Do NHS GP surgeries employing GPs additionally trained in integrative or complementary medicine have lower antibiotic prescribing rates? Retrospective cross-sectional analysis of national primary care prescribing data in England in 2016
| Autor: | Paschen von Flotow, Lorna Duncan, Esther T van der Werf, Erik W. Baars |
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| Rok vydání: | 2017 |
| Předmět: |
Complementary Therapies
Male integrative medicine National Health Programs Cross-sectional study General Practice Alternative medicine Comorbidity antibiotics 0302 clinical medicine complementary medicine Medicine 030212 general & internal medicine Practice Patterns Physicians' Child Referral and Consultation Respiratory Tract Infections General Medicine Middle Aged Anti-Bacterial Agents England Child Preschool Urinary Tract Infections Regression Analysis Female Integrative medicine General practice / Family practice Adult medicine.medical_specialty Adolescent education Primary care alternative therapy 03 medical and health sciences Young Adult Humans antimicrobial resistance Medical prescription Aged Retrospective Studies Surgeons business.industry Research Infant Newborn Infant Retrospective cohort study medicine.disease Drug Utilization Cross-Sectional Studies Relative risk Emergency medicine business antibiotic prescription rate 030217 neurology & neurosurgery |
| Zdroj: | BMJ Open, 2018(e020488) van der Werf-Kok, E, Duncan, L, von Flotow, P & Baars, E W 2018, ' Do NHS GP surgeries employing GPs additionally trained in Integrative or Complementary Medicine have lower antibiotic prescribing rates? Retrospective cross-sectional analysis of national primary care prescribing data in England in 2016 ', BMJ Open, vol. 8, no. 3, e020488 . https://doi.org/10.1136/bmjopen-2017-020488 BMJ Open |
| DOI: | 10.1136/bmjopen-2017-020488 |
| Popis: | ObjectiveTo determine differences in antibiotic prescription rates between conventional General Practice (GP) surgeries and GP surgeries employing general practitioners (GPs) additionally trained in integrative medicine (IM) or complementary and alternative medicine (CAM) (referred to as IM GPs) working within National Health Service (NHS) England.DesignRetrospective study on antibiotic prescription rates per STAR-PU (Specific Therapeutic group Age–sex weighting Related Prescribing Unit) using NHS Digital data over 2016. Publicly available data were used on prevalence of relevant comorbidities, demographics of patient populations and deprivation scores.SettingPrimary Care.Participants7283 NHS GP surgeries in England.Primary outcome measureThe association between IM GPs and antibiotic prescribing rates per STAR-PU with the number of antibiotic prescriptions (total, and for respiratory tract infection (RTI) and urinary tract infection (UTI) separately) as outcome.ResultsIM GP surgeries (n=9) were comparable to conventional GP surgeries in terms of list sizes, demographics, deprivation scores and comorbidity prevalence. Negative binomial regression models showed that statistically significant fewer total antibiotics (relative risk (RR) 0.78, 95% CI 0.64 to 0.97) and RTI antibiotics (RR 0.74, 95% CI 0.59 to 0.94) were prescribed at NHS IM GP surgeries compared with conventional NHS GP surgeries. In contrast, the number of antibiotics prescribed for UTI were similar between both practices.ConclusionNHS England GP surgeries employing GPs additionally trained in IM/CAM have lower antibiotic prescribing rates. Accessibility of IM/CAM within NHS England primary care is limited. Main study limitation is the lack of consultation data. Future research should include the differences in consultation behaviour of patients self-selecting to consult an IM GP or conventional surgery, and its effect on antibiotic prescription. Additional treatment strategies for common primary care infections used by IM GPs should be explored to see if they could be used to assist in the fight against antimicrobial resistance. |
| Databáze: | OpenAIRE |
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