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Healthcare-seeking behaviour in case of influenza-like illness in the French general population and factors associated with a GP consultation: an observational prospective study

Matthieu Ariza, Caroline Guerrisi, Cécile Souty, Louise Rossignol, Clément Turbelin, Thomas Hanslik, Vittoria Colizza and Thierry Blanchon
BJGP Open 2018; 1 (4): bjgpopen17X101253. DOI: https://doi.org/10.3399/bjgpopen17X101253
Matthieu Ariza
1 Graduate Researcher, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, , France
MD, MSc
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Caroline Guerrisi
2 Epidemiologist, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, , France
MSc
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Cécile Souty
3 Biostatistician, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, , France
PhD
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Louise Rossignol
4 GP, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, , France
MD, PhD
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Clément Turbelin
5 GP, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, , France
MD, PhD
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Thomas Hanslik
6 Internist Physician, UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, , France
7 Internist Physician, Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique — Hôpitaux de Paris, APHP, , France
8 Internist Physician, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, , France
MD, PhD
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Vittoria Colizza
9 Senior Researcher, Institute for Scientific Interchange, ISI Foundation, , Italy
10 Senior Researcher, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, , France
PhD
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Thierry Blanchon
11 Public Health Physician, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, , France
MD, PhD
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  • For correspondence: thierry.blanchon@upmc.fr
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Article Figures & Data

Tables

    • View popup
    Table 1. Sociodemographic characteristics of individuals included in the study (an individual may have been involved in 1, 2, or 3 seasons).
    2012–2013, n (%)2013–2014, n (%)2014–2015, n (%)
    N 175614241726
    Age, years (MD = 9)
     <18192 (11.0) 135 (9.5)173 (10.0)
     18–641306 (74.6) 1041 (73.2) 1231 (71.4)
     ≥65252 (14.4)247 (17.3) 320 (18.6)
    Female (MD = 0) 1154 (65.7)945 (66.4)1135 (65.8)
    Children in the household (MD = 12)
     None973 (55.6) 851 (59.9) 1024 (59.5)
     ≥1778 (44.4) 570 (40.1) 698 (40.5)
    Main activity (MD = 0)
     Full-time or part-time employment881 (50.2)722 (50.7)854 (49.5)
     Self-employment87 (5.0)66 (4.6)91 (5.3)
     Attending daycare/school/university246 (14.0)182 (12.8)210 (12.2)
     Home-maker/retired433 (24.7)355 (24.9)445 (25.8)
     Unemployed55 (3.1)45 (3.2)67 (3.9)
     Maternity leave––6 (0.3)
     Long-term sick-leave or parental leave32 (1.8)25 (1.8)24 (1.4)
     Other22 (1.2)29 (2.0)29 (1.6)
    Socioprofessional characteristics (MD = 249)
     Professional or office work698 (41.9) 585 (43.1) 690 (42.3)
     Retail, sales, catering, and hospitality46 (2.8) 30 (2.2) 37 (2.3)
     Skilled manual work31 (1.9) 30 (2.2) 40 (2.4)
     Other manual work18 (1.1) 12 (0.9) 17 (1.0)
     Other86 (5.2) 64 (4.7) 68 (4.2)
     Not applicable 788 (47.2) 636 (46.9) 781 (47.8)
    Level of education (MD = 379)
     Above high school diploma833 (58.3) 843 (60.3) 1037 (61.0)
     High school diploma or equivalent222 (15.5) 236 (16.9) 275 (16.2)
     Below high school diploma201 (14.1) 194 (13.9) 236 (13.9)
     Not applicable (age <16 years) 174 (12.1) 125 (8.9) 151 (8.9)
    Place of residence (MD = 0)
     Urban1412 (80.4)1157 (81.2) 1385 (80.2)
     Rural344 (19.6)267 (18.8)341 (19.8)
    • MD = missing data.

