Skip to main content Accessibility help
×
×
Home

Evidence of a care home effect on antibiotic prescribing for those that transition into a care home: a national data linkage study

  • L. Patterson (a1) (a2) (a3), A. Maguire (a2), C. Cardwell (a4), F. Kee (a2), C. Hughes (a5), L. Geoghegan (a6), L. Doherty (a3), M. Dolan (a7), N. Q. Verlander (a8) and D. O'Reilly (a4)...

Abstract

We compared antibiotic prescribing to older people in different settings to inform antibiotic stewardship interventions. We used data linkage to stratify individuals aged 65 years and over in Northern Ireland, 1st January 2012–31st December 2013, by residence: community dwelling, care home dwelling or ‘transitioned’ if admitted to a care home. The odds of being prescribed an antibiotic by residence were analysed using logistic regression, adjusting for patient demographics and selected medication use (proxy for co-morbidities). Trends in monthly antibiotic prescribing were examined in the 6 months pre- and post-admission to the care home. The odds of being prescribed at least one antibiotic were twofold higher in care homes compared with community dwellers (adjusted odds ratio 2.05, 95% CI 1.93–2.17). There was a proportionate increase of 51.5% in the percentage prescribed an antibiotic on admission, with a monthly average of 23% receiving an antibiotic in the 6 months post admission. While clinical need likely accounts for some of the observed antibiotic prescribing in care homes we cannot rule out more liberal prescribing, given the twofold difference between care home residents and their community dwelling peers having accounted for co-morbidities. The appropriateness of antibiotic prescribing in the care home setting should be examined.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Evidence of a care home effect on antibiotic prescribing for those that transition into a care home: a national data linkage study
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Evidence of a care home effect on antibiotic prescribing for those that transition into a care home: a national data linkage study
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Evidence of a care home effect on antibiotic prescribing for those that transition into a care home: a national data linkage study
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: L. Patterson, E-mail: lynsey.patterson@hscni.net

References

Hide All
1.O'Neill, J (2016) Tackling drug-resistance infections globally: final report and recommendations. The review on antimicrobial resistance. https://amr-review.org/sites/default/files/160518_Finalpaper_withcover.pdf (Accessed 6 September 2016).
2.Laxminarayan, R et al. (2016) Achieving global targets for antimicrobial resistance. Science 353, 874875.
3.Hughes, CM et al. (2012) ‘The way we do things around here’: an international comparison of treatment culture in nursing homes. Journal of the American Medical Directors Association 13, 360367.
4.Teixeira Rodrigues, A et al. (2013) Understanding physician antibiotic prescribing behaviour: a systematic review of qualitative studies. International Journal of Antimicrobial Agents 41, 203212.
5.Van Buul, LW et al. (2014) Factors influencing antibiotic prescribing in long-term care facilities: a qualitative in-depth study. BMC Geriatrics 14, 136.
6.Grijalva, CG, Nuorti, JP and Griffin, MR (2009) Antibiotic prescription rates for acute respiratory tract infections in US ambulatory settings. JAMA 302, 758.
7.Haeseker, MB et al. (2012) Trends in antibiotic prescribing in adults in Dutch general practice. PLoS One 7, e51860.
8.Covvey, JR et al. (2014) An association between socioeconomic deprivation and primary care antibiotic prescribing in Scotland. The Journal of Antimicrobial Chemotherapy 69, 835841.
9.Lee, GC et al. (2014) Outpatient antibiotic prescribing in the United States: 2000 to 2010. BMC Medicine 12, 96.
10.Hughes, CM and Tunney, MM (2013) Improving prescribing of antibiotics in long-term care: comment on ‘prolonged antibiotic treatment in long-term care’. JAMA Internal Medicine 173, 682683.
11.Rosello, A et al. (2017) Impact of long-term care facility residence on the antibiotic resistance of urinary tract Escherichia coli and Klebsiella. The Journal of Antimicrobial Chemotherapy 72, 11841192.
12.Maguire, A et al. (2013) Psychotropic medications and the transition into care: a national data linkage study. Journal of the American Geriatrics Society 61, 215221.
13.Patterson, L et al. (2014) The relationship between BMI and the prescription of anti-obesity medication according to social factors: a population cross sectional study. BMC Public Health 14, 87.
14.Bradley, MC et al. (2012) Potentially inappropriate prescribing and cost outcomes for older people: a cross-sectional study using the Northern Ireland Enhanced Prescribing Database. European Journal of Clinical Pharmacology 68, 14251433.
15.Chini, F et al. (2011) Can we use the pharmacy data to estimate the prevalence of chronic conditions? A comparison of multiple data sources. BMC Public Health 11, 688.
16.Lujic, S et al. (2017) Multimorbidity in Australia: comparing estimates derived using administrative data sources and survey data. PLoS One 12, e0183817.
17.Schröder, W et al. (2016) Gender differences in antibiotic prescribing in the community: a systematic review and meta-analysis. The Journal of Antimicrobial Chemotherapy 71, 18001806.
18.Smith, DRM et al. (2018) Understanding the gender gap in antibiotic prescribing: a cross-sectional analysis of English primary care. BMJ Open 8, e020203.
19.Information Services Division. Care home census for adults in Scotland. (2016) https://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Publications/2016-10-25/2016-10-25-CHCensus-Report.pdf?9542483092 (Accessed 8 February 2017).
20.van den Dool, C et al. (2016) The role of nursing homes in the spread of antimicrobial resistance over the healthcare network. Infection Control & Hospital Epidemiology 37, 761767.
21.Morin, L et al. (2016) Prevalence of potentially inappropriate medication use in older adults living in nursing homes: a systematic review. Journal of the American Medical Directors Association 17, 862.e1862.e9.
22.Opondo, D et al. (2012) Inappropriateness of medication prescriptions to elderly patients in the primary care setting: a systematic review. PLoS One 7, e43617.
23.Daneman, N et al. (2011) Antibiotic use in long-term care facilities. The Journal of Antimicrobial Chemotherapy 66, 28562863.
24.Van Buul, LW et al. (2012) Antibiotic use and resistance in long term care facilities. Journal of the American Medical Directors Association 13, 568.e1568.e13.
25.European Centre for Disease Prevention and Control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European long-term care facilities. April–May 2013 (2014). https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/healthcare-associated-infections-point-prevalence-survey-long-term-care-facilities-2013.pdf (Accessed 20 September 2016).
26.World Health Organisation. Global action plan on antimicrobial resistance (2015) http://www.wpro.who.int/entity/drug_resistance/resources/global_action_plan_eng.pdf (Accessed 8 February 2017).
27.Roche, E (2014) Time to change care home resident management: reflections on a GP-led service. British Journal of General Practice 64, 591592.
28.Scales, K et al. (2017) Nurse and medical provider perspectives on antibiotic stewardship in nursing homes. Journal of the American Geriatrics Society 65, 165171.
29.Charani, E, Cooke, J and Holmes, A (2010) Antibiotic stewardship programmes – what's missing? The Journal of Antimicrobial Chemotherapy 65, 22752277.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Patterson et al. supplementary material
Table S1

 Word (25 KB)
25 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed