Working Towards Accountable Antibiotic Prescribing in General Practice
Author(s): ,
Sean Wachtel
Affiliations:
University of Surrey, RCGP RSC, Departmeht of Clinical & Experimental Medicine
,
Julian Sherlock
Affiliations:
RCGP Research & Surveillance Centre
,
Chris Mcgee
Affiliations:
RCGP Research & Surveillance Centre
,
Rachel Byford
Affiliations:
RCGP Research & Surveillance Centre
Simon De Lusignan
Affiliations:
RCGP Research & Surveillance Centre
PHE ePoster Library. Wachtel S. 03/20/18; 205909; 12564
Dr. Sean Wachtel
Dr. Sean Wachtel
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Abstract
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Abstract Objectives - For the period 2011-2016 in UK English General Practices for antibiotic prescribing:To determine the degree of accountable prescribing i.e. the extent to which each prescription issued is matched by an appropriate indication.To compare prescribing to defined European standards.To define UK prescribing performance using quality indicators derived from the Public Health Laboratory Service, the National Institute of Clinical Excellence and NHS Wales.Design - Retrospective observational study using ontologically defined cases recorded by primary care physicians covering the period 2011 -16 combined with prescribing data. Appropriate indications were defined as infectious conditions that could reasonably be treated with antibiotics. Antibiotics were defined by EMIS and Read v2 codes.Setting - Primary Care based, utilizing records held by the Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) database, representative of all English General Practices.Participants - All patients registered with practices subscribing to the RCGP RSC database, in each of the 5 years of study, numbering between 1,527,499 and 1,687,002. Main outcome measures:The percentage of antibiotic prescriptions with an appropriate diagnosis recorded.The percentage of prescriptions meeting the European standards.The percentage of prescriptions issued as defined by UK national body standards. Results:The quality of prescribing improved over the study period, with up to 45 % of prescriptions issued in accordance with PHLS recommendations.The accountable prescribing rate in 2011 was 36 %, in 2016, 31 %.Fluoroquinolone prescribing met the European standard, but other European standards were not met.Conclusions:Where there is clear guidance for specific conditions, antibiotic prescribing has improved over the last five years.Overall accountability of UK General Practice antibiotic prescribing fell in the last 5 years.UK General Practice antibiotic prescribing met European standards for fluoroquinolones.
Abstract Objectives - For the period 2011-2016 in UK English General Practices for antibiotic prescribing:To determine the degree of accountable prescribing i.e. the extent to which each prescription issued is matched by an appropriate indication.To compare prescribing to defined European standards.To define UK prescribing performance using quality indicators derived from the Public Health Laboratory Service, the National Institute of Clinical Excellence and NHS Wales.Design - Retrospective observational study using ontologically defined cases recorded by primary care physicians covering the period 2011 -16 combined with prescribing data. Appropriate indications were defined as infectious conditions that could reasonably be treated with antibiotics. Antibiotics were defined by EMIS and Read v2 codes.Setting - Primary Care based, utilizing records held by the Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) database, representative of all English General Practices.Participants - All patients registered with practices subscribing to the RCGP RSC database, in each of the 5 years of study, numbering between 1,527,499 and 1,687,002. Main outcome measures:The percentage of antibiotic prescriptions with an appropriate diagnosis recorded.The percentage of prescriptions meeting the European standards.The percentage of prescriptions issued as defined by UK national body standards. Results:The quality of prescribing improved over the study period, with up to 45 % of prescriptions issued in accordance with PHLS recommendations.The accountable prescribing rate in 2011 was 36 %, in 2016, 31 %.Fluoroquinolone prescribing met the European standard, but other European standards were not met.Conclusions:Where there is clear guidance for specific conditions, antibiotic prescribing has improved over the last five years.Overall accountability of UK General Practice antibiotic prescribing fell in the last 5 years.UK General Practice antibiotic prescribing met European standards for fluoroquinolones.
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