A case study of nurse management of upper respiratory tract infections in general practice
Butler CC., Rees M., Kinnersley P., Rollnick S., Hood K.
Background. Nurses increasingly manage acute illness in United Kingdom (UK) general practice. Few data exist about patients routinely consulting with these nurses. There are concerns that providing this additional service will lower thresholds for consulting with an overall increase in workload. Upper respiratory tract infection (URTI) is the commonest reason for consulting. Inappropriate antibiotics promote resistant bacteria. Nurse management of URTI is an ideal opportunity to promote self-care and nonantibiotic management. Aims. To describe the effects of a specially trained practice nurse managing URTI in a general practice in Cardiff, UK. Methods. Descriptive study. Results. Data were collected on 132 patients consulting with the nurse. We also collected data on 234 patients consulting general practitioners (GPs) in the same practice. Patients seen by the nurse were younger and less likely to be given antibiotics at the time of their index illness than those who saw GPs (7% vs. 93%; P < 0·001). During the year following the consultation with the nurse, patients consulted slightly less often and received antibiotics for URTI less often compared with the year preceding this consultation (P = 0·02). Their consultation rate for all conditions did not change. The consultation rates for URTI of the patients managed by the GPs remained constant and consultations for all conditions increased (P < 0·01). Conclusions. Nurse management of URTI did not lower patients' threshold for future consulting, and patients who saw her were prescribed antibiotics less often.