scholarly journals Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis

2021 ◽  
Vol 13 (1) ◽  
pp. 5
Author(s):  
Marcus D. Cherry ◽  
Amanda Tapley ◽  
Debbie Quain ◽  
Elizabeth G. Holliday ◽  
Jean Ball ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Training ◽  
Antibiotic Prescription ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
Registrar Training

ABSTRACT INTRODUCTIONOver-prescription of antibiotics for common infective conditions is an important health issue. Infective conjunctivitis represents one of the most common eye-related complaints in general practice. Despite its self-limiting nature, there is evidence of frequent general practitioner (GP) antibiotic prescribing for this condition, which is inconsistent with evidence-based guidelines. AIMTo investigate the prevalence and associations of GP registrars’ (trainees’) prescription of antibiotics for infective conjunctivitis. METHODSWe performed a cross-sectional analysis of the Registrar Encounters in Clinical Training (ReCEnT) ongoing prospective cohort study, which documents GP registrars’ clinical consultations (involving collection of information from 60 consecutive consultations, at three points during registrar training). The outcome of the analyses was antibiotic prescription for a new diagnosis of conjunctivitis. Patient, registrar, practice and consultation variables were included in uni- and multivariable logistic regression analyses to test associations of these prescriptions. RESULTSIn total, 2333 registrars participated in 18 data collection rounds from 2010 to 2018. There were 1580 new cases of infective conjunctivitis (0.31% of all problems). Antibiotics (mainly topical) were prescribed in 1170 (74%) of these cases. Variables associated with antibiotic prescription included patients’ Aboriginal or Torres Strait Islander status, registrar organisation of a follow up (both registrar and other GP follow up), and earlier registrar training term (more junior status). DISCUSSIONGP registrars, like established GPs, prescribe antibiotics for conjunctivitis in excess of guideline recommendations, but prescribing rates are lower in later training. These prescribing patterns have educational, social and economic consequences. Further educational strategies may enhance attenuation of registrars’ prescribing during training.

scholarly journals Australian general practice trainees’ exposure to ophthalmic problems and implications for training: a cross-sectional analysis

2016 ◽  
Vol 8 (4) ◽  
pp. 295 ◽  
Author(s):  
Simon Morgan ◽  
Amanda Tapley ◽  
Kim M Henderson ◽  
Neil A Spike ◽  
Lawrie A McArthur ◽  
...  
Keyword(s):  
General Practice ◽  
Information Seeking ◽  
Learning Goals ◽  
Training Methods ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Australian General Practice ◽  
Simple Logistic ◽  
Sectional Analysis

ABSTRACT INTRODUCTION Eye conditions are common presentations in Australian general practice, with the potential for serious sequelae. Pre-vocational ophthalmology training for General Practitioner (GP) trainees is limited. AIM To describe the rate, nature and associations of ophthalmic problems managed by Australian GP trainees, and derive implications for education and training. METHODS Cross-sectional analysis from an ongoing cohort study of GP trainees’ clinical consultations. Trainees recorded demographic, clinical and educational details of consecutive patient consultations. Descriptive analyses report trainee, patient and practice demographics. Proportions of all problems managed in these consultations that were ophthalmology-related were calculated with 95% confidence intervals (CI). Associations were tested using simple logistic regression within the generalised estimating equations (GEE) framework. RESULTS In total, 884 trainees returned data on 184,476 individual problems or diagnoses from 118,541 encounters. There were 2649 ophthalmology-related problems, equating to 1.4% (95% CI: 1.38–1.49) of all problems managed. The most common eye presentations were conjunctivitis (32.5% of total problems), eyelid problems (14.9%), foreign body (5.3%) and dry eye (4.7%). Statistically significant associations were male trainee; male patient and patient aged 14 years or under; the problem being new and the patient being new to both trainee and practice; urban and of higher socioeconomic status practice location; the practice nurse not being involved; planned follow up not arranged; referral made; in-consultation information sought; and learning goals generated. DISCUSSION Trainees have comparable ophthalmology exposure to established GPs. However, associations with referral and information-seeking suggest GP trainees find ophthalmic problems challenging, reinforcing the critical importance of appropriate training.

scholarly journals Understanding the gender gap in antibiotic prescribing: a cross-sectional analysis of English primary care

