Post-consultation acute respiratory tract infection recovery : a latent class-informed analysis of individual patient data
© The Authors..
BACKGROUND: There is a lack of evidence regarding post-consultation symptom trajectories for patients with respiratory tract infections (RTIs) and whether patient characteristics can be used to predict illness duration.
AIM: To describe symptom trajectories in patients with RTIs, and assess baseline characteristics and adverse events associated with trajectories.
DESIGN AND SETTING: The study included data about 9103 adults and children from 12 primary care studies.
METHOD: A latent class-informed regression analysis of individual patient data from randomised controlled trials and observational cohort studies was undertaken. Post-consultation symptom trajectory (severity and duration), re-consultation with same or worsening illness, and admission to hospital were assessed.
RESULTS: In total, 90% of participants recovered from all symptoms by 28 days, regardless of antibiotic prescribing strategy (none, immediate, and delayed antibiotics). For studies of RTI with cough as a dominant symptom (n = 5314), four trajectories were identified: 'rapid (6 days)' (90% of participants recovered within 6 days) in 52.0%; 'intermediate (10 days)' (28.9%); 'slow progressive improvement (27 days)' (12.5%); and 'slow improvement with initial high symptom burden (27 days)' (6.6%). For cough, being aged 16-64 years (odds ratio [OR] 2.57, 95% confidence interval [CI] = 1.72 to 3.85 compared with <16 years), higher presenting illness baseline severity (OR 1.51, 95% CI = 1.12 to 2.03), presence of lung disease (OR 1.78, 95% CI = 1.44 to 2.21), and median and above illness duration before consultation (≥7 days) (OR 1.99, 95% CI = 1.68 to 2.37) were associated with slower recovery (>10 days) compared with faster recovery (≤10 days). Re-consultations and admissions to hospital for cough were higher in those with slower recovery (ORs: 2.15, 95% CI = 1.78 to 2.60 and 7.42, 95% CI = 3.49 to 15.78, respectively).
CONCLUSION: Older patients presenting with more severe, longer pre-consultation symptoms and chronic lung disease should be advised they are more likely to experience longer post-consultation illness durations, and that recovery rates are similar with and without antibiotics.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
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| Enthalten in: |
The British journal of general practice : the journal of the Royal College of General Practitioners - 73(2023), 728 vom: 15. März, Seite e196-e203 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hounkpatin, Hilda [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Bacterial Agents |
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| Anmerkungen: |
Date Completed 27.02.2023 Date Revised 03.03.2023 published: Electronic-Print Citation Status MEDLINE |
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| doi: |
10.3399/BJGP.2022.0229 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM353292931 |
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| 100 | 1 | |a Hounkpatin, Hilda |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Post-consultation acute respiratory tract infection recovery |b a latent class-informed analysis of individual patient data |
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| 500 | |a Date Completed 27.02.2023 | ||
| 500 | |a Date Revised 03.03.2023 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Authors. | ||
| 520 | |a BACKGROUND: There is a lack of evidence regarding post-consultation symptom trajectories for patients with respiratory tract infections (RTIs) and whether patient characteristics can be used to predict illness duration | ||
| 520 | |a AIM: To describe symptom trajectories in patients with RTIs, and assess baseline characteristics and adverse events associated with trajectories | ||
| 520 | |a DESIGN AND SETTING: The study included data about 9103 adults and children from 12 primary care studies | ||
| 520 | |a METHOD: A latent class-informed regression analysis of individual patient data from randomised controlled trials and observational cohort studies was undertaken. Post-consultation symptom trajectory (severity and duration), re-consultation with same or worsening illness, and admission to hospital were assessed | ||
| 520 | |a RESULTS: In total, 90% of participants recovered from all symptoms by 28 days, regardless of antibiotic prescribing strategy (none, immediate, and delayed antibiotics). For studies of RTI with cough as a dominant symptom (n = 5314), four trajectories were identified: 'rapid (6 days)' (90% of participants recovered within 6 days) in 52.0%; 'intermediate (10 days)' (28.9%); 'slow progressive improvement (27 days)' (12.5%); and 'slow improvement with initial high symptom burden (27 days)' (6.6%). For cough, being aged 16-64 years (odds ratio [OR] 2.57, 95% confidence interval [CI] = 1.72 to 3.85 compared with <16 years), higher presenting illness baseline severity (OR 1.51, 95% CI = 1.12 to 2.03), presence of lung disease (OR 1.78, 95% CI = 1.44 to 2.21), and median and above illness duration before consultation (≥7 days) (OR 1.99, 95% CI = 1.68 to 2.37) were associated with slower recovery (>10 days) compared with faster recovery (≤10 days). Re-consultations and admissions to hospital for cough were higher in those with slower recovery (ORs: 2.15, 95% CI = 1.78 to 2.60 and 7.42, 95% CI = 3.49 to 15.78, respectively) | ||
| 520 | |a CONCLUSION: Older patients presenting with more severe, longer pre-consultation symptoms and chronic lung disease should be advised they are more likely to experience longer post-consultation illness durations, and that recovery rates are similar with and without antibiotics | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a antibiotics | |
| 650 | 4 | |a general practice | |
| 650 | 4 | |a latent class analysis | |
| 650 | 4 | |a respiratory tract infections | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Stuart, Beth |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Shihua |e verfasserin |4 aut | |
| 700 | 1 | |a Yao, Guiqing |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Löffler, Christin |e verfasserin |4 aut | |
| 700 | 1 | |a Little, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Kenealy, Timothy |e verfasserin |4 aut | |
| 700 | 1 | |a Gillespie, David |e verfasserin |4 aut | |
| 700 | 1 | |a Francis, Nick A |e verfasserin |4 aut | |
| 700 | 1 | |a Bostock, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Becque, Taeko |e verfasserin |4 aut | |
| 700 | 1 | |a Arroll, Bruce |e verfasserin |4 aut | |
| 700 | 1 | |a Altiner, Attila |e verfasserin |4 aut | |
| 700 | 1 | |a Alonso-Coello, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Hay, Alastair D |e verfasserin |4 aut | |
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