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Br J Gen Pract. Oct 1, 2009; 59(567): 761–764.
PMCID: PMC2751918
Predictors of patient-initiated reconsultation for lower respiratory tract infections in general practice
Jochen WL Cals, MD, MSc, GP Trainee and Researcher
Department of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, The Netherlands
Kerenza Hood, PhD, Reader in Statistics
South East Wales Trials Unit, School of Medicine, Cardiff University, Wales
Nienke Aaftink, MD, MSc, Junior Researcher
Department of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, The Netherlands
Rogier M Hopstaken, MD, PhD, GP and Researcher
Foundation of Primary Health Care Centres Eindhoven, The Netherlands
Nick A Francis, MD, MRC Health Services Fellow
Department of Primary Care and Public Health, School of Medicine, Cardiff University, Wales
Geert-Jan Dinant, MD, PhD, Professor of General Practice
Department of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, The Netherlands
Christopher C Butler, MD, Professor of Primary Care Medicine
Department of Primary Care and Public Health, School of Medicine, Cardiff University, Wales
Address for correspondence Jochen Cals, Department of General Practice, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. E-mail: j.cals/at/hag.unimaas.nl
Received May 21, 2009; Revised June 11, 2009; Accepted July 24, 2009.
Abstract
Reconsultation for lower respiratory tract infection (LRTI) is common in general practice, but those who reconsult rarely have more significant illness warranting antibiotics. Knowledge of factors that predict patient-initiated reconsultation may allow clinicians to address specific issues during the initial consultation that could reduce reconsultations. Thirty-three per cent of a cohort of 431 LRTI patients in a randomised controlled trial reconsulted. Excluding 35 patients with GP-requested reconsultation left 28% (112/396) with a patient-initiated reconsultation during 28-day follow-up. Patient-reported dyspnoea and concerns that persisted after the initial consultation independently predicted patient-initiated reconsultation.
Keywords: communication, family practice, respiratory tract infections
Articles from The British Journal of General Practice are provided here courtesy of
Royal College of General Practitioners