[ { "phenotype_id": "PH901", "phenotype_version_id": 1881, "name": "Otitis Media", "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": "2022-04-04T07:09:17.288112Z", "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": "2022-04-04T07:09:17.288137Z", "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": 2673, "concept_version_id": 6759, "concept_name": "Otitis Media - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH901", "phenotype_version_id": 1881, "phenotype_name": "Otitis Media", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "A552.00", "description": "Postmeasles otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F51..00", "description": "Nonsuppurative otitis media + eustachian tube disorders", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F510.00", "description": "Acute non suppurative otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F510000", "description": "Acute otitis media with effusion", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F510011", "description": "Acute secretory otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F510100", "description": "Acute serous otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F510200", "description": "Acute mucoid otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F510300", "description": "Acute sanguinous otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F510z00", "description": "Acute nonsuppurative otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F511.00", "description": "Chronic otitis media with effusion, serous", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F511.11", "description": "Chronic secretory otitis media, serous", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F511z00", "description": "Chronic serous otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F512.00", "description": "Chronic otitis media with effusion, mucoid", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F512000", "description": "Glue ear, unspecified", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F512.11", "description": "Glue ear", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F512.12", "description": "Chronic secretory otitis media, mucoid", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F512z00", "description": "Chronic mucoid otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F513.00", "description": "Chronic otitis media with effusion, other", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F513100", "description": "Chronic otitis media with effusion, purulent", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F513111", "description": "Chronic secretory otitis media, purulent", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F514.00", "description": "Unspecified nonsuppurative otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F514100", "description": "Serous otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F514200", "description": "Catarrhal otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F514300", "description": "Mucoid otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F514z00", "description": "Nonsuppurative otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F515.00", "description": "Eustachian tube salpingitis", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F515.11", "description": "Catarrh - eustachian", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F52..00", "description": "Suppurative and unspecified otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F520.00", "description": "Acute suppurative otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F520000", "description": "Acute suppurative otitis media tympanic membrane intact", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F520100", "description": "Acute suppurative otitis media tympanic membrane ruptured", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F520300", "description": "Acute suppurative otitis media due to disease EC", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F520z00", "description": "Acute suppurative otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F521.00", "description": "Chronic suppurative otitis media, tubotympanic", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F522.00", "description": "Chronic suppurative otitis media, atticoantral", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F523.00", "description": "Chronic suppurative otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F524.00", "description": "Purulent otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F524000", "description": "Bilateral suppurative otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F525.00", "description": "Recurrent acute otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F526.00", "description": "Acute left otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F527.00", "description": "Acute right otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F528.00", "description": "Acute bilateral otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F52z.00", "description": "Otitis media NOS", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "F52z.11", "description": "Infection ear", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "SN30.11", "description": "Aero-otitis media", "attributes": { "Entity type": "res70: Otitis media", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/n5mq-xj82", "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": 1881, "version_name": "Otitis Media", "version_date": "2022-04-04T07:09:17.314084Z", "is_published": true, "is_latest": true } ] } ]