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Family Medicine Clinic Survey on the Treatment of Upper Respiratory Tract Infections
Upper respiratory tract infections affect both patients and medical staff. Alternative remedies, such as ascorbic acid and zinc lozenges, and home or cultural remedies, such as chicken soup, have become increasingly popular among the general public. We sought to determine how the physicians, residents, and staff at an urban family medicine clinic treat their colds.
Design
Cross-sectional survey.
Subjects
Physician, resident, nursing, and front desk staff at an urban family medicine clinic.
Instrument
A 1-page questionnaire listing 10 commonly used medical therapies, 5 commonly used nutritional supplements, 5 special foods or teas, and 10 miscellaneous other measures cited at informal staff lounge discussions, as possibly useful treatments for the common cold.
Results
Of the 46 questionnaire recipients, 43 recipients (94%) returned the surveys within 24 hours, with men constituting one third of the respondents. The composition of the survey was as follows: 23 residents (50%); 11 nursing and administrative staff (23%); and 9 faculty (22%). Respondents reported having an average number of 2.1 colds in the past year (range, 0-5 colds). Current cold symptoms were reported by 14 (32.6%) of the respondents.
Therapies Used
Some type of medication was used by 35 (81%) of the respondents (Table 1). Antipyretics were used by 25 respondents (60%), all of whom thought they were helpful. Decongestants were used by 15 (34%) of the respondents, most (37 respondents, 87%) of whom believed they were helpful. Cough suppressants and decongestants were cited as making symptoms worse for 1 or more respondents.
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Results of a Family Medicine Clinic Survey on the Treatment of Upper Respiratory Tract Infection*
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Nutritional supplements were also frequently used. Ascorbic acid, in doses ranging from 500 to 6000 mg/d, was taken by 21 (49%) of the staff, with a modal intake of 1000 mg/d. Most (27 respondents, 62%) were not certain how helpful ascorbic acid was for their symptoms. Echinacea was used by 15 (34%) of the respondents. Although no respondent felt worse after taking echinacea, only one third of the users reported that it was definitely helpful. Zinc and menthol eucalyptus lozenges were each used by 14 (33%) of the respondents. Zinc lozenges made symptoms worse, causing nausea in 2 of the 14 staff who used them.
The special food consumed by most cold sufferers was hot tea with honey and/or lemon, used by 28 (65%) of the respondents. Chicken soup was used by 14 (33%) of the respondentssimilar to the rate that decongestants and echinacea were used.
The most common other measure reported was extra rest, cited by 29 (67%) of the respondents. Several residents noted that they would like to have rested more but were unable to do so because of their job responsibilities. No respondents admitted to using antibiotics to treat a cold. None of the special foods, teas, or other measures reportedly caused any adverse symptoms.
Comment
Our family medicine clinic staff use a wide variety of therapies to treat the symptoms of their upper respiratory tract infections. Most commonly used measures include extra rest, hot tea with honey and/or lemon, and antipyretics. The next most commonly used therapies were ascorbic acid, echinacea, zinc lozenges, decongestants, chicken soup, and positive thinking.
This study needs to be replicated among a larger and more diverse sample of medical practitioners; it would be useful to compare the therapeutic choices of health professionals to those of our patients. In any case, home remedies and remedies previously thought to be alternative seem to have moved into the mainstream in the thinking of medical staff and practitioners in terms of personal health care choices.
Kathi J. Kemper, MD, MPH
Boston, Mass
Arch Fam Med. 1998;7:517-518.
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