    • View popup
    Table 2. Health characteristics of individuals included in the study (an individual may have been involved in 1, 2, or 3 seasons).
    2012–2013, n (%)2013–2014, n (%)2014–2015, n (%)
    N 175614241726
    Colds/flu-like diseases frequency (MD = 69)
     Rare1291 (74.5) 1011 (72.1) 1285 (75.5)
     Often421 (24.3) 363 (25.9) 393 (23.1)
     Don’t know20 (1.2) 28 (2.0)25 (1.4)
    Flu vaccination for the current season (MD = 0)
     No1360 (77.5)1062 (74.5)1278 (74.0)
     Yes394 (22.4)361 (25.4)445 (25.8)
     Don’t know2 (0.1)1 (0.1)3 (0.2)
    Smoking status (MD = 0)
     Never smoked1019 (58.0)819 (57.5)997 (57.8)
     Used to smoke480 (27.4)408 (28.7)517 (30.0)
     Still smoking257 (14.6)197 (13.8)212 (12.2)
    Comorbidities (MD = 0)
     No comorbidities1430 (81.4)1135 (79.7)1363 (79.0)
     ≥1 comorbidity326 (18.6)289 (20.3)363 (21.0)
     Treated asthma131 (7.5)118 (8.3)144 (8.3)
     Treated diabetes48 (2.7)47 (3.3)48 (2.8)
     Treated heart condition119 (6.8)90 (6.3)142 (8.2)
     Treated kidney condition7 (0.4)10 (0.7)9 (0.5)
     Treated immunodepression47 (2.7)40 (2.8)49 (2.8)
     Treated pulmonary condition50 (2.8)51 (3.6)58 (3.4)
     ≥1 respiratory allergy (MD = 0)677 (38.6)566 (39.7)659 (38.2)
    Pregnancy (MD = 35)
     Pregnant7 (0.4)8 (0.6)24 (1.4)
     Not pregnant544 (31.3) 424 (29.9) 512 (29.8)
     Not applicable (men or women <15 or >50 years old)1188 (68.3) 984 (69.5) 1180 (68.8)
    BMI, kg/m2 (MD = 73)
     <18.5200 (11.6) 156 (11.1) 190 (11.2)
     18.5–291348 (78.1) 1081 (76.8) 1296 (76.2)
     30–39158 (9.2) 152 (10.8) 197 (11.5)
     ≥4019 (1.1)19 (1.3)18 (1.1)
    At risk of influenza complications (MD = 85)
     No1215 (70.8) 954 (67.8) 1114 (65.6)
     Yes501 (29.2) 453 (32.2) 584 (34.4)
    • BMI = body mass index. MD = missing data. 

    • View popup
    Table 3. Characteristics of ILI episodes reported by participants included in the study.
    2012–2013, n (%)2013–2014, n (%)2014–2015, n (%)Total, n (%)
    N 2184177220676023
    Symptoms (MD = 0)
     Fever1162 (53.2)820 (46.3)1057 (51.1)3039 (50.5)
     Chills950 (43.5)696 (39.3)898 (43.4)2544 (42.2)
     Coryza1578 (72.3)1309 (73.9)1538 (74.4)4425 (73.5)
     Sneezing1206 (55.2)970 (54.7)1120 (54.2)3296 (54.7)
     Sore throat1516 (69.4)1287 (72.6)1377 (66.6)4180 (69.4)
     Cough1606 (73.5)1256 (70.9)1549 (74.9)4411 (73.2)
     Dyspnoea440 (20.1)355 (20.0)476 (23.0)1271 (21.1)
     Headaches1427 (65.3)1151 (65.0)1362 (65.9)3940 (65.4)
     Pain898 (41.1)637 (35.9)771 (37.3)2306 (38.2)
     Sputum436 (20.0)346 (19.5)366 (17.7)1148 (19.1)
     Asthenia1086 (49.7)809 (45.7)1008 (48.8)2903 (48.2)
    Sudden onset of symptoms (MD = 84)
     Yes2018 (93.7) 1649 (94.3) 1915 (94.1) 5582 (94.0)
     No136 (6.3) 100 (5.7) 121 (5.9)357 (6.0)
    Mean health score (± SD) (MD = 94) – – 42.8 (± 21.4) –
    Activities modification (MD = 50)
     No1056 (48.7) 937 (53.4) 975 (47.6) 2968 (49.7)
     Yes, without taking time off work/school662 (30.5) 513 (29.2) 631 (30.8) 1806 (30.2)
     Yes, with taking time off work/school450 (20.8) 306 (17.4) 443 (21.6) 1199 (20.1)
    • ILI = influenza-like illness. MD = missing data. SD = standard deviation.

