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...
| Publicado en: | Respiratory Care Vol. 59; no. 12; pp. 1918 - 1924 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Dec2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103922999&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103922999 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Dec2014 vid: 59 iid: 12 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 103922999 99763496 10.4187/respcare.03275 NLM25468986 103922999 ppf: 1918 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Access to Point-of-Care Tests Reduces the Prescription of Antibiotics Among Antibiotic-Requesting Subjects With Respiratory Tract Infections. aug: 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 refInfo: holdings: @attributes: islocal: N |
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