Purpose: For patients with respiratory tract infections evidence regarding bed rest, staying indoors and refraining from physical exercise is sparse. We wanted to explore how general practitioners (GPs) in Poland and Norway would advice such patients.
Method: Convenience samples of GPs in Poland (n=216) and Norway (n=171) read four vignettes in which patients presented symptoms consistent with pneumonia, sinusitis, common cold and exacerbation of chronic obstructive pulmonary disease (COPD), respectively. For each vignette the GPs were asked whether they would recommend staying indoors, staying in bed and refraining from physical exercise, and if so, for how many days. We used log-Poisson and ordinary least squares (OLS) regression to analyse differences between Polish and Norwegian GPs. Workload, specialty attainment, years of working experience and sex were included as potential confounders.
Result: For each vignette the proportions of GPs recommending the patient to stay indoors in Poland versus Norway were 98% versus 72% (pneumonia), 92% versus 26% (sinusitis), 87% versus 9% (common cold) and 92% versus 39% (exacerbation of COPD). Adjusted relative risks (95% CI) for recommending the patient to stay indoors in Poland versus Norway were 1.4 (1.2-1.5), 3.7 (2.8-4.8), 10.6 (6.3-17.7) and 2.5 (2.0-3.1) respectively. Among those who would recommend the patient to stay indoors, mean durations were 8.1, 6.6, 5.1 and 6.7 days in Poland versus 3.2, 2.8, 2.6 and 4.1 days in Norway, respectively. In OLS regression models differences in duration were statistically significant. Polish GPs were also more likely to recommend the patient to stay in bed and refrain from exercise, and for a longer time, than their Norwegian colleagues. With few exceptions differences remained statistically significant in regression models. For the patient with pneumonia 15%, 11% and 18% of the GPs would recommend staying indoors for three, five and seven days respectively, compared to 3%, 2% and 1% for four, six and eight days. Similar patterns were observed across all vignettes for bed rest, staying indoors and refraining for exercise.
Conclusion: GPs in Poland were more likely to recommend bed rest, staying indoors and refraining from exercise, which suggests that they perceived the cases as more serious than did their Norwegian colleagues. The inclination to recommend restrictions for three, five or seven days might indicate digit preferences in the GPs` judgments.
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