Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis
ABSTRACT INTRODUCTIONOver-prescription of antibiotics for common infective conditions is an important health issue. Infective conjunctivitis represents one of the most common eye-related complaints in general practice. Despite its self-limiting nature, there is evidence of frequent general practitio...
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CSIRO Publishing
2021-01-01
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Series: | Journal of Primary Health Care |
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Online Access: | https://www.publish.csiro.au/hc/pdf/HC20040 |
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doaj-14a7045b13d546278f4f994d880e6a71 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Parker Magin Kristen FitzGerald Neil Spike Alison Fielding Mieke L. van Driel Andrew Davey Jean Ball Elizabeth G. Holliday Debbie Quain Amanda Tapley Marcus D. Cherry |
spellingShingle |
Parker Magin Kristen FitzGerald Neil Spike Alison Fielding Mieke L. van Driel Andrew Davey Jean Ball Elizabeth G. Holliday Debbie Quain Amanda Tapley Marcus D. Cherry Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis Journal of Primary Health Care Epidemiology general practice conjunctivitis antibiotic stewardship medical education |
author_facet |
Parker Magin Kristen FitzGerald Neil Spike Alison Fielding Mieke L. van Driel Andrew Davey Jean Ball Elizabeth G. Holliday Debbie Quain Amanda Tapley Marcus D. Cherry |
author_sort |
Parker Magin |
title |
Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis |
title_short |
Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis |
title_full |
Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis |
title_fullStr |
Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis |
title_full_unstemmed |
Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis |
title_sort |
antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis |
publisher |
CSIRO Publishing |
series |
Journal of Primary Health Care |
issn |
1172-6156 |
publishDate |
2021-01-01 |
description |
ABSTRACT
INTRODUCTIONOver-prescription of antibiotics for common infective conditions is an important health issue. Infective conjunctivitis represents one of the most common eye-related complaints in general practice. Despite its self-limiting nature, there is evidence of frequent general practitioner (GP) antibiotic prescribing for this condition, which is inconsistent with evidence-based guidelines.
AIMTo investigate the prevalence and associations of GP registrars' (trainees') prescription of antibiotics for infective conjunctivitis.
METHODSWe performed a cross-sectional analysis of the Registrar Encounters in Clinical Training (ReCEnT) ongoing prospective cohort study, which documents GP registrars' clinical consultations (involving collection of information from 60 consecutive consultations, at three points during registrar training). The outcome of the analyses was antibiotic prescription for a new diagnosis of conjunctivitis. Patient, registrar, practice and consultation variables were included in uni- and multivariable logistic regression analyses to test associations of these prescriptions.
RESULTSIn total, 2333 registrars participated in 18 data collection rounds from 2010 to 2018. There were 1580 new cases of infective conjunctivitis (0.31% of all problems). Antibiotics (mainly topical) were prescribed in 1170 (74%) of these cases. Variables associated with antibiotic prescription included patients' Aboriginal or Torres Strait Islander status, registrar organisation of a follow up (both registrar and other GP follow up), and earlier registrar training term (more junior status).
DISCUSSIONGP registrars, like established GPs, prescribe antibiotics for conjunctivitis in excess of guideline recommendations, but prescribing rates are lower in later training. These prescribing patterns have educational, social and economic consequences. Further educational strategies may enhance attenuation of registrars' prescribing during training. |
topic |
Epidemiology general practice conjunctivitis antibiotic stewardship medical education |
url |
https://www.publish.csiro.au/hc/pdf/HC20040 |
work_keys_str_mv |
AT parkermagin antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT kristenfitzgerald antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT neilspike antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT alisonfielding antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT miekelvandriel antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT andrewdavey antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT jeanball antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT elizabethgholliday antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT debbiequain antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT amandatapley antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis AT marcusdcherry antibioticprescribingpatternsofgeneralpracticeregistrarsforinfectiveconjunctivitisacrosssectionalanalysis |
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doaj-14a7045b13d546278f4f994d880e6a712021-05-26T05:21:22ZengCSIRO PublishingJournal of Primary Health Care1172-61562021-01-01131514HC20040Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysisParker Magin0Kristen FitzGerald1Neil Spike2Alison Fielding3Mieke L. van Driel4Andrew Davey5Jean Ball6Elizabeth G. Holliday7Debbie Quain8Amanda Tapley9Marcus D. Cherry10University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia; and Corresponding author. Email: parker.magin@newcastle.edu.auGeneral Practice Training Tasmania, Hobart, Tasmania, Australia.Eastern Victoria General Practice Training, Melbourne, Victoria, Australia; and Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia.University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia.The University of Queensland, Primary Care Clinical Unit, Faculty of Medicine, Brisbane, Queensland, Australia.University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia.Hunter Medical Research Institute, Clinical Research Design IT and Statistical Support Unit, New Castle, NSW, AustraliaUniversity of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia.University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia.University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia.University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia.ABSTRACT INTRODUCTIONOver-prescription of antibiotics for common infective conditions is an important health issue. Infective conjunctivitis represents one of the most common eye-related complaints in general practice. Despite its self-limiting nature, there is evidence of frequent general practitioner (GP) antibiotic prescribing for this condition, which is inconsistent with evidence-based guidelines. AIMTo investigate the prevalence and associations of GP registrars' (trainees') prescription of antibiotics for infective conjunctivitis. METHODSWe performed a cross-sectional analysis of the Registrar Encounters in Clinical Training (ReCEnT) ongoing prospective cohort study, which documents GP registrars' clinical consultations (involving collection of information from 60 consecutive consultations, at three points during registrar training). The outcome of the analyses was antibiotic prescription for a new diagnosis of conjunctivitis. Patient, registrar, practice and consultation variables were included in uni- and multivariable logistic regression analyses to test associations of these prescriptions. RESULTSIn total, 2333 registrars participated in 18 data collection rounds from 2010 to 2018. There were 1580 new cases of infective conjunctivitis (0.31% of all problems). Antibiotics (mainly topical) were prescribed in 1170 (74%) of these cases. Variables associated with antibiotic prescription included patients' Aboriginal or Torres Strait Islander status, registrar organisation of a follow up (both registrar and other GP follow up), and earlier registrar training term (more junior status). DISCUSSIONGP registrars, like established GPs, prescribe antibiotics for conjunctivitis in excess of guideline recommendations, but prescribing rates are lower in later training. These prescribing patterns have educational, social and economic consequences. Further educational strategies may enhance attenuation of registrars' prescribing during training.https://www.publish.csiro.au/hc/pdf/HC20040Epidemiologygeneral practiceconjunctivitisantibiotic stewardshipmedical education |