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e020203 ◽  
Author(s):  
David R M Smith ◽  
F Christiaan K Dolk ◽  
Timo Smieszek ◽  
Julie V Robotham ◽  
Koen B Pouwels
Keyword(s):  
Primary Care ◽  
Tract Infection ◽  
Gender Gap ◽  
Antibiotic Prescription ◽  
The Elderly ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
To Receive

ObjectivesTo explore the causes of the gender gap in antibiotic prescribing, and to determine whether women are more likely than men to receive an antibiotic prescription per consultation.DesignCross-sectional analysis of routinely collected electronic medical records from The Health Improvement Network (THIN).SettingEnglish primary care.ParticipantsPatients who consulted general practices registered with THIN between 2013 and 2015.Primary and secondary outcome measuresTotal antibiotic prescribing was measured in children (<19 years), adults (19–64 years) and the elderly (65+ years). For 12 common conditions, the number of adult consultations was measured, and the relative risk (RR) of being prescribed antibiotics when consulting as female or with comorbidity was estimated.ResultsAmong 4.57 million antibiotic prescriptions observed in the data, female patients received 67% more prescriptions than male patients, and 43% more when excluding antibiotics used to treat urinary tract infection (UTI). These gaps were more pronounced in adult women (99% more prescriptions than men; 69% more when excluding UTI) than in children (9%; 0%) or the elderly (67%; 38%). Among adults, women accounted for 64% of consultations (62% among patients with comorbidity), but were not substantially more likely than men to receive an antibiotic prescription when consulting with common conditions such as cough (RR 1.01; 95% CI 1.00 to 1.02), sore throat (RR 1.01, 95% CI 1.00 to 1.01) and lower respiratory tract infection (RR 1.00, 95% CI 1.00 to 1.01). Exceptions were skin conditions: women were less likely to be prescribed antibiotics when consulting with acne (RR 0.67, 95% CI 0.66 to 0.69) or impetigo (RR 0.85, 95% CI 0.81 to 0.88).ConclusionsThe gender gap in antibiotic prescribing can largely be explained by consultation behaviour. Although in most cases adult men and women are equally likely to be prescribed an antibiotic when consulting primary care, it is unclear whether or not they are equally indicated for antibiotic therapy.

scholarly journals General practice training in regional and rural Australia: A cross‐sectional analysis of the Registrar Clinical Encounters in Training study

2020 ◽  
Vol 28 (1) ◽  
pp. 32-41
Author(s):  
Amanda Tapley ◽  
Andrew R. Davey ◽  
Mieke L. Driel ◽  
Elizabeth G. Holliday ◽  
Simon Morgan ◽  
...  
Keyword(s):  
General Practice ◽  
Cross Sectional ◽  
Training Study ◽  
Cross Sectional Analysis ◽  
Clinical Encounters ◽  
Sectional Analysis ◽  
Rural Australia ◽  
General Practice Training

Are neighborhood restaurants related to frequency of restaurant meals and dietary quality?: Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis

2021 ◽  
pp. 1-29
Author(s):  
Amy H. Auchincloss ◽  
Jingjing Li ◽  
Kari A. B. Moore ◽  
Manuel Franco ◽  
Mahasin S. Mujahid ◽  
...  
Keyword(s):  
Healthy Eating Index ◽  
Dietary Quality ◽  
Longitudinal Analyses ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Eating Out ◽  
Restaurant Meals ◽  
Sectional Analysis ◽  
Over Time

Abstract Objective: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. Design: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4.8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. Setting: Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012. Participants: Participants aged 45–84 years were followed for 10 years (n 3567). Results: Median HEI (out of 100) was 59 at baseline and 62 at follow-up. Cross-sectional analysis found residing in areas with a high density of restaurants (highest ranked quartile) was associated with 52% higher odds of frequently eating restaurant meals (≥3 times/week, odds ratio [OR]:1.52, 95% confidence interval [CI] 1.18-1.98) and 3% higher odds of having lower dietary quality (HEI lowest quartile<54, OR:1.03,CI:1.01-1.06); associations were not sustained in longitudinal analyses. Cross-sectional analysis found 34% higher odds of having lower dietary quality for those who frequently ate at restaurants (OR:1.34,CI:1.12-1.61); and more restaurant meals (over time increase ≥1 times/week) was associated with higher odds of having worse dietary quality at follow-up (OR:1.21,CI:1.00-1.46). Conclusions: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

