Family practitioners' advice about taking time off work for lower respiratory tract infections: A prospective study in twelve European primary care networks

Background: Acute cough and lower respiratory tract infections (LRTIs) are one of the most important causes of lost working hours. Aim: to explore variation and predictors in family practitioners (FPs) advice to patients with LRTIs about taking time off work in different European countries. Methods: Prospective observational study in primary care networks in 12 countries, with multilevel mixed-effects binomial logistic regression. Results: 324 FPs recruited 1616 employed adults who presented to primary care with LRTIs. The proportion of patients advised to take time off work varied from 7.6% in the Netherlands to 89.2% in Slovakia, and of these, 88.2% overall were advised to stay off work for seven days or less. None of Finnish or Dutch patients were advised to take more than 7 days off, in contrast to 35.5% of Polish and 27.0% of Slovak patients. The strongest predictors of FPs' advice about time off work were: patient symptoms interfering with normal activities (OR 4.43; P