scholarly journals Relationship between prescribing of antibiotics and other medicines in primary care: a cross-sectional study

2018 ◽  
Vol 69 (678) ◽  
pp. e42-e51 ◽  
Author(s):  
Yan Li ◽  
Anna Mölter ◽  
Andrew White ◽  
William Welfare ◽  
Victoria Palin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
General Practices ◽  
The Uk

BackgroundHigh levels of antibiotic prescribing are a major concern as they drive antimicrobial resistance. It is currently unknown whether practices that prescribe higher levels of antibiotics also prescribe more medicines in general.AimTo evaluate the relationship between antibiotic and general prescribing levels in primary care.Design and settingCross-sectional study in 2014–2015 of 6517 general practices in England using NHS digital practice prescribing data (NHS-DPPD) for the main study, and of 587 general practices in the UK using the Clinical Practice Research Datalink for a replication study.MethodLinear regression to assess determinants of antibiotic prescribing.ResultsNHS-DPPD practices prescribed an average of 576.1 antibiotics per 1000 patients per year (329.9 at the 5th percentile and 808.7 at the 95th percentile). The levels of prescribing of antibiotics and other medicines were strongly correlated. Practices with high levels of prescribing of other medicines (a rate of 27 159.8 at the 95th percentile) prescribed 80% more antibiotics than low-prescribing practices (rate of 8815.9 at the 5th percentile). After adjustment, NHS-DPPD practices with high prescribing of other medicines gave 60% more antibiotic prescriptions than low-prescribing practices (corresponding to higher prescribing of 276.3 antibiotics per 1000 patients per year). Prescribing of non-opioid painkillers and benzodiazepines were also strong indicators of the level of antibiotic prescribing. General prescribing levels were a much stronger driver for antibiotic prescribing than other risk factors, such as deprivation.ConclusionThe propensity of GPs to prescribe medications generally is an important driver for antibiotic prescribing. Interventions that aim to optimise antibiotic prescribing will need to target general prescribing behaviours, in addition to specifically targeting antibiotics.

scholarly journals Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Nebyu Daniel Amaha ◽  
Dawit G. Weldemariam ◽  
Nuru Abdu ◽  
Eyasu H. Tesfamariam
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Essential Medicines ◽  
Community Pharmacies ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Factors Affecting

Abstract Background Antibiotics require more prudent prescribing, dispensing and administration than other medicines because these medicines are at a greater risk of antimicrobial resistance (AMR). Studying the current medicine use practices and factors affecting the prescribing of an antibiotic would help decision makers to draft policies that would enable a more rational use of medicines. Methods A prospective, descriptive, and cross-sectional study was conducted to assess the current prescribing practices including antibiotics use in six community pharmacies in Asmara. A total of 600 encounters were reviewed using the WHO core prescribing indicators between May 5 and May 12, 2019 using stratified random sampling technique. Descriptive statistics and logistic regression were employed using IBM SPSS® (version 22). Results The average number of medicines per prescription was 1.76 and 83.14% of the medicines were prescribed using generic names while 98.39% of the medicines were from the National Essential Medicines List (NEML). The percentage of prescriptions containing antibiotics was 53%. The number of encounters containing injections was 7.8%. Patient age, gender and number of medicines prescribed were significantly associated with antibiotic prescribing at bivariate and multivariable models. Subjects under the age of 15 were approximately three times more likely to be prescribed antibiotic compared to subjects whose age is 65 and above (Adjusted Odds Ratio (AOR): 2.93, 95%CI: 1.71–5). Similarly, males were more likely to be prescribed antibiotic than females (AOR: 1.57, 95%CI: 1.10–2.24). Subjects to whom three to four medicines prescribed were two times more likely to be prescribed an antibiotic compared to those who were to be prescribed one to two medicines per encounter (AOR: 2.17, 95%CI: 1.35–3.5). A one-unit increase in the number of medicines increased the odds of antibiotic prescribing increased by 2.02 units (COR: 2.02; 95%CI: 1.62–2.52). Conclusions This study found that the percentage of antibiotics being prescribed at the community pharmacies in Asmara was 53% which deviated significantly from the WHO recommended values (20–26.8%). Furthermore, the percentage of encounters with an injection was 7.8% lower than the WHO value of 13.4–24.0%. Patients’ age, gender and number of medicines were significantly associated with antibiotic prescribing.

