Transcultural differences in illness behaviour and clinical outcome: an underestimated aspect of general practice?

Our aim was to assess international differences in illness behaviour and clinical outcome for patients in Europe with an episode of acute tonsillitis.

The subjects were 2423 patients from seven countries whose acute tonsillitis was treated with antibiotics. Each country selected at least 10 GPs who filled in a questionnaire for each episode of acute tonsillitis treated during a 3-month period, November 1989-May 1990. The outcome measure was the number of days of illness. Backwards multiple regression analysis with predictors (age, sex, country, initial temperature, days prior to illness) was performed.

The number of days of illness of patients with an episode of acute tonsillitis varied between the European countries, from 3 to 10 days. Country was the most important predictor, whereas disease-specific and patients' characteristics were not important predictors.

Duration of illness was primarily influenced by country. The countries in Eastern Europe especially were characterized by a longer duration of illness. Transcultural differences may influence the duration of illness and need more attention in daily practice.