Antibiotic usage in chronic rhinosinusitis: analysis of national primary care electronic health records

Hopkins, Claire; Williamson, Elizabeth; Morris, Stephen; Clarke, Caroline S.; Thomas, Mike; Evans, Hannah; Little, Paul; Lund, Valerie J.; Blackshaw, Helen; Schilder, Anne G. M.; Philpott, Carl; Carpenter, James; Denaxas, Spiros

doi:10.4193/rhin19.136

Cited by 16 publications

(17 citation statements)

References 23 publications

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“…32 Moreover, there may be a lack of adherence by general practitioners to guideline-established medical management of CRS, including overprescribing antibiotics for CRS in the primary care setting. 33,34 It is also possible that our study reflects the positive benefits of CRS management by specialists, from greater explanation of how to use topical medications, which may improve adherence, to greater guideline-directed treatment of CRS, including more conservative use of antibiotics and oral corticosteroids. Our results, which show CRS-related antibiotics and oral corticosteroids use to be elements of the disease process that are independent of chronic symptom burden, support previous studies that have identified putative inflammatory mediators or triggers that may drive the frequency of AECRS as distinct pathologic phenomenon.…”

Section: Discussionmentioning

confidence: 97%

“…With respect to the use of intranasal saline or intranasal corticosteroids, patients report challenges with adherence and using these medications on a regular basis 32 . Moreover, there may be a lack of adherence by general practitioners to guideline‐established medical management of CRS, including overprescribing antibiotics for CRS in the primary care setting 33–34 . It is also possible that our study reflects the positive benefits of CRS management by specialists, from greater explanation of how to use topical medications, which may improve adherence, to greater guideline‐directed treatment of CRS, including more conservative use of antibiotics and oral corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

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Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids

et al. 2019

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Objectives/Hypothesis: Antibiotics and oral corticosteroids are used in the treatment of acute exacerbations of chronic rhinosinusitis (AECRS) and reflect poor disease control. We sought to characterize utilization of these systemic medications after appropriate medical management of chronic rhinosinusitis (CRS). Study Design: Prospective observational study. Methods: One hundred fifty patients undergoing medical management for CRS were studied. Data were collected at enrollment and follow-up 3 to 12 months later. All patients were asked to report the number of CRS-related antibiotics and oral corticosteroids used in the last 3 months. CRS symptom burden was measured using the 22-item Sino-Nasal Outcome Test (SNOT-22). Associations were sought between CRS-related antibiotics and oral corticosteroids use at follow-up compared to enrollment. Results: From enrollment to follow-up, the mean number of CRS-related antibiotics courses used decreased by 0.2 courses (95% confidence interval [CI]: 0.1-0.4, P = .012), and the mean number of CRS-related oral corticosteroid courses used also decreased by 0.2 courses (95% CI: 0.1-0.3, P = .029). The number of CRS-related antibiotics used at follow-up was associated with CRS-related antibiotic use at enrollment (adjusted rate ratio [RR] = 1.58, 95% CI: 1.17-2.13, P = .003). The number of CRS-related oral corticosteroids used at follow-up was associated with reported CRS-related oral corticosteroid use at enrollment (adjusted RR = 3.20, 95% CI: 1.69-6.07, P < .001). SNOT-22 results at enrollment were also not predictive of future systemic medication use. Conclusions: Appropriate medical management of CRS is associated with decreased use of oral antibiotics and corticosteroids. Previous utilization of antibiotics and oral corticosteroids for CRS is associated with future use of these medications.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids

et al. 2019

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“…A systematic review has shown that data linkage is used in the field of perinatal health for both health surveillance and research purposes in European countries [8]. Several other studies have shown that linkage is used to explore various dynamics of population health such as social care, psychotic disorders, multi-morbidity, diabetes, obesity, mental health, cardiovascular, antibiotic use and Alzheimer using data linkage with different types of administrative data sources (both related to health and non-health) [7,[18][19][20][21][22][23][24][25][26][27][28][29][30]. For the surveillance of cancer, data linkage not only provides the opportunity to improve the population-based screening [31] but it also helps to detect different types of cancer recurrence [32] and to evaluate the socio-economic status of patients with cancer (e.g., return to work) [33].…”

Section: Discussionmentioning

confidence: 99%

Innovative use of data sources: a cross-sectional study of data linkage and artificial intelligence practices across European countries

et al. 2020

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Background: The availability of data generated from different sources is increasing with the possibility to link these data sources with each other. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the current use of data linkage at the individual level and artificial intelligence (AI) in routine public health activities, to identify the related estimated health indicators (i.e., outcome and intervention indicators) and health determinants of noncommunicable diseases and the obstacles to linking different data sources. Method: We performed a survey across European countries to explore the current practices applied by national institutes of public health, health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or AI). Results: The use of data linkage and AI at national institutes of public health, health information and statistics in Europe varies. The majority of European countries use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes. The use of AI to estimate health indicators is not frequent at national institutes of public health, health information and statistics. Using linked data, 46 health outcome indicators, 34 health determinants and 23 health intervention indicators were estimated in routine. The complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as obstacles to routine data linkage for public health surveillance and research.

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“…A systematic review has shown that data linkage is used in the eld of perinatal health for both health surveillance and research purposes in European countries [8]. Several other studies have shown that linkage is used to explore various dynamics of population health such as social care, psychotic disorders, multimorbidity, diabetes, obesity, mental health, cardiovascular, antibiotic use and Alzheimer using data linkage with different types of administrative data sources (both related to health and non-health) [7,[18][19][20][21][22][23][24][25][26][27][28][29][30]. For the surveillance of cancer, data linkage not only provides the opportunity to improve the population-based screening [31] but it also helps to detect different types of cancer recurrence [32] and to evaluate the socioeconomic status of patients with cancer (e.g., return to work) [33].…”

Section: Discussionmentioning

confidence: 99%

Innovative use of data sources: A Cross-sectional study of Data Linkage and Artificial Intelligence Practices across European Countries

Haneef

Delnord

Vernay

et al. 2020

Preprint

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Background: The availability of data generated from different sources is increasing with the possibility to link these data sources with each other. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the current use of data linkage at the individual level and artificial intelligence (AI) in routine public health activities, to identify the related estimated health indicators (i.e., outcome and intervention indicators) and health determinants of non-communicable diseases and the obstacles to linking different data sources. Method: We performed a survey across European countries to explore the current practices applied by national institutes of public health, health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or AI). Results: The use of data linkage and AI at national institutes of public health, health information and statistics in Europe varies. The majority of European countries use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes. The use of AI to estimate health indicators is not frequent at national institutes of public health, health information and statistics. Using linked data, 46 health outcome indicators, 34 health determinants and 23 health intervention indicators were estimated in routine. The complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as obstacles to routine data linkage for public health surveillance and research. Conclusions: Our results highlight that the majority of European countries have integrated data linkage in their routine public health activities but only a few use AI. A sustainable national health information system and a robust data governance framework allowing to link different data sources are essential to support evidence-informed health policy development. Building analytical capacity and raising awareness of the added value of data linkage in national institutes is necessary for improving the use of linked data in order to improve the quality of public health surveillance and monitoring activities.

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Antibiotic usage in chronic rhinosinusitis: analysis of national primary care electronic health records

Cited by 16 publications

References 23 publications

Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids

Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids

Innovative use of data sources: a cross-sectional study of data linkage and artificial intelligence practices across European countries

Innovative use of data sources: A Cross-sectional study of Data Linkage and Artificial Intelligence Practices across European Countries

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