@article{Aylin:2018:jac/dky237,
author = {Aylin, PP and Bou-Antoun, S and Costelloe, CE and Honeyford, CE and Hayhoe, B and Holmes, A and Mazidi, M and Johnson, AP},
doi = {jac/dky237},
journal = {Journal of Antimicrobial Chemotherapy},
pages = {2883--2892},
title = {Age-related decline in antibiotic prescribing for uncomplicated respiratory tract infections in primary care in England following the introduction of a national financial incentive (the Quality Premium) for health commissioners to reduce use of antibiotics in the community: an interrupted time series analysis},
url = {http://dx.doi.org/10.1093/jac/dky237},
volume = {73},
year = {2018}
}

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TY  - JOUR
AB  - Objectives: To assess the impact of the 2015/16 NHS England Quality Premium (which provided a financial incentive for Clinical Commissioning Groups to reduce antibiotic prescribing in primary care) on antibiotic prescribing by General Practitioners (GPs) for respiratory tract infections (RTIs).Method: Interrupted time series analysis using monthly patient-level consultation and prescribing data obtained from the Clinical Practice Research Datalink (CPRD), between April 2011 and March 2017. The study population comprised patients consulting a GP who were diagnosed with an RTI. We assessed the rate of antibiotic prescribing in patients (both aggregate and stratified by age) with a recorded diagnosis of uncomplicated RTI, before and after the implementation of the Quality Premium.Results: Prescribing rates decreased over the six year study period, with evident seasonality. Notably, there was a 3% drop in the rate of antibiotic prescribing (equating to 14.65 prescriptions per 1,000 RTI consultations) (p<0.05) in April 2015, coinciding with the introduction of the Quality Premium. This reduction was sustained, such that after two years there was a 3% decrease in prescribing relative to that expected had the pre-intervention trend continued. There was also a concurrent 2% relative reduction in the rate of broad-spectrum antibiotic prescribing. Antibiotic prescribing for RTIs diagnosed in children showed the greatest decline with a 6% relative change two years after the intervention. Of the RTI indications studied, the greatest reductions in antibiotic prescribing were seen for patients with sore throats.Conclusions: Community prescribing of antibiotics for RTIs significantly decreased following the introduction of the Quality Premium, with the greatest reduction seen in younger patients.
AU  - Aylin,PP
AU  - Bou-Antoun,S
AU  - Costelloe,CE
AU  - Honeyford,CE
AU  - Hayhoe,B
AU  - Holmes,A
AU  - Mazidi,M
AU  - Johnson,AP
DO  - jac/dky237
EP  - 2892
PY  - 2018///
SN  - 0305-7453
SP  - 2883
TI  - Age-related decline in antibiotic prescribing for uncomplicated respiratory tract infections in primary care in England following the introduction of a national financial incentive (the Quality Premium) for health commissioners to reduce use of antibiotics in the community: an interrupted time series analysis
T2  - Journal of Antimicrobial Chemotherapy
UR  - http://dx.doi.org/10.1093/jac/dky237
UR  - https://academic.oup.com/jac/article/73/10/2883/5043144
UR  - http://hdl.handle.net/10044/1/60358
VL  - 73
ER  - 

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