Public reporting influences antibiotic and injection prescription in primary care: a segmented regression analysis

Liu, Chenxi; Zhang, Xiaopeng; Wan, Jie

doi:10.1111/jep.12343

Cited by 20 publications

(24 citation statements)

References 36 publications

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“…First, risk-adjustment is needed to assess the quality of prescriptions. But unfortunately, a case-mix system for such risk-adjustment in primary care settings is not available yet47. Second, prescriptions for the three conditions accounted for a relatively large portion (approximately 20%) of the entire prescriptions collected.…”

Section: Methodsmentioning

confidence: 99%

Public reporting as a prescriptions quality improvement measure in primary care settings in China: variations in effects associated with diagnoses

Tang

Liu

Zhang

2016

Sci Rep

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The overprovision and irrational use of antibiotics and injections are a major public health concern. Public reporting has been adopted as a strategy to encourage good prescribing practices. This study evaluated the effects of public reporting on antibiotic and injection prescriptions in urban and rural primary care settings in Hubei province, China. A randomized control trial was conducted, with 10 primary care institutions being subject to public reporting and another 10 serving as controls. Prescription indicators were publicly reported monthly over a one-year period. Prescriptions for bronchitis, gastritis and hypertension before and after the intervention were collected. Difference-in-difference tests were performed to estimate the effect size of the intervention on five prescription indicators: percentage of prescriptions containing antibiotics; percentage of prescriptions containing two or more antibiotics; percentage of prescriptions containing injections; percentage of prescriptions containing antibiotic injections; and average prescription cost. Public reporting had varied effects on prescriptions for different diagnoses. It reduced antibiotic prescribing for gastritis. Prescriptions containing injections, especially antibiotic injections, also declined, but only for gastritis. A reduction of prescription costs was noted for bronchitis and gastritis. Public reporting has the potential to encourage good prescribing practices. Its effects vary with different disease conditions.

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Section: Methodsmentioning

confidence: 99%

Public reporting as a prescriptions quality improvement measure in primary care settings in China: variations in effects associated with diagnoses

Tang

Liu

Zhang

2016

Sci Rep

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“…Reliable evidence shows the need to reflect on the effects of these policies. Previous studies have focused more on the changes of the number of antibiotic prescriptions and their cost (Liang et al, 2014;Song et al, 2014b;Liu et al, 2015). Few studies have been designed sufficiently to examine the changes in antibiotic consumption based on ATC/DDD methodology, which could demonstrate the epidemiology of antibiotic resistance with a higher resolution (Wushouer et al, 2017;Qu et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Consumption Trends in China: Evidence From Six-Year Surveillance Sales Records in Shandong Province

et al. 2020

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Background: The overuse of antibiotics is a serious public health problem in China, causing a high rate of antimicrobial resistance. This study identified the trends of antibiotic consumption in China to provide evidence for further intervention. Method: The six-year surveillance data on antibiotic sales from 2012 to 2017, which served as a proxy for consumption, were collected from 39 public health care facilities in Shandong province, including three tertiary hospitals, six secondary hospitals, and 30 primary health centers. Based on the Anatomical Therapeutic Chemical (ATC)/DDD methodology, antibiotic consumption was formulated in defined daily doses (DDD) per 1,000 inhabitants per day (DID). Results: The total antibiotic consumption among all health care settings increased from 16.07 DID in 2012 to a peak of 17.44 DID in 2015 and then decreased to 11.35 DID in 2017 with a 34.90% reduction. J01C (beta-lactam antimicrobials, penicillin), the most frequently used antibiotic class, accounted for 36.32% of the total DID. Consumption of carbapenems increased from 0.029 DID in 2012 to 0.08 DID in 2017. Parenteral antibiotics accounted for nearly 40% of the total consumption. Compared with the 2012 figures, the 2017 consumption showed a small increase in hospital sector that was compensated by the decrease in community care. Conclusion: A substantial reduction in total antibiotic consumption was observed in China from 2012 to 2017. However, the extensive consumption of broad-spectrum antimicrobials, high proportion of parenteral antibiotic use, and increased use of lastresort antibiotics attracted public health concerns.

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“…To reduce misconceptions and misguided expectations about the treatment with antimicrobial agents, it is important to improve the patient's knowledge and attitude about the proper use of antibiotics [52]. A study in China showed that when performance data of physicians are available for public to view, the physicians appropriate prescribing behavior gradually improves [55].…”

Section: Disruption Of Bacterial Membrane Structurementioning

confidence: 99%

Antibiotics Overuse and Bacterial Resistance

Saleem¹,

Deters²,

Bastide³

et al. 2019

Ann Microbiol Res

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Antibiotic usage has become very widespread, as they are used to treat so many infectious diseases today. Antimicrobial agents exert their actions via different mechanisms including blockage of cell wall synthesis, interference of protein and/ or nucleic acid synthesis, interruption of cell membrane structure, and inhibition of a metabolic pathway. The treatment of bacterial infections with antimicrobial agents has become more difficult due to the capability of bacteria to develop resistance to antibiotics. Erroneous diagnosing, misconceptions, and improper physician-patient dynamics have led to overuse of antibiotics and the emergence of drug-resistant bacteria. Bacterial colonies have been shown to confer advantageous genetic information with ease, which is cause for concern. This, in turn, leads to a heightened urgency to create new forms of treatment that are effective against a greater proportion of a given bacterial colony. Effective ways of decreasing resistance include better diagnostic techniques, proper education and assessments, optimization of antibiotics usage, drug synergism, vaccine implementation, global efforts to combat resistance, and development of new antimicrobial agents.

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Public reporting influences antibiotic and injection prescription in primary care: a segmented regression analysis

Cited by 20 publications

References 36 publications

Public reporting as a prescriptions quality improvement measure in primary care settings in China: variations in effects associated with diagnoses

Public reporting as a prescriptions quality improvement measure in primary care settings in China: variations in effects associated with diagnoses

Antibiotic Consumption Trends in China: Evidence From Six-Year Surveillance Sales Records in Shandong Province

Antibiotics Overuse and Bacterial Resistance

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