Delayed antibiotic prescribing for respiratory tract infections: protocol of an individual patient data meta-analysis.

Autor:	Stuart B; Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK., Hounkpatin H; Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK., Becque T; Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK., Yao G; Biostatistics Research Group, Department of Health Sciences, College of Life Sciences, University of Leicester, Leiceister, UK., Zhu S; Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK., Alonso-Coello P; Iberoamerican Cochrane Centre, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain., Altiner A; Office for Educational Affairs, Department of General Medicine, University of Rostock, Rostock, Germany., Arroll B; Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand., Böhning D; Southampton Statistical Sciences Research Institute, University of Southampton, Southampton, UK., Bostock J; Divison of Health and Social Care Research, King's College London, London, UK., Bucher HCC; Basel Institute for Clinical Epidemiology and Biostatistics (CEB), University Hospital Basel and University of Basel, Basel, Switzerland., de la Poza M; Institut Català de la Salut, CAP Doctor Carles Ribas, Barcelona, Spain., Francis NA; Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK., Gillespie D; Centre for Trials Research, College of Biomedical & Life Sciences, Cardiff University, Cardiff, UK., Hay AD; Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Kenealy T; Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand., Löffler C; Institute of General Practice, Rostock University Medical Center, Rostock, Germany., Mas-Dalmau G; Knowledge and Research Management Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Muñoz L; Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain., Samuel K; ASPIRE PPI Panel, Leeds, Institute for Health Sciences, University of Leeds, Leeds, UK., Moore M; Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK., Little P; Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2019 Jan 21; Vol. 9 (1), pp. e026925. Date of Electronic Publication: 2019 Jan 21.
DOI:	10.1136/bmjopen-2018-026925
Abstrakt:	Introduction: Delayed prescribing can be a useful strategy to reduce antibiotic prescribing, but it is not clear for whom delayed prescribing might be effective. This protocol outlines an individual patient data (IPD) meta-analysis of randomised controlled trials (RCTs) and observational cohort studies to explore the overall effect of delayed prescribing and identify key patient characteristics that are associated with efficacy of delayed prescribing. Methods and Analysis: A systematic search of the databases Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid Embase, EBSCO CINAHL Plus and Web of Science was conducted to identify relevant studies from inception to October 2017. Outcomes of interest include duration of illness, severity of illness, complication, reconsultation and patient satisfaction. Study authors of eligible papers will be contacted and invited to contribute raw IPD data. IPD data will be checked against published data, harmonised and aggregated to create one large IPD database. Multilevel regression will be performed to explore interaction effects between treatment allocation and patient characteristics. The economic evaluation will be conducted based on IPD from the combined trial and observational studies to estimate the differences in costs and effectiveness for delayed prescribing compared with normal practice. A decision model will be developed to assess potential savings and cost-effectiveness in terms of reduced antibiotic usage of delayed prescribing and quality-adjusted life years. Ethics and Dissemination: Ethical approval was obtained from the University of Southampton Faculty of Medicine Research Ethics Committee (Reference number: 30068). Findings of this study will be published in peer-reviewed academic journals as well as General Practice trade journals and will be presented at national and international conferences. The results will have important public health implications, shaping the way in which antibiotics are prescribed in the future and to whom delayed prescriptions are issued. Prospero Registration Number: CRD42018079400. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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