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Delayed antibiotic prescribing for respiratory tract infections: an individual patient data meta-analysis

Delayed antibiotic prescribing for respiratory tract infections: an individual patient data meta-analysis
Delayed antibiotic prescribing for respiratory tract infections: an individual patient data meta-analysis

Introduction: Delayed prescribing can be a useful strategy to reduce antibiotic prescribing, but it is not clear for whom delayed prescribing might be effective. This protocol outlines an individual patient data (IPD) meta-analysis of randomised controlled trials (RCTs) and observational cohort studies to explore the overall effect of delayed prescribing and identify key patient characteristics that are associated with efficacy of delayed prescribing.
Methods and analysis: A systematic search of the databases Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid Embase, EBSCO CINAHL Plus and Web of Science was conducted to identify relevant studies from inception to October 2017. Outcomes of interest include duration of illness, severity of illness, complication, reconsultation and patient satisfaction. Study authors of eligible papers will be contacted and invited to contribute raw IPD data. IPD data will be checked against published data, harmonised and aggregated to create one large IPD database. Multilevel regression will be performed to explore interaction effects between treatment allocation and patient characteristics. The economic evaluation will be conducted based on IPD from the combined trial and observational studies to estimate the differences in costs and effectiveness for delayed prescribing compared with normal practice. A decision model will be developed to assess potential savings and cost-effectiveness in terms of reduced antibiotic usage of delayed prescribing and quality-adjusted life years.
Ethics and dissemination Ethical approval was obtained from the University of Southampton Faculty of Medicine Research Ethics Committee (Reference number: 30068). Findings of this study will be published in peer-reviewed academic journals as well as General Practice trade journals and will be presented at national and international conferences. The results will have important public health implications, shaping the way in which antibiotics are prescribed in the future and to whom delayed prescriptions are issued.
2044-6055
Stuart, Beth
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Hounkpatin, Hilda
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Becque, Taeko
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Yao, Lily
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Zhu, Shihua
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Alonso-Coello, Pablo
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Altiner, Attila
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Arroll, Bruce
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Bohning, Dankmar
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Bostock, Jennifer
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Bucher, Heiner C.
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Chao, Jennifer
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De La Poza Abad, Mariam
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Francis, NA
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Gillespie, David
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Hay, Alastair
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Kenealy, Timothy
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Loffler, Christin
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McCormick, David
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Mas-Dalmau, Gemma
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Munoz, Laura
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Samuel, Kirsty
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Moore, Michael
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Little, Paul
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Stuart, Beth
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Hounkpatin, Hilda
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Becque, Taeko
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Yao, Lily
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Zhu, Shihua
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Alonso-Coello, Pablo
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Altiner, Attila
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Arroll, Bruce
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Bohning, Dankmar
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Bostock, Jennifer
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Bucher, Heiner C.
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Chao, Jennifer
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De La Poza Abad, Mariam
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Francis, NA
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Gillespie, David
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Hay, Alastair
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Kenealy, Timothy
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Loffler, Christin
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McCormick, David
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Mas-Dalmau, Gemma
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Munoz, Laura
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Samuel, Kirsty
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Moore, Michael
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Little, Paul
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Stuart, Beth, Hounkpatin, Hilda, Becque, Taeko, Yao, Lily, Zhu, Shihua, Alonso-Coello, Pablo, Altiner, Attila, Arroll, Bruce, Bohning, Dankmar, Bostock, Jennifer, Bucher, Heiner C., Chao, Jennifer, De La Poza Abad, Mariam, Francis, NA, Gillespie, David, Hay, Alastair, Kenealy, Timothy, Loffler, Christin, McCormick, David, Mas-Dalmau, Gemma, Munoz, Laura, Samuel, Kirsty, Moore, Michael and Little, Paul (2019) Delayed antibiotic prescribing for respiratory tract infections: an individual patient data meta-analysis. BMJ Open, 9. (doi:10.1136/bmjopen-2018-026925).

Record type: Article

Abstract


Introduction: Delayed prescribing can be a useful strategy to reduce antibiotic prescribing, but it is not clear for whom delayed prescribing might be effective. This protocol outlines an individual patient data (IPD) meta-analysis of randomised controlled trials (RCTs) and observational cohort studies to explore the overall effect of delayed prescribing and identify key patient characteristics that are associated with efficacy of delayed prescribing.
Methods and analysis: A systematic search of the databases Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid Embase, EBSCO CINAHL Plus and Web of Science was conducted to identify relevant studies from inception to October 2017. Outcomes of interest include duration of illness, severity of illness, complication, reconsultation and patient satisfaction. Study authors of eligible papers will be contacted and invited to contribute raw IPD data. IPD data will be checked against published data, harmonised and aggregated to create one large IPD database. Multilevel regression will be performed to explore interaction effects between treatment allocation and patient characteristics. The economic evaluation will be conducted based on IPD from the combined trial and observational studies to estimate the differences in costs and effectiveness for delayed prescribing compared with normal practice. A decision model will be developed to assess potential savings and cost-effectiveness in terms of reduced antibiotic usage of delayed prescribing and quality-adjusted life years.
Ethics and dissemination Ethical approval was obtained from the University of Southampton Faculty of Medicine Research Ethics Committee (Reference number: 30068). Findings of this study will be published in peer-reviewed academic journals as well as General Practice trade journals and will be presented at national and international conferences. The results will have important public health implications, shaping the way in which antibiotics are prescribed in the future and to whom delayed prescriptions are issued.

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Accepted/In Press date: 22 November 2018
e-pub ahead of print date: 21 January 2019

Identifiers

Local EPrints ID: 427935
URI: http://eprints.soton.ac.uk/id/eprint/427935
ISSN: 2044-6055
PURE UUID: 054ce11c-df29-413a-bef3-409358e1ff59
ORCID for Beth Stuart: ORCID iD orcid.org/0000-0001-5432-7437
ORCID for Hilda Hounkpatin: ORCID iD orcid.org/0000-0002-1360-1791
ORCID for Taeko Becque: ORCID iD orcid.org/0000-0002-0362-3794
ORCID for Dankmar Bohning: ORCID iD orcid.org/0000-0003-0638-7106
ORCID for NA Francis: ORCID iD orcid.org/0000-0001-8939-7312
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 05 Feb 2019 17:30
Last modified: 16 Mar 2024 04:42

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Contributors

Author: Beth Stuart ORCID iD
Author: Taeko Becque ORCID iD
Author: Lily Yao
Author: Shihua Zhu
Author: Pablo Alonso-Coello
Author: Attila Altiner
Author: Bruce Arroll
Author: Dankmar Bohning ORCID iD
Author: Jennifer Bostock
Author: Heiner C. Bucher
Author: Jennifer Chao
Author: Mariam De La Poza Abad
Author: NA Francis ORCID iD
Author: David Gillespie
Author: Alastair Hay
Author: Timothy Kenealy
Author: Christin Loffler
Author: David McCormick
Author: Gemma Mas-Dalmau
Author: Laura Munoz
Author: Kirsty Samuel
Author: Michael Moore ORCID iD
Author: Paul Little

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