General practice registrars’ clinical exposure to dermatological procedures during general practice training: a cross-sectional analysis

2018 ◽  
Vol 29 (6) ◽  
pp. 357-366 ◽  
Author(s):  
Er Tsing Vivian Tng ◽  
Amanda Tapley ◽  
Andrew Davey ◽  
Sally De Zwaan ◽  
Simon Morgan ◽  
...  
Keyword(s):  
General Practice ◽  
Cross Sectional ◽  
Clinical Exposure ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
General Practice Training

scholarly journals Responses to clinical uncertainty in Australian general practice trainees: a cross-sectional analysis

2017 ◽  
Vol 51 (12) ◽  
pp. 1277-1288 ◽  
Author(s):  
Georga Cooke ◽  
Amanda Tapley ◽  
Elizabeth Holliday ◽  
Simon Morgan ◽  
Kim Henderson ◽  
...  
Keyword(s):  
General Practice ◽  
Cross Sectional ◽  
Clinical Uncertainty ◽  
Cross Sectional Analysis ◽  
Australian General Practice ◽  
Sectional Analysis

Prevalence and associations of gender concordance in general practice consultations: a cross-sectional analysis.

2015 ◽  
Vol 3 (4) ◽  
pp. 470 ◽  
Author(s):  
Allison Thomson ◽  
Simon Morgan ◽  
Amanda Tapley ◽  
Mike Van Driel ◽  
Kim Henderson ◽  
...  
Keyword(s):  
General Practice ◽  
Female Physician ◽  
Gender Effects ◽  
Male Physician ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Gender Concordance ◽  
And Gender ◽  
Sectional Analysis ◽  
Physician Patient

Rationale, aims and objectives: Gender effects on physician-patient interactions are well-established and gender concordance of the physician-patient dyad influences consultation dynamics, person-centeredness and outcomes. We aimed to establish the prevalence and associations of gender-concordant and gender-discordant consultations of general practice (family medicine) trainees and to compare outcomes of gender-concordant and gender-discordant consultations.Method: A cross-sectional analysis from an ongoing cohort study. The outcome measure was whether a consultation included a gender concordant (female-female, male-male) or discordant (male-female, female-male) physician-patient dyad. Independent variables related to patient, physician (registrar), practice, consultation content and consultation outcome.Results: Five hundred and ninety-two general practice (GP) registrars (trainees) in 4 of Australia’s 17 regional training programs provided data on 56,234 individual consultations. Sixty-two point nine percent of consultations were gender-concordant (73.5% female-female, 26.5% male-male) and 37.1% were gender-discordant (47.0% male physician-female patient, 53% female physician-male patient). Associations of having a gender-concordant consultation were patient female gender and younger age (<55), the patient not being new to the registrar and the registrar being part-time, younger and having worked at the practice previously. Addressing a reproductive/contraceptive/ genital problem was associated with gender concordance. Gender-concordant consultations were  ‘complex’: significantly longer than gender-discordant consultations, addressed a greater number of problems, resulted in more pathology ordered, more follow-up organised and more learning goals generated.Conclusions: Gender-concordant consultations may be more complex and gender-concordance is ‘sought’ by patients rather than being random.  Thus, efforts could be made in general practice to provide access to both male and female GPs, especially for female patients or groups or patients with particular needs. 

scholarly journals Gender differences in Australian general practice trainees performing procedures related to women’s reproductive health: A cross-sectional analysis

2018 ◽  
Vol 47 (10) ◽  
pp. 721-726 ◽  
Author(s):  
Fariba Aghajafari ◽  
Amanda Tapley ◽  
Mieke L van Driel ◽  
Andrew R Davey ◽  
Simon Morgan ◽  
...  
Keyword(s):  
Gender Differences ◽  
General Practice ◽  
Reproductive Health ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Australian General Practice ◽  
Women’S Reproductive Health ◽  
Women's Reproductive Health ◽  
Sectional Analysis

scholarly journals Antibiotic stewardship in skin infections: a cross-sectional analysis of early-career GP’s management of impetigo

