Title
Trial TORRENT software (recruitment aid) for the ADVICE (Acute Diahorrea and vomiting in children) study

Lead researcher
Dr Nick Francis, Cochrane Institute of Primary Care & Public Health, Cardiff University

Aim
To describe the presentation, management, and outcomes of acute diarrhoea and/or vomiting (D&V) in children presenting to primary care, and the health beliefs and attitudes of carer and general practitioners about the management of this illness in both primary and secondary care.

Background
Acute diarrhoea and vomiting in children is a common and important condition. One in five people in the UK are estimated to develop infectious intestinal disease [IID] each year. and accounts for over 300 deaths, 35,000 hospital admissions and around 3.4million physician consultations in the mid 1990’s.

Although not associated with a high mortality in resource rich countries, acute diarrhoea and vomiting results in a large burden on both NHS and community resources, with an annual cost of treatment for rotaviral gastroenteritis alone estimated at £14.8million.  It has been estimated that by the age of five years, almost every child will experience rotaviral gastroenteritis, and one in 54 infected children will need hospitalisation. The risk of developing a chronic gastrointestinal disorder is six times more likely subsequent to an acute episode of diarrhoea compared to those who have not had such an episode. These post-infectious disorders include irritable bowel syndrome (IBS), Guillain-Barré syndrome (GBS) and inflammatory bowel diseases (IBD) (e.g.  Crohn’s or ulcerative colitis).

Therefore, acute diarrhoea and vomiting not only results in an initial burden for families, General Practitioners and hospitals, it also increases the risk of resulting in a prolonged burden for individuals, families, and the health service.

Study design summary
This will be a descriptive study of the carers of 400 children suffering with acute diarrhoea and/or vomiting.  It will involve completion of a questionnaire on their child and a two-week diary post consultation which focus on patient symptoms, treatments and management.  These will be quantitatively analysed to construct a comprehensive description of the current management of children with diarrhoea and vomiting in the home and also provide a comparison between the advice given by GPs and the measures taken by the carers.  A six-month follow up will determine persistence of diarrhoea and/or vomiting and/or subsequent diagnosis of chronic gastrointestinal [GI] conditions.  An electronic CRF will collect data on all patients with diarrhoea and vomiting, the information recorded will include medication prescribed / recommended during the initial consultation.  Questionnaires will be completed by the GPs at the end of the recruitment period to investigate their health beliefs and attitudes towards dietary recommendations during managing acute diarrhoea and/or vomiting.

Total awarded
£24,000 for GP Software Capture System