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An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England

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An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England. / Thomson, Katie; Berry, Rachel; Robinson, Tomos et al.

In: BMC Public Health, Vol. 20, No. 1, 1148, 03.08.2020.

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Thomson K, Berry R, Robinson T, Brown H, Bambra C, Todd A. An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England. BMC Public Health. 2020 Aug 3;20(1):1148. doi: 10.1186/s12889-020-09227-x

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Thomson, Katie ; Berry, Rachel ; Robinson, Tomos et al. / An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England. In: BMC Public Health. 2020 ; Vol. 20, No. 1.

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@article{ae3db48a9a074a06b5eb96aa9b8bb3c1,
title = "An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England",
abstract = "Background: Internationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends - particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England. Methods: Antibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014-2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity. Results: Over time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU - a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences - with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU). Conclusion: Although antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England - with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised. ",
keywords = "Antibiotics, Deprivation, General practice, Health inequality, Prescribing",
author = "Katie Thomson and Rachel Berry and Tomos Robinson and Heather Brown and Clare Bambra and Adam Todd",
year = "2020",
month = aug,
day = "3",
doi = "10.1186/s12889-020-09227-x",
language = "English",
volume = "20",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "BMC",
number = "1",

}

RIS

TY - JOUR

T1 - An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England

AU - Thomson, Katie

AU - Berry, Rachel

AU - Robinson, Tomos

AU - Brown, Heather

AU - Bambra, Clare

AU - Todd, Adam

PY - 2020/8/3

Y1 - 2020/8/3

N2 - Background: Internationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends - particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England. Methods: Antibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014-2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity. Results: Over time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU - a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences - with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU). Conclusion: Although antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England - with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised.

AB - Background: Internationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends - particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England. Methods: Antibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014-2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity. Results: Over time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU - a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences - with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU). Conclusion: Although antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England - with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised.

KW - Antibiotics

KW - Deprivation

KW - General practice

KW - Health inequality

KW - Prescribing

U2 - 10.1186/s12889-020-09227-x

DO - 10.1186/s12889-020-09227-x

M3 - Journal article

C2 - 32741362

AN - SCOPUS:85088906998

VL - 20

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

IS - 1

M1 - 1148

ER -