How are reasons for encounter associated with influenza-like illness and acute respiratory infection diagnoses and interventions? A cohort study in eight Italian general practice populations

Nicola Buono, Michael Harris, Carmine Farinaro, Ferdinando Petrazzuoli, Angelo Cavicchi, Filippo D’Addio, Amedeo Scelsa, Baldassarre Mirra, Enrico Napolitano, Jean K. Soler

Research output: Contribution to journalArticlepeer-review


Background: Influenza-like illness (ILI) and Acute Respiratory Infections (ARI) are a considerable health problem in Europe. Most diagnoses are made by family physicians (FPs) and based on symptoms and clinical signs rather than on diagnostic testing. The International Classification of Primary Care (ICPC) advocates that FPs record patients’ ‘Reasons for Encounters’ (RfEs) as they are presented to them. This study analyses the association of patients’ RfEs with FPs’ diagnoses of ILI and ARI diagnoses and FPs’ management of those patients. Methods: Cohort study of practice populations. Over a 4-month period during the winter season 2013–14, eight FPs recorded ILI and ARI patients’ RfEs and how they were managed. FPs recorded details of their patients using the ICPC format, collecting data in an Episode of Care (EoC) structure. Results: There were 688 patients diagnosed as having ILI; between them they presented with a total of 2,153 RfEs, most commonly fever (79.7%), cough (59.7%) and pain (33.0%). The 848 patients with ARI presented with a total of 1,647 RfEs, most commonly cough (50.4%), throat symptoms (25.9%) and fever (19.9%). For patients with ILI, 37.0% of actions were related to medication for respiratory symptoms; this figure was 38.4% for patients with ARI. FPs referred six patients to specialists or hospitals (0.39% of all patients diagnosed with ILI and ARI). Conclusions: In this study of patients with ILI and ARI, less than half received a prescription from their FPs, and the illnesses were mainly managed in primary care, with few patients’ needing referral. The ICPC classification allowed a standardised data collection system, providing documentary evidence of the management of those diseases.

Original languageEnglish
Article number172
JournalBMC Family Practice
Issue number1
Early online date28 Aug 2021
Publication statusE-pub ahead of print - 28 Aug 2021


  • Influenza
  • Primary care
  • Respiratory infections
  • Symptom assessment

ASJC Scopus subject areas

  • Family Practice

Cite this