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Research

The accuracy and feasibility of respiratory rate measurements in acutely ill adult patients by GPs: a mixed-methods study

Feike J Loots, Irma Dekker, Ruo Chen Wang, Arthur RH van Zanten, Rogier M Hopstaken, Theo JM Verheij, Paul Giesen and Marleen Smits
BJGP Open 2022; 6 (4): BJGPO.2022.0029. DOI: https://doi.org/10.3399/BJGPO.2022.0029
Feike J Loots
1 Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
2 Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
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  • ORCID record for Feike J Loots
  • For correspondence: f.j.loots@umcutrecht.nl
Irma Dekker
2 Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
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Ruo Chen Wang
2 Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
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Arthur RH van Zanten
3 Gelderse Vallei Hospital, Department of Intensive Care, Willy Brandtlaan, Ede, The Netherlands
4 Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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Rogier M Hopstaken
5 Star-SHL Diagnostic Centres, Etten-Leur, The Netherlands
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Theo JM Verheij
1 Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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Paul Giesen
2 Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
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Marleen Smits
2 Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
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    Figure 1. Correlation between the respiratory rate measurements of the GP (counted during at least 15 seconds) and the reference measurement
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    Figure 2. Bland–Altman plot of the differences between the GP measurement of the respiratory rate and the reference measurement

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    Table 1. Background characteristics of the included acutely ill patients (n = 130), divided by patients in whom the GP did or did not count the respiratory rate for at least 15 seconds
    VariableRespiratory rate counted
    Yes(n = 33)No(n = 97)
    Median age, years (IQR)79 (68–86)79 (69–85)
    Sex, n (%)
     Male15 (45)50 (52)
     Female18 (55)47 (48)
    Type of complaint, n (%)
     Respiratory12 (36)16 (16)
     Infectious6 (18)11 (11)
     General malaise2 (6)12 (12)
     Cardiovascular4 (12)9 (9)
     Gastrointestinal4 (12)14 (14)
     Trauma2 (6)14 (14)
     Neurologic2 (6)6 (6)
     Other1 (3)15 (15)
    Urgency at triage, n (%)
     U1: immediate response2 (6)2 (2)
     U2: response as quickly as possible17 (52)41 (42)
     U3: response within a few hours13 (39)53 (55)
     U4: response within 24 hours1 (3)1 (1)
    Mean respiratory rate (SD)21 (7.3)20 (6.4)
    GP characteristics, n (%) (n = 35)
     Female sex14 (42)43 (44)
     >10 years' working experience25 (76)74 (76)
    • IQR= interquartile range. SD = standard deviation.

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    Table 2. Contingency tables of the assessment of the respiratory rate of the GP compared with the reference measurement at a cut-off of 22 breaths per minute (A), GP counted respiratory rate at least 15 seconds, and (B) Estimated respiratory rate by the GP
    Reference measurementTotal
    ≥22 per minute<22 per minute
    A. Counted by GP≥22 per minute12012
    <22 per minute21921
    Total141933
    B. Estimated by GP≥22 per minute9110
    <22 per minute122638
    Total212748
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The accuracy and feasibility of respiratory rate measurements in acutely ill adult patients by GPs: a mixed-methods study
Feike J Loots, Irma Dekker, Ruo Chen Wang, Arthur RH van Zanten, Rogier M Hopstaken, Theo JM Verheij, Paul Giesen, Marleen Smits
BJGP Open 2022; 6 (4): BJGPO.2022.0029. DOI: 10.3399/BJGPO.2022.0029

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The accuracy and feasibility of respiratory rate measurements in acutely ill adult patients by GPs: a mixed-methods study
Feike J Loots, Irma Dekker, Ruo Chen Wang, Arthur RH van Zanten, Rogier M Hopstaken, Theo JM Verheij, Paul Giesen, Marleen Smits
BJGP Open 2022; 6 (4): BJGPO.2022.0029. DOI: 10.3399/BJGPO.2022.0029
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Keywords

  • respiratory rate
  • general practice
  • primary health care
  • after-hours care
  • sepsis

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