Explaining variation in antibiotic prescribing between general practices in the UK

The Journal of Antimicrobial Chemotherapy
Koen B PouwelsJulie V Robotham

Abstract

Primary care practices in England differ in antibiotic prescribing rates, and, anecdotally, prescribers justify high prescribing rates based on their individual case mix. The aim of this paper was to explore to what extent factors such as patient comorbidities explain this variation in antibiotic prescribing. Primary care consultation and prescribing data recorded in The Health Improvement Network (THIN) database in 2013 were used. Boosted regression trees (BRTs) and negative binomial regression (NBR) models were used to evaluate associations between predictors and antibiotic prescribing rates. The following variables were considered as potential predictors: various infection-related consultation rates, proportions of patients with comorbidities, proportion of patients with inhaled/systemic corticosteroids or immunosuppressive drugs, and demographic traits. The median antibiotic prescribing rate was 65.6 (IQR 57.4-74.0) per 100 registered patients among 348 English practices. In the BRT model, consultation rates had the largest total relative influence on antibiotic prescribing rate (53.5%), followed by steroid and immunosuppressive drugs (31.6%) and comorbidities (12.2%). Only 21% of the deviance could be explained by an NBR m...Continue Reading

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Citations

Mar 1, 2018·The Journal of Antimicrobial Chemotherapy·Timo SmieszekJulie V Robotham
Mar 1, 2018·The Journal of Antimicrobial Chemotherapy·Koen B PouwelsTimo Smieszek
Apr 20, 2019·The Journal of Antimicrobial Chemotherapy·Kevin L SchwartzGary Garber
May 1, 2019·The Journal of Antimicrobial Chemotherapy·Victoria PalinTjeerd van Staa
Sep 20, 2020·Antibiotics·Liz Morrell On Behalf Of The Stepup Team
Oct 23, 2019·The Journal of Antimicrobial Chemotherapy·Beth StuartPaul Little
Aug 29, 2020·BMC Family Practice·Jonas K OlsenMerethe K Andersen
Mar 1, 2018·The Journal of Antimicrobial Chemotherapy·Sally C Davies
Aug 21, 2019·The Journal of Antimicrobial Chemotherapy·Magdalena NowakowskaVictoria Palin
Dec 20, 2020·Pharmacology Research & Perspectives·Rocío Fernández-UrrusunoUNKNOWN Infectious Diseases SEFAP team
Mar 9, 2021·Applied Health Economics and Health Policy·James BuchananSarah Wordsworth
Jun 3, 2021·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Kathleen O DegnanUNKNOWN CDC Prevention Epicenters Program
Jan 7, 2022·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Aleksandra J BorekSarah Tonkin-Crine

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