The Management of Patients with Pneumonia in Family Medicine in Slovenia

Abstract

Background: Pneumonia is among the most common infections treated in family practice. In Slovenia, a comprehensive management of pneumonia at the primary level has not yet been researched, which results in the lack of data regarding guideline adherence. Our aim was to describe the management of patients with pneumonia in family practices and to analyse characteristics of family physicians (FPs) and their practices which influence guideline adherence.Methods: The study was conducted as a cross-sectional research with clinical vignette and questions about characteristics of FPs and their practices, in the form of an online questionnaire; 892 specialists and FPs without specialty, and 320 residents were contacted. Using the guidelines, a proper management protocol for patients with pneumonia was designed and used for the evaluation of respondents’ answers. The collected data were analyzed using logistic regression.Results: The response rate was 475/1212 (39.2 %). When managing patients with pneumonia, 66.7 % of FPs performed a complete blood count with differential, 92.6 % CRP, 54.5 % chest X-ray, 62.6 % prescribed amoxicillin and 29.7 % amoxicillin with clavulanic acid. The correct preliminary diagnosis was provided by 93.7 % of FPs, correct diagnostics by 13.5 %, no referral by 90.3 %, proper treatment by 53.1 % and checkup by 48.8 % of FPs. 3.2 % of FPs exhibited an altogether adequate patient management. Negative association between female FPs and adequate diagnostics, and between FPs older than 45 years and adequate treatment and checkup was noticed.Conclusion: The research indicated many differences in managing pneumonia. Only a small share of FPs completely adhered to the set guidelines.