Antibiotic prescribing for sore throat

A cross-sectional analysis of the ReCEnT study exploring the habits of early-career doctors in family practice

A Dallas, ML Van Driel, S Morgan, A Tapley, Kim M Henderson, Jean Ball, C Oldmeadow, A Davey, KJ Mulquiney, Joshua Davis, N Spike, L McArthur, Paul Maginn

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: Acute sore throat is a common condition presenting to family practitioners. It is usually self-limiting, with antibiotic treatment recommended only for high-risk presentations. Overprescribing of antibiotics contributes to individual and community resistance. Learning to prescribe in the context of diagnostic uncertainty and patient pressures is a challenge for early-career doctors. Prescribing habits develop early and tend not to change with time.

    Objective: To establish the prevalence and associations of antibiotic prescribing for acute sore throat by Australian vocational trainees in family practice.

    Method: A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. This ongoing, multicentre prospective cohort study documents the nature of trainees’ consultation-based clinical experiences. Univariate and logistic regression analyses were conducted on data recorded in consultations for sore throat in nine collection periods during 2010–14.

    Results: Data from 856 individual trainees (response rate 95.2%) were analysed. Sore throat was managed in 2.3% encounters. Antibiotics were prescribed for 71.5% of sore throat diagnoses. The variables associated with prescribing were inner-regional location and higher socio-economic area. There was no significant association with younger age of patient or greater trainee experience. If an antibiotic was prescribed, the trainee was more likely to seek information from guidelines or a supervisor.

    Conclusions: The high frequency of antibiotic prescribing and the lack of attenuation in prescribing with increased experience suggest current educational interventions and the apprenticeship model of training is not fostering appropriate practice in this important clinical area. Targeted educational interventions, for supervisors as well as trainees, are indicated.
    Original languageEnglish
    Pages (from-to)302-308
    Number of pages7
    JournalFamily Practice
    Volume33
    Issue number3
    DOIs
    Publication statusPublished - 1 Jun 2016

    Fingerprint

    Pharyngitis
    Family Practice
    Habits
    Cross-Sectional Studies
    Anti-Bacterial Agents
    Referral and Consultation
    Foster Home Care
    Uncertainty
    Cohort Studies
    Logistic Models
    Regression Analysis
    Economics
    Learning
    Prospective Studies
    Guidelines
    Pressure

    Cite this

    Dallas, A ; Van Driel, ML ; Morgan, S ; Tapley, A ; Henderson, Kim M ; Ball, Jean ; Oldmeadow, C ; Davey, A ; Mulquiney, KJ ; Davis, Joshua ; Spike, N ; McArthur, L ; Maginn, Paul. / Antibiotic prescribing for sore throat : A cross-sectional analysis of the ReCEnT study exploring the habits of early-career doctors in family practice. In: Family Practice. 2016 ; Vol. 33, No. 3. pp. 302-308.
    @article{568c875bf2564db38d11600e89958bc2,
    title = "Antibiotic prescribing for sore throat: A cross-sectional analysis of the ReCEnT study exploring the habits of early-career doctors in family practice",
    abstract = "Background: Acute sore throat is a common condition presenting to family practitioners. It is usually self-limiting, with antibiotic treatment recommended only for high-risk presentations. Overprescribing of antibiotics contributes to individual and community resistance. Learning to prescribe in the context of diagnostic uncertainty and patient pressures is a challenge for early-career doctors. Prescribing habits develop early and tend not to change with time.Objective: To establish the prevalence and associations of antibiotic prescribing for acute sore throat by Australian vocational trainees in family practice.Method: A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. This ongoing, multicentre prospective cohort study documents the nature of trainees’ consultation-based clinical experiences. Univariate and logistic regression analyses were conducted on data recorded in consultations for sore throat in nine collection periods during 2010–14.Results: Data from 856 individual trainees (response rate 95.2{\%}) were analysed. Sore throat was managed in 2.3{\%} encounters. Antibiotics were prescribed for 71.5{\%} of sore throat diagnoses. The variables associated with prescribing were inner-regional location and higher socio-economic area. There was no significant association with younger age of patient or greater trainee experience. If an antibiotic was prescribed, the trainee was more likely to seek information from guidelines or a supervisor.Conclusions: The high frequency of antibiotic prescribing and the lack of attenuation in prescribing with increased experience suggest current educational interventions and the apprenticeship model of training is not fostering appropriate practice in this important clinical area. Targeted educational interventions, for supervisors as well as trainees, are indicated.",
    author = "A Dallas and {Van Driel}, ML and S Morgan and A Tapley and Henderson, {Kim M} and Jean Ball and C Oldmeadow and A Davey and KJ Mulquiney and Joshua Davis and N Spike and L McArthur and Paul Maginn",
    year = "2016",
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    doi = "10.1093/fampra/cmw014",
    language = "English",
    volume = "33",
    pages = "302--308",
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    Dallas, A, Van Driel, ML, Morgan, S, Tapley, A, Henderson, KM, Ball, J, Oldmeadow, C, Davey, A, Mulquiney, KJ, Davis, J, Spike, N, McArthur, L & Maginn, P 2016, 'Antibiotic prescribing for sore throat: A cross-sectional analysis of the ReCEnT study exploring the habits of early-career doctors in family practice', Family Practice, vol. 33, no. 3, pp. 302-308. https://doi.org/10.1093/fampra/cmw014

