Respiratory tract infections in Norwegian primary care 2006–2015: a registry-based study

Larsen, Leo; Wensaas, Knut‐Arne; Emberland, Knut Erik; Rørtveit, Guri

doi:10.1080/02813432.2022.2069711

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…Our findings of respiratory tract infections as a common diagnosis correspond well to both Norwegian and international findings [ 17 , 33 ]. The increase between 2016 to 2019 with the following decrease for 16–19-year-olds corresponds well to the aforementioned absence limit.…”

Section: Discussionsupporting

confidence: 91%

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Use of general practitioner services among youth and young adults in Norway from 2006 to 2021

Wahlberg,

Pape,

Austad

et al. 2023

Scandinavian Journal of Primary Health Care

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Objective To describe the frequency and content of contacts with general practitioners (GPs) among youth and young adults by sex, age and time, emphasizing mental health, sexual health and respiratory tract infections. Design Registry-based population-wide cohort study. Setting General practice in Norway 2006–2021. Subjects Norwegian residents aged 13–25 within the study period. Main outcome measures Contacts with GPs and out-of-hours services, including type of contact, specific procedures and diagnoses. Results Average number of GP consultations increased over the study period for all age groups. Conversation therapy and time-consuming consultations increased over time, while chlamydia testing and contraceptive guidance decreased among young women. Consultations with mental health diagnoses increased substantially over the study period for all age groups. Use of GP and out-of-hours services increased with age, with a peak at the end of upper secondary school. Youth more often met their own regular GP when consulting for mental health diagnoses than for respiratory tract infections. Conclusion This study confirmed the continuing trend of increasing use of general practice services among youth, with an increase in conversation therapy and consultations with mental health diagnoses. Procedures related to sexual health became less common. Youth usually meet their regular GP for consultations, in particular those whose diagnosis indicates the highest need of continuity.

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Section: Discussionsupporting

confidence: 91%

“…Youth and adolescents’ use of GP services has previously been studied for specific diagnoses or population subgroups, and mental health and respiratory tract infections are found to be common [ 17–19 ]. Data on GP contacts over time are publicly available but only for broader age groups [ 2 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Use of general practitioner services among youth and young adults in Norway from 2006 to 2021

Wahlberg,

Pape,

Austad

et al. 2023

Scandinavian Journal of Primary Health Care

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“…A recent Norwegian study covering 2006–2015 reported an increased number of consultations in primary care, but a decreased proportion of RTI consultations. 30 Studies from Swedish general practice from the same decade reported decreased consultation rates for RTIs and a corresponding decrease in antibiotic prescription rates. 26 , 31 Also, both Danish and English primary care research have reported decreased antibiotic prescription rates.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic treatment of respiratory tract infections in adults in Norwegian general practice

Skow

Fossum

Høye

et al. 2022

JAC-Antimicrobial Resistance

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Objectives To analyse the prevalence of respiratory tract infection (RTI) episodes with and without antibiotic prescriptions in adult patients in Norwegian general practice during the period 2012–2019. Methods Observational study linking data from the Norwegian Control and Payment for Health Reimbursements Database and the Norwegian Prescription Database. Episodes of acute RTIs in patients aged 18 years or older were identified and linked to antibiotic prescriptions dispensed within 7 days after diagnosis. We analysed annual infection rates and antibiotic prescription rates and antibiotics prescribed for the different RTI conditions. Results RTI episode rate per 1000 inhabitants was 312 in 2012 and 277 in 2019, but showed no linear trend of change during the study period (P = 0.205). Antibiotic prescription rate decreased from 37% of RTI episodes in 2012 to 23% in 2019 (P < 0.001). The reduction in prescribing was most pronounced for episodes coded with ICPC-2 symptom diagnoses, as well as upper RTIs, influenza, acute bronchitis and sinusitis. Prescriptions for phenoxymethylpenicillin decreased from 178 746 in 2012 to 143 095 in 2019, but increased as proportion of total antibiotic prescriptions from 40% in 2012 to 53% in 2019 (P < 0.001). Conclusions This study demonstrates stable RTI episode rates and reduced antibiotic prescription rates for RTIs for adults in Norwegian general practice 2012–2019. We also observed a shift towards relatively more use of phenoxymethylpenicillin and less broad-spectrum antibiotics. These changes are in line with the aims of the Norwegian strategy against antibiotic resistance.

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“…Around 1992, the costs attached to CRP POCT became reimbursed. Approximately 60% of all RTI-related consultations at primary care involve a CRP POCT, and in out-of-hour services, CRP POCT is performed in 70% of RTI-related consultations ( 49 ). A national guideline “antibiotics in primary care” gives instructions about the use of CRP and the interpretation of values when antibiotic prescribing should be considered for suspected lower RTI ( 50 ).…”

Section: Policy Options and Implicationsmentioning

confidence: 99%

C-reactive protein point-of-care testing in primary care—broader implementation needed to combat antimicrobial resistance

Llor,

Plate,

Bjerrum

et al. 2024

Front. Public Health

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This study presents the perspective of an international group of experts, providing an overview of existing models and policies and guidance to facilitate a proper and sustainable implementation of C-reactive protein point-of-care testing (CRP POCT) to support antibiotic prescribing decisions for respiratory tract infections (RTIs) with the aim to tackle antimicrobial resistance (AMR). AMR threatens to render life-saving antibiotics ineffective and is already costing millions of lives and billions of Euros worldwide. AMR is strongly correlated with the volume of antibiotics used. Most antibiotics are prescribed in primary care, mostly for RTIs, and are often unnecessary. CRP POCT is an available tool and has been proven to safely and cost-effectively reduce antibiotic prescribing for RTIs in primary care. Though established in a few European countries during several years, it has still not been implemented in many European countries. Due to the complexity of inappropriate antibiotic prescribing behavior, a multifaceted approach is necessary to enable sustainable change. The effect is maximized with clear guidance, advanced communication training for primary care physicians, and delayed antibiotic prescribing strategies. CRP POCT should be included in professional guidelines and implemented together with complementary strategies. Adequate reimbursement needs to be provided, and high-quality, and primary care-friendly POCT organization and performance must be enabled. Data gathering, sharing, and discussion as incentivization for proper behaviors should be enabled. Public awareness should be increased, and healthcare professionals’ awareness and understanding should be ensured. Impactful use is achieved when all stakeholders join forces to facilitate proper implementation.

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Respiratory tract infections in Norwegian primary care 2006–2015: a registry-based study

Cited by 3 publications

References 19 publications

Use of general practitioner services among youth and young adults in Norway from 2006 to 2021

Use of general practitioner services among youth and young adults in Norway from 2006 to 2021

Antibiotic treatment of respiratory tract infections in adults in Norwegian general practice

C-reactive protein point-of-care testing in primary care—broader implementation needed to combat antimicrobial resistance

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