IngentaConnect Management of community-acquired pneumonia by trained family gene...

Authors: Potena, A.¹; Simoni, M.¹; Cellini, M.²; Cartabellotta, A.³; Ballerin, L.¹; Piattella, M.¹; Putinati, S.¹

Source: The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 1, January 2008 , pp. 19-25(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: Community-acquired pneumonia (CAP) is a respiratory health disease with a high prevalence in the general population. Family general practitioners (GPs) can play an important role in CAP management by reducing unnecessary hospital admissions and, consequently, national health costs.

OBJECTIVE: To assess CAP management by trained GPs.

DESIGN: A course in CAP management, including a risk classification method based only on clinical criteria, was developed within the framework of an educational programme. GPs who participated in the programme (n = 220) were asked to collect data on their CAP patients.

RESULTS: GPs (n = 94, response rate 42.7%) provided information on 370 patients (50% males, aged 18-93 years). The numbers of patients judged to be at low, moderate and high risk were 81%, 13% and 6%, respectively. The admission rate was 19.5%. All home-treated patients had good clinical outcomes. Home treatment was based on quinolones (62%), beta-lactams (23%) and macrolides (15%). The attributable economic mean cost of antibiotic home treatment was €96 per episode (standard deviation 71, range 17-445).

CONCLUSIONS: The good outcomes suggest that GPs managed their CAP patients well, adhering to the content of the CAP management course. The risk evaluation of patients admitted to hospital, based exclusively on clinical elements, was consistent with more complex classification.

Keywords: disease management; family general practitioners; community-acquired pneumonia; antibiotics; educational programme

Document Type: Regular paper

Affiliations: 1: Respiratory Physio-Pathology Unit, Azienda Ospedaliero-Universitaria, Ferrara, Italy 2: Valuation and Control Service, Ferrara, Italy 3: Italian Evidence-based Medicine Group (GIMBE), Bologna, Italy

Management of community-acquired pneumonia by trained family general practitioners