Would GPs advise patients with respiratory tract infections to refrain from exercise, stay indoors or stay in bed? Survey of GPs in Poland and Norway

Trajectories of symptoms and healthcare use following respiratory tract infections in rural Anhui, China：a cross-sectional study

BACKGROUND

Respiratory tract infections (RTIs) are important health problems with high incidence and consequent economic costs. The study aimed to analyze trajectories of experienced RTI symptoms and use of healthcare and antibiotics.

METHOD

The study adopted a cross-sectional design and face-face interview using a structured questionnaire. The questionnaire comprised: a) social demographics; b) last episode of symptomatic RTIs; c) responses to the RTIs; d) antibiotics obtained from clinics and medicine shops for the RTIs. The study subjects were residents in randomly selected villages in Anhui, China. The study settings were the residents households. Descriptive analyses were conducted to draw symptoms trajectory and identify relationship between healthcare seeking and symptoms and common sociodemographic variables.

RESULT

A total 91.1% (1968) of 2160 eligible residents completed the interview who reported 1.83 episodes of RTIs in the pass year on average. Over half (54.8%) of these RTI episodes had led to visit to clinics for professional care and 51.9%, to use of antibiotics. The trajectories of common RTI symptoms featured a sharp increase and peak followed by a long tail along the days after onset of the infection. Over 60.5% of healthcare-seeking happened between two days before and one day after the symptoms peak. The study also revealed interesting pattern in the timing of different type of treatment following, e.g., taking leftover medicine and antibiotics happened the earliest and seeking professional help and getting antibiotics from clinics, the latest.

CONCLUSION

RTIs incur a large volume of healthcare-seeking and antibiotics use and there is an urgent need for effective education measures on proper service especially antibiotics use. Patients' reported RTI symptoms manifest peculiar trajectories and their retrospective recall of the course of prior RTI episodes and associated actions may guide their future responses to similar infections. Knowledge of these may help inform doctors about patient expectations, enabling them better manage shared decision- making around antibiotic treatment.

Health service utilization following symptomatic respiratory tract infections and influencing factors among urban and rural residents in Anhui, China

Aim:

This study seeks to identify healthcare utilization patterns following symptomatic respiratory tract infections (RTIs) and the variables that may influence these patterns.

Background:

RTIs are responsible for the bulk of the primary healthcare burden worldwide. Yet, the use of health services for RTIs displays great discrepancies between populations. This research examines the influence of social demographics, economic factors, and accessibility on healthcare utilization following RTIs.

Methods:

Structured interviews were administered by trained physicians at the households of informants selected by cluster randomization. Descriptive and multivariate binary logistic regression analysis was performed to assess healthcare utilization and associated independent variables.

Findings:

A total of 60 678 informants completed the interviews. Of the 2.9% informants exhibiting upper RTIs, 69.5–73.9% sought clinical care. Healthcare utilization rates for common cold, influenza, nine acute upper RTIs, and overall RTIs demonstrate statistically significant associations with the variables of age, type of residence, employment, medical insurance, annual food expenditure, distance to medical facilities, and others. The odds ratios for healthcare utilization rates varied substantially, ranging from 0.026 to 9.364. More than 69% of informants with RTIs sought clinical interventions. These findings signify a marked issue with the large amount of healthcare for self-limited RTIs.

How patients' experiences of respiratory tract infections affect healthcare-seeking and antibiotic use: insights from a cross-sectional survey in rural Anhui, China

OBJECTIVE

To investigate the occurrence of reported respiratory tract infection (RTI) symptoms and their effects on use of self and professional care among patients in the community.

DESIGN

A cross-sectional retrospective household survey.

SETTING

12 administrative villages from rural Anhui, China.

PARTICIPANTS

2160 rural adult residents aged ≥18 years registered as rural residents and actually living in the sampled villages when this study was conducted.

METHOD

The respondents were recruited using stratified-clustered randomised sampling. A structured questionnaire was deployed to solicit information about social demographics, symptoms of last RTI and healthcare-seeking following the RTI. Descriptive analyses were performed to investigate the reported symptoms, and multivariate logistic regression models were developed to identify relationships between number of concurrent symptoms and healthcare-seeking and antibiotics use.

RESULTS

A total of 1968 residents completed the survey, resulting in a response rate of 91.1%. The number of concurrent symptoms showed a clear increasing trend with seeking help from clinics and being prescribed antibiotics. Multivariate regression revealed statistically significant associations between the following: (a) visiting clinics and education (OR=0.790), sore throat (OR=1.355), cough (OR=1.492), shortness of breath (OR=1.707) and fever (OR=2.142); (b) buying medicine from shops without prescription and education (OR=1.230) and cough (OR=1.452); (c) getting antibiotics at clinics and sore throat (OR=2.05) and earache and/or tinnitus (OR=4.884); and (d) obtaining antibiotics at medicine shops and productive cough (OR=1.971).

CONCLUSIONS

Reported RTI symptoms play an important role in shaping both patient- and doctor-led responses.