Orlek, A.; Harvey, E.; Fisher, L.; Mehrkar, A.; Bacon, S.; Goldacre, B.; MacKenna, B.; Ashiru-Oredope, D. Patient Characteristics Associated with Repeat Antibiotic Prescribing Pre- and during the COVID-19 Pandemic: A Retrospective Nationwide Cohort Study of >19 Million Primary Care Records Using the OpenSAFELY Platform. Pharmacoepidemiology2023, 2, 168-187.
Orlek, A.; Harvey, E.; Fisher, L.; Mehrkar, A.; Bacon, S.; Goldacre, B.; MacKenna, B.; Ashiru-Oredope, D. Patient Characteristics Associated with Repeat Antibiotic Prescribing Pre- and during the COVID-19 Pandemic: A Retrospective Nationwide Cohort Study of >19 Million Primary Care Records Using the OpenSAFELY Platform. Pharmacoepidemiology 2023, 2, 168-187.
Orlek, A.; Harvey, E.; Fisher, L.; Mehrkar, A.; Bacon, S.; Goldacre, B.; MacKenna, B.; Ashiru-Oredope, D. Patient Characteristics Associated with Repeat Antibiotic Prescribing Pre- and during the COVID-19 Pandemic: A Retrospective Nationwide Cohort Study of >19 Million Primary Care Records Using the OpenSAFELY Platform. Pharmacoepidemiology2023, 2, 168-187.
Orlek, A.; Harvey, E.; Fisher, L.; Mehrkar, A.; Bacon, S.; Goldacre, B.; MacKenna, B.; Ashiru-Oredope, D. Patient Characteristics Associated with Repeat Antibiotic Prescribing Pre- and during the COVID-19 Pandemic: A Retrospective Nationwide Cohort Study of >19 Million Primary Care Records Using the OpenSAFELY Platform. Pharmacoepidemiology 2023, 2, 168-187.
Abstract
COVID-19 pandemic-related pressures on primary care may have driven inappropriate continuation of antibiotic prescriptions. Yet prescribing modality (repeat/non-repeat) has not previously been investigated in a pandemic context. Using the OpenSAFELY-TPP analytics platform, we analysed repeat/non-repeat prescribing frequency in monthly patient cohorts between Jan 2020–2022. In-depth analysis was conducted on Jan 2020 (“pre-pandemic”) and Jan 2021 (“pandemic”) cohorts. Per-patient prescribing and clinical conditions were determined by searching primary care record data using clinical code lists. Repeat prescribing was defined as >=3 prescriptions in a 6 month lookback period. Associations between demographics (e.g. age, sex, geography) and repeat/non-repeat prescribing were explored using unadjusted risk ratios. Antibiotic prescribing declined from May 2020; non-repeat prescribing declined more strongly than repeat prescribing (maximum declines -26% vs -11%, respectively). In the pandemic cohort, older patients were at higher risk of prescribing (especially repeat prescribing). The most common clinical conditions for repeat prescribing were COPD comorbidity and urinary tract infection. Comorbidities were more common among repeat vs non-repeat prescribed patients. In the pandemic cohort, vs pre-pandemic, repeat and non-repeat prescribing for comorbidities generally declined less compared with shorter-term conditions (infections, including COPD exacerbation/lower respiratory tract infection). Our findings inform ongoing development of stewardship interventions in England..
Keywords
Antibiotic stewardship; antibiotic prescribing; COVID-19; primary care; electronic health records; Antmicrobial Stewardship; AMS; General Practice
Subject
Public Health and Healthcare, Primary Health Care
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
