Acute respiratory infections : can a non-physician practitioner triage and treat patients by using an algorithm? Experience in a military primary care clinic
BACKGROUND: Acute respiratory viral infections are minor self-limited diseases. Studies have shown that patients with ARVI can be treated as effectively by non-physician practitioners as by physicians.
OBJECTIVES: To examine whether a military medic, using a structured questionnaire and an algorithm, can appropriately triage patients to receive over-the-counter medications and refer more complicated cases to a physician.
METHODS: The study group comprised 190 consecutive soldiers who presented to a military primary care clinic with symptoms of ARVI. Using a questionnaire, a medic recorded the patient's history and measured oral temperature, pulse rate and blood pressure. All patients were referred to a doctor. Physicians were "blind" to the medic's anamnesis and to the algorithm diagnosis. We compared the medic's anamnesis and therapeutic decisions with those of the doctors.
RESULTS: Patients were young (21.1 +/- 3.7 years) and generally healthy (93% without background illness). They usually had a minor disease (64% without fever) that was mostly diagnosed as viral ARVI (83% of cases). Ninety-nine percent were also examined by a physician. According to the patients' data, the medics showed high overall agreement with the doctors (83-97.9%). The proposed algorithm could have saved 37% of referrals to physicians, with a sensitivity of 95.2%. Had the medics been allowed to examine the pharynx for an exudate, the sensitivity might have been 97.6%.
CONCLUSIONS: Medics, equipped with a questionnaire and algorithm but without special training and without performing a physical examination, can appropriately triage patients and thereby reduce the number of referrals to physicians.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2005 |
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| Erschienen: |
2005 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
The Israel Medical Association journal : IMAJ - 7(2005), 9 vom: 01. Sept., Seite 578-82 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Golan, Danie [VerfasserIn] |
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| Themen: |
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| Anmerkungen: |
Date Completed 12.10.2005 Date Revised 19.11.2015 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM158029496 |
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| 100 | 1 | |a Golan, Danie |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Acute respiratory infections |b can a non-physician practitioner triage and treat patients by using an algorithm? Experience in a military primary care clinic |
| 264 | 1 | |c 2005 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 12.10.2005 | ||
| 500 | |a Date Revised 19.11.2015 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Acute respiratory viral infections are minor self-limited diseases. Studies have shown that patients with ARVI can be treated as effectively by non-physician practitioners as by physicians | ||
| 520 | |a OBJECTIVES: To examine whether a military medic, using a structured questionnaire and an algorithm, can appropriately triage patients to receive over-the-counter medications and refer more complicated cases to a physician | ||
| 520 | |a METHODS: The study group comprised 190 consecutive soldiers who presented to a military primary care clinic with symptoms of ARVI. Using a questionnaire, a medic recorded the patient's history and measured oral temperature, pulse rate and blood pressure. All patients were referred to a doctor. Physicians were "blind" to the medic's anamnesis and to the algorithm diagnosis. We compared the medic's anamnesis and therapeutic decisions with those of the doctors | ||
| 520 | |a RESULTS: Patients were young (21.1 +/- 3.7 years) and generally healthy (93% without background illness). They usually had a minor disease (64% without fever) that was mostly diagnosed as viral ARVI (83% of cases). Ninety-nine percent were also examined by a physician. According to the patients' data, the medics showed high overall agreement with the doctors (83-97.9%). The proposed algorithm could have saved 37% of referrals to physicians, with a sensitivity of 95.2%. Had the medics been allowed to examine the pharynx for an exudate, the sensitivity might have been 97.6% | ||
| 520 | |a CONCLUSIONS: Medics, equipped with a questionnaire and algorithm but without special training and without performing a physical examination, can appropriately triage patients and thereby reduce the number of referrals to physicians | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Zagetzki, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Vinker, Shlomo |e verfasserin |4 aut | |
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