Evidence map›Paper›PMID 32552886›Full record

ArticleBMC health services research2020

Antibiotic prescribing in UK care homes 2016-2017: retrospective cohort study of linked data.

Catherine M Smith, Haydn Williams, Arnoupe Jhass, Selina Patel, Elise Crayton, Fabiana Lorencatto, Susan Michie, Andrew C Hayward, Laura J Shallcross, Preserving Antibiotics through Safe Stewardship group

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Catherine M SmithInstitute of Health Informatics, University College London, London, NW1 2DA, UK. catherine.m.smith@ucl.ac.uk.ORCID http://orcid.org/0000-0003-3959-8479
Haydn WilliamsFour Seasons Health Care, Norcliffe House, Station Road, Wilmslow, Cheshire, SK9 1BU, UK.
Arnoupe JhassInstitute of Health Informatics, University College London, London, NW1 2DA, UK.
Selina PatelInstitute of Health Informatics, University College London, London, NW1 2DA, UK.
Elise CraytonCentre for Behaviour Change, University College London, WC1E 7HB, London, UK.
Fabiana LorencattoCentre for Behaviour Change, University College London, WC1E 7HB, London, UK.
Susan MichieCentre for Behaviour Change, University College London, WC1E 7HB, London, UK.
Andrew C HaywardInstitute of Epidemiology and Health Care, University College London, WC1E 7HB, London, UK.
Laura J ShallcrossInstitute of Health Informatics, University College London, London, NW1 2DA, UK.
Preserving Antibiotics through Safe Stewardship group
University College London · GBSmith Institute · GB

Funding

Economic and Social Research Council (GB) ES/P008321/1Medical Research Council MR/K006584/1
6 · The paper itself

Abstract

backgroundOlder people living in care homes are particularly susceptible to infections and antibiotics are therefore used frequently for this population. However, there is limited information on antibiotic prescribing in this setting. This study aimed to investigate the frequency, patterns and risk factors for antibiotic prescribing in a large chain of UK care homes.

methodsRetrospective cohort study of administrative data from a large chain of UK care homes (resident and care home-level) linked to individual-level pharmacy data. Residents aged 65 years or older between 1 January 2016 and 31 December 2017 were included. Antibiotics were classified by type and as new or repeated prescriptions. Rates of antibiotic prescribing were calculated and modelled using multilevel negative binomial regression.

results13,487 residents of 135 homes were included. The median age was 85; 63% residents were female. 28,689 antibiotic prescriptions were dispensed, the majority were penicillins (11,327, 39%), sulfonamides and trimethoprim (5818, 20%), or other antibacterials (4665, 16%). 8433 (30%) were repeat prescriptions. The crude rate of antibiotic prescriptions was 2.68 per resident year (95% confidence interval (CI) 2.64-2.71). Increased antibiotic prescribing was associated with residents requiring more medical assistance (adjusted incidence rate ratio for nursing opposed to residential care 1.21, 95% CI 1.13-1.30). Prescribing rates varied widely by care home but there were no significant associations with the care home-level characteristics available in routine data.

conclusionsRates of antibiotic prescribing in care homes are high and there is substantial variation between homes. Further research is needed to understand the drivers of this variation to enable development of effective stewardship approaches that target the influences of prescribing.

Indexed as

AgedAged, 80 and overAnti-Bacterial AgentsFemaleHomes for the AgedHumansMaleNursing HomesPractice Patterns, Physicians'Retrospective StudiesSemantic WebUnited KingdomAnti-Bacterial AgentsAnti-bacterial agentsAntibiotic prescribingAntibiotic stewardshipcare homeInfectionLong-term careOlder people

Identifiers

PMID32552886
PMCPMC7301534
OpenAlexW3036292325

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.