Sore throat management in New Zealand general practice.
OBJECTIVE
To describe the sore throat management practices by New Zealand general practitioners (GPs) and compare the rate of sore throat presentation over time.


METHODS
Data were collected from the National Primary Medical Care Survey carried out over 2001/2002. Analyses were done on patients who presented to the GP with the symptom of a sore throat as one of their reasons for visit. A systematic review of the New Zealand literature was done for sore throat presentation to GPs since 1966.


RESULTS
There were 10,506 records of visits gathered from 246 GPs and 335 patients presented sore throat as a reason for visit. Patients presented sore throat at a rate (SE) of 3.6 (0.26) per 100 encounters and varied by age (p=0.004), but not by socioeconomic deprivation (p=0.415) or by ethnic group (p=0.165). Patients' perceived urgency of visit had a greater impact in the rate of presentation for the 0-4 year age group than in the at-risk age group of 5-14 years (p=0.001). GPs recorded a 'Read code' diagnosis at a rate of 59.2 (3.96) recordings per 100 encounters. Among the 306 recorded diagnoses, 11.4% were explicit recordings of viral diagnoses. 7.6% of GPs ranked themselves as 'moderately' and 2.3% as 'highly' uncertain of their diagnosis. Throats swabs were taken at a rate of 6.6 (1.68) swabs per 100 encounters. Antibiotic prescribing rate was higher when sore throat was recorded as a reason for visit than not (p<0.001). There were no significant differences in throat swabs taken for sore throat patients prescribed an antibiotic or not (p=0.623). No Pacific person had a throat swab taken. Patients with sore throat who were Maori (73.5 [7.2]) or Pacific people (80.2 [17.3]) were more likely to be prescribed an antibiotic than Europeans (57.4 [4.62]). Since 1966, there were 16 New Zealand studies of patients presenting with respiratory disorders to their GP. Seven of these studies measured GP management of sore throat, and only 3 of these measured the rate of patients' sore throat symptom presentation. The rate of patients' sore throat presentation remained similar when compared with the Waikato study of 1991 (2.8%) that had a similar methodology.


CONCLUSIONS
Sore throat continues to be a common symptom that GPs manage in their work. Ethnic differences may have a part to play in how GPs manage sore throat. More research is needed to discover those factors that would encourage a greater proportion at-risk 5-14 year old children to attend their GP with sore throat.
Kljakovic
Marjan
M
Academic Unit of General Practice and Community Health, Rural and Community Clinical School, Australian National University Medical School, Canberra, Australia. marjan.kljakovic@anu.edu.au
Crampton
Peter
P
D000293:Adolescent; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005194:Family Practice / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009520:New Zealand; D010612:Pharyngitis / Q000175:diagnosis / Q000628:therapy*; D010614:Pharynx / Q000473:pathology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
D000900:Anti-Bacterial Agents