After-hours consultations and antibiotic prescribing for self-limiting upper respiratory tract infections in primary-care practices.

Peng, Z; He, W-Q; Hayen, A; Hall, J; Liu, B

After-hours consultations and antibiotic prescribing for self-limiting upper respiratory tract infections in primary-care practices.

Peng, Z He, W-Q Hayen, A

Hall, J Liu, B

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Publisher:: Cambridge University Press
Publication Type:: Journal Article
Citation:: Infection Control and Hospital Epidemiology, 2023, 45, (5), pp. 755-761
Issue Date:: 2023-07-07

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Field	Value	Language
dc.contributor.author	Peng, Z
dc.contributor.author	He, W-Q
dc.contributor.author	Hayen, A https://orcid.org/0000-0003-4046-8030
dc.contributor.author	Hall, J
dc.contributor.author	Liu, B
dc.date.accessioned	2023-09-12T04:22:16Z
dc.date.available	2023-09-12T04:22:16Z
dc.date.issued	2023-07-07
dc.identifier.citation	Infection Control and Hospital Epidemiology, 2023, 45, (5), pp. 755-761
dc.identifier.issn	0899-823X
dc.identifier.issn	1559-6834
dc.identifier.uri	http://hdl.handle.net/10453/172056
dc.description.abstract	OBJECTIVES: To determine the association between after-hours consultations and the likelihood of antibiotic prescribing for self-limiting upper respiratory tract infections (URTIs) in primary care practices.DESIGN: A cross-sectional analysis using Australian national primary-care practice data (MedicineInsight) between February 1, 2016 and January 31, 2019.SETTING: Nationwide primary-care practices across Australia.PARTICIPANTS: Adult and pediatric patients who visited primary care practices for first-time URTIs.METHODS: We estimated the proportion of first-time URTI episodes for which antibiotic prescribing occurred on the same day (immediate prescribing) using diagnoses and prescription records in the electronic primary-care database. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the likelihood of antibiotic prescribing by the time of primary care visits were calculated using generalized estimating equations.RESULTS: Among 357,287 URTI episodes, antibiotics were prescribed in 172,605 episodes (48.3%). After adjusting for patients' demographics, practice characteristics, and seasons, we detected a higher likelihood of antibiotic prescribing on weekends compared to weekdays (OR, 1.42; 95% CI, 1.39-1.45) and on national public holidays compared to nonholidays (OR, 1.23; 95% CI, 1.17-1.29). When we controlled for patient presentation and diagnosis, the association between antibiotic prescribing and after-hours consultations remained significant: weekend versus weekdays (OR, 1.37; 95% CI, 1.33-1.41) and holidays versus nonholidays (OR, 1.10; 95% CI, 1.03-1.18).CONCLUSIONS: Primary-care consultations on weekends and public holidays were associated with a higher likelihood of immediate antibiotic prescribing for self-limiting URTIs in primary care. This finding might be attributed to lower resourcing in after-hours health care.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Cambridge University Press
dc.relation.ispartof	Infection Control and Hospital Epidemiology
dc.relation.isbasedon	10.1017/ice.2022.160
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Epidemiology
dc.subject.classification	32 Biomedical and clinical sciences
dc.subject.classification	42 Health sciences
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Child
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Australia
dc.subject.mesh	Respiratory Tract Infections
dc.subject.mesh	Practice Patterns, Physicians'
dc.subject.mesh	Referral and Consultation
dc.subject.mesh	Inappropriate Prescribing
dc.subject.mesh	Humans
dc.subject.mesh	Respiratory Tract Infections
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Adult
dc.subject.mesh	Child
dc.subject.mesh	Referral and Consultation
dc.subject.mesh	Australia
dc.subject.mesh	Inappropriate Prescribing
dc.subject.mesh	Practice Patterns, Physicians'
dc.subject.mesh	Cervical Vertebrae
dc.subject.mesh	Deglutition Disorders
dc.subject.mesh	Diskectomy
dc.subject.mesh	Dysphonia
dc.subject.mesh	Follow-Up Studies
dc.subject.mesh	Humans
dc.subject.mesh	Intervertebral Disc Degeneration
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Spinal Fusion
dc.subject.mesh	Total Disc Replacement
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Child
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Australia
dc.subject.mesh	Respiratory Tract Infections
dc.subject.mesh	Practice Patterns, Physicians'
dc.subject.mesh	Referral and Consultation
dc.subject.mesh	Inappropriate Prescribing
dc.title	After-hours consultations and antibiotic prescribing for self-limiting upper respiratory tract infections in primary-care practices.
dc.type	Journal Article
utslib.citation.volume	45
utslib.location.activity	United States
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2023-09-12T04:22:15Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	45
utslib.citation.issue	5

Abstract:

OBJECTIVES: To determine the association between after-hours consultations and the likelihood of antibiotic prescribing for self-limiting upper respiratory tract infections (URTIs) in primary care practices.DESIGN: A cross-sectional analysis using Australian national primary-care practice data (MedicineInsight) between February 1, 2016 and January 31, 2019.SETTING: Nationwide primary-care practices across Australia.PARTICIPANTS: Adult and pediatric patients who visited primary care practices for first-time URTIs.METHODS: We estimated the proportion of first-time URTI episodes for which antibiotic prescribing occurred on the same day (immediate prescribing) using diagnoses and prescription records in the electronic primary-care database. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the likelihood of antibiotic prescribing by the time of primary care visits were calculated using generalized estimating equations.RESULTS: Among 357,287 URTI episodes, antibiotics were prescribed in 172,605 episodes (48.3%). After adjusting for patients' demographics, practice characteristics, and seasons, we detected a higher likelihood of antibiotic prescribing on weekends compared to weekdays (OR, 1.42; 95% CI, 1.39-1.45) and on national public holidays compared to nonholidays (OR, 1.23; 95% CI, 1.17-1.29). When we controlled for patient presentation and diagnosis, the association between antibiotic prescribing and after-hours consultations remained significant: weekend versus weekdays (OR, 1.37; 95% CI, 1.33-1.41) and holidays versus nonholidays (OR, 1.10; 95% CI, 1.03-1.18).CONCLUSIONS: Primary-care consultations on weekends and public holidays were associated with a higher likelihood of immediate antibiotic prescribing for self-limiting URTIs in primary care. This finding might be attributed to lower resourcing in after-hours health care.

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http://hdl.handle.net/10453/172056