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031527 ◽  
Author(s):  
Clare Heal ◽  
Hilary Gorges ◽  
Mieke L van Driel ◽  
Amanda Tapley ◽  
Josh Davis ◽  
...  
Keyword(s):  
Antibiotic Prescription ◽  
Early Career ◽  
Cross Sectional ◽  
Topical Antibiotics ◽  
Systemic Antibiotic ◽  
Cross Sectional Analysis ◽  
Clinical Encounters ◽  
New Diagnosis ◽  
Sectional Analysis ◽  
Systemic Antibiotics

ObjectiveTo establish the prevalence and associations of systemic antibiotic prescription for impetigo by early-career general practitioners (GPs) (GP registrars in their first 18 months in general practice).DesignA cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study.SettingReCEnT is an ongoing multisite cohort study of Australian registrars’ in-consultation clinical practice across five Australian states.ParticipantsRegistrars participating in ReCEnT from 2010 to 2017.Outcome measuresManagement of impetigo with systemic antibiotics.Results1741 registrars (response rate 96%) provided data from 384 731 problems identified in 246 434 consultations. Impetigo, on first presentation or follow-up, was managed in 930 (0.38%, 95% CI 0.35 to 0.40) consultations and comprised 0.24% (95% CI 0.23 to 0.26) of problems. 683 patients presented with a new diagnosis of impetigo of which 38/683 (5.6%) were not prescribed antibiotics; 239/683 (35.0%) were prescribed solely topical antibiotics; 306/683 (44.8%) solely systemic antibiotics and 100/683 (14.6%) both systemic and topical antibiotics. The most common systemic antibiotic prescribed was cephalexin (53.5%). Variables independently associated with prescription of systemic antibiotics were an inner regional (compared with major city) location (OR 1.82, 95% CI 1.06 to 3.13; p=0.028), seeking in-consultation information or advice (OR 2.17, 95% CI 1.47 to 3.23; p<0.001) and ordering pathology (OR 2.13, 95% CI 1.37 to 3.33; p=0.01).ConclusionsAustralian early-career GPs prescribe systemic antibiotics (the majority broad-spectrum) for a high proportion of initial impetigo presentations. Impetigo guidelines should clearly specify criteria for systemic antibiotic prescription and individual antibiotic choice. The role of non-antibiotic management and topical antiseptics needs to be explored further.

scholarly journals Estudio de seguimiento de egresados como herramienta para la actualización curricular con fines de acreditación de cuatro licenciaturas

2021 ◽  
Vol 4 (1) ◽  
pp. 16-31
Author(s):  
R. Méndez Torres ◽  
Ma. R. Sánchez Valencia
Keyword(s):  
Relevant Information ◽  
Academic Quality ◽  
Cross Sectional ◽  
Follow Up Study ◽  
Cross Sectional Analysis ◽  
Significant Difference ◽  
Initial Hypothesis ◽  
Self Knowledge ◽  
Sectional Analysis

El presente trabajo muestra el análisis comparativo de cohorte transversal que resulta del estudio de seguimiento de egresados para la generación 2013 de la Universidad Interactiva y a Distancia del Estado de Guanajuato (UNIDEG). La intención es realizar una actualización curricular que eventualmente permita la acreditación por parte de los organismos de COPAES de cuatro licenciaturas. Se parte de la hipótesis de que no existe diferencia significativa en los resultados y opiniones de los egresados de las diferentes carreras. Los resultados permiten conocer información relevante de los egresados que generan el autoconocimiento de la institución y la puesta en marcha de acciones de mejoramiento de la calidad académica y al mismo tiempo el acercamiento a los egresados para impulsar proyectos en los que se les involucre. This paper shows a cross sectional analysis of a graduates follow up study of 2013 generation of Universidad Interactiva y a Distancia del Estado de Guanajuato (UNIDEG). The purpose is to make a curricular update that eventually allow the accreditation by of the four bachelors by the members of COPAES. The initial hypothesis is that there is no significant difference in the results and opinions of graduates of different bachelors. The results let to know relevant information from graduates that generate self-knowledge of the institution to generate actions to improve academic quality while approaching graduates to promote projects in which they are involved.  

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