An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England.
Antibiotics
Deprivation
General practice
Health inequality
Prescribing
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
03 Aug 2020
03 Aug 2020
Historique:
received:
13
12
2019
accepted:
08
07
2020
entrez:
4
8
2020
pubmed:
4
8
2020
medline:
15
12
2020
Statut:
epublish
Résumé
Internationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends - particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England. Antibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014-2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity. Over time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU - a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences - with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU). Although antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England - with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised.
Sections du résumé
BACKGROUND
BACKGROUND
Internationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends - particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England.
METHODS
METHODS
Antibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014-2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity.
RESULTS
RESULTS
Over time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU - a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences - with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU).
CONCLUSION
CONCLUSIONS
Although antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England - with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised.
Identifiants
pubmed: 32741362
doi: 10.1186/s12889-020-09227-x
pii: 10.1186/s12889-020-09227-x
pmc: PMC7397662
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1148Subventions
Organisme : Medical Research Council
ID : MR/K02325X/1
Pays : United Kingdom
Organisme : Fuse
ID : MR/K02325X/1
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