Do influenza and acute respiratory infective diseases weigh heavily on general practitioners’ daily practice?

Sauro, Alfonso; Barone, Filippo; Blasio, Giuseppe De; Russo, Luigi; Santillo, Luigi

doi:10.1080/13814780600757153

Cited by 27 publications

(25 citation statements)

References 5 publications

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“…From a limitations perspective, individuals who did not receive medical attention for their ARI were not recruited, thus results are not necessarily generalizable to all influenza illness cases in the community. From a measurement perspective, variations of the ARI symptom severity metric used in this study have been used in numerous other investigations [30-38] and have been previously correlated with influenza positive status [19] and viral shedding [20], but have not been formally validated and remain a subjective measure of symptom perceptions that may be subject to recall and self-presentation biases, as is common with some other self-reported metrics [39]. This is a particular concern in some subgroup comparisons where symptom severity expectations may vary as a result of perceptual priming during study enrollment (e.g., different beliefs on how influenza vaccination should impact symptoms).…”

Section: Discussionmentioning

confidence: 99%

“…The severity of seasonal influenza symptoms compared to non-influenza ARI has not been extensively studied though. One study reported an association between increased symptom severity in patients with laboratory confirmed 2009 pandemic influenza compared to seasonal influenza [18]; limited evidence also suggests that influenza ARI may be more severe than ARI due to other causes [19]. In an influenza challenge study, symptom severity was associated with increased magnitude of influenza virus shedding [20].…”

Section: Introductionmentioning

confidence: 99%

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A cross-sectional analysis of symptom severity in adults with influenza and other acute respiratory illness in the outpatient setting

2014

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BackgroundAcute respiratory infections (ARIs) are common in outpatient practice, and the severity of symptoms contributes to the overall burden of illness. We examined the association between a subjective symptom severity score, demographic and clinical characteristics, and presence of laboratory-confirmed influenza among central Wisconsin adults who sought care for ARI during four influenza seasons. We hypothesized that adults with laboratory-confirmed influenza would rate their symptoms as more severe relative to adults without influenza, and vaccinated adults with influenza would rate symptoms as less severe than those who were not vaccinated.MethodsPatients with acute respiratory illness, including feverishness or cough symptoms ≤ 7 days duration, were prospectively enrolled and tested for influenza by reverse transcription polymerase chain reaction (RT-PCR) during influenza seasons 2007–08 through 2010–11. Perceived severity was self-rated during the enrollment interview for eight symptoms, on a scale of 0 (absent) to 3 (severe). Scores for each symptom were summed to generate a combined severity score ranging from 1 to 24 for each individual. The association between influenza test result and severity score was examined using linear regression.ResultsThere were 2,374 individuals included in the analysis, including 324 with RT-PCR confirmed influenza. The mean symptom severity score was 12.3 (±4.1) points, and the most common symptoms were cough (92%), fatigue (91%), and nasal congestion (84%). In the final adjusted model, influenza infection was the strongest independent predictor of higher severity score, with a mean increase of 1.7 points compared to those who were influenza negative (p < 0.001). Among adults with influenza, the association between influenza vaccination and symptom severity was modified by age (p < 0.001). In adults ≥ 65 years old with RT-PCR confirmed influenza, symptom severity was 31% lower in those who were vaccinated as compared to those who were not vaccinated.ConclusionsInfluenza is associated with more severe symptoms of acute respiratory illness. The association between influenza vaccination and reduced symptom severity in older adults should be confirmed and explored further in other populations and seasons.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A cross-sectional analysis of symptom severity in adults with influenza and other acute respiratory illness in the outpatient setting

2014

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“…Accordingly, the extra workload of influenza patients puts pressure on the primary care service during epidemics, and this is added to normal activity [10]. General practices in Norway generally pre-book appointments and have a few available appointments for acute illnesses every day.…”

Section: Introductionmentioning

confidence: 99%

Capacity and Adaptations of General Practice during an Influenza Pandemic

et al. 2013

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BackgroundGPs play a major role in influenza epidemics, and most patients with influenza-like-illness (ILI) are treated in general practice or by primary care doctors on duty in out-of-hours services (OOH). Little is known about the surge capacity in primary care services during an influenza pandemic, and how the relationship between them changes.AimTo investigate how general practice and OOH services were used by patients during the 2009 pandemic in Norway and the impact of the pandemic on primary care services in comparison to a normal influenza season.MaterialsData from electronic remuneration claims from all OOH doctors and regular GPs for 2009.MethodsWe conducted a registry-based study of all ILI consultations in the 2009 pandemic with the 2008/09 influenza season (normal season) as baseline for comparison.ResultsThe majority (82.2%) of ILI consultations during the 2009 pandemic took place in general practice. The corresponding number in the 2008/09 season was 89.3%. Compared with general practice, the adjusted odds ratio for ILI with all other diagnoses as reference in OOH services was 1.23 (95% CI, 1.18, 1.27) for the 2008/2009 season and 1.87 (95% CI, 1.84, 1.91) for the pandemic influenza season. In total there was a 3.3-fold increase in ILI consultations during the pandemic compared to the 2008/09 season. A 5.5-fold increase of ILI consultations were observed in OOH services in comparison to the 2008/09 season. Children and young adults with ILI were the most frequent users of OOH services during influenza periods.ConclusionsThe autumn pandemic wave resulted in a significantly increased demand on primary care services. However, GPs in primary care services in Norway showed the ability to increase capacity in a situation with increased patient demand.

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“…Upper respiratory tract infections result in an estimated increase of 12.5% in patient visits per month during cold and flu season. 19 In the United States, direct medical costs related to the common cold (physician visits, secondary infections and medications) were an estimated $17 billion a year in 1997. 17 Indirect costs owing to missed work because of illness or caring for an ill child were an estimated $25 billion a year.…”

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confidence: 99%