Excessive use of rapid tests in respiratory tract infections in Swedish primary health care.
A 1-y retrospective study of problem oriented electronic patient records, for encounters concerning respiratory tract infection, was performed. The aim was to analyse the management of respiratory tract infections in primary health care in terms of diagnostic coding, tests and antibiotic treatment using data from electronic patient records. 12 primary health care centres with a registered population of 102,050 residents in 3 counties in southeast Sweden participated. Data were retrieved electronically from records of patient encounters concerning respiratory tract infections. The data were: patient age and gender, date of contact, diagnostic code, CRP and GABHS tests and results, as well as antibiotic prescriptions. In a total of 19,965 encounters, the most frequent diagnoses were common cold (40%), acute tonsillitis (18%), and acute bronchitis (15%). A total of 4445 GABHS tests (in 22% of encounters) and 6141 CRP tests (31%) were performed, and both tests were done in 1910 encounters (10%). A total of 7934 antibiotic prescriptions were registered. The proportion of patients tested and prescribed an antibiotic varied greatly between centres. We found an excessive, and much varying, use of rapid tests in encounters for respiratory tract infections. Data retrieval from electronic patient record systems was a feasible method to study the use of laboratory tests in relation to pharmacological treatment.
Engström
Sven
S
Ryd Health Centre, Linköping, Sweden. sven.engstrom@lio.se
Mölstad
Sigvard
S
Lindström
Kjell
K
Nilsson
Gunnar
G
Borgquist
Lars
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013297:Streptococcus pyogenes / Q000145:classification*; D011795:Surveys and Questionnaires; D013548:Sweden; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*
D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein