Variation of GP antibiotic prescribing tendency for contacts with out-of-hours primary care in Denmark - a cross-sectional register-based study

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Variation of GP antibiotic prescribing tendency for contacts with out-of-hours primary care in Denmark - a cross-sectional register-based study. / Huibers, Linda; Vestergaard, Claus Høstrup; Keizer, Ellen et al.

I: Scandinavian Journal of Primary Health Care, Bind 40, Nr. 2, 2022, s. 227-236.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{13201e74c08d4084aeafa114e75ae184,
title = "Variation of GP antibiotic prescribing tendency for contacts with out-of-hours primary care in Denmark - a cross-sectional register-based study",
abstract = "OBJECTIVE: To study variation in antibiotic prescribing rates among general practitioners (GP) in out-of-hours (OOH) primary care and to explore GP characteristics associated with these rates.DESIGN: Population-based observational registry study using routine data from the OOH primary care registration system on patient contacts and antibiotic prescriptions combined with national register data.SETTING: OOH primary care of the Central Denmark Region.SUBJECTS: All patient contacts in 2014-2017.MAIN OUTCOME MEASURES: GPs' tendency to prescribe antibiotics. Excess variation (not attributable to chance).RESULTS: We included 794,220 clinic consultations (16.1% with antibiotics prescription), 281,141 home visits (11.6% antibiotics), and 1,583,919 telephone consultations (5.8% antibiotics). The excess variation in the tendency to prescribe antibiotics was 1.56 for clinic consultations, 1.64 for telephone consultations, and 1.58 for home visits. Some GP characteristics were significantly correlated with a higher tendency to prescribe antibiotics, including 'activity level' (i.e. number of patients seen in the past hour) for clinic and telephone consultations, 'familiarity with OOH care' (i.e. number of OOH shifts in the past 180 days), male sex, and younger age for home visits. Overall, GP characteristics explained little of the antibiotic prescribing variation seen among GPs (Pseudo r2: 0.008-0.025).CONCLUSION: Some variation in the GPs' tendency to prescribe antibiotics was found for OOH primary care contacts. Available GP characteristics, such as GPs' activity level and familiarity with OOH care, explained only small parts of this variation. Future research should focus on identifying factors that can explain this variation, as this knowledge could be used for designing interventions.KEY POINTSCurrent awareness:Antibiotic prescribing rates seem to be higher in out-of-hours than in daytime primary care.Most important results:Antibiotic prescribing rates varied significantly among general practitioners after adjustment for contact- and patient-characteristics.This variation remained even after accounting for variation attributable to chance.General practitioners' activity level and familiarity with out-of-hours care were positively associated with their tendency to prescribe antibiotics.",
keywords = "out-of-hours medical care, primary health care, physicians, prescriptions, general practice, Denmark, anti-bacterial agents, infections, Out-of-hours medical care, POPULATION, PATTERNS, RESPIRATORY-TRACT INFECTIONS, Cross-Sectional Studies, General Practitioners, Humans, Male, After-Hours Care, Practice Patterns, Physicians', Primary Health Care, Anti-Bacterial Agents/therapeutic use",
author = "Linda Huibers and Vestergaard, {Claus H{\o}strup} and Ellen Keizer and Bech, {Bodil Hammer} and Flemming Bro and Christensen, {Morten Bondo}",
year = "2022",
doi = "10.1080/02813432.2022.2073981",
language = "English",
volume = "40",
pages = "227--236",
journal = "Scandinavian Journal of Primary Health Care",
issn = "0281-3432",
publisher = "Taylor & Francis ",
number = "2",

}

RIS

TY - JOUR

T1 - Variation of GP antibiotic prescribing tendency for contacts with out-of-hours primary care in Denmark - a cross-sectional register-based study