    • View popup
    Table 4. Healthcare-seeking behaviour following ILI in participants included in the study
    2012–2013, n (%)2013–2014, n (%)2014–2015, n (%)Total, n (%)
    ILI episodes
    N
    2184177220676023
    Consultation (MD = 0)
     GP738 (33.8)535 (30.2)688 (33.3)1961 (32.6)
     GP consultation among individuals at risk of ILI complications218 (34.9) 175 (31.0) 244 (34.5) 637 (33.6)
     Pharmacist–188 (10.6)173 (8.4)361 (9.4)
     Hospital emergencies59 (2.7)39 (2.2)44 (2.1)142 (2.4)
     Specialist44 (2.0)25 (1.4)29 (1.4)98 (1.6)
     Other33 (1.5)19 (1.1)9 (0.4)61 (1.0)
     None1425 (65.2)1137 (64.2)1303 (63.0)3865 (64.2)
    Hospitalisations (MD = 60) 20 (0.9)16 (0.9)21 (1.0)57 (1.0)
    Drug intake (MD = 5)
     Analgesics1904 (87.2)1508 (85.3) 1806 (87.4)5218 (86.7)
     Antitussives815 (37.3)565 (32) 767 (37.1)2147 (35.7)
     Antibiotics (prescribed)451 (20.7)328 (18.6) 417 (20.2)1196 (19.9)
     Antibiotics (self-medication)31 (1.4)25 (1.4)25 (1.2)81 (1.3)
     Antivirals (prescribed)18 (0.8)11 (0.6)18 (0.9)47 (0.8)
     Antivirals (self-medication)1 (0.0) 2 (0.1) 2 (0.1)5 (0.1)
     Antivirals prescribed to individuals at ILI risk4 (0.6) 5 (0.9)7 (1.0) 16 (0.8)
     Homeopathy400 (18.3)273 (15.4)340 (16.5) 1013 (16.8)
     Aromatherapy or herbal medicine–373 (21.1) 414 (20.0)787 (20.5)
     Others499 (22.8)366 (20.7)435 (21.1) 1300 (21.6)
    Internet search (MD = 73) 145 (6.7) 125 (7.1)187 (9.1) 457 (7.7)
    • ILI = influenza-like illness. MD = missing data

    • View popup
    Table 5. Significant factors associated with GP consultation for ILI in France between 2012 and 2015 in multivariate analysis
    NNumber of ILI episodes with
    a GP consultation, n (%)
    OR (95% CI)P-value
    Level of education
     Above high school diploma3312972 (29.3)1 (Ref)
     High school diploma or equivalent895287 (32.1)1.25 (1.03 to 1.52)0.021
     Below high school diploma780293 (37.6)1.43 (1.18 to 1.74)<0.001
     Not applicable (age <16 years)579266 (45.9)1.63 (1.30 to 2.03)<0.001
    Residence
     Urban48591554 (32.0)1 (Ref)
     Rural1164407 (35.0)1.21 (1.02 to 1.43)0.026
    Internet search in case of ILI
     No54931733 (31.5)1 (Ref)
     Yes457210 (46.0)1.63 (1.30 to 2.03)<0.001
    Previous GP consultation for ILI during the current influenza season
     No56481733 (31.4)1 (Ref)
     Yes375188 (50.1)1.43 (1.11 to 1.83)0.005
    Alternative medicines utilisation
     No44501529 (34.4)1 (Ref)
     Yes1568431 (27.5)0.68 (0.58 to 0.78)<0.001
    Symptomsa
     Fever30391350 (44.4)2.57 (2.26 to 2.93)<0.001
     Sneezing32961042 (31.6)0.78 (0.69 to 0.88)<0.001
     Cough44111633 (37.0) 1.60 (1.37 to 1.86)<0.001
     Dyspnea1271558 (43.9)1.38 (1.19 to 1.60)<0.001
     Sputum1148551 (48.0) 1.75 (1.50 to 2.05)<0.001
     Asthenia29031209 (41.6)1.93 (1.70 to 2.19)<0.001
    • aThe reference group had no symptoms. ILI = influenza-like illness. OR = odds ratio. Ref = reference.

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Healthcare-seeking behaviour in case of influenza-like illness in the French general population and factors associated with a GP consultation: an observational prospective study
Matthieu Ariza, Caroline Guerrisi, Cécile Souty, Louise Rossignol, Clément Turbelin, Thomas Hanslik, Vittoria Colizza, Thierry Blanchon
BJGP Open 2018; 1 (4): bjgpopen17X101253. DOI: 10.3399/bjgpopen17X101253

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Healthcare-seeking behaviour in case of influenza-like illness in the French general population and factors associated with a GP consultation: an observational prospective study
Matthieu Ariza, Caroline Guerrisi, Cécile Souty, Louise Rossignol, Clément Turbelin, Thomas Hanslik, Vittoria Colizza, Thierry Blanchon
BJGP Open 2018; 1 (4): bjgpopen17X101253. DOI: 10.3399/bjgpopen17X101253
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Keywords

  • influenza-like illness
  • healthcare seeking behaviour
  • general population
  • web-based study
  • general practice

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