Access to Point-of-Care Tests Reduces the Prescription of Antibiotics Among Antibiotic-Requesting Subjects With Respiratory Tract Infections.

BACKGROUND: General practitioners (GPs) often feel uncomfortable when patients request an antibiotic when there is likely little benefit. This study evaluates the effect of access to point-of-care tests on decreasing the prescription of antibiotics in respiratory tract infections in subjects who exp...

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Publicado en:Respiratory Care Vol. 59; no. 12; pp. 1918 - 1924
Autores principales: Llor, Carl, Bjerrum, Lars, Munck, Anders, Cots, Josep M., Hernández, Silvia, Moragas, Ana
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Dec2014
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Access to Point-of-Care Tests Reduces the Prescription of Antibiotics Among Antibiotic-Requesting Subjects With Respiratory Tract Infections.
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        au:
          Llor, Carl
          Bjerrum, Lars
          Munck, Anders
          Cots, Josep M.
          Hernández, Silvia
          Moragas, Ana
        affil: Institute of Primary Care and Public Health. School of Medicine, Cardiff University, Cardiff, Wales
      sug:
        subj:
          Respiratory Tract Infections Diagnosis
          Respiratory Tract Infections Drug Therapy
          Antibiotics Administration and Dosage
          Prescribing Patterns
          Human
          Spain
          Pretest-Posttest Design
          Descriptive Statistics
          Confidence Intervals
          Multiple Logistic Regression
          Male
          Female
          Adult
          Middle Age
          Aged
          Odds Ratio
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: BACKGROUND: General practitioners (GPs) often feel uncomfortable when patients request an antibiotic when there is likely little benefit. This study evaluates the effect of access to point-of-care tests on decreasing the prescription of antibiotics in respiratory tract infections in subjects who explicitly requested an antibiotic prescription. METHODS: Spanish GPs registered all cases of respiratory tract infections over a 3-week period before and after an intervention undertaken in 2008 and 2009. Patients with acute sinusitis, pneumonia, and exacerbations of COPD were excluded. Two types of interventions were performed: the full intervention group received prescriber feedback with discussion of the results of the first registry, courses for GPs, guidelines, patient information leaflets, workshops, and access to point-of-care tests (rapid streptococcal antigen detection test and C-reactive protein test); and the partial intervention group underwent all of the above interventions except for the workshop and access to point-of-care tests. RESULTS: A total of 210 GPs were assigned to the full intervention group and 71 to the partial intervention group. A total of 25,479 subjects with respiratory tract infections were included, of whom 344 (1.4%) requested antibiotic prescribing. Antibiotics were more frequently prescribed to subjects requesting them compared with those who did not (49.1% vs 18.5%, P < .001). In the group of GPs assigned to the partial intervention group, 53.1% of subjects requesting antibiotics received a prescription before and 60% after the intervention, without statistical differences being observed. In the group of GPs assigned to the full intervention group, the percentages were 55.1% and 36.2%, respectively, with a difference of 18.9% (95% CI: 6.4%–30.6%, P < .05). CONCLUSIONS: Access to point-of-care tests reduces antibiotic use in subjects who explicitly request an antibiotic prescription.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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