Use of delayed antibiotic prescription in primary care

One of several strategies developed to reduce inappropriate antibiotic use in situations where the indication is not clear is delayed antibiotic prescription (DAP), defined as an antibiotic prescription issued for the patient to take only in case of feeling worse or not feeling better several days a...

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Authors: Poza Abad, Mariam de la|||0000-0001-5993-1596, Mas Dalmau, Gemma|||0000-0003-3720-0797, Gich, Ignasi|||0000-0003-3975-6588, Martínez García, Laura|||0000-0003-0126-8706, Llor, Carl|||0000-0001-6644-717X, Alonso-Coello, Pablo|||0000-0002-8001-8504
Format: article
Publication Date:2019
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:253267
Online Access:https://ddd.uab.cat/record/253267
https://dx.doi.org/urn:doi:10.1186/s12875-019-0934-7
Access Level:Open access
Keyword:Delayed antibiotic prescription
Primary care
Survey
Infectious disease
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spelling Use of delayed antibiotic prescription in primary carea cross-sectional studyPoza Abad, Mariam de la|||0000-0001-5993-1596Mas Dalmau, Gemma|||0000-0003-3720-0797Gich, Ignasi|||0000-0003-3975-6588Martínez García, Laura|||0000-0003-0126-8706Llor, Carl|||0000-0001-6644-717XAlonso-Coello, Pablo|||0000-0002-8001-8504Delayed antibiotic prescriptionPrimary careSurveyInfectious diseaseOne of several strategies developed to reduce inappropriate antibiotic use in situations where the indication is not clear is delayed antibiotic prescription (DAP), defined as an antibiotic prescription issued for the patient to take only in case of feeling worse or not feeling better several days after the visit. We conducted a survey to identify DAP use in Spanish primary care settings. We surveyed 23 healthcare centers located in 4 autonomous regions where a randomized controlled trial (RCT) on DAP was underway. The primary variable was use of DAP. Categorical and quantitative variables were analyzed by means of the chi-squared test and non-parametric tests, respectively. The survey was sent to 375 healthcare professionals, 215 of whom responded (57.3% response rate), with 46% of these respondents declaring that they had used DAP in routine practice before the RCT started (66.6% afterwards), mostly (91.5%) for respiratory tract infections (RTIs), followed by urinary infections (45.1%). Regarding DAP use for RTIs, the most frequent conditions were pharyngotonsillitis (88.7%), acute bronchitis (62.7%), mild chronic obstructive pulmonary disease exacerbations (59.9%), sinusitis (51.4%), and acute otitis media (45.1%). Most respondents considered that DAP reduced emergency visits (85.4%), scheduled visits (79%) and inappropriate antibiotic use (73.7%) and most also perceived patients to be generally satisfied with the DAP approach (75.6%). Having participated or not in the DAP RCT (74.1% versus 46.2%; p < 0.001), having previously used or not used DAP (86.8% versus 44.2%; p < 0.001), and being a physician versus being a nurse (81.8% versus 18.2%; p < 0.001) were factors that reflected significantly higher rates of DAP use. The majority of primary healthcare professionals in Spain do not use DAP. Those who use DAP believe that it reduces primary care visits and inappropriate antibiotic use, while maintaining patient satisfaction. Given the limited use of DAP in our setting, and given that its use is mainly limited to RTIs, DAP has considerable potential in terms of its implementation in routine practice. The online version of this article (10.1186/s12875-019-0934-7) contains supplementary material, which is available to authorized users.Universitat Autònoma de Barcelona 22019-01-0120192019-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/253267https://dx.doi.org/urn:doi:10.1186/s12875-019-0934-7reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengInstituto de Salud Carlos III https://doi.org/10.13039/501100004587 CPII15/0034open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2532672026-06-06T12:50:31Z
dc.title.none.fl_str_mv Use of delayed antibiotic prescription in primary care
a cross-sectional study
title Use of delayed antibiotic prescription in primary care
