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Antibiotics for acute cough: an international observational study of patient adherence in primary care

Antibiotics for acute cough: an international observational study of patient adherence in primary care
Antibiotics for acute cough: an international observational study of patient adherence in primary care
Background: Non-adherence to acute antibiotic prescriptions is poorly described and may impact on clinical outcomes, healthcare costs, and interpretation of research. It also results in leftover antibiotics that could be used inappropriately.

Aim: To describe adherence to antibiotics prescribed for adults presenting with acute cough in primary care, factors associated with non-adherence, and associated recovery.

Design and setting: Prospective observational cohort study in general practices in 14 European primary care networks.

Method: GPs recorded patient characteristics and prescribing decisions for adults with acute cough or clinical presentation suggestive of lower respiratory tract infection. Patients recorded antibiotic consumption and daily symptoms over 28 days. Rates of adherence to prescribed antibiotics were assessed, and factors associated with non-adherence were identified using logistic regression. Recovery was compared using a Cox proportional hazards model.

Results: Of 2520 patients prescribed immediate or no antibiotics at the index consultation, 282 (11.2%) took an antibiotic during the follow-up period that was not prescribed for them at the index consultation. Of these, 38.1% had no reconsultations during this period. Prior duration of symptoms, antibiotic treatment duration, antibiotic choice, and primary care network were all associated with adherence. There was no difference in time to recovery between those who were prescribed antibiotics at the index consultation and were fully adherent, partially adherent, and non-adherent.

Conclusion: Non-adherence to antibiotics for acute cough or lower respiratory tract infection is common. Duration of treatment, choice of antibiotic, and setting were associated with adherence but adherence to treatment was not associated with differences in recovery
anti-bacterial agents, cough, general practice, medication adherence, respiratory tract infections
0960-1643
e429-e437
Francis, Nick A.
4fef3cf0-2dda-4294-bde7-e29eb33bbfdc
Gillespie, David
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Nuttall, Jacqueline
1e454af7-f89e-4e93-b537-bc3a04989ad1
Hood, Kerenza
62906d76-4931-4b12-9a64-0c867c7b84c1
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Cals, Jochen W.
cf15c88f-856d-4793-b26a-c38aa85556ab
Goossens, Herman
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Butler, Christopher C.
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Moore, M.
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GRACE Project Group
Francis, Nick A.
4fef3cf0-2dda-4294-bde7-e29eb33bbfdc
Gillespie, David
a1389d8b-011c-408e-8064-2ce4ccf3312a
Nuttall, Jacqueline
1e454af7-f89e-4e93-b537-bc3a04989ad1
Hood, Kerenza
62906d76-4931-4b12-9a64-0c867c7b84c1
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Cals, Jochen W.
cf15c88f-856d-4793-b26a-c38aa85556ab
Goossens, Herman
31f8e1ae-7da0-473c-bd49-f911c2187451
Butler, Christopher C.
2782a915-eb8d-48bb-ae70-118114697f57
Moore, M.
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Francis, Nick A., Gillespie, David, Nuttall, Jacqueline, Hood, Kerenza, Little, Paul, Verheij, Theo, Coenen, Samuel, Cals, Jochen W., Goossens, Herman, Butler, Christopher C. and Moore, M. , GRACE Project Group (2012) Antibiotics for acute cough: an international observational study of patient adherence in primary care. British Journal of General Practice, 62 (599), e429-e437. (doi:10.3399/bjgp12X649124). (PMID:22687236)

Record type: Article

Abstract

Background: Non-adherence to acute antibiotic prescriptions is poorly described and may impact on clinical outcomes, healthcare costs, and interpretation of research. It also results in leftover antibiotics that could be used inappropriately.

Aim: To describe adherence to antibiotics prescribed for adults presenting with acute cough in primary care, factors associated with non-adherence, and associated recovery.

Design and setting: Prospective observational cohort study in general practices in 14 European primary care networks.

Method: GPs recorded patient characteristics and prescribing decisions for adults with acute cough or clinical presentation suggestive of lower respiratory tract infection. Patients recorded antibiotic consumption and daily symptoms over 28 days. Rates of adherence to prescribed antibiotics were assessed, and factors associated with non-adherence were identified using logistic regression. Recovery was compared using a Cox proportional hazards model.

Results: Of 2520 patients prescribed immediate or no antibiotics at the index consultation, 282 (11.2%) took an antibiotic during the follow-up period that was not prescribed for them at the index consultation. Of these, 38.1% had no reconsultations during this period. Prior duration of symptoms, antibiotic treatment duration, antibiotic choice, and primary care network were all associated with adherence. There was no difference in time to recovery between those who were prescribed antibiotics at the index consultation and were fully adherent, partially adherent, and non-adherent.

Conclusion: Non-adherence to antibiotics for acute cough or lower respiratory tract infection is common. Duration of treatment, choice of antibiotic, and setting were associated with adherence but adherence to treatment was not associated with differences in recovery

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More information

Published date: June 2012
Keywords: anti-bacterial agents, cough, general practice, medication adherence, respiratory tract infections
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 342862
URI: http://eprints.soton.ac.uk/id/eprint/342862
ISSN: 0960-1643
PURE UUID: adb9beb0-afd1-42d6-8dbc-0e670964564d
ORCID for M. Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 17 Sep 2012 11:10
Last modified: 26 Nov 2021 02:49

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Contributors

Author: Nick A. Francis
Author: David Gillespie
Author: Jacqueline Nuttall
Author: Kerenza Hood
Author: Paul Little
Author: Theo Verheij
Author: Samuel Coenen
Author: Jochen W. Cals
Author: Herman Goossens
Author: Christopher C. Butler
Author: M. Moore ORCID iD
Corporate Author: GRACE Project Group

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