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Dental consultations in UK general practice and antibiotic prescribing rates: a retrospective cohort study

Dental consultations in UK general practice and antibiotic prescribing rates: a retrospective cohort study
Dental consultations in UK general practice and antibiotic prescribing rates: a retrospective cohort study

BACKGROUND: The frequency of consulting for dental problems in general medical practice, and antibiotic prescribing associated with these consultations, is poorly described.

AIM: To describe consultation rates and antibiotic use for dental problems in UK general medical practice, and explore factors associated with antibiotic prescribing for dental conditions.

DESIGN AND SETTING: A retrospective cohort study using Clinical Practice Research Datalink, a database of general practice patient records in the UK.

METHOD: All dental consultations between 2004 and 2013 were identified. The main outcome was the prescription of an antibiotic during a dental consultation. Multilevel logistic regression was conducted to examine factors associated with antibiotic prescription.

RESULTS: In all, 288 169 dental consultations were included in the cohort. The average rate of dental consultations was 6.06 consultations per 1000 patient-years. Rates of dental consultation decreased from 6.84 consultations per 1000 patient-years in 2008, to 4.23 consultations per 1000 patient-years in 2013. Consultation rates were higher among females than males and highest in patients aged 20-29 years. An antibiotic was prescribed in 57.1% of consultations. Significant predictors (P<0.001) of antibiotic prescribing included: patient middle age, male sex, and previous consultations for tooth-related problems. Antibiotics were more likely to be prescribed during consultations in December (odds ratio [OR] 1.18, 95% confidence interval [CI] = 1.13 to 1.24, P<0.001, reference month: June) and on a Monday (OR 1.10, 95% CI = 1.07 to 1.13, P<0.001) or a Friday (OR 1.15, 95% CI = 1.12 to 1.18, P<0.001, reference day: Wednesday).

CONCLUSION: Consultation rates for dental problems in UK general practice are relatively low but more than half result in the prescription of an antibiotic. This raises concerns about patient morbidity and contributions to antimicrobial resistance.

Anti-Bacterial Agents/economics, Female, General Practice/economics, General Practice, Dental/economics, Health Services Accessibility/economics, Humans, Logistic Models, Male, Practice Patterns, Physicians'/statistics & numerical data, Primary Health Care, Referral and Consultation/economics, Retrospective Studies, Socioeconomic Factors, United Kingdom/epidemiology
0960-1643
e329-e336
Cope, Anwen L
e4f0a157-0f4f-4e30-b02e-f1037df72135
Chestnutt, Ivor G
9e5aa7b4-0d23-443d-bb53-08dd5703ba37
Wood, Fiona
fc0b6a76-2928-4bda-aafc-2be3ac74446b
Francis, Nick A
9b610883-605c-4fee-871d-defaa86ccf8e
Cope, Anwen L
e4f0a157-0f4f-4e30-b02e-f1037df72135
Chestnutt, Ivor G
9e5aa7b4-0d23-443d-bb53-08dd5703ba37
Wood, Fiona
fc0b6a76-2928-4bda-aafc-2be3ac74446b
Francis, Nick A
9b610883-605c-4fee-871d-defaa86ccf8e

Cope, Anwen L, Chestnutt, Ivor G, Wood, Fiona and Francis, Nick A (2016) Dental consultations in UK general practice and antibiotic prescribing rates: a retrospective cohort study. British Journal of General Practice, 66 (646), e329-e336. (doi:10.3399/bjgp16X684757).

Record type: Article

Abstract

BACKGROUND: The frequency of consulting for dental problems in general medical practice, and antibiotic prescribing associated with these consultations, is poorly described.

AIM: To describe consultation rates and antibiotic use for dental problems in UK general medical practice, and explore factors associated with antibiotic prescribing for dental conditions.

DESIGN AND SETTING: A retrospective cohort study using Clinical Practice Research Datalink, a database of general practice patient records in the UK.

METHOD: All dental consultations between 2004 and 2013 were identified. The main outcome was the prescription of an antibiotic during a dental consultation. Multilevel logistic regression was conducted to examine factors associated with antibiotic prescription.

RESULTS: In all, 288 169 dental consultations were included in the cohort. The average rate of dental consultations was 6.06 consultations per 1000 patient-years. Rates of dental consultation decreased from 6.84 consultations per 1000 patient-years in 2008, to 4.23 consultations per 1000 patient-years in 2013. Consultation rates were higher among females than males and highest in patients aged 20-29 years. An antibiotic was prescribed in 57.1% of consultations. Significant predictors (P<0.001) of antibiotic prescribing included: patient middle age, male sex, and previous consultations for tooth-related problems. Antibiotics were more likely to be prescribed during consultations in December (odds ratio [OR] 1.18, 95% confidence interval [CI] = 1.13 to 1.24, P<0.001, reference month: June) and on a Monday (OR 1.10, 95% CI = 1.07 to 1.13, P<0.001) or a Friday (OR 1.15, 95% CI = 1.12 to 1.18, P<0.001, reference day: Wednesday).

CONCLUSION: Consultation rates for dental problems in UK general practice are relatively low but more than half result in the prescription of an antibiotic. This raises concerns about patient morbidity and contributions to antimicrobial resistance.

Full text not available from this repository.

More information

Published date: May 2016
Additional Information: © British Journal of General Practice 2016.
Keywords: Anti-Bacterial Agents/economics, Female, General Practice/economics, General Practice, Dental/economics, Health Services Accessibility/economics, Humans, Logistic Models, Male, Practice Patterns, Physicians'/statistics & numerical data, Primary Health Care, Referral and Consultation/economics, Retrospective Studies, Socioeconomic Factors, United Kingdom/epidemiology

Identifiers

Local EPrints ID: 436496
URI: http://eprints.soton.ac.uk/id/eprint/436496
ISSN: 0960-1643
PURE UUID: 1b7277d5-cdf5-468a-a18f-932a3a213066
ORCID for Nick A Francis: ORCID iD orcid.org/0000-0001-8939-7312

Catalogue record

Date deposited: 11 Dec 2019 17:30
Last modified: 17 Dec 2019 01:20

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