spellingShingle Use of delayed antibiotic prescription in primary care
Poza Abad, Mariam de la|||0000-0001-5993-1596
Delayed antibiotic prescription
Primary care
Survey
Infectious disease
title_short Use of delayed antibiotic prescription in primary care
title_full Use of delayed antibiotic prescription in primary care
title_fullStr Use of delayed antibiotic prescription in primary care
title_full_unstemmed Use of delayed antibiotic prescription in primary care
title_sort Use of delayed antibiotic prescription in primary care
dc.creator.none.fl_str_mv Poza Abad, Mariam de la|||0000-0001-5993-1596
Mas Dalmau, Gemma|||0000-0003-3720-0797
Gich, Ignasi|||0000-0003-3975-6588
Martínez García, Laura|||0000-0003-0126-8706
Llor, Carl|||0000-0001-6644-717X
Alonso-Coello, Pablo|||0000-0002-8001-8504
author Poza Abad, Mariam de la|||0000-0001-5993-1596
author_facet Poza Abad, Mariam de la|||0000-0001-5993-1596
Mas Dalmau, Gemma|||0000-0003-3720-0797
Gich, Ignasi|||0000-0003-3975-6588
Martínez García, Laura|||0000-0003-0126-8706
Llor, Carl|||0000-0001-6644-717X
Alonso-Coello, Pablo|||0000-0002-8001-8504
author_role author
author2 Mas Dalmau, Gemma|||0000-0003-3720-0797
Gich, Ignasi|||0000-0003-3975-6588
Martínez García, Laura|||0000-0003-0126-8706
Llor, Carl|||0000-0001-6644-717X
Alonso-Coello, Pablo|||0000-0002-8001-8504
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Delayed antibiotic prescription
Primary care
Survey
Infectious disease
topic Delayed antibiotic prescription
Primary care
Survey
Infectious disease
description One of several strategies developed to reduce inappropriate antibiotic use in situations where the indication is not clear is delayed antibiotic prescription (DAP), defined as an antibiotic prescription issued for the patient to take only in case of feeling worse or not feeling better several days after the visit. We conducted a survey to identify DAP use in Spanish primary care settings. We surveyed 23 healthcare centers located in 4 autonomous regions where a randomized controlled trial (RCT) on DAP was underway. The primary variable was use of DAP. Categorical and quantitative variables were analyzed by means of the chi-squared test and non-parametric tests, respectively. The survey was sent to 375 healthcare professionals, 215 of whom responded (57.3% response rate), with 46% of these respondents declaring that they had used DAP in routine practice before the RCT started (66.6% afterwards), mostly (91.5%) for respiratory tract infections (RTIs), followed by urinary infections (45.1%). Regarding DAP use for RTIs, the most frequent conditions were pharyngotonsillitis (88.7%), acute bronchitis (62.7%), mild chronic obstructive pulmonary disease exacerbations (59.9%), sinusitis (51.4%), and acute otitis media (45.1%). Most respondents considered that DAP reduced emergency visits (85.4%), scheduled visits (79%) and inappropriate antibiotic use (73.7%) and most also perceived patients to be generally satisfied with the DAP approach (75.6%). Having participated or not in the DAP RCT (74.1% versus 46.2%; p < 0.001), having previously used or not used DAP (86.8% versus 44.2%; p < 0.001), and being a physician versus being a nurse (81.8% versus 18.2%; p < 0.001) were factors that reflected significantly higher rates of DAP use. The majority of primary healthcare professionals in Spain do not use DAP. Those who use DAP believe that it reduces primary care visits and inappropriate antibiotic use, while maintaining patient satisfaction. Given the limited use of DAP in our setting, and given that its use is mainly limited to RTIs, DAP has considerable potential in terms of its implementation in routine practice. The online version of this article (10.1186/s12875-019-0934-7) contains supplementary material, which is available to authorized users.
publishDate 2019
dc.date.none.fl_str_mv 2
2019-01-01
2019
2019-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/253267
https://dx.doi.org/urn:doi:10.1186/s12875-019-0934-7
url https://ddd.uab.cat/record/253267
https://dx.doi.org/urn:doi:10.1186/s12875-019-0934-7
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 CPII15/0034
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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