ERIK WIEZELL - Use of vital signs for infections in general practice

Project description

Introduction
Infections in primary care are very common. Most patients consulting general practice display harmless infections, but infections can also be potentially life-threatening. We know that family physicians sometimes prescribe antibiotics for harmless viral infections. Early diagnosis and treatment of for e.g., pneumonia is important in reducing morbidity and mortality. The correct assessment of disease severity is important for choosing level of care. By measuring vital signs, severe disease can be revealed. RIA-VS (Remote Investigation and Assessment of Vital Signs device) is a new camera-prototype developed in Sweden with the ability to measure vital signs without contact quickly from one meter’s distance. This should significantly reduce the risk of missing severe infections. The new device uses modern camera technique, harmless light, and advanced computing. The device views the patient’s face for 30 seconds without risk for physical injury from the new equipment.

Aim

The doctoral thesis hopes to answer the following questions.

1. How is pneumonia assessed and diagnosed in a primary health care setting?
2. Evaluate a new camera-prototype system for contactless measurement of vital signs.
3. If available, does the use of RIA-VS systems increase the number of documented vital sign measures for people visiting primary health care for infections?
4. If available, does the use of RIA-VS systems affect prescribing of antibiotics for patients with upper respiratory tract infections?

Methods

The first study is a retrospective study investigating how pneumonia is assessed and diagnosed including vital signs in approximately 800 patients at ten randomly selected primary health care centres and three randomly selected primary care out-of -hours services.

The second study will evaluate the accuracy of an RIA-VS. In the third and fourth study primary health care centres will be randomized into interventional or controls. The interventional practices will have the RIA-VS-prototype available and be encouraged to use it on all patient with infections. Patient visits concerning infections will be checked against upper respiratory tract infections and if antibiotics are prescribed. We will then compare results regarding measured and documented vital signs and antibiotic prescribing between controls and interventional practices.

Relevance

The first study will create knowledge on the use of vital sign assessment for pneumonia in primary care. This is important knowledge when developing guidelines and antimicrobial stewardship interventions, as pneumonia is a potentially lethal condition. The other three studies will evaluate the RIA-VS and investigate if the use of this method will lead to more frequently measured and documented vital signs, safer care, and a more rational prescribing of antibiotics for patients with potentially severe respiratory tract infections.