdom--UK; Hungary; United States--US; Europe; Ukraine; Moldova; Spain; Greece; Armenia; Netherlands; Belgium; Ireland; Denmark; Poland; Georgia; France; Germany
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Collection:
Databases of international organizations
Database:
ProQuest Central
Type of study:
Observational study
/
Prognostic study
Language:
English
Journal:
BMJ Open
Year:
2021
Document Type:
Article
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