Pharyngitis
Conditions
Keywords
Guideline, Sore throat, Pharmacy, Nurses, Physicians
Brief summary
This project aims to investigate if an organisational change of patient flow away from medical practitioners can reduce unnecessary antibiotic prescribing in patients attending with a sore throat as the main complaint.
Detailed description
Today patients appear either at a PHC centre or at the Pharmacy. The Pharmacy may provide advice on analgesic or refer the patient to a PHC centre. At the PHC centre, the patient may first appear to the medical practitioner or a nurse pending on local routines. The current Swedish guideline recommends no antibiotics and no testing for patients with 0-2 Centor criteria. For patients with 3-4 Centor criteria the guideline recommends testing and only consider antibiotics if GAS is present. COVID-19 has gradually transformed from expressing itself as a severe lower respiratory tract infection to be more of an upper respiratory tract infection. Furthermore, COVID-19 is likely to transform from a pandemic to an endemic state with a low continuous incidence. Hence, in response to COVID-19 it seems crucial to identify to what extent the common sore throat is caused by the SARS-CoV-2. Furthermore, a large controlled clinical trial is required to sort out if patients attending with a sore throat as the main complaint are best managed by medical practitioners, nurses or pharmacists. This study aims to perform such a controlled clinical trial comparing the outcome of sore throat patients management by medical practitioner, nurses and pharmacists. This study also aims to investigate to what extent the SARS-CoV-2 virus is identified in these patients.
Interventions
BEHAVIORALPhysicians assess patients
Physicians are asked to assess patients following the current Swedish guideline
BEHAVIORALNurses assess patients
Nurses are asked to assess patients following the current Swedish guideline
BEHAVIORALPharmacists assess patients
Pharmacists are asked to assess patients following the current Swedish guideline
Sponsors
Vastra Gotaland Region
Göteborg University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Parallel groups each with different interventions.
Eligibility
Sex/Gender
ALL
Age
6 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The patient is contacting/attending PHC centre or Pharmacy presenting with a sore throat as the main complaint. * Male or female, aged ≥6 years. * Fluent in Swedish (reading, writing, conversational) (applicable to caregivers/parents/guardians in case of children). * Mental state such that he or she can understand and give informed consent to participation in the study by signing the Information and Consent Form. * Provision of signed and dated Informed Consent Form.
Exclusion criteria
* The illness episode is classified as potentially complicated or potentially critically ill * Presence of SARS-CoV-2 virus in a patient first appearing at the PHC in a cluster where the assessment is supposed to be done by the pharmacists. The patient will not be sent to the pharmacist in case of presence of SARS-CoV-2-virus. * Patient request to be withdrawn from the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Guideline adherence | Immediately after the consultation | Will the proportion of patients attending for an uncomplicated acute sore throat being managed according to prevailing guidelines differ if the initial assessment is made by a medical practitioner, a trained nurse or a trained pharmacist |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Illness severity | Immediately after the consultation | What proportion of patients attending PHC centres or pharmacies are classified as apparently uncomplicated, potentially complicated or potentially critically ill |
| Type of patients seeking care | Immediately after the consultation | Will patient characteristics differ if the patient first appears to the medical practitioner, a trained nurse or a trained pharmacist? |
| Presence of SARS-CoV-2 virus | Immediately after the consultation | To what extent do patients attending Primary Health Care/Pharmacies due to an acute sore throat harbour the SARS-CoV-2 virus? |
Countries
Sweden
Contacts
CONTACTCarl Wikberg, PhD
PRINCIPAL_INVESTIGATORRonny Gunnarsson, PhD
University of Gothenburg and Region Vastra Gotaland
Outcome results
None listed