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Lugg, Fiona
Languages: English
Types: Doctoral thesis
Subjects: RJ
Paediatric gastroenteritis [GE] is a common and important condition that causes a considerable burden on the NHS, the families and the patient. Despite this, the evidence for effective management is limited. Only a proportion of patients (and parents) consult, but we know little about their reasons for consulting and how they manage the illness at home.\ud Using a mix of methods this project aimed to explore the current management of paediatric gastroenteritis in the United Kingdom, focussing specifically on home management and primary care consultations.\ud A prospective case series was designed in which primary care clinicians within Wales identified and invited paediatric patients (and their parent) to take part in the study. Baseline information was recorded for all eligible patients. Parents of eligible patients were invited to take part in a qualitative telephone interview as well as being identified through social media. Clinicians were approached to take part in a separate qualitative study. Anonymous patient records of paediatric patients presenting to primary care between 2003 and 2012 were extracted from CPRD\ud Results show a decrease in consultation rates over 10 years however hospital referrals and stool sample requests have increased. Parents’ attitudes toward GE management impacted on their actions around prevention of illness and transmission. The variety of beliefs around causes of and threats from GE also influenced their actions. Reported clinical decisions and advice to parents were often not in line with current guidance from expert bodies. Many clinicians were not aware of guidelines on managing paediatric GE which might account for some of the variability in their management.\ud Variation can ultimately result in inappropriate management and thus increase the burden of illness on both families and the NHS. Parent and clinician beliefs need to be addressed in order to ensure management of GE is appropriate and not detrimental to patients.
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