JMIR Publications

ABSTRACT

Background:

Sore throat is a common reason for overuse of antibiotics. Clinical prediction rules and testing of throat swab or saliva samples both have the potential to help identify those most and least likely to benefit from antibiotics.

Objective:

We aimed to develop an online tool to help patients and parents / carers self-assess sore throat symptoms and take throat swab and saliva samples for diagnostic testing. We then explored the acceptability and feasibility of using the tool in adults and children with sore throat.

Methods:

We used the ‘person-based-approach’ to develop an online tool and then recruited adults and children with sore throats through participating general practices and social media advertising. Participants self-assessed the presence of FeverPAIN and Centor score criteria, and attempted to photograph their throat and take throat swabs and saliva tests. Study processes were observed via video call and participants were interviewed about their views of using the online tool. Self-assessed throat inflammation and pus were compared to clinician evaluation of patients’ throat photographs.

Results:

Forty-five participants (33 adults and 12 children) were recruited. 44 (97.8%) completed all FeverPAIN and Centor scoring elements and most reported finding self-assessment relatively easy. A few participants found clinical features (lymph nodes, throat inflammation and pus) difficult to assess. 18 (40.0%) provided a throat photograph of adequate quality for clinical assessment. There was moderate agreement between self-assessed features and clinician-assessed photographs for inflammation and pus. 88.9%, 93.3%, 88.9% and 80.0% provided analyzable bacterial swab, viral swab, saliva sponge and saliva drool samples respectively. Participants were generally happy and confident in providing samples, with saliva samples rated as slightly more acceptable than swab samples.

Conclusions:

An online intervention was found to be helpful for adults and parents of children in assessing clinical features of throat infections and taking samples. Patients may need additional support in assessing clinical features and providing photographs.