Breaking News
May 24, 2018 - Tau mutations may serve as novel risk factor for cancer
May 24, 2018 - Sun Pharma Announces FDA Approval of Yonsa (abiraterone acetate) to Treat Metastatic Castration-Resistant Prostate Cancer
May 24, 2018 - Nurse dead in Congo as Ebola vaccination campaign starts
May 24, 2018 - Unique imaging technique identifies biomarkers of cellular damage done by diabetic retinopathy
May 24, 2018 - Study identifies key food allergy policies that parents want in schools to improve safety of kids
May 24, 2018 - Formaldehyde risk found to be higher in e-cigarettes than originally thought
May 24, 2018 - NIH commences first-in-human trial evaluating experimental treatment for Ebola
May 24, 2018 - Study finds no link between surveillance intensity and detection of recurrence or survival in CRC patients
May 24, 2018 - FDA Alert: Oral Over-the-Counter Benzocaine Products: Drug Safety Communication
May 24, 2018 - Fiber-fermenting bacteria improve health of type 2 diabetes patients
May 24, 2018 - Higher exposure to carbon monoxide in utero increases risk of poor lung function in infants
May 24, 2018 - Neurologists identify new type of vertigo
May 24, 2018 - Scientists identify new inherited neurodevelopmental disease
May 24, 2018 - New family support program improves patient-centered care and lowers hospitalization costs
May 24, 2018 - Researchers take important step toward finding protein biomarkers during cancer surgery
May 24, 2018 - Deadly form of black lung disease found to be increasing among U.S. coal miners
May 24, 2018 - Robust Immune Responses for Herpes Zoster Subunit Vaccine
May 24, 2018 - Optical Coherence Tomography | Texas Heart Institute
May 24, 2018 - Type 2 diabetes slowly rising in Auckland kids – Pacific and Māori have highest rates
May 24, 2018 - Study explores brain chemistry of alcohol exposure in people with family history of AUD
May 24, 2018 - Study shows AVATS procedure as safe, effective alternative for patients deemed ‘inoperable’
May 24, 2018 - Comparative Analysis of a Complex Monoclonal Antibody
May 24, 2018 - Penn investigators discover source of immune molecule involved in nasal polyps, asthma
May 24, 2018 - Berries and Grapes May Keep You Breathin’ Easy
May 24, 2018 - Access and utilization of dental services for Medicaid children 2013-2015
May 23, 2018 - New research raises concern about rate of postpartum hemorrhage
May 23, 2018 - Researchers create new modeling framework that takes a zoonotic perspective on Ebola
May 23, 2018 - Study compares bacteria in humans to the laboratory
May 23, 2018 - Frequent sauna bathing reduces risk of stroke
May 23, 2018 - Landmark trial to test implantable defibrillator in diabetic patients with history of heart attack
May 23, 2018 - Vitamin C consumption may reduce harm to baby’s lungs due to smoking during pregnancy
May 23, 2018 - Researchers complete genomic map of chronic lymphocytic leukemia
May 23, 2018 - Medical students take to the streets to learn about real world problems at the root of poor health
May 23, 2018 - New efforts to curb high blood pressure in Asia
May 23, 2018 - Malaria-causing parasite seeks refuge inside the liver to replicate and survive
May 23, 2018 - Slower rates of stimulation may be more effective in brain therapy, suggests research
May 23, 2018 - Study finds connection between one partner’s BMI and other spouse’s risk of developing diabetes
May 23, 2018 - Mapping the Genes Responsible for Pluripotency
May 23, 2018 - FDA Alert: Homeopathic Teething Drops, Nausea Drops, Intestinal Colic Drops, Stomach Calm, Expectorant Cough Syrup, Silver-Zinc Throat Spray, and Argentum Elixir by MBI Distributing: Recall
May 23, 2018 - Genetic fixer-uppers may predict bladder cancer prognosis
