[ { "phenotype_id": "PH900", "phenotype_version_id": 1879, "name": "Otitis Externa", "definition": "Objectives: \n\nTo examine variations across general practices and factors associated with antibiotic prescribing for common infections in UK primary care to identify potential targets for improvement and optimization of prescribing.\n\n\nMethods: \n\nOral antibiotic prescribing for common infections was analysed using anonymized UK primary care electronic health records between 2000 and 2015 using the Clinical Practice Research Datalink (CPRD). The rate of prescribing for each condition was observed over time and mean change points were compared with national guideline updates. Any correlation between the rate of prescribing for each infectious condition was estimated within a practice. Predictors of prescribing were estimated using logistic regression in a matched patient cohort (1:1 by age, sex and calendar time).\n\n\nResults: \n\nOver 8 million patient records were examined in 587 UK general practices. Practices varied considerably in their propensity to prescribe antibiotics and this variance increased over time. Change points in prescribing did not reflect updates to national guidelines. Prescribing levels within practices were not consistent for different infectious conditions. A history of antibiotic use significantly increased the risk of receiving a subsequent antibiotic (by 22%–48% for patients with three or more antibiotic prescriptions in the past 12months), as did higher BMI, history of smoking and flu vaccinations. Other drivers for receiving an antibiotic varied considerably for each condition.\n\n\nConclusions: \n\nLarge variability in antibiotic prescribing between practices and within practices was observed. Prescribing guidelines alone do not positively influence a change in prescribing, suggesting more targeted interventions are required to optimize antibiotic prescribing in the UK.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Victoria Palin, Anna Molter, Darren M Ashcroft, Andrew White, William Welfare, Tjeerd van Staa, Antibiotic prescribing for common infections in UK general practice variability and drivers. Journal of Antimicrobial Chemotherapy, 74:2440-2450, 2019." } ], "validation": "", "citation_requirements": "", "created": "2022-04-04T07:09:15.481608Z", "author": "Victoria Palin, Anna Molter, Miguel Belmonte, Darren M Ashcroft, Andrew White, William Welfare, Tjeerd van Staa", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2022-04-04T07:09:15.481633Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Disease or syndrome", "value": "2" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 } ], "coding_system": [ { "name": "Read codes v2", "value": 5 } ], "event_date_range": "01/01/2000 - 30/06/2015", "concept_information": [ { "concept_id": 2672, "concept_version_id": 6757, "concept_name": "Otitis Externa - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH900", "phenotype_version_id": 1879, "phenotype_name": "Otitis Externa", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "2D95.00", "description": "O/E - tympanic membrane red", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F500.00", "description": "Perichondritis of pinna", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F500000", "description": "Unspecified perichondritis of pinna", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F500100", "description": "Acute perichondritis of pinna", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F500200", "description": "Chronic pinna perichondritis", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F500211", "description": "Chondrodermatitis nodularis helicis", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F500300", "description": "Chondrodermatitis nodularis helicis", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F500z00", "description": "Perichondritis of pinna NOS", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501.00", "description": "Infective otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501000", "description": "Unspecified infective otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501100", "description": "Acute infective otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501111", "description": "Abscess, external ear", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501112", "description": "Cellulitis, external ear", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501200", "description": "Acute infection of pinna", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501300", "description": "Acute swimmers' ear", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501400", "description": "Infective otitis externa due to erysipelas", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501411", "description": "Erysipelas - otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501700", "description": "Infective otitis externa due to impetigo", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501711", "description": "Impetigo - otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501900", "description": "Other acute external ear infections", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501E00", "description": "Other chronic infective otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501F00", "description": "Chronic infective otitis externa NOS", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501G00", "description": "Haemorrhagic otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501y00", "description": "Other specified infective otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F501z00", "description": "Infective otitis externa NOS", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F502.00", "description": "Other otitis externa", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F502z00", "description": "Otitis externa NOS", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F502z11", "description": "Inflammation ear external", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F506.00", "description": "Abscess of external ear", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F586.00", "description": "Otorrhoea", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F586000", "description": "Unspecified otorrhoea", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F586011", "description": "Discharging ear NOS", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F586200", "description": "Otorrhagia", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F586z00", "description": "Otorrhoea NOS", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F587.00", "description": "Otalgia", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F587000", "description": "Unspecified otalgia", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F587.11", "description": "Ear pain", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F587z00", "description": "Otalgia NOS", "attributes": { "Entity type": "res70: Otitis externa", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/8g8d-0d85", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 1879, "version_name": "Otitis Externa", "version_date": "2022-04-04T07:09:15.510255Z", "is_published": true, "is_latest": true } ] } ]