Examining Non-Visit-Based Antibiotic Use to Improve Safety and Limit Resistance
Examining Non-Visit-Based Antibiotic Use to Improve Safety and Limit Resistance
批准号:
9507380
负责人:
Jeffrey A. Linder
金额:
$27.67万
依托单位国家:
美国
项目类别:
财政年份:
2016
资助国家:
美国
项目状态:
已结题
起止时间:
2016-09-30 至 2019-08-31
中文摘要
项目总结/文摘
英文摘要
Project Summary/Abstract
Background: Antibiotic overuse threatens patient safety by causing adverse effects and threatens the
effectiveness of antibiotics through the development of antibiotic resistance. However, studies to describe and
interventions to address these safety risks have focused on visit-based antibiotic prescribing. Non-visit-based
antibiotic use and prescribing has been largely invisible. In preliminary work, we found that 23% of patients
who received an antibiotic prescription did not have an office visit in the study year. We have also found that
clinicians prescribed 39% of antibiotic prescriptions on days when patients did not have visits. Non-visit-based
antibiotic fills by patients and prescribing by clinicians may contribute to patients' risk of adverse events and
hasten the spread of antibiotic resistance, but non-visit-based antibiotic prescribing has not been measured.
Research Strategy: To measure and describe the safety risk and antibiotic resistance pressure from
contemporary non-visit-based antibiotic use in the United States, we propose complementary specific aims
using claims data and electronic health record (EHR) prescribing data. Our main hypotheses are that 1) non-
visit-based antibiotic prescribing accounts for a significant proportion (>20%) of antibiotic use and 2) the
majority (>50%) of non-visit-based antibiotic use is untethered to a proximate clinic visit or a chronic, recurrent
problem. To address these hypotheses and plan for future interventions, we have 3 Specific Aims. Specific
Aim 1 is to perform a retrospective cohort study of medical and prescription drug claims of care received by
over 10 million commercial health plan and 50 million Medicaid enrollees to measure and describe non-visit-
based antibiotic prescription fills relative to all antibiotic fills. Specific Aim 2 is to perform a cohort study of
electronic health record (EHR) prescribing to measure and describe non-visit-based antibiotic prescribing as
well as conduct a mixed-methods study of EHR data and qualitative interviews with clinicians to understand the
rationales for non-visit-based antibiotic prescribing. Specific Aim 3 is to use the results of the national study,
cohort study, and mixed-methods sub-study to develop an evidence-based toolkit that can be used by other
clinicians, health systems, payors, and stakeholders to measure and address non-visit-based antibiotic use.
Implications and Future Directions: In the near term, this project will open a novel research front, quickly
expanding our understanding of antibiotic use in the United States. In the longer-term – at a time when the US
health care system is moving towards less visit-based care – this project will lay the foundation for
interventions to encourage judicious antibiotic prescribing and use, even in the absence of clinic visits. The
ultimate goal of this project and subsequent interventions is to preserve antibiotic effectiveness, limit the
spread of antibiotic-resistant bacteria, and to promote patient safety in ambulatory settings.
期刊论文(0)
专著(0)
科研奖励(0)
会议论文
Patient-Centered Stewardship to Improve Antibiotic Use in Ambulatory Care
-
批准号:10801756
-
项目类别:
-
资助金额:$50.0万
-
财政年份:2023
-
负责人:Jeffrey A. Linder
-
依托单位:
The Claude D. Pepper Older Americans Independence Center (OAIC) at Northwestern University
-
批准号:10027130
-
项目类别:
-
资助金额:$142.52万
-
财政年份:2020
-
负责人:Jeffrey A. Linder
-
依托单位:
The Claude D. Pepper Older Americans Independence Center (OAIC) at Northwestern University
-
批准号:10455650
-
项目类别:
-
资助金额:$142.07万
-
财政年份:2020
-
负责人:Jeffrey A. Linder
-
依托单位:
The Claude D. Pepper Older Americans Independence Center (OAIC) at Northwestern University
-
批准号:10220719
-
项目类别:
-
资助金额:$141.95万
-
财政年份:2020
-
负责人:Jeffrey A. Linder
-
依托单位:
The Claude D. Pepper Older Americans Independence Center (OAIC) at Northwestern University
-
批准号:10670159
-
项目类别:
-
资助金额:$141.63万
-
财政年份:2020
-
负责人:Jeffrey A. Linder
-
依托单位:
Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis
-
批准号:8265219
-
项目类别:
-
资助金额:$29.67万
-
财政年份:2010
-
负责人:Jeffrey A. Linder
-
依托单位:
Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis
-
批准号:8142077
-
项目类别:
-
资助金额:$30.24万
-
财政年份:2010
-
负责人:Jeffrey A. Linder
-
依托单位:
Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis
-
批准号:7939152
-
项目类别:
-
资助金额:$32.36万
-
财政年份:2010
-
负责人:Jeffrey A. Linder
-
依托单位:
Demonstration of Near Zero Antibiotic Prescribing for Acute Bronchitis
-
批准号:8479333
-
项目类别:
-
资助金额:$30.12万
-
财政年份:2010
-
负责人:Jeffrey A. Linder
-
依托单位:
Improving Care for Acute Respiratory Infection
-
批准号:7279313
-
项目类别:
-
资助金额:$13.39万
-
财政年份:2004
-
负责人:Jeffrey A. Linder
-
依托单位:
Improving Care for Acute Respiratory Infection
-
批准号:6814411
-
项目类别:
-
资助金额:$13.35万
-
财政年份:2004
-
负责人:Jeffrey A. Linder
-
依托单位:
Improving Care for Acute Respiratory Infection
-
批准号:7086374
-
项目类别:
-
资助金额:$13.39万
-
财政年份:2004
-
负责人:Jeffrey A. Linder
-
依托单位:
Improving Care for Acute Respiratory Infection
-
批准号:6948920
-
项目类别:
-
资助金额:$13.38万
-
财政年份:2004
-
负责人:Jeffrey A. Linder
-
依托单位:
Improving Care for Acute Respiratory Infection
-
批准号:7478345
-
项目类别:
-
资助金额:$13.39万
-
财政年份:2004
-
负责人:Jeffrey A. Linder
-
依托单位:
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