May 23, 2018 - Investigational technology could increase donor organ supply for lung transplants
May 23, 2018 - Prediabetic patients with OSA could lower their resting heart rates by using CPAP
May 23, 2018 - Schizophrenics’ blood samples feature genetic material from more types of microorganisms
May 23, 2018 - Subtle hearing deficits can change the brains of young people
May 23, 2018 - New study shows increased rates of hospitalization for suicide among youths
May 23, 2018 - Proportion of Drug-Intoxicated Organ Donors on the Rise in U.S.
May 23, 2018 - Using virtual biopsies to improve melanoma detection
May 23, 2018 - Compassion meditation training may increase brain’s resilience to suffering of other people
May 23, 2018 - New AAD PSA uses social media imagery to highlight tanning hazards
May 23, 2018 - Frequent MRSA surveillance could contain infection in newborns, study finds
May 23, 2018 - Medicaid expansion linked to reduction in ICU utilization
May 23, 2018 - Proteins moderating nicotine dependence may help fat cells burn energy
May 23, 2018 - Researchers identify mechanisms that regulate mammary gland development
May 23, 2018 - ‘Low-Alcohol’ Booze Labels May Backfire
May 23, 2018 - Social isolation could increase risk of death, hospitalizations for heart failure patients
May 23, 2018 - New research shows that children with autism are able to create imaginary friends
May 23, 2018 - New technology could make prosthetic use more intuitive and reliable
May 23, 2018 - HU researchers explore how simulated microgravity affects gene expression, muscle cell differentiation
May 23, 2018 - Researchers develop injectable bandage to stop fatal blood loss, activate wound healing
May 23, 2018 - Exercising for 4-5 days per week is needed to keep the heart young
May 23, 2018 - Porvair Sciences offers wide range of reagent reservoirs for use with automated liquid handling systems
May 23, 2018 - New study unravels secrets of HIV’s persistence
May 23, 2018 - IDF launches initiative to improve health services for displaced people with diabetes
May 23, 2018 - Maintaining healthy weight between early adulthood and middle age could help avoid diabetes
May 23, 2018 - DNA vaccine shows promise for colorectal cancer
May 23, 2018 - Abnormal brain connections seen in preschoolers with autism
May 23, 2018 - Study finds increase in number of calls to US Poison Control Centers about ADHD medication exposures
May 23, 2018 - Yoghurt before a meal packed with health benefits
May 23, 2018 - New tool predicts the lifetime risk of Alzheimer’s
May 23, 2018 - Scientists reveal mechanisms that may help preterm infants extend nephron development window
May 23, 2018 - Unnecessary antibiotic use for asthma exacerbations linked to increased hospital stays, costs
May 23, 2018 - Quitting cigarettes linked to better lung health than long-term light smoking
May 23, 2018 - Researchers shed light on how androgen deprivation therapy increases risk for cardiovascular mortality
May 23, 2018 - Ingesting blue dye tablet during colonoscopy aids in detecting difficult-to-see polyps
May 23, 2018 - Patients with low-back pain benefit from early physical therapy
May 23, 2018 - Researchers discover link between tuberculosis and Parkinson’s disease
May 23, 2018 - FDA Approves Doptelet (avatrombopag) for Chronic Liver Disease Patients with Thrombocytopenia who are Undergoing a Medical Procedure
May 23, 2018 - Is knee pain linked to depression?
May 23, 2018 - Research team uncovers new information that more accurately explains formation of tumors
May 23, 2018 - Brain stimulation shows promise in treating obesity by reducing food cravings
Inappropriate antibiotic prescribing linked to patient’s age and race, study shows

