| Title: |
Post-consultation acute respiratory tract infection recovery: a latent class informed analysis of individual patient data from randomised controlled trials and observational studies |
| Authors: |
Hounkpatin, Hilda; Stuart, Beth; Zhu, Shihua; Yao, Guiqing; Moore, Michael; Löffler, Christin; Little, Paul; Kenealy, Timothy; Gillespie, David; Francis, Nick A; Bostock, Jennifer; Becque, Taeko; Arroll, Bruce; Altiner, Attila; Alonso-Coello, Pablo; Hay, Alastair D |
| Publisher Information: |
Royal College of General Practitioners |
| Publication Year: |
2023 |
| Collection: |
Cardiff University: ORCA (Online Research @ Cardiff) |
| Description: |
Background: There is a lack of evidence regarding post-consultation symptom trajectories for patients with respiratory tract infections (RTIs) and whether patient characteristics can be used to predict illness duration. Aim: To describe symptom trajectories in patients with RTIs, assess baseline characteristics and adverse events associated with trajectories. Design and setting: 9103 adults and children from 12 primary care studies. Method: Individual patient data latent class-informed regression analysis of randomised controlled trials and observational cohort studies. Post-consultation symptom trajectory (severity and duration), re-consultation with same or worsening illness and hospitalisation were assessed. Results: 90% of participants recovered from all symptoms by 28 days, regardless of antibiotic strategy. For studies of RTI with cough as a dominant symptom (n=5314), four trajectories were identified: ‘rapid[6]’ (90% of participants recovered within 6 days)’ in 52.0%; ‘intermediate[10]’ (28.9%); ‘slow progressive improvement[27]’ (12.5%); and ‘slow initial high symptom burden[27]’ (6.6%). Older age (OR: (95% CI): 2.57 (1.72-3.85), higher presenting illness baseline severity (OR) (95% CIs): 1.51 (1.12-2.03)); presence of lung disease (OR (95% CI): 1.78 (1.44-2.21)); above median illness duration prior to consultation (OR (95% CI): 1.99 (1.68-2.37)) were associated with slower recovery (>10 days) compared to faster recovery (≤10 days). Re-consultations and hospitalisations were respectively higher in those with slower recovery (ORs: 2.15 (1.78-2.60) and 7.42 (3.49-15.78)). Conclusion: Older patients presenting with more severe, longer pre-consultation symptoms, and chronic lung disease should be advised they are more likely to experience longer post-consultation illness durations, and that recovery rates are similar with and without antibiotics. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://orca.cardiff.ac.uk/id/eprint/154613/7/e196.full.pdf; Hounkpatin, Hilda, Stuart, Beth, Zhu, Shihua, Yao, Guiqing, Moore, Michael, Löffler, Christin, Little, Paul, Kenealy, Timothy, Gillespie, David https://orca.cardiff.ac.uk/view/cardiffauthors/A111852Z.html orcid:0000-0002-6934-2928 orcid:0000-0002-6934-2928, Francis, Nick A, Bostock, Jennifer, Becque, Taeko, Arroll, Bruce, Altiner, Attila, Alonso-Coello, Pablo and Hay, Alastair D 2023. Post-consultation acute respiratory tract infection recovery: a latent class informed analysis of individual patient data from randomised controlled trials and observational studies. British Journal of General Practice 73 (728) , e196-e203. 10.3399/BJGP.2022.0229 https://doi.org/10.3399/BJGP.2022.0229 file https://orca.cardiff.ac.uk/id/eprint/154613/7/e196.full.pdf |
| DOI: |
10.3399/BJGP.2022.0229 |
| Availability: |
https://orca.cardiff.ac.uk/id/eprint/154613/; https://doi.org/10.3399/BJGP.2022.0229; https://orca.cardiff.ac.uk/id/eprint/154613/7/e196.full.pdf |
| Rights: |
cc_by_4_0 |
| Accession Number: |
edsbas.7771CA44 |
| Database: |
BASE |