scholarly journals ISQUA18-2495The Impact of a National Antimicrobial Stewardship Programmes on Antibiotic Prescribing in Primary Care in England: An Interrupted Time Series Analysis

2018 ◽  
Vol 30 (suppl_2) ◽  
pp. 37-38
Author(s):  
V Balinskaite ◽  
A Holmes ◽  
A Johnson ◽  
P Aylin
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Time Series Analysis ◽  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Antibiotic Prescribing ◽  
Interrupted Time Series Analysis ◽  
Series Analysis

scholarly journals Successful improvement of antibiotic prescribing at Primary Care in Andalusia following the implementation of an antimicrobial guide through multifaceted interventions: An interrupted time-series analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0233062
Author(s):  
Rocío Fernández-Urrusuno ◽  
Carmen Marina Meseguer Barros ◽  
Regina Sandra Benavente Cantalejo ◽  
Elena Hevia ◽  
Carmen Serrano Martino ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Antibiotic Prescribing ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Multifaceted Interventions

scholarly journals Ramadan is not associated with increased infection risk in Pakistani and Bangladeshi populations: Findings from controlled interrupted time series analysis of UK primary care data

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262530
Author(s):  
Munerah Almulhem ◽  
Rasiah Thayakaran ◽  
Shahjehan Hanif ◽  
Tiffany Gooden ◽  
Neil Thomas ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Prescription Data ◽  
Interrupted Time Series Analysis ◽  
Electronic Health Record Data ◽  
Series Analysis

Background The effect of fasting on immunity is unclear. Prolonged fasting is thought to increase the risk of infection due to dehydration. This study describes antibiotic prescribing patterns before, during, and after Ramadan in a primary care setting within the Pakistani and Bangladeshi populations in the UK, most of whom are Muslims, compared to those who do not observe Ramadan. Method Retrospective controlled interrupted time series analysis of electronic health record data from primary care practices. The study consists of two groups: Pakistanis/Bangladeshis and white populations. For each group, we constructed a series of aggregated, daily prescription data from 2007 to 2017 for the 30 days preceding, during, and after Ramadan, respectively. Findings Controlling for the rate in the white population, there was no evidence of increased antibiotic prescription in the Pakistani/Bangladeshi population during Ramadan, as compared to before Ramadan (IRR: 0.994; 95% CI: 0.988–1.001, p = 0.082) or after Ramadan (IRR: 1.006; 95% CI: 0.999–1.013, p = 0.082). Interpretation In this large, population-based study, we did not find any evidence to suggest that fasting was associated with an increased susceptibility to infection.

scholarly journals Antimicrobial stewardship during the COVID-19 epidemic: population-based cohort study and interrupted time series analysis in the United Kingdom

2021 ◽  
pp. BJGP.2020.1051
Author(s):  
Emma Rezel-Potts ◽  
Veline L'Esperance ◽  
Martin Gullifiord
Keyword(s):  
Time Series ◽  
Cohort Study ◽  
Time Series Analysis ◽  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Population Based ◽  
Antibiotic Prescribing ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Tract Infections

Background. The COVID-19 pandemic has altered the context for antimicrobial stewardship in primary care. Aim: To assess the effect of the pandemic on antibiotic prescribing, accounting for changes in consultations for respiratory and urinary tract infections (RTIs/UTIs). Design and Setting: Population-based cohort study using the UK Clinical Practice Research Datalink (CPRD) (January 2017 to September 2020). Method: Interrupted time series analysis evaluated changes in antibiotic prescribing and RTI/UTI consultations adjusting for age, gender, season and secular trends. We assessed the proportion of COVID-19 episodes associated with antibiotic prescribing. Results: There were 253,655 registered patients in 2017 and 232,218 in 2020 with 559,461 antibiotic prescriptions, 216,110 RTI consultations and 36,402 UTI consultations. Compared to pre-pandemic months, March 2020 was associated with higher prescribing (adjusted rate ratio 1.13; 95% confidence interval 1.11 to 1.16). Prescribing fell below predicted rates between April and August 2020, reaching a minimum in May (0.73, 0.71 to 0.75). Pandemic months were associated with lower rates of RTI/UTI consultations, particularly in April for RTIs (0.23; 0.22 to 0.25). There were small reductions in the proportion of RTI consultations with antibiotic prescribed and no reduction for UTIs. Among 25,889 COVID-19 patients, 2,942 (11%) had antibiotics within a COVID-19 episode. Conclusion: Pandemic months were initially associated with increased antibiotic prescribing which then fell below expected levels during the national lockdown. Findings are reassuring that antibiotic stewardship priorities have not been neglected due to COVID-19. Research is required into the effects of reduced RTI/UTI consultations on incidence of serious bacterial infection.