Inappropriate antibiotic prescribing linked to patient’s age and race, study shows

image_pdfDownload PDFimage_print

A patient’s age and race are associated with risk of receiving an unneeded antibiotic prescription for upper respiratory conditions caused by viruses, according to a study published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. Additionally, the study found that advanced practice providers, such as nurse practitioners and physician assistants, are 15 percent more likely than physician providers to prescribe antibiotics to adults.

“By undertaking this research, we can help ensure that our local patients receive the most appropriate, safe care, and are not inappropriately prescribed antibiotics,” said Lisa Davidson, MD, an author of the study and medical director for the Antimicrobial Support Network at Carolinas HealthCare System. “These results also show that strategies to reduce inappropriate prescribing must be tailored for outpatient settings. At Carolinas HealthCare System, we’ve equipped our outpatient providers with scripts and educational materials to help guide conversations with patients about antibiotics. We’ve also given them checklists for over-the-counter medicines, which they can recommend to patients who have viral symptoms.”

The researchers reviewed prescribing patterns of 281,315 adult and pediatric patients seen across 898 providers and 246 outpatient practices at Carolinas HealthCare System, based in Charlotte, North Carolina. These patients were treated between January 1, 2014, and May 31, 2016, for four common conditions that do not routinely require antibiotics: viral upper respiratory infection, bronchitis, sinusitis, and non-suppurative otitis (uninfected fluid in the middle ear).

Key findings of the study include:

  • Acute bronchitis was the most common indication for which an antibiotic was potentially prescribed inappropriately.
  • The risk of receiving an antibiotic at a visit was higher for adult patients aged 40-64. Prescribing rates declined for adults older than age 64.
  • White adult and pediatric patients, as well as adult patients with commercial insurance, were more likely to receive inappropriate antibiotic treatment for these viral illnesses.
  • After adjusting for patient and practice factors, advanced practice providers were 15 percent more likely to prescribe an antibiotic than physician providers for adult patients.
  • The age of the providers was also significantly associated with higher levels of antibiotic prescriptions for these illnesses, increasing as providers aged, up to 61.
  • Family medicine practices had the highest rate of prescribing, while pediatric practices had the lowest.
  • Pediatric practices were 16 percent less likely to prescribe an antibiotic compared to urgent care practices.
  • For adults seen in a metropolitan area, the risk of receiving an antibiotic was 36 percent greater than those seen in rural practices.

As a result of these findings, researchers recommended tailoring interventions to specific settings of care, provider types, and patient characteristics, which could be more effective in improving appropriate prescribing and ultimately reducing antibiotic resistance. Additionally, they suggest that future national stewardship efforts should target education and antimicrobial stewardship interventions for advanced practice providers, as their role continues to grow. Detailed results indicate that patient and provider education, specifically on appropriate prescribing for bronchitis that includes guidance on correct use of azithromycin, may be particularly effective. To further reduce unnecessary prescribing, researchers cited a need for in-depth qualitative research to understand the interactions between patients and providers that may influence prescribing for viral illnesses.

“Understanding the factors that impact prescribing is critical to determining how to reduce the misuse of antibiotics,” said Melanie Spencer, PhD, executive director of Carolinas HealthCare System’s Center for Outcomes Research and Evaluation. “Our findings demonstrate that variation in prescribing patterns exists and is associated with several patient, practice, and provider characteristics.”

Data for the study was pulled from electronic health records to analyze patient, provider, and practice factors. Patient factors included indication for the visit, age, race, gender, health of the patient, and the average number of visits per patient. Providers’ prescribing patterns were reviewed by age and type of provider, such as advanced practice providers, and physicians holding a medical doctor or doctor of osteopath degree. Practice characteristics included practice type, rural versus urban setting, and year of visit.

The authors note several study limitations, including the use of administrative billing data to identify visits (visit-level data from the electronic health records was used in the analysis) and the health system’s geographic footprint in the Southeastern United States, which is well-documented to have the highest prescribing rates in the US.

Source:

http://shea-online.org/index.php/journal-news/press-room/press-release-archives/567-study-shows-inappropriate-antibiotic-prescribing-differs-by-patient-age-insurance-and-race

Tagged with:

About author

Related Articles