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Antibiotic prescribing during office hours and out-of-hours: a comparison of quality and quantity in primary care in the Netherlands

Overview of attention for article published in British Journal of General Practice, February 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (73rd percentile)
  • Above-average Attention Score compared to outputs of the same age and source (55th percentile)

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Title
Antibiotic prescribing during office hours and out-of-hours: a comparison of quality and quantity in primary care in the Netherlands
Published in
British Journal of General Practice, February 2017
DOI 10.3399/bjgp17x689641
Pubmed ID
Authors

Vera Ec Debets, Theo Jm Verheij, Alike W van der Velden

Abstract

Unnecessary and non-first-choice antibiotic prescribing is a significant problem in primary care. It is often argued that irrational prescribing is higher during out-of-hours (OOH) consultations. To obtain insight into the quantity and quality of OOH antibiotic prescribing for commonly presented infectious diseases. Two two-way comparisons of 1) nationally dispensed antibiotics during office hours and OOH care, using data from the Dutch Foundation of Pharmaceutical Statistics, and 2) regional prescribing quality data from 45 primary care practices from Utrecht and its vicinity, and two large OOH services in Utrecht and Woerden. From the national data, yearly dispensed antibiotics were analysed per prescriber type, with respect to time (office hours or OOH) of prescription, types of antibiotics, and patients' age group. Regional prescribing rates, choice of antibiotic, and appropriateness of prescribing were compared for otitis media, sinusitis, tonsillitis, bronchitis, cystitis, and impetigo. Appropriateness was assessed by comparing all relevant information from medical files with the guideline recommendations. Only 6% of GP-prescribed antibiotics were prescribed OOH. OOH, cystitis and acute otitis media presented most often. First-choice prescribing was comparable for the two settings, whereas prescribing rates were higher OOH, with comparatively more amoxicillin(/clavulanate). The appropriateness evaluation, however, revealed that overprescribing was comparable, or even lower than, for daily practice. The suggestion that OOH antibiotic prescribing quality is worse than in daily practice does not seem founded. The higher OOH prescribing rates can be explained by a different population of presenting patients. The appropriateness of prescribing rather than prescribing rates, therefore, should be used to determine quality.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 84 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 84 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 14 17%
Student > Ph. D. Student 12 14%
Student > Bachelor 9 11%
Researcher 9 11%
Student > Postgraduate 5 6%
Other 10 12%
Unknown 25 30%
Readers by discipline Count As %
Medicine and Dentistry 27 32%
Pharmacology, Toxicology and Pharmaceutical Science 7 8%
Nursing and Health Professions 6 7%
Biochemistry, Genetics and Molecular Biology 2 2%
Psychology 2 2%
Other 9 11%
Unknown 31 37%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 October 2018.
All research outputs
#4,592,128
of 22,955,959 outputs
Outputs from British Journal of General Practice
#1,724
of 4,294 outputs
Outputs of similar age
#83,033
of 311,210 outputs
Outputs of similar age from British Journal of General Practice
#40
of 90 outputs
Altmetric has tracked 22,955,959 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,294 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.5. This one has gotten more attention than average, scoring higher than 59% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 311,210 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.
We're also able to compare this research output to 90 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.