• Alice Serafini, Lucia Palandri, Peter Konstantin Kurotschka, Chiara Giansante, Maria Rita Sabattini, Martina Alfina Lavenia, Marina Scarpa, Davide Fornaciari, Matteo Morandi, Francesco Bellelli, Maria Stella Padula, Elena Righi, Giulia Ugolini, Silvia Riccomi, MAGMA Study Group, and MAGMA Group.
• Department of Primary Care, Local Health Authority of Modena, Modena, Italy.
• Eur J Gen Pract. 2023 Dec 1; 29 (2): 21863952186395.

BackgroundMost symptomatic SARS-CoV-2 infections produce mild to moderate symptoms. Although most patients are managed in the outpatient setting, little is known about the effect of general practitioners' (GP) management strategies on the outcomes of COVID-19 outpatients in Italy.ObjectivesDescribe the management of Italian GPs of SARS-CoV-2 infected adult patients and explore whether GP active care and monitoring are associated with reducing hospitalisation and death.MethodsRetrospective observational study of SARS-CoV-2 infected adult outpatients managed by GPs in Modena (Italy) from March 2020 to April 2021. Information on management and monitoring strategies, patients' socio-demographic characteristics, comorbidities, and outcomes (hospitalisation and death due to COVID-19) were retrieved through an electronic medical record review and analysed descriptively and through multiple logistic regression.ResultsOut of the 5340 patients from 46 GPs included in the study, 3014 (56%) received remote monitoring, and 840 (16%) had at least one home visit. More than 85% of severe or critical patients were actively monitored (73% daily) and 52% were visited at home. Changes over time in patients' therapeutic management were observed in concordance with the guidelines' release. Active daily remote monitoring and home visits were strongly associated with reduced hospitalisation rate (OR 0.52, 95% CI 0.33-0.80 and OR 0.50, 95% CI 0.33-0.78 respectively).ConclusionGPs effectively managed an increasing number of outpatients during the first waves of the pandemic. Active monitoring and home visits were associated with reduced hospitalisation in COVID-19 outpatients.

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