Safety netting advice for respiratory tract infections in out-of-hours primary care: A qualitative analysis of consultation videos

Figures & data

Table 1. Framework analysis safety netting advice.

Diagnosis
Patients’ age	Child < 3 years
	Child 3–16 years Adult
Antibiotic prescribed	Yes Delayed No
Quote(s) relating to safety netting advice
Elements of safety netting advice	Discussing uncertainty
	Discussing alarm symptoms
	How, where and when to seek help
	Expected time course and follow-up consultation when there are concerns
Description and assessment analysts	Description of safety netting, remarks, general feeling, striking features
Score	1 = No safety netting advice
	2 = Limited safety advice netting
	3 = (Extensive) safety netting advice
Written information towards the patient?	Verbal only
	Verbal and written, none
Type of follow-up advice documented in   electronic health record	Empty
	No follow-up
	Regular GP
	Regular GP + more information
	Emergency department
	Details of ‘GP + more information’ in electronic health record or other information on safety netting advice

GP: General practioner.

Table 2. Characteristics of the general practitioners (GPs) and patients.

Number of participating GPs	19
Age in years of GPs
Mean (SD)	42.47 (13.4)
Median	39
Range (min.–max.)	26–64
Years in practice
Mean (SD)	14.7 (12.4)
Median	12
Range (min.–max.)	1–38
Gender distribution of GPs
Male	7
Female	12
Type of GP practice they work in during regular office hours (outside OOH care)
Solo	2
Duo	1
Group	15
Community health centre	1
GP trainee (GP in specialty training)	2 (/19)
Duration of the consultations in hh:mm:ss
Mean (SD)	00:12:19 (00:05:13)
Median	00:11:21
Range (min.–max.)	00:04:24–00:30:04
Consultations per GP
Mean (SD)	4.05 (2.25)
Median	4
Range (min.–max.)	1–8
Number of participating patients	77
Age in years of patients
Mean (SD)	22.30 (21.75)
Median	22
Range (min.–max.)	0–89
Missing values	6
Gender distribution of patients
Male	33
Female	44
Different diagnoses
Upper respiratory tract infection	31
Otitis media/otitis externa	10
Sore throat/pharyngitis/tonsillitis/  uvulitis/throat abscess	13
Sinusitis	7
Viral/flu-like illness	5
Tracheitis/laryngitis	4
Bronchitis	3
Pneumonia	1
Bronchiolitis	1
Lymphadenopathy	1
Fever	1

GP: General practioner; OOH: out-of-hours.

Table 3. The association between safety netting advice given during a consultation and (delayed) antibiotic prescribing.

Consultation with	(Delayed) antibiotic prescription (n = 14)	No antibiotic prescription (n = 63)	Total (n = 77)
Safety netting advice	10 (71.4%)	16 (25.4%)	26
Limited safety netting advice	3 (21.4%)	30 (47.6%)	33
No safety netting advice	1 (7.1%)	17 (27.0%)	18

Table 4. Follow-up advices documented in the electronic health record.

Type of follow-up advice	Number (n = 77)
Medical note missing	8
Empty field	1
No follow-up	15
Regular GP (referral of the patient to their own GP during office hours)	43
Regular GP + more information (referral of the patient to their own GP during office hours, GP-on call can add information in an open-text field)	10
Emergency department (referral of the patient to the hospital’s emergency department)	0

GP: general practitioner.