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Antibiotic prescribing by ambulatory care physicians for adults with nasopharyngitis, URIs, and acute bronchitis in Taiwan: a multi-level modeling approach.
Fam Pract. 2005 Apr; 22(2):160-7.FP

Abstract

BACKGROUND

Imprudent prescribing of antibiotics in ambulatory care in Asia is of great concern. However, an adequate understanding of factors associated with antibiotic prescribing patterns in Asia has not been achieved.

OBJECTIVE

Our aim was to identify patient and physician characteristics that influence antibiotic prescribing for adults with nasopharyngitis (common colds), upper respiratory tract infections (URIs) or bronchitis in Taiwan.

METHODS

Generalized Estimating Equations (GEE) were used to analyze all 128,260 episodes of common colds, URIs and bronchitis generated by a random sample of 137,935 adult National Health Insurance (NHI) beneficiaries (> or = 18 years old) in Taiwan in 2000.

RESULTS

Multivariate analysis results revealed substantial variations across different physician groups. Physician age and accreditation level of the physician's practice setting were the characteristics most associated with prescribing of antibiotics at the initial encounters for these episodes of care. Urban practising physicians (adjusted OR 1.69, 95% CI 1.29-2.21) and those who were self-dispensing or with on-site pharmacists (adjusted OR 1.32, 95% CI 1.19-1.46) were also higher prescribers of antibiotics for adults. Other significant physician predictors included physician specialty, patient volume, and ownership of practice setting.

CONCLUSIONS

Results suggest that both accessibility to updated medical information and economic incentives of the attending physician may shape prescribing of antibiotics in ambulatory care in Taiwan. Interventions should be developed to influence these modifiable factors to reduce antibiotic prescriptions of questionable value.

Authors+Show Affiliations

Department of Health Education, National Taiwan Normal University, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15722399

Citation

Huang, Nicole, et al. "Antibiotic Prescribing By Ambulatory Care Physicians for Adults With Nasopharyngitis, URIs, and Acute Bronchitis in Taiwan: a Multi-level Modeling Approach." Family Practice, vol. 22, no. 2, 2005, pp. 160-7.
Huang N, Chou YJ, Chang HJ, et al. Antibiotic prescribing by ambulatory care physicians for adults with nasopharyngitis, URIs, and acute bronchitis in Taiwan: a multi-level modeling approach. Fam Pract. 2005;22(2):160-7.
Huang, N., Chou, Y. J., Chang, H. J., Ho, M., & Morlock, L. (2005). Antibiotic prescribing by ambulatory care physicians for adults with nasopharyngitis, URIs, and acute bronchitis in Taiwan: a multi-level modeling approach. Family Practice, 22(2), 160-7.
Huang N, et al. Antibiotic Prescribing By Ambulatory Care Physicians for Adults With Nasopharyngitis, URIs, and Acute Bronchitis in Taiwan: a Multi-level Modeling Approach. Fam Pract. 2005;22(2):160-7. PubMed PMID: 15722399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibiotic prescribing by ambulatory care physicians for adults with nasopharyngitis, URIs, and acute bronchitis in Taiwan: a multi-level modeling approach. AU - Huang,Nicole, AU - Chou,Yiing-Jenq, AU - Chang,Hong-Jen, AU - Ho,Monto, AU - Morlock,Laura, Y1 - 2005/02/18/ PY - 2005/2/22/pubmed PY - 2005/7/8/medline PY - 2005/2/22/entrez SP - 160 EP - 7 JF - Family practice JO - Fam Pract VL - 22 IS - 2 N2 - BACKGROUND: Imprudent prescribing of antibiotics in ambulatory care in Asia is of great concern. However, an adequate understanding of factors associated with antibiotic prescribing patterns in Asia has not been achieved. OBJECTIVE: Our aim was to identify patient and physician characteristics that influence antibiotic prescribing for adults with nasopharyngitis (common colds), upper respiratory tract infections (URIs) or bronchitis in Taiwan. METHODS: Generalized Estimating Equations (GEE) were used to analyze all 128,260 episodes of common colds, URIs and bronchitis generated by a random sample of 137,935 adult National Health Insurance (NHI) beneficiaries (> or = 18 years old) in Taiwan in 2000. RESULTS: Multivariate analysis results revealed substantial variations across different physician groups. Physician age and accreditation level of the physician's practice setting were the characteristics most associated with prescribing of antibiotics at the initial encounters for these episodes of care. Urban practising physicians (adjusted OR 1.69, 95% CI 1.29-2.21) and those who were self-dispensing or with on-site pharmacists (adjusted OR 1.32, 95% CI 1.19-1.46) were also higher prescribers of antibiotics for adults. Other significant physician predictors included physician specialty, patient volume, and ownership of practice setting. CONCLUSIONS: Results suggest that both accessibility to updated medical information and economic incentives of the attending physician may shape prescribing of antibiotics in ambulatory care in Taiwan. Interventions should be developed to influence these modifiable factors to reduce antibiotic prescriptions of questionable value. SN - 0263-2136 UR - https://www.unboundmedicine.com/medline/citation/15722399/Antibiotic_prescribing_by_ambulatory_care_physicians_for_adults_with_nasopharyngitis_URIs_and_acute_bronchitis_in_Taiwan:_a_multi_level_modeling_approach_ L2 - https://academic.oup.com/fampra/article-lookup/doi/10.1093/fampra/cmh734 DB - PRIME DP - Unbound Medicine ER -