Document Detail


Doctor characteristics and prescribing antibiotics for urinary tract infections: the experience of an Asian country.
MedLine Citation:
PMID:  20722886     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
RATIONALE, AIMS AND OBJECTIVES: This study aims to explore the relationship between doctor characteristics and prescribing behaviour for patients with urinary tract infections (UTIs) using a 2-year population-based data set in Taiwan.
METHODS: This study used data from the Taiwan National Health Insurance Research Database. Our study sample consists of first-time ambulatory care visits for treatment of UTIs among female patients between 2005 and 2006 (n=45,934). The primary outcome studied was 'whether a broad-spectrum antibiotic was prescribed', and the key independent variables were 'doctor characteristics'. Doctor characteristics included gender, age (<41, 41-50, >50), specialty, type (hospital-based vs. office-based) and practice location. Multivariate logistic regression analysis using generalized estimated equations was performed to assess the adjusted odds ratio of the doctors using broad-spectrum antibiotics.
RESULTS: Among the sampled patients, 13.5% were prescribed broad-spectrum antibiotics at their first visit for treatment of UTIs. The adjusted odds of prescribing second-line antibiotics for doctors aged between 41-50 years and >50 years were 0.80 (P<0.001) and 0.90 (P=0.007) times, respectively, that of doctors aged <41 years. Doctors specializing in family medicine were 1.10 (P=0.006) times more likely than doctors specializing in obstetrics and gynaecology to prescribe broad-spectrum, and office-based doctors were 1.41 (P<0.001) times more likely than hospital-based doctors to do so.
CONCLUSIONS: We conclude that there is variation in doctor prescribing behaviour of antimicrobial therapy for UTIs, after adjusting for possible confounding factors. Continuing medical education and intervention should be designed for doctor groups with undesirable performance in prescribing antibiotics.
Authors:
Yi-Chun Lin; Hsiu-Chen Lin; Herng-Ching Lin
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Publication Detail:
Type:  Journal Article     Date:  2010-08-15
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  16     ISSN:  1365-2753     ISO Abbreviation:  J Eval Clin Pract     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  1221-6     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Section of Infectious Diseases, Department of Internal Medicine, Taipei Medical University Hospital and Lecturer, School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
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