scholarly journals COVID-19 and Antibiotic Prescribing in Pediatric Primary Care

PEDIATRICS ◽  
2022 ◽  
Author(s):  
Lauren Dutcher ◽  
Yun Li ◽  
Giyoung Lee ◽  
Robert Grundmeier ◽  
Keith W. Hamilton ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
The United States ◽  
Pediatric Primary Care ◽  
Antibiotic Prescribing ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
The Impact

BACKGROUND AND OBJECTIVES: With the onset of the coronavirus disease 2019 (COVID-19) pandemic, pediatric ambulatory encounter volume and antibiotic prescribing both decreased; however, the durability of these reductions in pediatric primary care in the United States has not been assessed. METHODS: We conducted a retrospective observational study to assess the impact of the COVID-19 pandemic and associated public health measures on antibiotic prescribing in 27 pediatric primary care practices. Encounters from January 1, 2018, through June 30, 2021, were included. The primary outcome was monthly antibiotic prescriptions per 1000 patients. Interrupted time series analysis was performed. RESULTS: There were 69 327 total antibiotic prescriptions from April through December in 2019 and 18 935 antibiotic prescriptions during the same months in 2020, a 72.7% reduction. The reduction in prescriptions at visits for respiratory tract infection (RTI) accounted for 87.3% of this decrease. Using interrupted time series analysis, overall antibiotic prescriptions decreased from 31.6 to 6.4 prescriptions per 1000 patients in April 2020 (difference of −25.2 prescriptions per 1000 patients; 95% CI: −32.9 to −17.5). This was followed by a nonsignificant monthly increase in antibiotic prescriptions, with prescribing beginning to rebound from April to June 2021. Encounter volume also immediately decreased, and while overall encounter volume quickly started to recover, RTI encounter volume returned more slowly. CONCLUSIONS: Reductions in antibiotic prescribing in pediatric primary care during the COVID-19 pandemic were sustained, only beginning to rise in 2021, primarily driven by reductions in RTI encounters. Reductions in viral RTI transmission likely played a substantial role in reduced RTI visits and antibiotic prescriptions.

scholarly journals Community-based testing of migrants for infectious diseases (COMBAT-ID): impact, acceptability and cost-effectiveness of identifying infectious diseases among migrants in primary care: protocol for an interrupted time-series, qualitative and health economic analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e029188 ◽  
Author(s):  
Manish Pareek ◽  
Helen C Eborall ◽  
Fatimah Wobi ◽  
Kate S Ellis ◽  
Evangelos Kontopantelis ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Cost Effectiveness ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Infectious Diseases ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Series Analysis

BackgroundMigration is a major global driver of population change. Certain migrants may be at increased risk of infectious diseases, including tuberculosis (TB), HIV, hepatitis B and hepatitis C, and have poorer outcomes. Early diagnosis and management of these infections can reduce morbidity, mortality and onward transmission and is supported by national guidelines. To date, screening initiatives have been sporadic and focused on individual diseases; systematic routine testing of migrant groups for multiple infections is rarely undertaken and its impact is unknown. We describe the protocol for the evaluation of acceptability, effectiveness and cost-effectiveness of an integrated approach to screening migrants for a range of infectious diseases in primary care.Methods and analysisWe will conduct a mixed-methods study which includes an observational cohort with interrupted time-series analysis before and after the introduction of routine screening of migrants for infectious diseases (latent TB, HIV, hepatitis B and hepatitis C) when first registering with primary care within Leicester, UK. We will assess trends in the monthly number and rate of testing and diagnosis for latent TB, HIV, hepatitis B and hepatitis C to determine the effect of the policy change using segmented regression analyses at monthly time-points. Concurrently, we will undertake an integrated qualitative sub-study to understand the views of migrants and healthcare professionals to the new testing policy in primary care. Finally, we will evaluate the cost-effectiveness of combined infection testing for migrants in primary care.Ethics and disseminationThe study has received HRA and NHS approvals for both the interrupted time-series analysis (16/SC/0127) and the qualitative sub-study (16/EM/0159). For the interrupted time-series analysis we will only use fully anonymised data. For the qualitative sub-study, we will gain written, informed, consent. Dissemination of the results will be through local and national meetings/conferences as well as publications in peer-reviewed journals.

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