Burden of disease in children with respiratory tract infections in primary care: diary-based cohort study
M J C Schot1, A R J Dekker1, C H van Werkhoven1
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Respiratory tract infections (RTIs) in children significantly impact families, causing symptom burden, childcare/school absence, and parental work loss. Improved communication about these effects can enhance doctor-parent understanding.
Area of Science:
- Pediatrics
- General Practice
- Public Health
Background:
- Respiratory tract infections (RTIs) are a frequent reason for pediatric primary care visits.
- Miscommunication between parents and general practitioners (GPs) can lead to antibiotic overprescription.
- The broader impact of RTIs on children's daily lives and family functioning, beyond specific symptoms, is less understood.
Purpose of the Study:
- To delineate the comprehensive impact of RTIs on children and their parents.
- To quantify illness-related symptoms, absenteeism from care/school, healthcare utilization, and over-the-counter (OTC) medication use.
- To inform better communication strategies in pediatric primary care settings.
Main Methods:
- Utilized prospectively collected diary data from 149 children with RTIs in primary care settings.
- Employed survival analysis to determine the duration of various symptoms.
- Data originated from two distinct randomized clinical trials.
Main Results:
- Common RTI impacts include disturbed sleep, reduced food/fluid intake, malaise, and disrupted daily activities, with sleep disturbances being the most prolonged.
- Over half of children (52%) experienced absence from childcare or school.
- Significant parental work absence was reported (28% of mothers, 20% of fathers), alongside high rates of re-consultation (48%) and frequent OTC medication use.
Conclusions:
- Acknowledging the substantial burden of RTIs on children and families is crucial.
- Enhanced communication and understanding between GPs and parents regarding the holistic impact of childhood RTIs can improve consultations.
- This understanding may mitigate factors contributing to antibiotic overprescription.
Background:
Respiratory tract infections (RTIs) are a common reason for children to consult in general practice. Antibiotics are often prescribed, in part due to miscommunication between parents and GPs. The duration of specific respiratory symptoms has been widely studied. Less is known about illness-related symptoms and the impact of these symptoms on family life, including parental production loss. Better understanding of the natural course of illness-related symptoms in RTI in children and impact on family life may improve GP-parent communication during RTI consultations.
Objective:
To describe the general impact of RTI on children and parents regarding illness-related symptoms, absenteeism from childcare, school and work, use of health care facilities, and the use of over-the-counter (OTC) medication.
Methods:
Prospectively collected diary data from two randomized clinical trials in children with RTI in primary care (n = 149). Duration of symptoms was analysed using survival analysis.
Results:
Disturbed sleep, decreased intake of food and/or fluid, feeling ill and/or disturbance at play or other daily activities are very common during RTI episodes, with disturbed sleep lasting longest. Fifty-two percent of the children were absent for one or more days from childcare or school, and 28% of mothers and 20% of fathers reported absence from work the first week after GP consultation. Re-consultation occurred in 48% of the children. OTC medication was given frequently, particularly paracetamol and nasal sprays.
Conclusion:
Appreciation of, and communication about the general burden of disease on children and their parents, may improve understanding between GPs and parents consulting with their child.
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