Management of community-acquired pneumonia by trained family general practitioners.
METHODS
Community-acquired pneumonia (CAP) is a respiratory health disease with a high prevalence in the general population. Family general practitioners (GPs) can play an important role in CAP management by reducing unnecessary hospital admissions and, consequently, national health costs.


OBJECTIVE
To assess CAP management by trained GPs.


METHODS
A course in CAP management, including a risk classification method based only on clinical criteria, was developed within the framework of an educational programme. GPs who participated in the programme (n = 220) were asked to collect data on their CAP patients.


RESULTS
GPs (n = 94, response rate 42.7%) provided information on 370 patients (50% males, aged 18-93 years). The numbers of patients judged to be at low, moderate and high risk were 81%, 13% and 6%, respectively. The admission rate was 19.5%. All home-treated patients had good clinical outcomes. Home treatment was based on quinolones (62%), beta-lactams (23%) and macrolides (15%). The attributable economic mean cost of antibiotic home treatment was euro 96 per episode (standard deviation 71, range 17-445).


CONCLUSIONS
The good outcomes suggest that GPs managed their CAP patients well, adhering to the content of the CAP management course. The risk evaluation of patients admitted to hospital, based exclusively on clinical elements, was consistent with more complex classification.
Potena
A
A
Respiratory Physio-Pathology Unit, Azienda Ospedaliero-Universitaria, Ferrara, Italy. pta@unife.it
Simoni
M
M
Cellini
M
M
Cartabellotta
A
A
Ballerin
L
L
Piattella
M
M
Putinati
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D003661:Decision Support Techniques; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents