ACTUAL ISSUES OF DIAGNOSTICS AND MANAGEMENT TACTICS OF PATIENTS WITH ACUTE RESPIRATORY INFECTIONS IN OUTPATIENT PRACTICE AND TEACHING
DOI:
https://doi.org/10.11603/1811-2471.2019.v.i3.10437Keywords:
acute respiratory infection, diagnosis, patient counseling, treatment tactics, wait-and-see strategyAbstract
SUMMARY. Acute respiratory infections (ARI) are in most cases an outpatient pathology, so the issue of diagnosing and developing patient management tactics at the primary care stage is an important task of medical education and practice.
The aim – to identify key aspects relevant to clinical practice and medical education through the development of a European clinical protocol for the management of patients with acute respiratory infection (Croatia).
Results and Discussion. Acute respiratory infections are often short-lived seasonal illnesses, and patients recover without adverse effects. ARI is a burden to the patient, family, community and health care system because of its prevalence. Most upper respiratory tract ARI can be recognized on the basis of a qualitative medical history and careful clinical examination. Further diagnostic studies are only required in some cases that are clearly regulated by the clinical protocol.
As a rule, the family doctor’s office should focus on assessing the localization of ARI, i.e. whether it is an upper or lower respiratory tract infection, and what is the most likely cause of ARI – viruses or bacteria. Often, it is not necessary to determine the exact cause of ARI, as these are most often self-medicated diseases, that why they are treated in primary medical care condition. This determines the specifics of the clinical approach of the family physician to the patient with ARI, since it does not affect the decision how to treat the patient.
Diagnostic studies are prescribed only when the clinical picture is not clear, and sometimes to confirm the cause of infection in suspected strep throat infection, when we intend to prescribe antibiotics according to the clinical protocol.
Conclusion. The discrepancy between patients’ expectations and professional recommendations for self-help (self-medication), as well as antibiotic and vaccine prophylaxis, can be regulated by intensive patient education, careful differential diagnosis, confidence building between the patient and family physician.
References
Mostovyi, Yu.M. (Ed.). (2019). Suchasni klasyfikatsii ta standarty likuvannia zakhvoriuvan vnutrishnikh orhaniv. Nevidkladni stany v terapii. Analizy: normatyvni pokaznyky, traktuvannia zmin [Modern classifications and standards of treatment of diseases of internal organs. Emergency conditions in therapy. Analyzes: regulatory indicators, interpretation of changes]. Kyiv: Tsentr DZK [in Ukrainian].
Francetic, I., Makar-Ausperger, K., Likic, R., Erdeljic, V., Radacic Aumiler, M., & Bielen, L. (2012). Smjernice za primjenu antimikrobnih lijekova (Guidelines for Antimicrobials Application). III Izdanje, Izdavac: Klinicki bolnicki centar Zagreb.
Kocevar-Gucek, N., Homar, V., Svab, I., Rotar-Pavlic, D. (2012). Akutne okuzbe dihal. Druzinska medicina. Ljubljana: Zdruzenje zdravnikov druzinske medicine.
Katic, M., & Svab, I. (2017). Family medicine. Zagreb: Medicinska naklada.
(2018). National Institute for Health and Clinical Excellence (NICE). Respiratory tract infections -(2011). WHO: Influenza (Seasonal). Retrieved from: http://www.who.int/mediacentre/factsheets/fs211/en/.
(2011). WHO: Programmes and research. Initiative for vaccine research. Retrieved from: http://www.who.int/vaccine_research/diseases/ari/en/index.html.
