Consultation in out-of-hours practice: a clinical review of Lyme disease

Brydon, Sharon; MacVicar, Sonya

Abstract

In recent times, telephone triage and virtual consultation have been expedited in the out-of-hours urgent primary care setting. This brings challenges concerning gaining a comprehensive history and building a therapeutic relationship between nurse prescriber and patient. This article presents a clinical review of Lyme disease to explore consultation models and how implementing a hybrid consultation approach may support the practitioner to develop safe prescribing practices and optimise patient expectations. This review of Lyme disease management highlights the sparse, low-quality evidence available, with national guidance indicating antimicrobial treatment for those who present with an erythema migrans rash prior to laboratory testing confirmation. This reinforces the importance of reaching a shared decision with the patient understanding of the perceived risk and benefits of treatment. The factors discussed include Lyme disease prevention and how the practitioner ensures safety netting in the out-of-hours setting.

Citation

Brydon, S., & MacVicar, S. (2022). Consultation in out-of-hours practice: a clinical review of Lyme disease. Journal of Prescribing Practice, 4(9), https://doi.org/10.12968/jprp.2022.4.9.396

• Journal Article Type: Article
• Acceptance Date: Aug 23, 2022
• Online Publication Date: Sep 12, 2022
• Publication Date: 2022-09
• Deposit Date: Aug 24, 2022
• Publicly Available Date: Mar 13, 2023
• Print ISSN: 2631-8385
• Publisher: Mark Allen Healthcare
• Peer Reviewed: Peer Reviewed
• Volume: 4
• Issue: 9
• DOI: https://doi.org/10.12968/jprp.2022.4.9.396
• Keywords: Lyme disease; Doxycycline; advancing practice; consultation models; nurse prescribing
• Public URL: http://researchrepository.napier.ac.uk/Output/2898933