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Eur J Gen Pract. 2019 Aug 13:1-6. doi: 10.1080/13814788.2019.1639669. [Epub ahead of print]

Pertussis diagnostic practices of general practitioners in the Netherlands: A survey study.

Author information

1
a Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service , Heerlen , the Netherlands.
2
b Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+) , Maastricht , the Netherlands.
3
c Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University (UM) , Maastricht , the Netherlands.

Abstract

Background: Pertussis testing is most important when transmission to vulnerable groups is likely. Patients with signs and symptoms suggestive of pertussis are prevalent in primary care, yet general practitioners' (GPs) reasons (not) to test for pertussis are largely unknown. Objectives: To evaluate GP-reported diagnostic practices for pertussis, reasons for (not) testing and intentions towards testing among GPs. Methods: A total of 594 Dutch GPs were invited by email to participate in a survey study including a questionnaire reflecting on their pertussis diagnostic practices, reasons for (not) testing and the intention to test for pertussis in the year of 2013. Intention to test was measured as the likelihood to test for eight clinical vignettes. Results: In total, 122 GPs (21%) completed the online questionnaire. Most GPs reported having diagnosed at least one pertussis case (84%) in the previous year. Of all GPs, 14% did not perform any pertussis tests in the last year. The most reported reason for testing was to confirm the clinical pertussis diagnosis (70%); the most reported reason for not testing was that the diagnostic test result does not influence treatment (70%). Overall, judging from the clinical vignettes, GPs reported being more likely to perform diagnostic testing based on symptoms than based on vulnerable groups at risk. Conclusion: In contrast to national guidelines, our results suggest that GPs report to test for pertussis mainly based on clinical symptoms rather than based on protecting vulnerable groups at risk.

KEYWORDS:

Whooping cough; general practice; general practitioners; primary healthcare

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