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.

scholarly journals Community-based testing of migrants for infectious diseases in the UK (COMBAT-ID)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Pareek
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Infectious Diseases ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Latent Tb

Abstract Background Migration 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 analysis We 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 dissemination The 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.

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 Mental health impacts of flooding: a controlled interrupted time series analysis of prescribing data in England

2017 ◽  
Vol 71 (10) ◽  
pp. 970-973 ◽  
Author(s):  
Ai Milojevic ◽  
Ben Armstrong ◽  
Paul Wilkinson
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Time Series Analysis ◽  
Antidepressant Drugs ◽  
Interrupted Time Series ◽  
Well Being ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Care Practices ◽  
Primary Care Practices

BackgroundThere is emerging evidence that people affected by flooding suffer adverse impacts on their mental well-being, mostly based on self-reports.MethodsWe examined prescription records for drugs used in the management of common mental disorder among primary care practices located in the vicinity of recent large flood events in England, 2011–2014. A controlled interrupted time series analysis was conducted of the number of prescribing items for antidepressant drugs in the year before and after the flood onset. Pre–post changes were compared by distance of the practice from the inundated boundaries among 930 practices located within 10 km of a flood.ResultsAfter control for deprivation and population density, there was an increase of 0.59% (95% CI 0.24 to 0.94) prescriptions in the postflood year among practices located within 1 km of a flood over and above the change observed in the furthest distance band. The increase was greater in more deprived areas.ConclusionsThis study suggests an increase in prescribed antidepressant drugs in the year after flooding in primary care practices close to recent major floods in England. The degree to which the increase is actually concentrated in those flooded can only be determined by more detailed linkage studies.

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 Impact of guidance publication on primary care prescribing rates of simple analgesia: an interrupted time series analysis in England

2020 ◽  
pp. bjgp20X714101
Author(s):  
Hannah Reichel ◽  
Rhian Stanbrook ◽  
Hans Johnson ◽  
William Proto ◽  
Mary Shantikumar ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Time Series Analysis ◽  
Health Inequality ◽  
Implementation Intentions ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Practice Level ◽  
Series Analysis ◽  
The Impact

Abstract Background: In March 2018, NHS England published guidance for Clinical Commissioning Groups (CCGs; NHS bodies that commission health services for local areas) to encourage implementation of policy to reduce primary care prescriptions of over-the-counter medications, including simple analgesia. Aims: To investigate: the impact of guidance publication on prescribing rates of simple analgesia (oral paracetamol, oral ibuprofen and topical non-steroidal anti-inflammatory drugs [NSAIDS]) in primary care; CCG implementation intentions; and whether it has created a health inequality based on socioeconomic status. Design and Setting: Interrupted time series analysis of primary care prescribing data in England. Methods: Practice-level prescribing data from January 2015 to March 2019 were obtained from NHS Digital. Interrupted time series analyses assessed the association of guidance publication with prescribing rates. The association between practice-level prescribing rates and Index of Multiple Deprivation score (a marker of socioeconomic deprivation) before and after publication was quantified using multivariable Poisson regression. Freedom of information requests were submitted to all CCGs. Results: There was a 4% reduction in prescribing of simple analgesia following guidance publication (adjusted incidence rate ratio [aIRR] 0.96, 95% CI 0.92-0.99, p=0.027), adjusting for underlying time trend and seasonality. Practice-level prescribing rates were greater in more deprived areas. There was considerable diversity across CCGs in whether or how they chose to implement the guidance. Conclusion: Guidance publication was associated with a small reduction in the prescribing rates of simple analgesia across England, without evidence of creating an additional health inequality.

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