Relationship between prescribing of antibiotics and other medicines in primary care: a cross-sectional study.
antibiotics
benzodiazepines
drug prescribing
general practice
non-antibiotics
non-opioid painkillers
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
11
05
2018
accepted:
13
07
2018
pubmed:
19
12
2018
medline:
3
1
2020
entrez:
19
12
2018
Statut:
ppublish
Résumé
High 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. To evaluate the relationship between antibiotic and general prescribing levels in primary care. Cross-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. Linear regression to assess determinants of antibiotic prescribing. NHS-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. The 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.
Sections du résumé
BACKGROUND
BACKGROUND
High 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.
AIM
OBJECTIVE
To evaluate the relationship between antibiotic and general prescribing levels in primary care.
DESIGN AND SETTING
METHODS
Cross-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.
METHOD
METHODS
Linear regression to assess determinants of antibiotic prescribing.
RESULTS
RESULTS
NHS-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.
CONCLUSION
CONCLUSIONS
The 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.
Identifiants
pubmed: 30559110
pii: bjgp18X700457
doi: 10.3399/bjgp18X700457
pmc: PMC6301355
doi:
Substances chimiques
Analgesics, Non-Narcotic
0
Anti-Bacterial Agents
0
Prescription Drugs
0
Benzodiazepines
12794-10-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e42-e51Informations de copyright
© British Journal of General Practice 2019.
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