A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India

The co-existence of different types of medical systems (medical pluralism) is a typical feature of India's healthcare system. For conditions such as influenza-like illness (ILI), where non-specific disease signs/symptoms exist, clinical reasoning in the context of medical pluralism becomes cruc...

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Main Authors: Ahankari, Anand S., Myles, Puja R., Tsang, S., Khan, F., Atre, S., Langley, Tessa, Kudale, A., Bains, Manpreet
Format: Article
Published: Taylor and Francis 2017
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Online Access:https://eprints.nottingham.ac.uk/44266/
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author Ahankari, Anand S.
Myles, Puja R.
Tsang, S.
Khan, F.
Atre, S.
Langley, Tessa
Kudale, A.
Bains, Manpreet
author_facet Ahankari, Anand S.
Myles, Puja R.
Tsang, S.
Khan, F.
Atre, S.
Langley, Tessa
Kudale, A.
Bains, Manpreet
author_sort Ahankari, Anand S.
building Nottingham Research Data Repository
collection Online Access
description The co-existence of different types of medical systems (medical pluralism) is a typical feature of India's healthcare system. For conditions such as influenza-like illness (ILI), where non-specific disease signs/symptoms exist, clinical reasoning in the context of medical pluralism becomes crucial. Recognising this need, we undertook a qualitative study, which explored factors underpinning clinical decisions on diagnosis and management of ILI. The study involved semi-structured interviews including clinical vignettes with 20 healthcare practitioners (working within allopathy, homeopathy and Ayurveda) working in the private healthcare sector in Solapur city, India. An inquiry was conducted into criteria influencing the diagnosis, treatment, referral to specialist care and role of treatment guidelines for ILI. Thematic analysis was used to identify aspects relating to ILI diagnosis, treatment and referral. The diagnosis of influenza was based largely on clinical symptoms suggestive of influenza in the absence of other diagnoses. Referral for laboratory tests was only initiated if illness did not resolve, generally after 2-3 consultations. Antibiotics were often prescribed for persistent illness, with antivirals rarely considered. Some differences between practitioners from different medical systems were observed in relation to treatment and referral in case of persistent illness. A combination of analytical and intuitive clinical reasoning was used by the participants and clinical decisions were based on both social and clinical factors. Clinical decision-making was rarely a linear process and respondents felt that broad guidelines on influenza that allowed doctors to account for the sociocultural context within which they practised medicine would be helpful.
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spelling nottingham-442662020-05-04T18:53:42Z https://eprints.nottingham.ac.uk/44266/ A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India Ahankari, Anand S. Myles, Puja R. Tsang, S. Khan, F. Atre, S. Langley, Tessa Kudale, A. Bains, Manpreet The co-existence of different types of medical systems (medical pluralism) is a typical feature of India's healthcare system. For conditions such as influenza-like illness (ILI), where non-specific disease signs/symptoms exist, clinical reasoning in the context of medical pluralism becomes crucial. Recognising this need, we undertook a qualitative study, which explored factors underpinning clinical decisions on diagnosis and management of ILI. The study involved semi-structured interviews including clinical vignettes with 20 healthcare practitioners (working within allopathy, homeopathy and Ayurveda) working in the private healthcare sector in Solapur city, India. An inquiry was conducted into criteria influencing the diagnosis, treatment, referral to specialist care and role of treatment guidelines for ILI. Thematic analysis was used to identify aspects relating to ILI diagnosis, treatment and referral. The diagnosis of influenza was based largely on clinical symptoms suggestive of influenza in the absence of other diagnoses. Referral for laboratory tests was only initiated if illness did not resolve, generally after 2-3 consultations. Antibiotics were often prescribed for persistent illness, with antivirals rarely considered. Some differences between practitioners from different medical systems were observed in relation to treatment and referral in case of persistent illness. A combination of analytical and intuitive clinical reasoning was used by the participants and clinical decisions were based on both social and clinical factors. Clinical decision-making was rarely a linear process and respondents felt that broad guidelines on influenza that allowed doctors to account for the sociocultural context within which they practised medicine would be helpful. Taylor and Francis 2017-07-03 Article PeerReviewed Ahankari, Anand S., Myles, Puja R., Tsang, S., Khan, F., Atre, S., Langley, Tessa, Kudale, A. and Bains, Manpreet (2017) A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India. Anthropology and Medicine . pp. 1-22. ISSN 1469-2910 India Influenza-like illness Clinical reasoning Decision-making http://www.tandfonline.com/doi/full/10.1080/13648470.2017.1321459 doi:10.1080/13648470.2017.1321459 doi:10.1080/13648470.2017.1321459
spellingShingle India
Influenza-like illness
Clinical reasoning
Decision-making
Ahankari, Anand S.
Myles, Puja R.
Tsang, S.
Khan, F.
Atre, S.
Langley, Tessa
Kudale, A.
Bains, Manpreet
A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India
title A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India
title_full A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India
title_fullStr A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India
title_full_unstemmed A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India
title_short A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India
title_sort qualitative study exploring factors influencing clinical decision-making for influenza-like illness in solapur city, maharashtra, india
topic India
Influenza-like illness
Clinical reasoning
Decision-making
url https://eprints.nottingham.ac.uk/44266/
https://eprints.nottingham.ac.uk/44266/
https://eprints.nottingham.ac.uk/44266/