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Research

Primary Care Consultations after Hospitalisation for Pneumonia: A Large Population-based Cohort Study

Vadsala Baskaran, Fiona Pearce, Rowan H Harwood, Tricia McKeever and Wei Shen Lim
British Journal of General Practice 14 December 2020; BJGP.2020.0890. DOI: https://doi.org/10.3399/BJGP.2020.0890
Vadsala Baskaran
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  • For correspondence: reksha_01@yahoo.com
Fiona Pearce
3 Department of Respiratory Medicine, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, United Kingdom of Great Britain and Northern Ireland
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Rowan H Harwood
4 Department of Respiratory Medicine, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, United Kingdom of Great Britain and Northern Ireland
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Tricia McKeever
5 Department of Respiratory Medicine, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, United Kingdom of Great Britain and Northern Ireland
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Wei Shen Lim
6 Department of Respiratory Medicine, Nottingham City Hospital NHS Trust, Nottingham, United Kingdom of Great Britain and Northern Ireland
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Abstract

Background: Up to 70% of patients report ongoing symptoms four weeks after hospitalisation for pneumonia, and the impact on primary care is poorly understood. Aim: To investigate the frequency of primary care consultations after hospitalisation for pneumonia, and the reasons for consultation. Design: Population-based cohort study. Setting: UK primary care database of anonymised medical records (Clinical Practice Research Datalink, CPRD) linked to Hospital Episode Statistics (HES), England. Methods: Adults with the first ICD-10 code for pneumonia (J12-J18) recorded in HES between July 2002-June 2017 were included. Primary care consultation within 30 days of discharge was identified as the recording of any medical Read code (excluding administration-related codes) in CPRD. Competing-risks regression analyses were conducted to determine the predictors of consultation and antibiotic use at consultation; death and readmission were competing events. Reasons for consultation were examined. Results: Of 56,396 adults, 55.9% (n=31,542) consulted primary care within 30 days of discharge. The rate of consultation was highest within 7 days (4.7 per 100 person-days). The strongest predictor for consultation was a higher number of primary care consultations in the year prior to index admission (adjusted sHR 8.98, 95% CI 6.42-12.55). The commonest reason for consultation was for a respiratory disorder (40.7%, n=12,840), 12% for pneumonia specifically. At consultation, 31.1% (n=9,823) received further antibiotics. Penicillins (41.6%, n=5,753) and macrolides (21.9%, n=3,029) were the commonest antibiotics prescribed. Conclusion: Following hospitalisation for pneumonia, a significant proportion of patients consulted primary care within 30 days, highlighting the morbidity experienced by patients during recovery from pneumonia.

  • Mental health
  • Drug and substance abuse
  • Patient groups
  • Inequalities
  • Education and standards
  • Undergraduate education
  • Received September 27, 2020.
  • Accepted November 30, 2020.
  • Copyright © 2020, The Authors

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Accepted Manuscript
Primary Care Consultations after Hospitalisation for Pneumonia: A Large Population-based Cohort Study
Vadsala Baskaran, Fiona Pearce, Rowan H Harwood, Tricia McKeever, Wei Shen Lim
British Journal of General Practice 14 December 2020; BJGP.2020.0890. DOI: 10.3399/BJGP.2020.0890

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Accepted Manuscript
Primary Care Consultations after Hospitalisation for Pneumonia: A Large Population-based Cohort Study
Vadsala Baskaran, Fiona Pearce, Rowan H Harwood, Tricia McKeever, Wei Shen Lim
British Journal of General Practice 14 December 2020; BJGP.2020.0890. DOI: 10.3399/BJGP.2020.0890
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Keywords

  • Mental health
  • Drug and substance abuse
  • Patient groups
  • Inequalities
  • Education and standards
  • Undergraduate education

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Print ISSN: 0960-1643
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