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DOI: 10.1055/s-0029-1202140
© Georg Thieme Verlag Stuttgart · New York
Husten in der allgemeinärztlichen Sprechstunde – Differenzialdiagnosen unterscheiden sich gegenüber Klinik
Cough in the GP consultation hour – Differential diagnoses differ from hospital diagnosesPublication History
Publication Date:
19 January 2009 (online)
In der Sächsischen Studie für Allgemeinmedizin (SESAM-2) war Husten das häufigste Symptom, das eine Beratung durch den Hausarzt auslöste. Husten ist in erster Linie eine Krankheit von Patienten mittleren Alters, wobei Frauen und Männer fast gleich häufig betroffen sind. Im Gegensatz zum klinischen Krankengut, das eine große Bandbreite an Differenzialdiagnosen liefert, fielen 91 % der Diagnosen in der Hausarztpraxis in das Kapitel der ICD-10 respiratorische Probleme bei Neuerkrankungen. Um Schlussfolgerungen für die Anamnestik zu ziehen wurde analysiert, welche Begleitbeschwerden signifikant häufiger bei Hustenden vorkamen. Für die Behandlung des Hustens in der Praxis bedarf es der Implementierung von evidenzbasierten Beratungs- und Managementkonzepten.
Coughing was the most frequently occurring symptom recorded by the Sesam-2 study of GP consultation hours. Coughing is usually a complaint of the middle-aged, the incidence being almost the same in males and females. 91 % of the diagnoses arrived at during GP consultation hours were of the ICD-10 category of respiratory problems if the disease was fresh. This differed considerably from the incidence of diagnoses in hospitals where there is a great bandspread of differential diagnoses. For the purpose of arriving at conclusions for the anamnesis, the relative frequency of associated symptoms was analyzed. Treatment of cough depends on the implementation of concepts of counselling and management based on collected evidence.
Key words
Cough - GP - causes for seeking medical advice - differential diagnoses - SESAM-2 study
Literatur
- 1 Braun R.. Feinstruktur einer Allgemeinarztpraxis – Diagnostische und statistische Ergebnisse. 1 ed. Stuttgart: Schattauer-Verlag 1961
- 2 Butler CG, Kinnersley P, Prout H. et al. . Antibiotics and shared decision-making in primary care. Journal of Antimicrobial Chemotherapy. 2001; 48 435-440
- 3 Charles J, Pan Y, Britt H.. Trends in childhood illness and treatment in Australian general practice, 1971–2001. Med J Aust. 2004; 180 216-219
- 4 Coenen S, Royen P van, Michiels B, Denekens J.. Optimizing antibiotic prescribing for acute cough in general practice: a cluster-randomized controlled trial. J Antimicrob Chemother. 2004; 54 661-672
- 5 Creer DD, Dilworth JP, Gillespie SH. et al. . Aetiological role of viral and bacterial infections in acute adult lower respiratory tract infection (LRTI) in primary care. Thorax. 2006; 61 75-79
- 6 Hannaford PC, Simpson JA, Bisset AF. et al. . The prevalence of ear, nose and throat problems in the community: results from a national cross-sectional postal survey in Scotland. Family Practice. 2005; 22 227-233
- 7 Hickmann DE, Stebbins MR, Hanak JR, Guglielmo BJ.. Pharmacy-based Intervention to reduce antibiotic bronchitis. Ann Pharmacother. 2003; 37 187-191
- 8 Himmel W, Hummers-Pradier E, Kochen MM, Pelz J.. Treatment of respiratory tract infections – a study in 18 general practices in Germany. Eur J Gen Prac. 1999; 5 15-20
- 9 Hing E, Cherry DK, Woodwell DA.. National Ambulatory Medical Care Survey: 2004 summary. Adv Data. 2006; 374 1-33
- 10 Landolt-Theus P.. Fälleverteilung in der Allgemeinmedizin. Der Allgemeinarzt. 1992; 14 254-268
- 11 Okkes IM, Oskam SK, Lamberts H.. ICPC in the Amsterdam Transition Project. CD-Rom. Amsterdam: Academic Medical Center/University of Amsterdam, Department of Family Medicine. 2005
- 12 Ponka D, Kirlew M.. Cough. Canadian Family Physician. 2007; 53 690-691
- 13 Sondik E, Anderson J, Curtin L. et al. . National Ambulatory Medical Care Survey: 1995–1996 Summary. Vital and Health Statistics. 1999; 13 1-123
- 14 Welschen l, Kuyvenhoven MM, Hoes AW, Verheij TJ.. Effectiveness of a multiple intervention to reduce antibiotic prescribing for respiratory tract symptoms in primary care: randomised controlled trial. BMJ. 2004; 329 431-436
Korrespondenz
Thomas Frese
Selbständige Abteilung für Allgemeinmedizin Universitätsklinikum Leipzig
Philipp-Rosenthal-Straße 27a
04103 Leipzig
Fax: 0341/9715719
Email: haeb@medizin.uni-leipzig.de