scholarly journals Appropriateness of Antibiotic Prescribing for Acute Sinusitis in Primary Care: A Cross-sectional Study

2020 ◽  
Author(s):  
Katie N Truitt ◽  
Tiffany Brown ◽  
Ji Young Lee ◽  
Jeffrey A Linder
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Acute Sinusitis ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Abstract The proportion of sinusitis visits that meet antibiotic prescribing criteria is unknown. Of 425 randomly selected sinusitis visits, 50% (214) met antibiotic prescribing criteria. There was no significant difference in antibiotic prescribing at visits that did (205/214 [96%]) and did not (193/211 [92%]; P = .07) meet antibiotic prescribing criteria.

scholarly journals Association between Physicians’ Perception of Shared Decision Making with Antibiotic Prescribing Behavior in Primary Care in Hubei, China: A Cross-Sectional Study

Antibiotics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 876
Author(s):  
Dan Wang ◽  
Chenxi Liu ◽  
Xuemei Wang ◽  
Xinping Zhang
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Positive Perception ◽  
Cross Sectional ◽  
Prescribing Behavior ◽  
Physician Patient ◽  
The Relationship ◽  
Over 40 Years

Shared decision-making (SDM) has been advocated as one effective strategy for improving physician–patient relationships and optimizing clinical outcomes. Our study aimed to measure physicians’ perception of SDM and establish the relationship between physicians’ perception of SDM and prescribing behavior in patients with upper respiratory tract infections. One cross-sectional study was conducted in Hubei Province from December 2019 to January 2020. The SDM questionnaire and prescription data of 2018 from electronic health records data were matched for each physician in this study. Multilevel modeling was applied to explore the relationship between physicians’ perception of SDM and antibiotic prescribing in primary care. Analyses were statistically controlled for demographic characteristics of the physicians and patients. Physicians’ positive perception of SDM had small but statistically significant effects on lower prescribing of antibiotics in the patient group aged over 40 years (odds ratio (OR) < 1; p < 0.05). Moreover, female physicians (OR = 0.71; p = 0.007) with higher educational levels (bachelor’s degree and above; OR = 0.71; p = 0.024) were significantly associated with the prescribing of less antibiotics (p < 0.05). A more positive perception of SDM was demonstrated as one significant predictor of less prescribing of antibiotics in the patient group over 40 years. There may be a promising focus of implementing SDM strategies targeting physician–patient communication in primary care.

scholarly journals Examining variations in prescribing safety in UK general practice: cross sectional study using the Clinical Practice Research Datalink

BMJ ◽  
2015 ◽  
pp. h5501 ◽  
Author(s):  
S Jill Stocks ◽  
Evangelos Kontopantelis ◽  
Artur Akbarov ◽  
Sarah Rodgers ◽  
Anthony J Avery ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Practice ◽  
Cross Sectional Study ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Drug Use Evaluation of Crystalline Penicillin in Pediatrics Ward of Dessie Referral Hospital, North East Ethiopia: A Hospital Based Cross Sectional Study

2020 ◽  
Author(s):  
Taklo Simeneh Yazie ◽  
Ayalneh Gedif Tessema
Keyword(s):  
Drug Interaction ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
North East ◽  
Significant Difference ◽  
Dessie Referral Hospital

Background: Antibiotic resistance is a worldwide issue due to rise of antibiotic consumption and wide variation in antibiotic prescribing practices. Crystalline penicillin is the most highly consumed antibiotics by hospitalized pediatrics patients in Dessie Referral Hospital and its utilization pattern is not known in the study area. The objective is to assess the appropriateness of crystalline penicillin use in pediatrics ward of Dessie Referral Hospital, Northeast Ethiopia. Methods: A hospital based cross-sectional study was used for evaluating medication records of hospitalized pediatric patients who received crystalline penicillin from October to December 2018. Results: A total of 262 hospitalized pediatrics patient records were included in the study. All the 262 (100%) cases were consistent with guidelines for contraindication and drug interaction to use the drug. Crystalline penicillin use was consistent with guideline recommendations in 93.8%, 92.8%, 89.6%, 66.7% and 39.4% of the cases with regard to, indication, outcome, frequency, dose and duration of treatment, respectively. The observed value of all drug utilization evaluation parameters except drug interaction and contraindication showed statistically significant difference from the set threshold in nonparametric binomial test. Conclusion: The result of the current study especially with regard to dose and duration is much below the recommended threshold and needs scheduled trainings and necessary interventions to tackle the problem.

