Evidence map›Paper›PMID 36167419›Full record

ArticleCMAJ open

Chronic diseases and compliance with provincial guidelines for outpatient antibiotic prescription in cases of otitis media and respiratory infections: a population-based study of linked data in Quebec, Canada, 2010-2017.

Élise Fortin, Geneviève Deceuninck, Caroline Sirois, Caroline Quach, Marc Simard, Marc Dionne, Sonia Jean, Alejandra Irace-Cima, Nadine Magali-Ufitinema

Open access · diamondAbstract read
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In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 32% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Evaluating Antibiotic Treatment Guideline Adherence to Ongoing Antibiotic Stewardship in a Tertiary Care Setting: A Retrospective Observational Study.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2024
    Article
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

9 authors at 1 institution in 1 country.

Élise FortinInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que. elise.fortin@inspq.qc.ca.
Geneviève DeceuninckInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que.
Caroline SiroisInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que.
Caroline QuachInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que.
Marc SimardInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que.
Marc DionneInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que.
Sonia JeanInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que.
Alejandra Irace-CimaInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que.
Nadine Magali-UfitinemaInstitut national de santé publique du Québec (Fortin, Deceuninck, Sirois, Simard, Jean, Irace-Cima), Québec, Que.; Department of Microbiology, Infectious Diseases and Immunology (Fortin, Quach), Faculty of Medicine, University of Montreal, Montréal, Que.; Department of Social and Preventive Medicine (Fortin, Sirois, Simard), Faculty of Medicine, Laval University; Centre d'excellence sur le vieillissement de Québec (Sirois), Centre de recherche du CHU de Québec; Faculty of Medicine (Dionne), Laval University; Centre de recherche du CHU de Québec (Dionne); Department of Medicine (Jean), Faculty of Medicine, Laval University; Direction de la prévention et du contrôle des maladies infectieuses (Magali-Ufitinema), Direction générale adjointe de la protection de la santé publique, Ministère de la Santé et des Services sociaux, Québec, Que.
Université Laval · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundIn Quebec, antibiotic use is higher among outpatients with chronic diseases. We sought to measure compliance with provincial guidelines for the treatment of otitis media and common respiratory infections, and to measure variations in compliance according to the presence of certain chronic diseases.

methodsWe conducted a population-based study of linked data on antibiotic dispensing covered by the public drug insurance plan between April 2010 and March 2017. We included patients who had consulted a primary care physician within 2 days before being dispensed an antibiotic for an infection targeted by provincial guidelines, including bronchitis in patients with chronic obstructive pulmonary disease, otitis media, pharyngitis, pneumonia and sinusitis. We computed proportions of prescriptions compliant with guidelines (use of recommended antibiotic for children, and use of recommended antibiotic and dosage for adults) by age group (children or adults) and chronic disease (respiratory, cardiovascular, diabetes, mental disorder or none). We measured the impact of chronic diseases on compliance using robust Poisson regression.

resultsWe analyzed between 14 677 and 198 902 prescriptions for each infection under study. Compliance was greater than 87% among children, but was lower among children with asthma (proportion ratios between 0.97 and 1.00). In adults, the chosen antibiotic was compliant for at least 73% of prescriptions, except for pharyngitis (≤ 61%). Accounting for dosage lowered compliance to between 31% and 61%. Compliance was lower in the presence of chronic diseases (proportion ratios between 0.94 and 0.98).

interpretationIt is possible that prescribing noncompliant prescriptions was sometimes appropriate, but the high frequency of noncompliance suggests room for improvement. Given that variations associated with chronic diseases were small, disease-specific guidelines for antibiotic prescriptions are likely to have a limited impact on compliance.

Indexed as

Otitis MediaPharyngitisRespiratory Tract InfectionsAdultAnti-Bacterial AgentsChildChronic DiseaseDrug PrescriptionsHumansOutpatientsPractice Patterns, Physicians'QuebecSemantic WebAnti-Bacterial Agents

Identifiers

PMID36167419
PMCPMC9578749
OpenAlexW4297374377

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.