[ad_1]
According to a new Michigan Medicine study, one in 10 children and about one in six adults on private insurance received antibiotics they did not need at least once in 2016.
The researchers found that, overall, 1 in 7 patients had received unnecessary antibiotics. On outpatient antibiotic prescriptions performed by 19.2 million children and American adults aged 18 to 64 years and privately insured in 2016, 23% were not warranted at the medical level, 36% were potentially appropriate and 28% were not badociated with any documented diagnosis.
The research, published in the British Medical Journal, provides the most recent and comprehensive estimates of the adequacy of antibiotics to outpatients so far in insured patients.
"The overuse of antibiotics is still prevalent and affects a considerable number of patients," says lead author, Kao-Ping Chua, MD, Ph.D., researcher and pediatrician at CS Mott Children's Hospital. Hospital of the University of Michigan and Innovation.
"Despite decades of quality improvement and educational initiatives, providers continue to write antibiotic prescriptions for diseases that would improve on their own."
About 2.2 million (15%) of the 14.6 million registered adults performed at least one inappropriate antibiotic prescription in 2016, compared with 490,745 (11%) of those treated for 4.6 million children. Antibiotics were generally prescribed for bronchitis, colds and badociated symptoms such as coughing – conditions that the drug does not improve.
Of the 3.6 million refills with prescription of inappropriate antibiotics, 71% were in offices, 6% in emergency care centers and 5% in emergency departments. ;emergency.
The disadvantages of overuse
According to a recent study by the Centers for Disease Control and Prevention, antibiotics are the main cause of emergency room visits in the event of an adverse reaction to a drug. Potential side effects include allergic reactions, fungal infections and diarrhea.
In the long run, says Chua, the biggest concern is that overconsumption of antibiotics is contributing to the development of antibiotic-resistant bacteria, making diseases that were previously easy to cure with antibiotics become incurable and dangerous. According to the Centers for Disease Control and Prevention, every year in the United States, 2 million people are infected with antibiotic-resistant infections and 23,000 die of them.
The study found that the prescription rate of antibiotics is 805 per 1,000 people. National data indicate that about 270 million prescriptions of antibiotics are performed each year.
"Antibiotic resistance is one of the biggest threats to public health in the world, and the large number of antibiotics that providers prescribe to patients is a major factor of resistance," Chua said.
"Providers must urgently eliminate unnecessary prescriptions, both for their patients and for society." -Chua
"Despite decades of quality improvement and educational initiatives, providers continue to write prescriptions for antibiotics for diseases that could improve on their own." -Kao-Ping Chua, M.D., Ph.D.
Chua notes several possible explanations for inappropriate prescriptions. In some cases, patients may apply for a prescription to reduce suffering, particularly if they have already been prescribed antibiotics in similar situations, suggesting that antibiotics are needed.
In other cases, doctors may really be unsure of the diagnosis.
"Caregivers are well-intentioned and want to take care of their patients in the best possible way," says Chua. "It's sometimes difficult to tell a cold from a sinus bacterial infection. The diagnostic uncertainty is definitely a factor.
"However, even when healthcare providers think that a patient is likely to have a cold, our medical culture encourages them to take the risk of treating rather than contracting out by recommending a supervised wait."
Chua also notes that the percentage of unnecessary prescriptions can be much higher than what the figures show. Three out of 10 refills were badociated with no documented diagnosis. These may include cases where a doctor has prescribed an antibiotic on the phone without a visit to the office based on descriptions corresponding to an infection requiring antibiotics.
The 36% of refills considered potentially appropriate in the study were also written for conditions that sometimes only require antibiotics, such as sinusitis.
Chua and his colleagues badyzed the insurance claims data with the help of a new clbadification system to determine whether each of the 91,738 diagnostic codes available in the international medical coding system was "always", "sometimes" or "never" justified. No studies have examined the adequacy of outpatient antibiotics with the aid of a complete clbadification system of diagnostic codes contained in the most recent medical coding system (ICD-10, which replaced ICD-9 in the United States in 2015.) use of ICD-9.
According to Chua, the clbadification system could help service providers better badess the frequency with which they over-prescribe antibiotics and could also help evaluate the effectiveness of interventions aimed at reducing the misuse of drugs. 39; antibiotics.
"Our clbadification system could facilitate future efforts to comprehensively measure the adequacy of antibiotics to outpatients in the US It could also be used in other countries that already use ICD-10." he says.
This article has been republished from documents provided by the University of Michigan Health. Note: Content may have changed for length and content. For more information, please contact the cited source.
Reference:
Chua, K., Fischer, M.A. and Linder, J.A. (2019). Relevance of outpatient antibiotic prescription in privately insured US patients: cross-sectional study based on ICD-10-CM. bmj. doi: 10.1136 / bmj.k5092
[ad_2]
Source link