scholarly journals Antibiotic prescribing in care homes in the UK, 2016–17: a cross-sectional study of linked data

The Lancet ◽  
2019 ◽  
Vol 394 ◽  
pp. S6
Author(s):  
Catherine M Smith ◽  
Haydn Williams ◽  
Andrew Normington ◽  
Andrew C Hayward ◽  
Laura J Shallcross
Keyword(s):  
Linked Data ◽  
Cross Sectional Study ◽  
Care Homes ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Uk

scholarly journals Disease burden of diabetes, diabetic retinopathy and their future projections in the UK: cross-sectional analyses of a primary care database

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050058
Author(s):  
Sajjad Haider ◽  
Rasiah Thayakaran ◽  
Anuradha Subramanian ◽  
Konstantinos A Toulis ◽  
David Moore ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Disease Burden ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Future Projections ◽  
Primary Care Database ◽  
The Uk ◽  
Care Database

ObjectivesTo estimate the current disease burden, trends and future projections for diabetes mellitus (DM) and diabetic retinopathy (DR) in the IQVIA Medical Research Data (IMRD).Participants/design/settingWe performed a cross-sectional study of patients aged 12 and above to determine the prevalence of DM and DR from the IMRD database (primary care database) in January 2017, involving a total population of 1 80 824 patients with DM. We also carried out a series of cross-sectional studies to investigate prevalence trends, and then applied a double exponential smoothing model to forecast the future burden of DM and DR in the UK.ResultsThe crude DM prevalence in 2017 was 5.2%. The DR, sight-threatening retinopathy (STR) and diabetic maculopathy prevalence figures in 2017 were 33.78%, 12.28% and 7.86%, respectively, in our IMRD cross-sectional study. There were upward trends in the prevalence of DM, DR and STR, most marked and accelerating in STR in type 1 DM but slowing in type 2 DM, and in the overall prevalence of DR.ConclusionOur results suggest differential rising trends in the prevalence of DM and DR. Preventive strategies, as well as treatment services planning, can be based on these projected prevalence estimates. Improvements that are necessary for the optimisation of care pathways, and preparations to meet demand and capacity challenges, can also be based on this information. The limitations of the study can be overcome by a future collaborative study linking DR screening and hospital eye services data.

scholarly journals Gambling problems among patients in primary care: a cross-sectional study of general practices

2017 ◽  
Vol 67 (657) ◽  
pp. e274-e279 ◽  
Author(s):  
Sean Cowlishaw ◽  
Lone Gale ◽  
Alison Gregory ◽  
Jim McCambridge ◽  
David Kessler
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Problem Gambling ◽  
Family Members ◽  
Cross Sectional Study ◽  
Gambling Problems ◽  
Sectional Study ◽  
Cross Sectional ◽  
Risky Alcohol ◽  
General Practices

BackgroundPrimary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems.AimTo indicate the extent of gambling problems among patients attending general practices, and explore settings or patient groups that experience heightened vulnerability.Design and settingCross-sectional study of patients attending 11 general practices in Bristol, South West England.MethodAdult patients (n= 1058) were recruited from waiting rooms of practices that were sampled on the basis of population characteristics. Patients completed anonymous questionnaires comprising measures of mental health problems (for example, depression) and addictive behaviours (for example, risky alcohol use). The Problem Gambling Severity Index (PGSI) measured gambling problems, along with a single-item measure of gambling problems among family members. Estimates of extent and variability according to practice and patient characteristics were produced.ResultsThere were 0.9% of all patients exhibiting problem gambling (PGSI ≥5), and 4.3% reporting problems that were low to moderate in severity (PGSI 1–4). Around 7% of patients reported gambling problems among family members. Further analyses indicated that rates of any gambling problems (PGSI ≥1) were higher among males and young adults, and more tentatively, within a student healthcare setting. They were also elevated among patients exhibiting drug use, risky alcohol use, and depression.ConclusionThere is need for improved understanding of the burden of, and responses to, patients with gambling problems in general practices, and new strategies to increase identification to facilitate improved care and early intervention.

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