AU - Huibers, Linda

AU - Vestergaard, Claus Høstrup

AU - Keizer, Ellen

AU - Bech, Bodil Hammer

AU - Bro, Flemming

AU - Christensen, Morten Bondo

PY - 2022

Y1 - 2022

N2 - OBJECTIVE: To study variation in antibiotic prescribing rates among general practitioners (GP) in out-of-hours (OOH) primary care and to explore GP characteristics associated with these rates.DESIGN: Population-based observational registry study using routine data from the OOH primary care registration system on patient contacts and antibiotic prescriptions combined with national register data.SETTING: OOH primary care of the Central Denmark Region.SUBJECTS: All patient contacts in 2014-2017.MAIN OUTCOME MEASURES: GPs' tendency to prescribe antibiotics. Excess variation (not attributable to chance).RESULTS: We included 794,220 clinic consultations (16.1% with antibiotics prescription), 281,141 home visits (11.6% antibiotics), and 1,583,919 telephone consultations (5.8% antibiotics). The excess variation in the tendency to prescribe antibiotics was 1.56 for clinic consultations, 1.64 for telephone consultations, and 1.58 for home visits. Some GP characteristics were significantly correlated with a higher tendency to prescribe antibiotics, including 'activity level' (i.e. number of patients seen in the past hour) for clinic and telephone consultations, 'familiarity with OOH care' (i.e. number of OOH shifts in the past 180 days), male sex, and younger age for home visits. Overall, GP characteristics explained little of the antibiotic prescribing variation seen among GPs (Pseudo r2: 0.008-0.025).CONCLUSION: Some variation in the GPs' tendency to prescribe antibiotics was found for OOH primary care contacts. Available GP characteristics, such as GPs' activity level and familiarity with OOH care, explained only small parts of this variation. Future research should focus on identifying factors that can explain this variation, as this knowledge could be used for designing interventions.KEY POINTSCurrent awareness:Antibiotic prescribing rates seem to be higher in out-of-hours than in daytime primary care.Most important results:Antibiotic prescribing rates varied significantly among general practitioners after adjustment for contact- and patient-characteristics.This variation remained even after accounting for variation attributable to chance.General practitioners' activity level and familiarity with out-of-hours care were positively associated with their tendency to prescribe antibiotics.

AB - OBJECTIVE: To study variation in antibiotic prescribing rates among general practitioners (GP) in out-of-hours (OOH) primary care and to explore GP characteristics associated with these rates.DESIGN: Population-based observational registry study using routine data from the OOH primary care registration system on patient contacts and antibiotic prescriptions combined with national register data.SETTING: OOH primary care of the Central Denmark Region.SUBJECTS: All patient contacts in 2014-2017.MAIN OUTCOME MEASURES: GPs' tendency to prescribe antibiotics. Excess variation (not attributable to chance).RESULTS: We included 794,220 clinic consultations (16.1% with antibiotics prescription), 281,141 home visits (11.6% antibiotics), and 1,583,919 telephone consultations (5.8% antibiotics). The excess variation in the tendency to prescribe antibiotics was 1.56 for clinic consultations, 1.64 for telephone consultations, and 1.58 for home visits. Some GP characteristics were significantly correlated with a higher tendency to prescribe antibiotics, including 'activity level' (i.e. number of patients seen in the past hour) for clinic and telephone consultations, 'familiarity with OOH care' (i.e. number of OOH shifts in the past 180 days), male sex, and younger age for home visits. Overall, GP characteristics explained little of the antibiotic prescribing variation seen among GPs (Pseudo r2: 0.008-0.025).CONCLUSION: Some variation in the GPs' tendency to prescribe antibiotics was found for OOH primary care contacts. Available GP characteristics, such as GPs' activity level and familiarity with OOH care, explained only small parts of this variation. Future research should focus on identifying factors that can explain this variation, as this knowledge could be used for designing interventions.KEY POINTSCurrent awareness:Antibiotic prescribing rates seem to be higher in out-of-hours than in daytime primary care.Most important results:Antibiotic prescribing rates varied significantly among general practitioners after adjustment for contact- and patient-characteristics.This variation remained even after accounting for variation attributable to chance.General practitioners' activity level and familiarity with out-of-hours care were positively associated with their tendency to prescribe antibiotics.

KW - out-of-hours medical care

KW - primary health care

KW - physicians

KW - prescriptions

KW - general practice

KW - Denmark

KW - anti-bacterial agents

KW - infections

KW - Out-of-hours medical care

KW - POPULATION

KW - PATTERNS

KW - RESPIRATORY-TRACT INFECTIONS

KW - Cross-Sectional Studies

KW - General Practitioners

KW - Humans

KW - Male

KW - After-Hours Care

KW - Practice Patterns, Physicians'

KW - Primary Health Care

KW - Anti-Bacterial Agents/therapeutic use

U2 - 10.1080/02813432.2022.2073981

DO - 10.1080/02813432.2022.2073981

M3 - Journal article

C2 - 35703579

VL - 40

SP - 227

EP - 236

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

SN - 0281-3432

IS - 2

ER -