Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis

Parker Magin; Kristen FitzGerald; Neil Spike; Alison Fielding; Mieke L. van Driel; Andrew Davey; Jean Ball; Elizabeth G. Holliday; Debbie Quain; Amanda Tapley; Marcus D. Cherry

Journal of Primary Health Care (Jan 2021)

Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis

Parker Magin,
Kristen FitzGerald,
Neil Spike,
Alison Fielding,
Mieke L. van Driel,
Andrew Davey,
Jean Ball,
Elizabeth G. Holliday,
Debbie Quain,
Amanda Tapley,
Marcus D. Cherry

Affiliations

Parker Magin: University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia; and Corresponding author. Email: [email protected]
Kristen FitzGerald: General Practice Training Tasmania, Hobart, Tasmania, Australia.
Neil Spike: Eastern Victoria General Practice Training, Melbourne, Victoria, Australia; and Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia.
Alison Fielding: University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia.
Mieke L. van Driel: The University of Queensland, Primary Care Clinical Unit, Faculty of Medicine, Brisbane, Queensland, Australia.
Andrew Davey: University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia.
Jean Ball: Hunter Medical Research Institute, Clinical Research Design IT and Statistical Support Unit, New Castle, NSW, Australia
Elizabeth G. Holliday: University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia.
Debbie Quain: University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia.
Amanda Tapley: University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia; and GP Synergy, General Practice Regional Training Organisation, NSW and ACT Research and Evaluation Unit, Newcastle, New South Wales, Australia.
Marcus D. Cherry: University of Newcastle, School of Medicine and Public Health, Faculty of Health and Medicine, Callaghan, New South Wales, Australia.

Journal volume & issue: Vol. 13, no. 1
pp. 5 – 14

Abstract

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ABSTRACT INTRODUCTIONOver-prescription of antibiotics for common infective conditions is an important health issue. Infective conjunctivitis represents one of the most common eye-related complaints in general practice. Despite its self-limiting nature, there is evidence of frequent general practitioner (GP) antibiotic prescribing for this condition, which is inconsistent with evidence-based guidelines. AIMTo investigate the prevalence and associations of GP registrars' (trainees') prescription of antibiotics for infective conjunctivitis. METHODSWe performed a cross-sectional analysis of the Registrar Encounters in Clinical Training (ReCEnT) ongoing prospective cohort study, which documents GP registrars' clinical consultations (involving collection of information from 60 consecutive consultations, at three points during registrar training). The outcome of the analyses was antibiotic prescription for a new diagnosis of conjunctivitis. Patient, registrar, practice and consultation variables were included in uni- and multivariable logistic regression analyses to test associations of these prescriptions. RESULTSIn total, 2333 registrars participated in 18 data collection rounds from 2010 to 2018. There were 1580 new cases of infective conjunctivitis (0.31% of all problems). Antibiotics (mainly topical) were prescribed in 1170 (74%) of these cases. Variables associated with antibiotic prescription included patients' Aboriginal or Torres Strait Islander status, registrar organisation of a follow up (both registrar and other GP follow up), and earlier registrar training term (more junior status). DISCUSSIONGP registrars, like established GPs, prescribe antibiotics for conjunctivitis in excess of guideline recommendations, but prescribing rates are lower in later training. These prescribing patterns have educational, social and economic consequences. Further educational strategies may enhance attenuation of registrars' prescribing during training.

Published in Journal of Primary Health Care

ISSN: 1172-6164 (Print); 1172-6156 (Online)
Publisher: CSIRO Publishing
Country of publisher: Australia
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.publish.csiro.au/hc

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