    Antibiotic prescribing for sore throat : A cross-sectional analysis of the ReCEnT study exploring the habits of early-career doctors in family practice. / Dallas, A; Van Driel, ML; Morgan, S; Tapley, A; Henderson, Kim M; Ball, Jean; Oldmeadow, C; Davey, A; Mulquiney, KJ; Davis, Joshua; Spike, N; McArthur, L; Maginn, Paul.

    In: Family Practice, Vol. 33, No. 3, 01.06.2016, p. 302-308.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Antibiotic prescribing for sore throat

    T2 - A cross-sectional analysis of the ReCEnT study exploring the habits of early-career doctors in family practice

    AU - Dallas, A

    AU - Van Driel, ML

    AU - Morgan, S

    AU - Tapley, A

    AU - Henderson, Kim M

    AU - Ball, Jean

    AU - Oldmeadow, C

    AU - Davey, A

    AU - Mulquiney, KJ

    AU - Davis, Joshua

    AU - Spike, N

    AU - McArthur, L

    AU - Maginn, Paul

    PY - 2016/6/1

    Y1 - 2016/6/1

    N2 - Background: Acute sore throat is a common condition presenting to family practitioners. It is usually self-limiting, with antibiotic treatment recommended only for high-risk presentations. Overprescribing of antibiotics contributes to individual and community resistance. Learning to prescribe in the context of diagnostic uncertainty and patient pressures is a challenge for early-career doctors. Prescribing habits develop early and tend not to change with time.Objective: To establish the prevalence and associations of antibiotic prescribing for acute sore throat by Australian vocational trainees in family practice.Method: A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. This ongoing, multicentre prospective cohort study documents the nature of trainees’ consultation-based clinical experiences. Univariate and logistic regression analyses were conducted on data recorded in consultations for sore throat in nine collection periods during 2010–14.Results: Data from 856 individual trainees (response rate 95.2%) were analysed. Sore throat was managed in 2.3% encounters. Antibiotics were prescribed for 71.5% of sore throat diagnoses. The variables associated with prescribing were inner-regional location and higher socio-economic area. There was no significant association with younger age of patient or greater trainee experience. If an antibiotic was prescribed, the trainee was more likely to seek information from guidelines or a supervisor.Conclusions: The high frequency of antibiotic prescribing and the lack of attenuation in prescribing with increased experience suggest current educational interventions and the apprenticeship model of training is not fostering appropriate practice in this important clinical area. Targeted educational interventions, for supervisors as well as trainees, are indicated.

    AB - Background: Acute sore throat is a common condition presenting to family practitioners. It is usually self-limiting, with antibiotic treatment recommended only for high-risk presentations. Overprescribing of antibiotics contributes to individual and community resistance. Learning to prescribe in the context of diagnostic uncertainty and patient pressures is a challenge for early-career doctors. Prescribing habits develop early and tend not to change with time.Objective: To establish the prevalence and associations of antibiotic prescribing for acute sore throat by Australian vocational trainees in family practice.Method: A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. This ongoing, multicentre prospective cohort study documents the nature of trainees’ consultation-based clinical experiences. Univariate and logistic regression analyses were conducted on data recorded in consultations for sore throat in nine collection periods during 2010–14.Results: Data from 856 individual trainees (response rate 95.2%) were analysed. Sore throat was managed in 2.3% encounters. Antibiotics were prescribed for 71.5% of sore throat diagnoses. The variables associated with prescribing were inner-regional location and higher socio-economic area. There was no significant association with younger age of patient or greater trainee experience. If an antibiotic was prescribed, the trainee was more likely to seek information from guidelines or a supervisor.Conclusions: The high frequency of antibiotic prescribing and the lack of attenuation in prescribing with increased experience suggest current educational interventions and the apprenticeship model of training is not fostering appropriate practice in this important clinical area. Targeted educational interventions, for supervisors as well as trainees, are indicated.

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