幻影处方:检查抗菌药物处方的频率没有病人访问

B. Riedle, Linnea A. Polgreen, J. Cavanaugh, M. Schroeder, P. Polgreen
{"title":"幻影处方:检查抗菌药物处方的频率没有病人访问","authors":"B. Riedle, Linnea A. Polgreen, J. Cavanaugh, M. Schroeder, P. Polgreen","doi":"10.1017/ice.2016.269","DOIUrl":null,"url":null,"abstract":"OBJECTIVE To investigate the scale of antimicrobial prescribing without a corresponding visit, and to compare the attributes of patients who received antimicrobials with a corresponding visit with those who did not have a visit. DESIGN Retrospective cohort. METHODS We followed up 185,010 Medicare patients for 1 year after an acute myocardial infarction. For each antimicrobial prescribed, we determined whether the patient had an inpatient, outpatient, or provider claim in the 7 days prior to the antimicrobial prescription being filled. We compared the proportions of patient characteristics for those prescriptions associated with a visit and without a visit (ie, phantom prescriptions). We also compared the rates at which different antimicrobials were prescribed without a visit. RESULTS We found that of 356,545 antimicrobial prescriptions, 14.75% had no evidence of a visit in the week prior to the prescription being filled. A higher percentage of patients without a visit were identified as white (P<.001) and female (P<.001). Patients without a visit had a higher likelihood of survival and fewer additional cardiac events (acute myocardial infarction, cardiac arrest, stroke, all P<.001). Among the antimicrobials considered, amoxicillin, penicillin, and agents containing trimethoprim and methenamine were much more likely to be prescribed without a visit. In contrast, levofloxacin, metronidazole, moxifloxacin, vancomycin, and cefdinir were much less likely to be prescribed without a visit. CONCLUSIONS Among this cohort of patients with chronic conditions, phantom prescriptions of antimicrobials are relatively common and occurred more frequently among those patients who were relatively healthy. Infect Control Hosp Epidemiol 2017;38:273–280","PeriodicalId":13655,"journal":{"name":"Infection Control &#x0026; Hospital Epidemiology","volume":"121 1","pages":"273 - 280"},"PeriodicalIF":0.0000,"publicationDate":"2016-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"14","resultStr":"{\"title\":\"Phantom Prescribing: Examining the Frequency of Antimicrobial Prescriptions Without a Patient Visit\",\"authors\":\"B. Riedle, Linnea A. Polgreen, J. Cavanaugh, M. Schroeder, P. Polgreen\",\"doi\":\"10.1017/ice.2016.269\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE To investigate the scale of antimicrobial prescribing without a corresponding visit, and to compare the attributes of patients who received antimicrobials with a corresponding visit with those who did not have a visit. DESIGN Retrospective cohort. METHODS We followed up 185,010 Medicare patients for 1 year after an acute myocardial infarction. For each antimicrobial prescribed, we determined whether the patient had an inpatient, outpatient, or provider claim in the 7 days prior to the antimicrobial prescription being filled. We compared the proportions of patient characteristics for those prescriptions associated with a visit and without a visit (ie, phantom prescriptions). We also compared the rates at which different antimicrobials were prescribed without a visit. RESULTS We found that of 356,545 antimicrobial prescriptions, 14.75% had no evidence of a visit in the week prior to the prescription being filled. A higher percentage of patients without a visit were identified as white (P<.001) and female (P<.001). Patients without a visit had a higher likelihood of survival and fewer additional cardiac events (acute myocardial infarction, cardiac arrest, stroke, all P<.001). Among the antimicrobials considered, amoxicillin, penicillin, and agents containing trimethoprim and methenamine were much more likely to be prescribed without a visit. In contrast, levofloxacin, metronidazole, moxifloxacin, vancomycin, and cefdinir were much less likely to be prescribed without a visit. CONCLUSIONS Among this cohort of patients with chronic conditions, phantom prescriptions of antimicrobials are relatively common and occurred more frequently among those patients who were relatively healthy. Infect Control Hosp Epidemiol 2017;38:273–280\",\"PeriodicalId\":13655,\"journal\":{\"name\":\"Infection Control &#x0026; Hospital Epidemiology\",\"volume\":\"121 1\",\"pages\":\"273 - 280\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"14\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infection Control &#x0026; Hospital Epidemiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1017/ice.2016.269\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Control &#x0026; Hospital Epidemiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1017/ice.2016.269","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 14

摘要

目的了解未进行相应就诊的抗菌药物处方规模,比较有相应就诊的患者与未进行相应就诊的患者的属性。设计回顾性队列。方法:我们对185,010例急性心肌梗死后的医保患者进行了为期1年的随访。对于每种抗菌素处方,我们确定患者在填写抗菌素处方前7天内是否有住院、门诊或提供者索赔。我们比较了那些与就诊和未就诊相关的处方(即虚幻处方)的患者特征比例。我们还比较了在没有就诊的情况下处方不同抗菌剂的比率。结果:在356545张抗菌药物处方中,14.75%的患者在配药前一周没有就诊证据。未就诊的患者比例较高的是白人(P< 0.001)和女性(P< 0.001)。没有就诊的患者有更高的生存可能性和更少的额外心脏事件(急性心肌梗死、心脏骤停、中风,均P< 0.001)。在所考虑的抗菌剂中,阿莫西林、青霉素和含有甲氧苄啶和甲基苯丙胺的药物更有可能在没有就诊的情况下开处方。相比之下,左氧氟沙星、甲硝唑、莫西沙星、万古霉素和头孢地尼在没有就诊的情况下开处方的可能性要小得多。结论:在这组慢性疾病患者中,抗菌药物的虚幻处方相对常见,在相对健康的患者中发生的频率更高。中华流行病学杂志,2017;38 (4):391 - 391
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Phantom Prescribing: Examining the Frequency of Antimicrobial Prescriptions Without a Patient Visit
OBJECTIVE To investigate the scale of antimicrobial prescribing without a corresponding visit, and to compare the attributes of patients who received antimicrobials with a corresponding visit with those who did not have a visit. DESIGN Retrospective cohort. METHODS We followed up 185,010 Medicare patients for 1 year after an acute myocardial infarction. For each antimicrobial prescribed, we determined whether the patient had an inpatient, outpatient, or provider claim in the 7 days prior to the antimicrobial prescription being filled. We compared the proportions of patient characteristics for those prescriptions associated with a visit and without a visit (ie, phantom prescriptions). We also compared the rates at which different antimicrobials were prescribed without a visit. RESULTS We found that of 356,545 antimicrobial prescriptions, 14.75% had no evidence of a visit in the week prior to the prescription being filled. A higher percentage of patients without a visit were identified as white (P<.001) and female (P<.001). Patients without a visit had a higher likelihood of survival and fewer additional cardiac events (acute myocardial infarction, cardiac arrest, stroke, all P<.001). Among the antimicrobials considered, amoxicillin, penicillin, and agents containing trimethoprim and methenamine were much more likely to be prescribed without a visit. In contrast, levofloxacin, metronidazole, moxifloxacin, vancomycin, and cefdinir were much less likely to be prescribed without a visit. CONCLUSIONS Among this cohort of patients with chronic conditions, phantom prescriptions of antimicrobials are relatively common and occurred more frequently among those patients who were relatively healthy. Infect Control Hosp Epidemiol 2017;38:273–280
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
ICE volume 39 issue 7 Cover and Front matter ICE volume 39 issue 7 Cover and Back matter ICE volume 39 issue 6 Cover and Front matter ICE volume 39 issue 6 Cover and Back matter ICE volume 39 issue 5 Cover and Back matter
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1