Evidence map›Paper›PMID 31576508›Full record

Observational studyJournal of general internal medicine2019

Association between Physician Intensity of Antibiotic Prescribing and the Prescription of Benzodiazepines, Opioids and Proton-Pump Inhibitors to Nursing Home Residents: a Population-Based Observational Study.

Kieran L Quinn, Michael A Campitelli, Christina Diong, Nick Daneman, Nathan M Stall, Andrew M Morris, Allan S Detsky, Lianne Jeffs, Colleen J Maxwell, Chaim M Bell and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kieran L QuinnDepartment of Medicine, University of Toronto, Toronto, ON, Canada. kieran.quinn@sinaihealthsystem.ca.
Michael A CampitelliICES, Toronto, ON, Canada.
Christina DiongICES, Toronto, ON, Canada.
Nick DanemanDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Nathan M StallInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Andrew M MorrisDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Allan S DetskyDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Lianne JeffsInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Colleen J MaxwellICES, Toronto, ON, Canada.
Chaim M BellDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Susan E BronskillICES, Toronto, ON, Canada.

Funding

CIHR MOP-136854
6 · The paper itself

Abstract

backgroundPrescribing patterns for episodic medications, such as antibiotics, might make useful surrogate measures of a physician's overall prescribing practice because use is common, and variation exists across prescribers. However, the extent to which a physician's current antibiotic prescribing practices are associated with the rate of prescription of other potentially harmful medications remains unknown.

objectiveTo examine the association between a physician's rate of antibiotic prescribing and their prescribing rate of benzodiazepines, opioids and proton-pump inhibitors in older adults.

designPopulation-based cohort study in nursing homes in Ontario, Canada, which provides comprehensive clinical, behavioural and functional information on all patients.

participants1926 physicians who provided care among 128,979 physician-patient pairs in 2015. MAIN MEASURES: Likelihood of prescribing a benzodiazepine, opioid or proton-pump inhibitor between low-, average- and high-intensity antibiotic prescribers, adjusted for patient characteristics. KEY

resultsCompared with average-intensity antibiotic prescribers, high-intensity prescribers had an increased likelihood of prescribing a benzodiazepine (odds ratio 1.21 [95% CI, 1.11-1.32]), an opioid (odds ratio 1.28 [95% CI, 1.17-1.39]) or a proton-pump inhibitor (odds ratio 1.38 [95% CI, 1.27-1.51]]. High-intensity antibiotic prescribers were more likely to be high prescribers of all three medications (odds ratio 6.24 [95% CI, 2.90-13.39]) and also more likely to initiate all three medications, compared with average-intensity prescribers.

conclusionsThe intensity of a physician's episodic antibiotic prescribing was significantly associated with the likelihood of new and continued prescribing of opioids, benzodiazepines and proton-pump inhibitors in nursing homes. Patterns of episodic prescribing may be a useful mechanism to target physician-level interventions to optimize general prescribing behaviors, instead of prescribing behaviors for single medications.

Indexed as

Drug PrescriptionsAnalgesics, OpioidAnti-Bacterial AgentsBenzodiazepinesFemaleHumansLong-Term CareMaleNursing HomesOntarioPopulation SurveillancePractice Patterns, Physicians'Proton Pump InhibitorsAnalgesics, OpioidAnti-Bacterial AgentsBenzodiazepinesProton Pump Inhibitorsanti-bacterial agentsdrug prescriptionsinappropriate prescribingnursing homephysicians practice patterns

Identifiers

PMID31576508
PMCPMC6854144

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.